BSN 315 HESI RN SPECIALTY
PHARMACOLOGY EXAM V2 (LATEST
2026/2027 UPDATE) QUESTIONS &
ANSWERS | 100% CORRECT | GRADE A -
NIGHTINGALE
AT NIGHTINGALE COLLEGE
Each question includes:
Full NCLEX/HESI-style stem
Multiple-choice options
Clearly identified correct answer
Deep rationale (3–5 sentences) for each correct answer
BSN 315 – HESI RN Specialty Pharmacology Exam V2 (Latest Update)
Question 1
A client diagnosed with methicillin-resistant Staphylococcus aureus (MRSA) is
prescribed intravenous vancomycin. Which nursing assessment is most appropriate to
identify a potential adverse effect of this medication?
a. Whisper test
b. Romberg test
c. Tactile discrimination
d. Skin turgor
Correct Answer: a. Whisper test
Rationale:
Vancomycin is associated with ototoxicity, particularly when administered in high
doses or infused rapidly. The whisper test is a simple bedside assessment that
evaluates hearing acuity and can help detect early auditory changes. Early
identification of hearing loss allows prompt intervention to prevent permanent
,damage. Other options assess balance, sensation, or hydration status and are not
directly related to vancomycin toxicity.
Question 2
The nurse is reviewing medications for a client who reports nausea, vomiting, and
diarrhea. Which medication should the nurse withhold and report to the healthcare
provider?
a. Colchicine
b. Erythromycin
c. Naproxen
d. Labetalol
Correct Answer: a. Colchicine
Rationale:
Colchicine has a narrow therapeutic index and commonly causes gastrointestinal
symptoms as an early sign of toxicity. Severe nausea, vomiting, and diarrhea may
indicate dangerous drug accumulation. Continuing the medication could result in bone
marrow suppression or organ failure. The nurse should withhold the drug and notify
the provider immediately.
Question 3
A mother asks why her newborn must receive a vitamin K injection shortly after birth.
Which explanation should the nurse provide?
a. Newborns lack intestinal bacteria that synthesize vitamin K
b. Oral vitamin K prevents clotting factor synthesis
c. Maternal vitamin K intake is typically inadequate
d. Newborns cannot absorb vitamin K for several months
Correct Answer: a. Newborns lack intestinal bacteria that synthesize vitamin K
,Rationale:
Vitamin K is essential for the synthesis of clotting factors II, VII, IX, and X. Newborns
are born with sterile intestines and therefore cannot produce vitamin K naturally.
Without supplementation, infants are at risk for hemorrhagic disease of the newborn.
The injection provides immediate protection against bleeding.
Question 4
A client is receiving fentanyl through an epidural infusion for postoperative pain
management. Which side effect should the nurse anticipate during the first 24 hours of
therapy?
a. Headache
b. Agitation
c. Urinary retention
d. Abdominal cramping and diarrhea
Correct Answer: c. Urinary retention
Rationale:
Opioids administered via epidural infusion can inhibit bladder detrusor muscle
contraction. This often results in urinary retention, especially during the initial phase of
therapy. Monitoring intake and output is essential to prevent bladder overdistention.
Other listed effects are less common in early epidural opioid use.
Question 5
The nurse is preparing to administer a medication known to have a high first-pass
hepatic effect. Which route of administration should the nurse clarify with the
healthcare provider?
a. Oral
b. Buccal
, c. Sublingual
d. Intravenous
Correct Answer: a. Oral
Rationale:
The first-pass effect occurs when a drug is extensively metabolized by the liver before
reaching systemic circulation. Oral medications are absorbed through the
gastrointestinal tract and transported directly to the liver via the portal system. This
significantly reduces drug bioavailability. Alternative routes bypass hepatic
metabolism and may be preferred.
Question 6
The nurse is teaching a client prescribed carisoprodol for muscle spasms. Which
substance should the client be instructed to avoid?
a. Aspirin-containing products
b. Antacids
c. Alcoholic beverages
d. Dairy products
Correct Answer: c. Alcoholic beverages
Rationale:
Carisoprodol is a centrally acting muscle relaxant that causes CNS depression. Alcohol
can potentiate these effects, increasing the risk for sedation, respiratory depression,
and impaired motor coordination. Concurrent use significantly raises the risk of injury.
Clients should be advised to avoid alcohol entirely while taking this medication.
Question 7
A client is receiving dexamethasone following neurosurgery. Which findings should the
nurse monitor for? (Select all that apply.)
PHARMACOLOGY EXAM V2 (LATEST
2026/2027 UPDATE) QUESTIONS &
ANSWERS | 100% CORRECT | GRADE A -
NIGHTINGALE
AT NIGHTINGALE COLLEGE
Each question includes:
Full NCLEX/HESI-style stem
Multiple-choice options
Clearly identified correct answer
Deep rationale (3–5 sentences) for each correct answer
BSN 315 – HESI RN Specialty Pharmacology Exam V2 (Latest Update)
Question 1
A client diagnosed with methicillin-resistant Staphylococcus aureus (MRSA) is
prescribed intravenous vancomycin. Which nursing assessment is most appropriate to
identify a potential adverse effect of this medication?
a. Whisper test
b. Romberg test
c. Tactile discrimination
d. Skin turgor
Correct Answer: a. Whisper test
Rationale:
Vancomycin is associated with ototoxicity, particularly when administered in high
doses or infused rapidly. The whisper test is a simple bedside assessment that
evaluates hearing acuity and can help detect early auditory changes. Early
identification of hearing loss allows prompt intervention to prevent permanent
,damage. Other options assess balance, sensation, or hydration status and are not
directly related to vancomycin toxicity.
Question 2
The nurse is reviewing medications for a client who reports nausea, vomiting, and
diarrhea. Which medication should the nurse withhold and report to the healthcare
provider?
a. Colchicine
b. Erythromycin
c. Naproxen
d. Labetalol
Correct Answer: a. Colchicine
Rationale:
Colchicine has a narrow therapeutic index and commonly causes gastrointestinal
symptoms as an early sign of toxicity. Severe nausea, vomiting, and diarrhea may
indicate dangerous drug accumulation. Continuing the medication could result in bone
marrow suppression or organ failure. The nurse should withhold the drug and notify
the provider immediately.
Question 3
A mother asks why her newborn must receive a vitamin K injection shortly after birth.
Which explanation should the nurse provide?
a. Newborns lack intestinal bacteria that synthesize vitamin K
b. Oral vitamin K prevents clotting factor synthesis
c. Maternal vitamin K intake is typically inadequate
d. Newborns cannot absorb vitamin K for several months
Correct Answer: a. Newborns lack intestinal bacteria that synthesize vitamin K
,Rationale:
Vitamin K is essential for the synthesis of clotting factors II, VII, IX, and X. Newborns
are born with sterile intestines and therefore cannot produce vitamin K naturally.
Without supplementation, infants are at risk for hemorrhagic disease of the newborn.
The injection provides immediate protection against bleeding.
Question 4
A client is receiving fentanyl through an epidural infusion for postoperative pain
management. Which side effect should the nurse anticipate during the first 24 hours of
therapy?
a. Headache
b. Agitation
c. Urinary retention
d. Abdominal cramping and diarrhea
Correct Answer: c. Urinary retention
Rationale:
Opioids administered via epidural infusion can inhibit bladder detrusor muscle
contraction. This often results in urinary retention, especially during the initial phase of
therapy. Monitoring intake and output is essential to prevent bladder overdistention.
Other listed effects are less common in early epidural opioid use.
Question 5
The nurse is preparing to administer a medication known to have a high first-pass
hepatic effect. Which route of administration should the nurse clarify with the
healthcare provider?
a. Oral
b. Buccal
, c. Sublingual
d. Intravenous
Correct Answer: a. Oral
Rationale:
The first-pass effect occurs when a drug is extensively metabolized by the liver before
reaching systemic circulation. Oral medications are absorbed through the
gastrointestinal tract and transported directly to the liver via the portal system. This
significantly reduces drug bioavailability. Alternative routes bypass hepatic
metabolism and may be preferred.
Question 6
The nurse is teaching a client prescribed carisoprodol for muscle spasms. Which
substance should the client be instructed to avoid?
a. Aspirin-containing products
b. Antacids
c. Alcoholic beverages
d. Dairy products
Correct Answer: c. Alcoholic beverages
Rationale:
Carisoprodol is a centrally acting muscle relaxant that causes CNS depression. Alcohol
can potentiate these effects, increasing the risk for sedation, respiratory depression,
and impaired motor coordination. Concurrent use significantly raises the risk of injury.
Clients should be advised to avoid alcohol entirely while taking this medication.
Question 7
A client is receiving dexamethasone following neurosurgery. Which findings should the
nurse monitor for? (Select all that apply.)
