FORTIS COLLEGE NUR100 HESI
PHARMACOLOGY EXAM V1 2026–2027 |
COMPLETE STUDY GUIDE, PRACTICE
QUESTIONS & VERIFIED ANSWERS WITH
RATIONALES
• This 200-question HESI Pharmacology practice exam mirrors the format and rigor
of the Fortis College NUR100 exam, covering all major drug classes, mechanisms,
nursing implications, and client safety priorities tested on the HESI.
• Study by attempting each question independently before reading the correct
answer and EXPERT RATIONALE — this active recall method maximizes retention
and prepares you for the real exam format.
Question 1 A nurse is preparing to administer a medication that inhibits the
enzyme acetylcholinesterase. Which effect should the nurse anticipate?
A. Decreased heart rate and increased gastric motility
B. Increased heart rate and bronchodilation
C. Decreased gastric motility and urinary retention
D. Elevated blood pressure and mydriasis
E. Skeletal muscle relaxation and sedation
Correct Answer: A. Decreased heart rate and increased gastric motility
EXPERT RATIONALE: Acetylcholinesterase inhibitors prevent the breakdown of
acetylcholine, increasing its availability at cholinergic synapses. This produces
parasympathomimetic (SLUDGE) effects including bradycardia, increased GI motility,
miosis, urinary urgency, and increased secretions.
Question 2 A client is prescribed atropine preoperatively. The nurse
understands that the primary purpose of this anticholinergic medication is to:
A. Prevent postoperative nausea and vomiting
,B. Reduce anxiety and promote sedation
C. Decrease respiratory secretions during surgery
D. Lower blood pressure during anesthesia induction
E. Prevent bronchospasm during intubation
Correct Answer: C. Decrease respiratory secretions during surgery
EXPERT RATIONALE: Atropine blocks muscarinic receptors, reducing salivary and
bronchial secretions. Preoperatively, this is used to keep the airway dry and reduce
aspiration risk during anesthesia and intubation.
Question 3 A nurse administers epinephrine to a client in anaphylactic shock.
Which therapeutic effect should be expected first?
A. Decreased urinary output
B. Bronchodilation and increased blood pressure
C. Bradycardia and decreased cardiac output
D. Decreased serum glucose
E. Peripheral vasodilation
Correct Answer: B. Bronchodilation and increased blood pressure
EXPERT RATIONALE: Epinephrine stimulates both alpha-1 receptors (causing
vasoconstriction and increased BP) and beta-2 receptors (causing bronchodilation).
These effects rapidly reverse the bronchospasm and hypotension characteristic of
anaphylaxis.
Question 4 A client taking metoprolol asks why this medication is prescribed
for hypertension. The nurse explains that beta-1 selective blockers lower
blood pressure primarily by:
A. Dilating peripheral arterioles directly
,B. Reducing cardiac output by decreasing heart rate and contractility
C. Blocking alpha receptors in vascular smooth muscle
D. Increasing renal excretion of sodium and water
E. Inhibiting angiotensin-converting enzyme
Correct Answer: B. Reducing cardiac output by decreasing heart rate and
contractility
EXPERT RATIONALE: Metoprolol selectively blocks beta-1 adrenergic receptors in the
heart, reducing heart rate and myocardial contractility. This decreases cardiac output
and consequently lowers blood pressure.
Question 5 A nurse is caring for a client receiving IV morphine for pain
management. Which assessment finding requires the most immediate
intervention?
A. Respiratory rate of 8 breaths per minute
B. Mild nausea without vomiting
C. Urine output of 40 mL/hour
D. Blood pressure of 110/70 mmHg
E. Pain score of 4 out of 10
Correct Answer: A. Respiratory rate of 8 breaths per minute
EXPERT RATIONALE: Opioid-induced respiratory depression is life-threatening. A
respiratory rate below 12 breaths per minute requires immediate intervention, including
stimulating the client, applying oxygen, and preparing to administer naloxone (Narcan)
as an opioid antagonist.
Question 6 A client on long-term corticosteroid therapy asks why they must
not stop the medication abruptly. The nurse's best response is:
A. "Stopping suddenly causes rebound hypertension."
, B. "Your body's adrenal glands may have stopped making cortisol and need time to
recover."
C. "Abrupt discontinuation causes severe allergic reactions."
D. "The medication must be stopped gradually to prevent kidney damage."
E. "Stopping suddenly causes blood sugar to drop dangerously low."
Correct Answer: B. "Your body's adrenal glands may have stopped making
cortisol and need time to recover."
EXPERT RATIONALE: Long-term corticosteroid use suppresses the hypothalamic-
pituitary-adrenal (HPA) axis. Abrupt discontinuation can precipitate adrenal crisis
because the adrenal glands have been suppressed and cannot immediately resume
adequate cortisol production. Tapering allows recovery of the HPA axis.
Question 7 A nurse is administering digoxin to a client. Before administration,
the nurse assesses an apical pulse of 54 beats per minute. The nurse should:
A. Administer the dose and document the heart rate
B. Administer half the prescribed dose
C. Hold the medication and notify the prescriber
D. Administer the dose and recheck in one hour
E. Request a stat serum digoxin level only
Correct Answer: C. Hold the medication and notify the prescriber
EXPERT RATIONALE: Digoxin increases vagal tone and slows AV conduction. The
standard parameter for holding digoxin is an apical pulse below 60 beats per minute in
adults. The nurse should withhold the dose and notify the prescriber before proceeding.
Question 8 A client is receiving heparin therapy. Which lab value does the
nurse monitor to evaluate therapeutic effectiveness?
A. Prothrombin time (PT)
PHARMACOLOGY EXAM V1 2026–2027 |
COMPLETE STUDY GUIDE, PRACTICE
QUESTIONS & VERIFIED ANSWERS WITH
RATIONALES
• This 200-question HESI Pharmacology practice exam mirrors the format and rigor
of the Fortis College NUR100 exam, covering all major drug classes, mechanisms,
nursing implications, and client safety priorities tested on the HESI.
• Study by attempting each question independently before reading the correct
answer and EXPERT RATIONALE — this active recall method maximizes retention
and prepares you for the real exam format.
Question 1 A nurse is preparing to administer a medication that inhibits the
enzyme acetylcholinesterase. Which effect should the nurse anticipate?
A. Decreased heart rate and increased gastric motility
B. Increased heart rate and bronchodilation
C. Decreased gastric motility and urinary retention
D. Elevated blood pressure and mydriasis
E. Skeletal muscle relaxation and sedation
Correct Answer: A. Decreased heart rate and increased gastric motility
EXPERT RATIONALE: Acetylcholinesterase inhibitors prevent the breakdown of
acetylcholine, increasing its availability at cholinergic synapses. This produces
parasympathomimetic (SLUDGE) effects including bradycardia, increased GI motility,
miosis, urinary urgency, and increased secretions.
Question 2 A client is prescribed atropine preoperatively. The nurse
understands that the primary purpose of this anticholinergic medication is to:
A. Prevent postoperative nausea and vomiting
,B. Reduce anxiety and promote sedation
C. Decrease respiratory secretions during surgery
D. Lower blood pressure during anesthesia induction
E. Prevent bronchospasm during intubation
Correct Answer: C. Decrease respiratory secretions during surgery
EXPERT RATIONALE: Atropine blocks muscarinic receptors, reducing salivary and
bronchial secretions. Preoperatively, this is used to keep the airway dry and reduce
aspiration risk during anesthesia and intubation.
Question 3 A nurse administers epinephrine to a client in anaphylactic shock.
Which therapeutic effect should be expected first?
A. Decreased urinary output
B. Bronchodilation and increased blood pressure
C. Bradycardia and decreased cardiac output
D. Decreased serum glucose
E. Peripheral vasodilation
Correct Answer: B. Bronchodilation and increased blood pressure
EXPERT RATIONALE: Epinephrine stimulates both alpha-1 receptors (causing
vasoconstriction and increased BP) and beta-2 receptors (causing bronchodilation).
These effects rapidly reverse the bronchospasm and hypotension characteristic of
anaphylaxis.
Question 4 A client taking metoprolol asks why this medication is prescribed
for hypertension. The nurse explains that beta-1 selective blockers lower
blood pressure primarily by:
A. Dilating peripheral arterioles directly
,B. Reducing cardiac output by decreasing heart rate and contractility
C. Blocking alpha receptors in vascular smooth muscle
D. Increasing renal excretion of sodium and water
E. Inhibiting angiotensin-converting enzyme
Correct Answer: B. Reducing cardiac output by decreasing heart rate and
contractility
EXPERT RATIONALE: Metoprolol selectively blocks beta-1 adrenergic receptors in the
heart, reducing heart rate and myocardial contractility. This decreases cardiac output
and consequently lowers blood pressure.
Question 5 A nurse is caring for a client receiving IV morphine for pain
management. Which assessment finding requires the most immediate
intervention?
A. Respiratory rate of 8 breaths per minute
B. Mild nausea without vomiting
C. Urine output of 40 mL/hour
D. Blood pressure of 110/70 mmHg
E. Pain score of 4 out of 10
Correct Answer: A. Respiratory rate of 8 breaths per minute
EXPERT RATIONALE: Opioid-induced respiratory depression is life-threatening. A
respiratory rate below 12 breaths per minute requires immediate intervention, including
stimulating the client, applying oxygen, and preparing to administer naloxone (Narcan)
as an opioid antagonist.
Question 6 A client on long-term corticosteroid therapy asks why they must
not stop the medication abruptly. The nurse's best response is:
A. "Stopping suddenly causes rebound hypertension."
, B. "Your body's adrenal glands may have stopped making cortisol and need time to
recover."
C. "Abrupt discontinuation causes severe allergic reactions."
D. "The medication must be stopped gradually to prevent kidney damage."
E. "Stopping suddenly causes blood sugar to drop dangerously low."
Correct Answer: B. "Your body's adrenal glands may have stopped making
cortisol and need time to recover."
EXPERT RATIONALE: Long-term corticosteroid use suppresses the hypothalamic-
pituitary-adrenal (HPA) axis. Abrupt discontinuation can precipitate adrenal crisis
because the adrenal glands have been suppressed and cannot immediately resume
adequate cortisol production. Tapering allows recovery of the HPA axis.
Question 7 A nurse is administering digoxin to a client. Before administration,
the nurse assesses an apical pulse of 54 beats per minute. The nurse should:
A. Administer the dose and document the heart rate
B. Administer half the prescribed dose
C. Hold the medication and notify the prescriber
D. Administer the dose and recheck in one hour
E. Request a stat serum digoxin level only
Correct Answer: C. Hold the medication and notify the prescriber
EXPERT RATIONALE: Digoxin increases vagal tone and slows AV conduction. The
standard parameter for holding digoxin is an apical pulse below 60 beats per minute in
adults. The nurse should withhold the dose and notify the prescriber before proceeding.
Question 8 A client is receiving heparin therapy. Which lab value does the
nurse monitor to evaluate therapeutic effectiveness?
A. Prothrombin time (PT)
