RN HESI PHARMACOLOGY V3 ULTIMATE EXAM PREPARATION: 200 COMPREHENSIVE MULTIPLE-CHOICE PRACTICE QUESTIONS WITH DETAILED RATIONALES COVERING ALL CORE TOPICS (CARDIOVASCULAR, NEUROLOGICAL/PSYCHIATRIC, ENDOCRINE, RESPIRATORY, INFECTIOUS DISEASE, AND CRITICAL C

RN HESI PHARMACOLOGY V3 ULTIMATE EXAM PREPARATION: 200 COMPREHENSIVE MULTIPLE-CHOICE PRACTICE QUESTIONS WITH DETAILED RATIONALES COVERING ALL CORE TOPICS (CARDIOVASCULAR, NEUROLOGICAL/PSYCHIATRIC, ENDOCRINE, RESPIRATORY, INFECTIOUS DISEASE, AND CRITICAL CARE PHARMACOLOGY) 1. A client with heart failure is prescribed digoxin. Which finding would indicate toxicity? A. Heart rate of 68 beats per minute B. Serum potassium level of 3.2 mEq/L C. Blood pressure of 130/80 mmHg D. Respiratory rate of 18 breaths per minute Answer: B. Serum potassium level of 3.2 mEq/L Rationale: Hypokalemia increases the risk of digoxin toxicity. Normal potassium is 3.5-5.0 mEq/L. A low potassium level potentiates digoxin's effects on the heart, increasing toxicity risk. Other options are within normal ranges. ________________________________________ 2. A client is prescribed warfarin. Which laboratory value is most important to monitor? A. Serum creatinine B. Platelet count C. International Normalized Ratio (INR) D. Hemoglobin levels Answer: C. International Normalized Ratio (INR) Rationale: INR is the primary monitoring parameter for warfarin therapy. The therapeutic range is typically 2.0-3.0 for most indications. Monitoring INR ensures appropriate anticoagulation and prevents bleeding complications. ________________________________________ 3. Which medication should the nurse question if prescribed for a client with a sulfa allergy? A. Metformin B. Furosemide C. Lisinopril D. Metoprolol Answer: B. Furosemide Rationale: Furosemide is a sulfonamide derivative and is contraindicated in clients with sulfa allergies due to cross-sensitivity. Metformin, lisinopril, and metoprolol do not contain sulfa. ________________________________________ 4. A client receives IV morphine sulfate 4 mg. Which assessment finding requires immediate action? A. Respiratory rate of 10 breaths per minute B. Pain rating decrease from 8 to 4 C. Blood pressure of 110/70 mmHg D. Heart rate of 88 beats per minute Answer: A. Respiratory rate of 10 breaths per minute Rationale: Morphine can cause respiratory depression. A respiratory rate below 12 breaths per minute indicates significant respiratory depression requiring intervention. The nurse should prepare to administer naloxone if respiratory depression worsens. ________________________________________ 5. A client is prescribed metformin. Which teaching point is most important? A. Take medication with meals to reduce GI upset B. Expect weight gain as a side effect C. Monitor for hypoglycemia immediately after taking D. Take medication on an empty stomach Answer: A. Take medication with meals to reduce GI upset Rationale: Metformin commonly causes gastrointestinal side effects. Taking with meals significantly reduces nausea, diarrhea, and abdominal discomfort. Metformin rarely causes hypoglycemia alone and does not typically cause weight gain. ________________________________________ 6. Which medication requires the nurse to monitor for ototoxicity? A. Gentamicin B. Cephalexin C. Azithromycin D. Doxycycline Answer: A. Gentamicin Rationale: Gentamicin is an aminoglycoside antibiotic known for ototoxicity and nephrotoxicity. Monitoring for hearing loss, tinnitus, and vertigo is essential during therapy. ________________________________________ 7. A client with asthma is prescribed albuterol. Which side effect should the nurse include in teaching? A. Sedation B. Bradycardia C. Tachycardia D. Hypotension Answer: C. Tachycardia Rationale: Albuterol is a beta-2 agonist that can also stimulate beta-1 receptors, causing tachycardia and palpitations. This is a common side effect that clients should be aware of. ________________________________________ 8. A client receiving heparin therapy has an aPTT of 120 seconds. What is the nurse's priority action? A. Continue the heparin drip as prescribed B. Increase the heparin rate C. Notify the healthcare provider and prepare to administer protamine sulfate D. Draw a stat PT/INR Answer: C. Notify the healthcare provider and prepare to administer protamine sulfate