HESI Pharmacology Exam 1 (2026/2027) |
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Updated 2026 | A+ Guaranteed
Question 1
A client with heart failure is prescribed digoxin. Which finding indicates digoxin toxicity?
A) Anorexia, nausea, and vomiting
B) Tachycardia
C) Hyperkalemia
D) Weight gain
Answer: A) Anorexia, nausea, and vomiting
Rationale: Anorexia, nausea, and vomiting are early signs of digoxin toxicity. Other
signs include visual disturbances (yellow-green halos), bradycardia, and dysrhythmias.
Hypokalemia, not hyperkalemia, increases the risk of digoxin toxicity .
Question 2
The nurse is teaching a client about warfarin therapy. Which statement indicates
understanding?
A) "I will use an electric razor for shaving."
B) "I will take ibuprofen for headaches."
C) "I will increase my intake of leafy green vegetables."
D) "I can stop this medication if I have no side effects."
Answer: A) "I will use an electric razor for shaving."
Rationale: Warfarin increases bleeding risk. Clients should use an electric razor, avoid
NSAIDs (which increase bleeding risk), maintain consistent vitamin K intake (not increase
it), and continue the medication as prescribed .
,Question 3
A client is prescribed warfarin and has an INR of 5.5. Which action should the nurse
take?
A) Administer vitamin K
B) Increase the warfarin dose
C) Continue the current dose
D) Administer protamine sulfate
Answer: A) Administer vitamin K
Rationale: The therapeutic INR range for warfarin is typically 2-3. An INR of 5.5 indicates
excessive anticoagulation and bleeding risk. Vitamin K is the specific antidote for
warfarin. Protamine sulfate is used for heparin overdose .
Question 4
The nurse is caring for a client receiving a continuous IV heparin infusion. The aPTT is 95
seconds (therapeutic range 60-80 seconds). Which action should the nurse take?
A) Increase the infusion rate
B) Decrease the infusion rate
C) Continue the current infusion rate
D) Stop the infusion and notify the provider
Answer: D) Stop the infusion and notify the provider
Rationale: An aPTT above the therapeutic range indicates excessive anticoagulation and
increased bleeding risk. The nurse should stop the infusion and notify the provider.
Heparin is therapeutic when aPTT is 1.5-2.5 times normal (typically 60-80 seconds) .
Question 5
A client is prescribed clopidogrel (Plavix). Which statement by the client indicates
understanding?
A) "I will take this medication with food to prevent stomach upset."
B) "I will report any unusual bleeding or bruising."
,C) "I can stop this medication if I have no chest pain."
D) "I can take ibuprofen if I have a headache."
Answer: B) "I will report any unusual bleeding or bruising."
Rationale: Clopidogrel is an antiplatelet medication that increases bleeding risk. Clients
should report signs of bleeding such as easy bruising, prolonged bleeding, or dark
stools. Ibuprofen should be avoided due to increased bleeding risk .
Question 6
A client with atrial fibrillation is prescribed amiodarone. Which adverse effect should the
nurse monitor?
A) Hypothyroidism
B) Hyperthyroidism
C) Pulmonary fibrosis
D) All of the above
Answer: D) All of the above
Rationale: Amiodarone can cause both hypothyroidism and hyperthyroidism due to its
high iodine content, as well as pulmonary fibrosis, which is a serious adverse effect
requiring immediate intervention. Blue-gray skin discoloration and corneal
microdeposits are also possible .
Question 7
Prior to administering morning medications, the nurse assesses a client receiving
digoxin 0.25 mg PO. Which finding indicates the nurse should withhold the medication?
A) Apical pulse of 52 bpm
B) Blood pressure of 130/74 mm Hg
C) Respiratory rate of 18 breaths/min
D) Temperature of 98.6°F
Answer: A) Apical pulse of 52 bpm
, Rationale: Digoxin decreases heart rate. The medication should be withheld if the apical
pulse is below 60 bpm in adults. The provider should be notified before administering
the dose. Bradycardia may indicate digoxin toxicity .
Question 8
The nurse is teaching a client about nitroglycerin sublingual tablets. Which instruction
should the nurse include?
A) "Take one tablet every 2 minutes until pain subsides."
B) "Swallow the tablet with a full glass of water."
C) "Store the tablets in a dark container away from heat."
D) "Expect a burning sensation under your tongue as a sign the tablet is potent."
Answer: C) "Store the tablets in a dark container away from heat."
Rationale: Nitroglycerin tablets are light- and heat-sensitive and should be stored in
their original dark glass container. The correct dosing is one tablet every 5 minutes for
up to 3 doses; tablets are placed under the tongue, not swallowed .
Question 9
A client with hypertension is prescribed lisinopril. Which adverse effect requires
immediate intervention?
A) Dry cough
B) Angioedema
C) Dizziness
D) Headache
Answer: B) Angioedema
Rationale: Angioedema (swelling of the lips and tongue) is a life-threatening allergic
reaction to ACE inhibitors such as lisinopril. It requires immediate intervention. A dry
cough is a common side effect but not immediately life-threatening .
Question 10
100% Verified Questions & Answers | Latest
Updated 2026 | A+ Guaranteed
Question 1
A client with heart failure is prescribed digoxin. Which finding indicates digoxin toxicity?
A) Anorexia, nausea, and vomiting
B) Tachycardia
C) Hyperkalemia
D) Weight gain
Answer: A) Anorexia, nausea, and vomiting
Rationale: Anorexia, nausea, and vomiting are early signs of digoxin toxicity. Other
signs include visual disturbances (yellow-green halos), bradycardia, and dysrhythmias.
Hypokalemia, not hyperkalemia, increases the risk of digoxin toxicity .
Question 2
The nurse is teaching a client about warfarin therapy. Which statement indicates
understanding?
A) "I will use an electric razor for shaving."
B) "I will take ibuprofen for headaches."
C) "I will increase my intake of leafy green vegetables."
D) "I can stop this medication if I have no side effects."
Answer: A) "I will use an electric razor for shaving."
Rationale: Warfarin increases bleeding risk. Clients should use an electric razor, avoid
NSAIDs (which increase bleeding risk), maintain consistent vitamin K intake (not increase
it), and continue the medication as prescribed .
,Question 3
A client is prescribed warfarin and has an INR of 5.5. Which action should the nurse
take?
A) Administer vitamin K
B) Increase the warfarin dose
C) Continue the current dose
D) Administer protamine sulfate
Answer: A) Administer vitamin K
Rationale: The therapeutic INR range for warfarin is typically 2-3. An INR of 5.5 indicates
excessive anticoagulation and bleeding risk. Vitamin K is the specific antidote for
warfarin. Protamine sulfate is used for heparin overdose .
Question 4
The nurse is caring for a client receiving a continuous IV heparin infusion. The aPTT is 95
seconds (therapeutic range 60-80 seconds). Which action should the nurse take?
A) Increase the infusion rate
B) Decrease the infusion rate
C) Continue the current infusion rate
D) Stop the infusion and notify the provider
Answer: D) Stop the infusion and notify the provider
Rationale: An aPTT above the therapeutic range indicates excessive anticoagulation and
increased bleeding risk. The nurse should stop the infusion and notify the provider.
Heparin is therapeutic when aPTT is 1.5-2.5 times normal (typically 60-80 seconds) .
Question 5
A client is prescribed clopidogrel (Plavix). Which statement by the client indicates
understanding?
A) "I will take this medication with food to prevent stomach upset."
B) "I will report any unusual bleeding or bruising."
,C) "I can stop this medication if I have no chest pain."
D) "I can take ibuprofen if I have a headache."
Answer: B) "I will report any unusual bleeding or bruising."
Rationale: Clopidogrel is an antiplatelet medication that increases bleeding risk. Clients
should report signs of bleeding such as easy bruising, prolonged bleeding, or dark
stools. Ibuprofen should be avoided due to increased bleeding risk .
Question 6
A client with atrial fibrillation is prescribed amiodarone. Which adverse effect should the
nurse monitor?
A) Hypothyroidism
B) Hyperthyroidism
C) Pulmonary fibrosis
D) All of the above
Answer: D) All of the above
Rationale: Amiodarone can cause both hypothyroidism and hyperthyroidism due to its
high iodine content, as well as pulmonary fibrosis, which is a serious adverse effect
requiring immediate intervention. Blue-gray skin discoloration and corneal
microdeposits are also possible .
Question 7
Prior to administering morning medications, the nurse assesses a client receiving
digoxin 0.25 mg PO. Which finding indicates the nurse should withhold the medication?
A) Apical pulse of 52 bpm
B) Blood pressure of 130/74 mm Hg
C) Respiratory rate of 18 breaths/min
D) Temperature of 98.6°F
Answer: A) Apical pulse of 52 bpm
, Rationale: Digoxin decreases heart rate. The medication should be withheld if the apical
pulse is below 60 bpm in adults. The provider should be notified before administering
the dose. Bradycardia may indicate digoxin toxicity .
Question 8
The nurse is teaching a client about nitroglycerin sublingual tablets. Which instruction
should the nurse include?
A) "Take one tablet every 2 minutes until pain subsides."
B) "Swallow the tablet with a full glass of water."
C) "Store the tablets in a dark container away from heat."
D) "Expect a burning sensation under your tongue as a sign the tablet is potent."
Answer: C) "Store the tablets in a dark container away from heat."
Rationale: Nitroglycerin tablets are light- and heat-sensitive and should be stored in
their original dark glass container. The correct dosing is one tablet every 5 minutes for
up to 3 doses; tablets are placed under the tongue, not swallowed .
Question 9
A client with hypertension is prescribed lisinopril. Which adverse effect requires
immediate intervention?
A) Dry cough
B) Angioedema
C) Dizziness
D) Headache
Answer: B) Angioedema
Rationale: Angioedema (swelling of the lips and tongue) is a life-threatening allergic
reaction to ACE inhibitors such as lisinopril. It requires immediate intervention. A dry
cough is a common side effect but not immediately life-threatening .
Question 10
