,HESI RN Pharmacology V3 Exam (3 Set Exams) | Actual
Exams with Rationales
HESI RN Pharmacology V3 Exam - Set 1
HESI RN Pharmacology V3 Exam - Set 2
HESI RN Pharmacology V3 Exam - Set 3
HESI RN Pharmacology V3 Exam - Set 1
Q1. A 54-year-old client with hypertension (HTN) and type 2 diabetes mellitus (T2DM) is
preparing to take the first dose of captopril. His daily medications include
spironolactone 25 mg/day, metformin 500 mg twice a day, and insulin glargine 25 units
daily. The nurse outlines several instructions:
• Instruction 1: Increase the insulin glargine dose by 3 units on the morning of the
first dose.
• Instruction 2: Limit fluids for several days before the first dose.
• Instruction 3: Lie down if blood pressure drops quickly after the first dose.
• Instruction 4: Monitor blood pressure for several hours after the first dose.
• Instruction 5: Hold spironolactone for 3 days prior to the first dose.
Question: For each nursing instruction below, indicate if it is Indicated
(safe/appropriate) or Contraindicated (unsafe/inappropriate) for a client starting
captopril.
A. 1 and 2 are Indicated; 3, 4, 5 are Contraindicated
B. 1, 2, 5 are Contraindicated; 3, 4 are Indicated
C. 1, 4 are Indicated; 2, 3, 5 are Contraindicated
D. 3, 5 are Indicated; 1, 2, 4 are Contraindicated
Answer: B
Rationale: Instructions #1, #2, #5 are Contraindicated; Instructions #3, #4 are Indicated.
Instruction 1 (increasing insulin without proven need) is contraindicated. Instruction 2
,(limiting fluids pre–first-dose ACE inhibitor) is contraindicated due to risk of dehydration
and severe hypotension. Instruction 3 (lie down if BP drops) is indicated for safety after
first-dose hypotension. Instruction 4 (monitor BP for several hours) is indicated to assess
first-dose hypotension. Instruction 5 (hold spironolactone for 3 days) is not routinely
required unless hyperkalemia is an active concern .
Q2. A client with major depression is receiving a new prescription for duloxetine. Which
information is MOST important for the nurse to obtain?
A. Family history of mental illness
B. Weight change in the last month
C. Liver function laboratory results
D. Recent use of other antidepressants
Answer: C
Rationale: Duloxetine (an SNRI) can be hepatotoxic—checking liver enzymes (ALT, AST)
is crucial before therapy. Although a history of mental illness, weight changes, and
concurrent antidepressants matter, ensuring normal or monitored hepatic function is
highest priority .
Q3. Which nursing action has the HIGHEST priority when administering a dose of
codeine with acetaminophen to a client?
A. Advise the client that the medication should start working in about 30 minutes
B. Instruct the client to request assistance when ambulating to the bathroom
C. Tell the client to notify the nurse if the pain is not relieved
D. Administer a stool softener or laxative at the same time
Answer: B
Rationale: Codeine can cause sedation and orthostatic hypotension. The top priority is
preventing falls and injury by having the client call for help when getting up .
CASE STUDY (NGN-Style) - "Select All That Apply"
, Q4. A 54-year-old client with HTN and T2DM has labs suggestive of possible
fluid/electrolyte changes. Which questions should the nurse ask? Select All That Apply:
A. "Have you noticed the need to urinate less often?"
B. "Are you taking any supplements?"
C. "Do you use any salt substitutes?"
D. "Have you experienced urgency to urinate?"
E. "Have you experienced itching or hives?"
F. "Have you noticed that your skin is dry?"
Answers: A, B, C, D
Rationale: Reduced urination could mean fluid retention/kidney changes. Supplements
may add unexpected potassium or sodium. Salt substitutes often contain potassium—
important if on spironolactone. Urgency can indicate changes in fluid balance or
glycemic control .
Q5. After receiving five doses of filgrastim, a client's WBC count rises from 2,500/mm³ to
5,000/mm³. Which action should the nurse implement?
A. Inform the client that the medication has been effective
B. Assess the client's vital signs
C. Implement neutropenic precautions
D. Review culture and sensitivity reports
Answer: A
Rationale: Filgrastim helps stimulate neutrophil production. A WBC increase from low
to within normal range demonstrates therapeutic success .
Q6. A client receives a new prescription for montelukast (Singulair). Which teaching
should the nurse provide?
A. The medication contracts bronchial smooth muscle
B. Montelukast helps increase mucus in the lungs
C. Montelukast helps repair base-lung tissue
D. It prophylactically limits the inflammatory response to allergens
Exams with Rationales
HESI RN Pharmacology V3 Exam - Set 1
HESI RN Pharmacology V3 Exam - Set 2
HESI RN Pharmacology V3 Exam - Set 3
HESI RN Pharmacology V3 Exam - Set 1
Q1. A 54-year-old client with hypertension (HTN) and type 2 diabetes mellitus (T2DM) is
preparing to take the first dose of captopril. His daily medications include
spironolactone 25 mg/day, metformin 500 mg twice a day, and insulin glargine 25 units
daily. The nurse outlines several instructions:
• Instruction 1: Increase the insulin glargine dose by 3 units on the morning of the
first dose.
• Instruction 2: Limit fluids for several days before the first dose.
• Instruction 3: Lie down if blood pressure drops quickly after the first dose.
• Instruction 4: Monitor blood pressure for several hours after the first dose.
• Instruction 5: Hold spironolactone for 3 days prior to the first dose.
Question: For each nursing instruction below, indicate if it is Indicated
(safe/appropriate) or Contraindicated (unsafe/inappropriate) for a client starting
captopril.
A. 1 and 2 are Indicated; 3, 4, 5 are Contraindicated
B. 1, 2, 5 are Contraindicated; 3, 4 are Indicated
C. 1, 4 are Indicated; 2, 3, 5 are Contraindicated
D. 3, 5 are Indicated; 1, 2, 4 are Contraindicated
Answer: B
Rationale: Instructions #1, #2, #5 are Contraindicated; Instructions #3, #4 are Indicated.
Instruction 1 (increasing insulin without proven need) is contraindicated. Instruction 2
,(limiting fluids pre–first-dose ACE inhibitor) is contraindicated due to risk of dehydration
and severe hypotension. Instruction 3 (lie down if BP drops) is indicated for safety after
first-dose hypotension. Instruction 4 (monitor BP for several hours) is indicated to assess
first-dose hypotension. Instruction 5 (hold spironolactone for 3 days) is not routinely
required unless hyperkalemia is an active concern .
Q2. A client with major depression is receiving a new prescription for duloxetine. Which
information is MOST important for the nurse to obtain?
A. Family history of mental illness
B. Weight change in the last month
C. Liver function laboratory results
D. Recent use of other antidepressants
Answer: C
Rationale: Duloxetine (an SNRI) can be hepatotoxic—checking liver enzymes (ALT, AST)
is crucial before therapy. Although a history of mental illness, weight changes, and
concurrent antidepressants matter, ensuring normal or monitored hepatic function is
highest priority .
Q3. Which nursing action has the HIGHEST priority when administering a dose of
codeine with acetaminophen to a client?
A. Advise the client that the medication should start working in about 30 minutes
B. Instruct the client to request assistance when ambulating to the bathroom
C. Tell the client to notify the nurse if the pain is not relieved
D. Administer a stool softener or laxative at the same time
Answer: B
Rationale: Codeine can cause sedation and orthostatic hypotension. The top priority is
preventing falls and injury by having the client call for help when getting up .
CASE STUDY (NGN-Style) - "Select All That Apply"
, Q4. A 54-year-old client with HTN and T2DM has labs suggestive of possible
fluid/electrolyte changes. Which questions should the nurse ask? Select All That Apply:
A. "Have you noticed the need to urinate less often?"
B. "Are you taking any supplements?"
C. "Do you use any salt substitutes?"
D. "Have you experienced urgency to urinate?"
E. "Have you experienced itching or hives?"
F. "Have you noticed that your skin is dry?"
Answers: A, B, C, D
Rationale: Reduced urination could mean fluid retention/kidney changes. Supplements
may add unexpected potassium or sodium. Salt substitutes often contain potassium—
important if on spironolactone. Urgency can indicate changes in fluid balance or
glycemic control .
Q5. After receiving five doses of filgrastim, a client's WBC count rises from 2,500/mm³ to
5,000/mm³. Which action should the nurse implement?
A. Inform the client that the medication has been effective
B. Assess the client's vital signs
C. Implement neutropenic precautions
D. Review culture and sensitivity reports
Answer: A
Rationale: Filgrastim helps stimulate neutrophil production. A WBC increase from low
to within normal range demonstrates therapeutic success .
Q6. A client receives a new prescription for montelukast (Singulair). Which teaching
should the nurse provide?
A. The medication contracts bronchial smooth muscle
B. Montelukast helps increase mucus in the lungs
C. Montelukast helps repair base-lung tissue
D. It prophylactically limits the inflammatory response to allergens
