BSN HESI 315 Pharmacology Exam V1 –
2026/2027 Actual Questions with Revised
Answers, 100% Verified - Nightingale
College
EXAM OVERVIEW
BSN HESI 315 Pharmacology Exam V1 at Nightingale College assesses nursing
students' knowledge of:
• Pharmacokinetics and Pharmacodynamics
• Safe Medication Administration Standards
• Cardiovascular and Renal Pharmacology
• Endocrine and Metabolic Agents
• Neuropharmacology and Psychiatric Agents
• Antimicrobial and Immunological Therapy
• Gastrointestinal and Respiratory Agents
• Professional, Legal, and Ethical Regulations
CARDIOVASCULAR & RENAL PHARMACOLOGY (Questions 1–30)
,1. A client with chronic heart failure is prescribed digoxin. Which assessment
finding is the most critical indicator of potential digoxin toxicity?
A. Hypokalemia
B. Visual disturbances and anorexia
C. Increased urinary output
D. Heart rate of 82 beats per minute
Answer: B. Visual disturbances and anorexia
Rationale: Digoxin toxicity classically presents with gastrointestinal symptoms
(anorexia, nausea, vomiting) and neurological/visual changes (halo vision, green-
yellow vision, confusion). While hypokalemia predisposes a patient to digoxin
toxicity, it is not a symptom of toxicity itself.
2. The nurse is reviewing therapeutic serum drug levels. Which level indicates a
value outside the therapeutic range?
A. Phenytoin: 15 mcg/mL
B. Theophylline: 12 mcg/mL
C. Lithium: 0.9 mEq/L
D. Digoxin: 2.8 ng/mL
Answer: D. Digoxin: 2.8 ng/mL
Rationale: The therapeutic range for digoxin is 0.5 to 2.0 ng/mL. A level of 2.8
ng/mL is toxic and puts the client at risk for severe dysrhythmias.
,3. A client has been prescribed spironolactone for the management of primary
hypertension. Which dietary instruction is most important for the nurse to
emphasize?
A. Increase intake of dark leafy greens and bananas
B. Avoid high-protein foods
C. Limit the intake of potassium-rich foods and salt substitutes
D. Drink at least 4 liters of water daily
Answer: C. Limit the intake of potassium-rich foods and salt substitutes
Rationale: Spironolactone is a potassium-sparing diuretic. Consuming potassium-
rich foods or salt substitutes (which are typically potassium-based) increases the
risk of severe hyperkalemia, which can lead to cardiac arrest.
4. A client is taking spironolactone and lisinopril. Which electrolyte imbalance
is this client at extreme risk of developing?
A. Hypokalemia
B. Hyponatremia
C. Hypercalcemia
D. Hyperkalemia
Answer: D. Hyperkalemia
Rationale: Both spironolactone (a potassium-sparing diuretic) and lisinopril (an
ACE inhibitor that reduces aldosterone secretion) promote potassium retention.
Combining these medications significantly increases the risk of severe
hyperkalemia.
, 5. A client with heart failure is taking furosemide daily. Which laboratory value
should the nurse monitor most closely?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
Answer: B. Serum potassium
Rationale: Furosemide is a potent loop diuretic that causes excretion of water,
sodium, and potassium. Hypokalemia is a common and dangerous side effect that
can precipitate fatal cardiac arrhythmias, especially in patients taking digoxin.
6. A client is taking a loop diuretic, furosemide, and is also prescribed digoxin.
The nurse understands that hypokalemia increases the risk of digoxin toxicity.
What mechanism explains this interaction?
A. Hypokalemia increases digoxin absorption in the stomach
B. Potassium competes with digoxin for binding sites on the Na+/K+ ATPase pump
C. Furosemide directly blocks the metabolism of digoxin in the liver
D. Potassium deficiency decreases the renal excretion of digoxin
Answer: B. Potassium competes with digoxin for binding sites on the Na+/K+
ATPase pump
Rationale: Potassium ions compete with digoxin for binding on the Na+/K+ ATPase
pump. When potassium levels are low, more digoxin can bind to the pump, greatly
magnifying its clinical effect and toxicity risk.
2026/2027 Actual Questions with Revised
Answers, 100% Verified - Nightingale
College
EXAM OVERVIEW
BSN HESI 315 Pharmacology Exam V1 at Nightingale College assesses nursing
students' knowledge of:
• Pharmacokinetics and Pharmacodynamics
• Safe Medication Administration Standards
• Cardiovascular and Renal Pharmacology
• Endocrine and Metabolic Agents
• Neuropharmacology and Psychiatric Agents
• Antimicrobial and Immunological Therapy
• Gastrointestinal and Respiratory Agents
• Professional, Legal, and Ethical Regulations
CARDIOVASCULAR & RENAL PHARMACOLOGY (Questions 1–30)
,1. A client with chronic heart failure is prescribed digoxin. Which assessment
finding is the most critical indicator of potential digoxin toxicity?
A. Hypokalemia
B. Visual disturbances and anorexia
C. Increased urinary output
D. Heart rate of 82 beats per minute
Answer: B. Visual disturbances and anorexia
Rationale: Digoxin toxicity classically presents with gastrointestinal symptoms
(anorexia, nausea, vomiting) and neurological/visual changes (halo vision, green-
yellow vision, confusion). While hypokalemia predisposes a patient to digoxin
toxicity, it is not a symptom of toxicity itself.
2. The nurse is reviewing therapeutic serum drug levels. Which level indicates a
value outside the therapeutic range?
A. Phenytoin: 15 mcg/mL
B. Theophylline: 12 mcg/mL
C. Lithium: 0.9 mEq/L
D. Digoxin: 2.8 ng/mL
Answer: D. Digoxin: 2.8 ng/mL
Rationale: The therapeutic range for digoxin is 0.5 to 2.0 ng/mL. A level of 2.8
ng/mL is toxic and puts the client at risk for severe dysrhythmias.
,3. A client has been prescribed spironolactone for the management of primary
hypertension. Which dietary instruction is most important for the nurse to
emphasize?
A. Increase intake of dark leafy greens and bananas
B. Avoid high-protein foods
C. Limit the intake of potassium-rich foods and salt substitutes
D. Drink at least 4 liters of water daily
Answer: C. Limit the intake of potassium-rich foods and salt substitutes
Rationale: Spironolactone is a potassium-sparing diuretic. Consuming potassium-
rich foods or salt substitutes (which are typically potassium-based) increases the
risk of severe hyperkalemia, which can lead to cardiac arrest.
4. A client is taking spironolactone and lisinopril. Which electrolyte imbalance
is this client at extreme risk of developing?
A. Hypokalemia
B. Hyponatremia
C. Hypercalcemia
D. Hyperkalemia
Answer: D. Hyperkalemia
Rationale: Both spironolactone (a potassium-sparing diuretic) and lisinopril (an
ACE inhibitor that reduces aldosterone secretion) promote potassium retention.
Combining these medications significantly increases the risk of severe
hyperkalemia.
, 5. A client with heart failure is taking furosemide daily. Which laboratory value
should the nurse monitor most closely?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
Answer: B. Serum potassium
Rationale: Furosemide is a potent loop diuretic that causes excretion of water,
sodium, and potassium. Hypokalemia is a common and dangerous side effect that
can precipitate fatal cardiac arrhythmias, especially in patients taking digoxin.
6. A client is taking a loop diuretic, furosemide, and is also prescribed digoxin.
The nurse understands that hypokalemia increases the risk of digoxin toxicity.
What mechanism explains this interaction?
A. Hypokalemia increases digoxin absorption in the stomach
B. Potassium competes with digoxin for binding sites on the Na+/K+ ATPase pump
C. Furosemide directly blocks the metabolism of digoxin in the liver
D. Potassium deficiency decreases the renal excretion of digoxin
Answer: B. Potassium competes with digoxin for binding sites on the Na+/K+
ATPase pump
Rationale: Potassium ions compete with digoxin for binding on the Na+/K+ ATPase
pump. When potassium levels are low, more digoxin can bind to the pump, greatly
magnifying its clinical effect and toxicity risk.
