1
2025-2026 NGN HESI RN Pharmacology Exam Test Bank (4
Versions) with Verified Answers and Rationales (100%
Correct) | RN HESI Pharmacology with NGN Latest
2025/2026 Already A+ Graded (Newest!).
1. A client with congestive heart failure is prescribed furosemide 40 mg IV for
acute fluid overload. Which assessment finding is the nurse’s highest priority
before giving the dose?
A. Serum potassium 3.2 mEq/L
B. Bilateral dependent pitting edema
C. Breath sounds with scattered crackles
D. Recent weight gain of 3 kg in 2 days
Answer: A. Serum potassium 3.2 mEq/L
Rationale: Furosemide is a loop diuretic that causes potassium loss and can
precipitate life-threatening hypokalemia. A potassium of 3.2 mEq/L is low
address or correct potassium before giving a diuretic. Other findings support
the dose but are not the immediate safety concern.
, 2
2. A patient is started on warfarin (Coumadin) for a new DVT. Which lab will
the nurse monitor to evaluate therapeutic effect?
A. aPTT
B. INR
C. Platelet count
D. D-dimer
Answer: B. INR
Rationale: Warfarin’s anticoagulant effect is monitored with the INR
(prothrombin time standardized). aPTT is used for heparin. Platelet count
monitors for heparin-induced thrombocytopenia risk with heparin, not
warfarin. D-dimer diagnoses thrombosis, not anticoagulant effect.
3. A client receiving insulin lispro (Humalog) before breakfast becomes pale,
diaphoretic, and shaky 90 minutes after the meal. Which action should the
nurse take first?
A. Give 4 oz fruit juice PO.
B. Administer glucagon IM.
C. Offer a protein snack.
D. Recheck blood glucose immediately.
Answer: D. Recheck blood glucose immediately.
Rationale: These are hypoglycemia signs — first confirm with a bedside
glucose check. If low, treat quickly with fast-acting carbohydrate (e.g., fruit
juice). Glucagon is for severe hypoglycemia when the patient cannot take
PO. A protein snack alone is not appropriate for acute hypoglycemia.
, 3
4. A client on ACE inhibitor (lisinopril) reports a persistent dry cough. What
is the nurse’s best action?
A. Advise to stop the medication immediately.
B. Notify prescriber—ask about switching to an ARB.
C. Instruct patient to increase fluid intake.
D. Check blood pressure and withhold dose if hypotensive.
Answer: B. Notify prescriber—ask about switching to an ARB.
Rationale: A persistent dry cough is a well-known adverse effect of ACE
inhibitors. The nurse should report it; prescribers commonly change to an
angiotensin II receptor blocker (ARB). Do not advise stopping a prescription
without provider input.
5. A postoperative patient receives morphine IV and has a respiratory rate of
8/min and decreased responsiveness. What is the nurse’s priority action?
A. Administer naloxone (opioid antagonist).
B. Stimulate the patient and monitor vitals.
C. Place the patient in high-flow oxygen by mask.
D. Notify the physician and document findings.
Answer: A. Administer naloxone (opioid antagonist).
Rationale: Respiratory depression with decreased responsiveness from
morphine is life-threatening. Rapid reversal with naloxone is priority.
Stimulation and oxygen are supportive but naloxone is definitive. Notify
physician after emergent reversal.
, 4
6. A client taking levothyroxine for hypothyroidism asks when to take the
medication. The best instruction is:
A. Take with breakfast to avoid stomach upset.
B. Take at bedtime with a glass of milk.
C. Take on an empty stomach 30–60 minutes before breakfast.
D. Take with iron supplement to improve absorption.
Answer: C. Take on an empty stomach 30–60 minutes before breakfast.
Rationale: Levothyroxine is best absorbed on an empty stomach; taking it
before breakfast improves bioavailability. Calcium or iron supplements
impair absorption and should be spaced several hours apart.
7. A client with chronic obstructive pulmonary disease (COPD) is prescribed
ipratropium (Atrovent) inhaler. Which expected therapeutic effect should
the nurse teach?
A. Rapid relief of bronchospasm similar to albuterol.
B. Long-term suppression of airway inflammation.
C. Decreased bronchoconstriction by blocking muscarinic receptors.
D. Increased mucous clearance by liquefying secretions.
Answer: C. Decreased bronchoconstriction by blocking muscarinic
receptors.
Rationale: Ipratropium is an anticholinergic that reduces
bronchoconstriction via muscarinic blockade. It is slower-acting than short-
acting beta agonists and is not an anti-inflammatory or mucolytic.
2025-2026 NGN HESI RN Pharmacology Exam Test Bank (4
Versions) with Verified Answers and Rationales (100%
Correct) | RN HESI Pharmacology with NGN Latest
2025/2026 Already A+ Graded (Newest!).
1. A client with congestive heart failure is prescribed furosemide 40 mg IV for
acute fluid overload. Which assessment finding is the nurse’s highest priority
before giving the dose?
A. Serum potassium 3.2 mEq/L
B. Bilateral dependent pitting edema
C. Breath sounds with scattered crackles
D. Recent weight gain of 3 kg in 2 days
Answer: A. Serum potassium 3.2 mEq/L
Rationale: Furosemide is a loop diuretic that causes potassium loss and can
precipitate life-threatening hypokalemia. A potassium of 3.2 mEq/L is low
address or correct potassium before giving a diuretic. Other findings support
the dose but are not the immediate safety concern.
, 2
2. A patient is started on warfarin (Coumadin) for a new DVT. Which lab will
the nurse monitor to evaluate therapeutic effect?
A. aPTT
B. INR
C. Platelet count
D. D-dimer
Answer: B. INR
Rationale: Warfarin’s anticoagulant effect is monitored with the INR
(prothrombin time standardized). aPTT is used for heparin. Platelet count
monitors for heparin-induced thrombocytopenia risk with heparin, not
warfarin. D-dimer diagnoses thrombosis, not anticoagulant effect.
3. A client receiving insulin lispro (Humalog) before breakfast becomes pale,
diaphoretic, and shaky 90 minutes after the meal. Which action should the
nurse take first?
A. Give 4 oz fruit juice PO.
B. Administer glucagon IM.
C. Offer a protein snack.
D. Recheck blood glucose immediately.
Answer: D. Recheck blood glucose immediately.
Rationale: These are hypoglycemia signs — first confirm with a bedside
glucose check. If low, treat quickly with fast-acting carbohydrate (e.g., fruit
juice). Glucagon is for severe hypoglycemia when the patient cannot take
PO. A protein snack alone is not appropriate for acute hypoglycemia.
, 3
4. A client on ACE inhibitor (lisinopril) reports a persistent dry cough. What
is the nurse’s best action?
A. Advise to stop the medication immediately.
B. Notify prescriber—ask about switching to an ARB.
C. Instruct patient to increase fluid intake.
D. Check blood pressure and withhold dose if hypotensive.
Answer: B. Notify prescriber—ask about switching to an ARB.
Rationale: A persistent dry cough is a well-known adverse effect of ACE
inhibitors. The nurse should report it; prescribers commonly change to an
angiotensin II receptor blocker (ARB). Do not advise stopping a prescription
without provider input.
5. A postoperative patient receives morphine IV and has a respiratory rate of
8/min and decreased responsiveness. What is the nurse’s priority action?
A. Administer naloxone (opioid antagonist).
B. Stimulate the patient and monitor vitals.
C. Place the patient in high-flow oxygen by mask.
D. Notify the physician and document findings.
Answer: A. Administer naloxone (opioid antagonist).
Rationale: Respiratory depression with decreased responsiveness from
morphine is life-threatening. Rapid reversal with naloxone is priority.
Stimulation and oxygen are supportive but naloxone is definitive. Notify
physician after emergent reversal.
, 4
6. A client taking levothyroxine for hypothyroidism asks when to take the
medication. The best instruction is:
A. Take with breakfast to avoid stomach upset.
B. Take at bedtime with a glass of milk.
C. Take on an empty stomach 30–60 minutes before breakfast.
D. Take with iron supplement to improve absorption.
Answer: C. Take on an empty stomach 30–60 minutes before breakfast.
Rationale: Levothyroxine is best absorbed on an empty stomach; taking it
before breakfast improves bioavailability. Calcium or iron supplements
impair absorption and should be spaced several hours apart.
7. A client with chronic obstructive pulmonary disease (COPD) is prescribed
ipratropium (Atrovent) inhaler. Which expected therapeutic effect should
the nurse teach?
A. Rapid relief of bronchospasm similar to albuterol.
B. Long-term suppression of airway inflammation.
C. Decreased bronchoconstriction by blocking muscarinic receptors.
D. Increased mucous clearance by liquefying secretions.
Answer: C. Decreased bronchoconstriction by blocking muscarinic
receptors.
Rationale: Ipratropium is an anticholinergic that reduces
bronchoconstriction via muscarinic blockade. It is slower-acting than short-
acting beta agonists and is not an anti-inflammatory or mucolytic.
