RN HESI Pharmacology V3 (2026) PDF | Actual Exams
with Rationales COMPREHENSIVE PHARMACOLOGY
EXAMINATION Practice Questions with Answers and
Detailed Rationales
1. A client is prescribed clopidogrel (Plavix). Which of the following
instructions is CONTRAINDICATED for this medication?
A) Monitor blood pressure for several hours after the first dose
B) Lie down if blood pressure drops quickly after the first dose
C) Hold spironolactone for 3 days prior to the first dose
D) Report any unusual bleeding or bruising
Rationale: Clopidogrel is an antiplatelet medication. Holding spironolactone
is not routinely required unless hyperkalemia is an active concern. Monitoring
blood pressure is indicated because clopidogrel can cause hypotension. Lying
down if blood pressure drops is a safety measure.
2. A client is prescribed clopidogrel (Plavix) after a myocardial
infarction. The nurse should monitor the client for which adverse effect?
A) Hyperglycemia
B) Bleeding and bruising
C) Bradycardia
D) Hypokalemia
Rationale: Clopidogrel is an antiplatelet agent that inhibits platelet
aggregation, increasing the risk of bleeding and bruising. The nurse should
monitor for signs of bleeding.
3. A client is prescribed warfarin (Coumadin). Which laboratory value
should the nurse monitor to evaluate therapeutic effectiveness?
A) aPTT
B) PT/INR
,C) Platelet count
D) Hemoglobin
Rationale: Warfarin therapy is monitored by PT/INR, with a therapeutic INR
of 2-3 for most indications. aPTT is used for heparin monitoring.
4. A client receiving heparin therapy has an aPTT of 120 seconds
(normal 25-35 seconds). The nurse should anticipate which action?
A) Increase the heparin infusion rate
B) Hold the heparin infusion and notify the healthcare provider
C) Administer vitamin K
D) Decrease the heparin infusion rate
Rationale: An aPTT > 100 seconds indicates excessive anticoagulation and
increased bleeding risk. The heparin should be held and the provider notified.
Protamine sulfate is the antidote for heparin.
5. A client is prescribed digoxin (Lanoxin) for heart failure. Which
finding indicates digoxin toxicity?
A) Visual disturbances (yellow-green halos) and nausea
B) Tachycardia
C) Hypertension
D) Hyperkalemia
Rationale: Digoxin toxicity causes visual disturbances (yellow-green halos,
blurred vision), nausea, vomiting, and bradycardia.
6. The nurse is administering furosemide (Lasix) to a client with heart
failure. Which laboratory value should the nurse monitor?
A) Potassium levels
B) Calcium levels
C) Sodium levels
D) Magnesium levels
,Rationale: Furosemide is a loop diuretic that can cause hypokalemia.
Potassium levels should be monitored closely.
7. A client with hypertension is prescribed lisinopril (Prinivil). Which
adverse effect should the nurse teach the client to report?
A) Bradycardia
B) Persistent cough and angioedema
C) Hypoglycemia
D) Hyperkalemia
Rationale: Lisinopril (ACE inhibitor) can cause a persistent dry cough and
angioedema (swelling of the lips, tongue, or throat). These should be reported
promptly.
8. A client is prescribed amiodarone for atrial fibrillation. Which adverse
effect is associated with long-term amiodarone therapy?
A) Hyperglycemia
B) Pulmonary fibrosis
C) Hypokalemia
D) Bradycardia
Rationale: Amiodarone can cause pulmonary fibrosis, thyroid dysfunction,
and corneal deposits. Pulmonary function tests and chest X-rays should be
monitored.
9. A client prescribed metoprolol (Lopressor) for hypertension should
be taught to monitor for which adverse effect?
A) Tachycardia
B) Bradycardia and hypotension
C) Hyperglycemia
D) Hyperkalemia
Rationale: Beta-blockers like metoprolol can cause bradycardia and
hypotension by blocking beta-adrenergic receptors.
, 10. A client with angina is prescribed sublingual nitroglycerin. The nurse
should instruct the client to:
A) Swallow the tablet with water
B) Place the tablet under the tongue until it dissolves
C) Chew the tablet for faster results
D) Take the tablet with food
Rationale: Sublingual nitroglycerin is placed under the tongue and allowed to
dissolve for rapid absorption. It should not be swallowed or chewed.
11. A client is prescribed enoxaparin (Lovenox) for DVT prophylaxis.
The nurse should administer this medication by which route?
A) Intramuscular
B) Subcutaneous
C) Intravenous
D) Oral
Rationale: Enoxaparin is administered subcutaneously in the abdomen. It
should not be given IM or IV.
12. A client receiving spironolactone (Aldactone) should be taught to
avoid which of the following?
A) Foods high in sodium
B) Salt substitutes containing potassium
C) Caffeine
D) Grapefruit juice
Rationale: Spironolactone is a potassium-sparing diuretic. Salt substitutes
often contain potassium, which can lead to hyperkalemia when combined
with this medication.
with Rationales COMPREHENSIVE PHARMACOLOGY
EXAMINATION Practice Questions with Answers and
Detailed Rationales
1. A client is prescribed clopidogrel (Plavix). Which of the following
instructions is CONTRAINDICATED for this medication?
A) Monitor blood pressure for several hours after the first dose
B) Lie down if blood pressure drops quickly after the first dose
C) Hold spironolactone for 3 days prior to the first dose
D) Report any unusual bleeding or bruising
Rationale: Clopidogrel is an antiplatelet medication. Holding spironolactone
is not routinely required unless hyperkalemia is an active concern. Monitoring
blood pressure is indicated because clopidogrel can cause hypotension. Lying
down if blood pressure drops is a safety measure.
2. A client is prescribed clopidogrel (Plavix) after a myocardial
infarction. The nurse should monitor the client for which adverse effect?
A) Hyperglycemia
B) Bleeding and bruising
C) Bradycardia
D) Hypokalemia
Rationale: Clopidogrel is an antiplatelet agent that inhibits platelet
aggregation, increasing the risk of bleeding and bruising. The nurse should
monitor for signs of bleeding.
3. A client is prescribed warfarin (Coumadin). Which laboratory value
should the nurse monitor to evaluate therapeutic effectiveness?
A) aPTT
B) PT/INR
,C) Platelet count
D) Hemoglobin
Rationale: Warfarin therapy is monitored by PT/INR, with a therapeutic INR
of 2-3 for most indications. aPTT is used for heparin monitoring.
4. A client receiving heparin therapy has an aPTT of 120 seconds
(normal 25-35 seconds). The nurse should anticipate which action?
A) Increase the heparin infusion rate
B) Hold the heparin infusion and notify the healthcare provider
C) Administer vitamin K
D) Decrease the heparin infusion rate
Rationale: An aPTT > 100 seconds indicates excessive anticoagulation and
increased bleeding risk. The heparin should be held and the provider notified.
Protamine sulfate is the antidote for heparin.
5. A client is prescribed digoxin (Lanoxin) for heart failure. Which
finding indicates digoxin toxicity?
A) Visual disturbances (yellow-green halos) and nausea
B) Tachycardia
C) Hypertension
D) Hyperkalemia
Rationale: Digoxin toxicity causes visual disturbances (yellow-green halos,
blurred vision), nausea, vomiting, and bradycardia.
6. The nurse is administering furosemide (Lasix) to a client with heart
failure. Which laboratory value should the nurse monitor?
A) Potassium levels
B) Calcium levels
C) Sodium levels
D) Magnesium levels
,Rationale: Furosemide is a loop diuretic that can cause hypokalemia.
Potassium levels should be monitored closely.
7. A client with hypertension is prescribed lisinopril (Prinivil). Which
adverse effect should the nurse teach the client to report?
A) Bradycardia
B) Persistent cough and angioedema
C) Hypoglycemia
D) Hyperkalemia
Rationale: Lisinopril (ACE inhibitor) can cause a persistent dry cough and
angioedema (swelling of the lips, tongue, or throat). These should be reported
promptly.
8. A client is prescribed amiodarone for atrial fibrillation. Which adverse
effect is associated with long-term amiodarone therapy?
A) Hyperglycemia
B) Pulmonary fibrosis
C) Hypokalemia
D) Bradycardia
Rationale: Amiodarone can cause pulmonary fibrosis, thyroid dysfunction,
and corneal deposits. Pulmonary function tests and chest X-rays should be
monitored.
9. A client prescribed metoprolol (Lopressor) for hypertension should
be taught to monitor for which adverse effect?
A) Tachycardia
B) Bradycardia and hypotension
C) Hyperglycemia
D) Hyperkalemia
Rationale: Beta-blockers like metoprolol can cause bradycardia and
hypotension by blocking beta-adrenergic receptors.
, 10. A client with angina is prescribed sublingual nitroglycerin. The nurse
should instruct the client to:
A) Swallow the tablet with water
B) Place the tablet under the tongue until it dissolves
C) Chew the tablet for faster results
D) Take the tablet with food
Rationale: Sublingual nitroglycerin is placed under the tongue and allowed to
dissolve for rapid absorption. It should not be swallowed or chewed.
11. A client is prescribed enoxaparin (Lovenox) for DVT prophylaxis.
The nurse should administer this medication by which route?
A) Intramuscular
B) Subcutaneous
C) Intravenous
D) Oral
Rationale: Enoxaparin is administered subcutaneously in the abdomen. It
should not be given IM or IV.
12. A client receiving spironolactone (Aldactone) should be taught to
avoid which of the following?
A) Foods high in sodium
B) Salt substitutes containing potassium
C) Caffeine
D) Grapefruit juice
Rationale: Spironolactone is a potassium-sparing diuretic. Salt substitutes
often contain potassium, which can lead to hyperkalemia when combined
with this medication.
