PHARMACOLOGY II EXAM
(3 Set Exams)
Nightingale College
Actual Qs & Verified Ans to Pass the Exam
This Hesi test contains:
❖ passing score Guarantee
❖ (3 Set Exams)
❖ Format Set of Multiple-choice
❖ questions with incorporating Next Generation NCLEX
(NGN) and Case scenarios questions
❖ Expert-Verified Explanations & Solutions
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,Table of Contents
BSN 315 HESI Pharmacology II Exam 1 ......................... 2
BSN 315 HESI Pharmacology II Exam 2 ....................... 56
BSN 315 HESI Pharmacology II Exam 3 ..................... 104
BSN 315 HESI Pharmacology II Exam 1
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1. A female client with multiple sclerosis reports having less fatigue
and improved memory since she began using the herbal supplement,
ginkgo biloba. Which information is most important for the nurse to
include in the teaching plans for this client?
A. Aspirin and nonsteroidal anti-inflammatory drugs interact with ginkgo
B. nausea and diarrhea can occur when using this supplement
C. anxiety and headaches increased with use of ginkgo
D. ginkgo biloba use should be limited and not taken during pregnancy
Correct Answer: D. ginkgo biloba use should be limited and not taken
during pregnancy
Expert Rationale:
Providing safety information on the limitations of ginkgo biloba, especially
regarding pregnancy, is essential due to potential teratogenic effects and
,bleeding risks. While interactions with NSAIDs and aspirin are important,
the priority teaching addresses when use is contraindicated. Educating the
client about adverse effects should complement but not overshadow safety
warnings.
## Question 2:
Patient Scenario:
A patient is receiving digoxin therapy for chronic heart failure. The
nurse notes the following vital signs and laboratory results:
- Heart rate: 56 bpm
- Serum digoxin level: 2.8 ng/mL (therapeutic range 0.8–2.0 ng/mL)
- Serum potassium: 3.2 mEq/L (normal 3.5–5.0 mEq/L)
What is the nurse’s priority action?
A) Administer digoxin as ordered and observe the patient.
B) Hold the next dose of digoxin and notify the provider.
C) Administer potassium supplements and digoxin.
D) Prepare for immediate cardioversion.
Correct Answer: B) Hold the next dose of digoxin and notify the provider.
Expert Rationale:
The patient has signs of digoxin toxicity: bradycardia, elevated digoxin
level, and hypokalemia (which increases digoxin toxicity risk). The nurse
should withhold digoxin, notify the provider, and monitor closely. Immediate
cardioversion is not indicated unless arrhythmias develop.
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3. In explaining the benefits of the combination anti-infective drug
TMP-SMZ (Bactrim) to a client receiving the medication for a urinary
tract infection, what rationale should the nurse provide?
A. Each drug could cause damage to the kidneys if taken separately
B. One drug reduces the risk of side effects caused by the drug
C. while one drug provide relief, the other fights the infection
D. the two drugs work together to reduce resistance of the bacterial
infection of symptoms
Correct Answer: D. the two drugs work together to reduce resistance of
the bacterial infection of symptoms
Expert Rationale:
TMP-SMZ combines two antibiotics with different mechanisms of action to
synergistically kill bacteria, which decreases the chance of resistance
development. The combined effect also broadens the antimicrobial
spectrum. Explaining synergy and resistance prevention helps client
understanding of multi-agent therapy advantages.
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4. Client being treated with Haldol for schizophrenia is complaining of
jaw tightness and a stiff neck. Which interventions should the nurse
implement?
,A. give PRN dose of diphenhydramine Benadryl
B. assess client other sensory hallucinations
C. massage neck until muscles begin to relax
D. obtain a 12 lead EKG
Correct Answer: A. give PRN dose of diphenhydramine Benadryl
Expert Rationale:
Jaw tightness and stiff neck can indicate extrapyramidal side effects (EPS),
specifically acute dystonia, a common adverse effect of Haldol
(haloperidol). Diphenhydramine (Benadryl) is an anticholinergic effective in
resolving acute dystonic reactions. Massaging the neck is inappropriate
and potentially harmful, while assessment for hallucinations or obtaining
EKG does not address the urgent EPS symptoms.
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5. Which intervention is most important for the nurse to implement for
a client receiving Lispro (Humalog) insulin?
A. Check blood glucose levels every six hours
B. Provide meals at the same time that insulin is given
C. Assess for hypoglycemia between meals
D. Keeping oral liquid or glucose source available
Correct Answer: B. Provide meals at the same time that insulin is given
Expert Rationale:
,Humalog is a rapid-acting insulin with onset within 15 minutes and peak
around 1 hour, requiring meal intake timing to prevent hypoglycemia.
Delayed meals risk hypoglycemia; therefore, synchronization with food
intake is critical. While monitoring glucose and having glucose sources are
important, preventing hypoglycemia by coordinating insulin and meals is a
priority.
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6. A client who takes nonsteroidal anti-inflammatory drugs (NSAIDs)
every day for rheumatoid arthritis is being treated for anemia. Which
intervention is most important for the nurse to include in the plan of
care?
A. Observe for gastrointestinal bleeding
B. Monitor liver function test results
C. Protect skin from bruising
D. Offered dietary selections rich in iron
Correct Answer: A. Observe for gastrointestinal bleeding
Expert Rationale:
Chronic NSAID use is associated with an increased risk of GI mucosal
damage leading to bleeding, which can cause or worsen anemia.
Observing for bleeding signs is vital to prevent complications. While dietary
iron helps anemia, identifying and addressing its cause is paramount. Liver
function monitoring is less directly related, and bruising protection is more
related to platelet function disorders.
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7. A client receives a prescription for theophylline (Theo-Dur) PO to be
initiated in the morning after the dose of theophylline IV is complete.
The nurse determines that a theophylline level drawn yesterday was
22 mcg/mL. Based on this information, which action should the nurse
implement?
A. Hold the theophylline dose and notify the health care provider.
B. Start the client on a half-dose of theophylline PO.
C. The theophylline dose can be initiated as planned.
D. The client is not ready to be weaned from the IV to the PO route.
Correct Answer: A. Hold the theophylline dose and notify the health care
provider.
Expert Rationale:
A theophylline level of 22 mcg/mL exceeds the therapeutic range (typically
10–20 mcg/mL) and may indicate toxicity risk. The nurse must hold the
dose and notify the provider to prevent adverse effects such as cardiac
arrhythmias or seizures. Initiating or reducing the dose without provider
guidance could risk harm.
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8. The nurse is reviewing a client's laboratory results before a
procedure in which a neuromuscular blocking agent is a standing
,order. Which finding should the nurse report to the health care
provider?
A. Hypokalemia
B. Hyponatremia
C. Hypercalcemia
D. Hypomagnesemia
Correct Answer: A. Hypokalemia
Expert Rationale:
Hypokalemia increases the risk of adverse effects and prolonged
neuromuscular blockade when neuromuscular blocking agents are given.
Electrolyte imbalances, especially low potassium, affect nerve and muscle
excitability. Reporting hypokalemia allows correction before procedure to
prevent complications.
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9. The nurse preparing a child for transport to the operating room for
an emergency appendectomy. The anesthesiologist prescribes
atropine sulfate (Atropine), IM STAT. What is the primary purpose for
administering this drug to the child at this time?
A. Decrease the oral secretions
B. Reduce the child's anxiety
C. Potentiate the opioid effects
D. Prevent possible peritonitis
, Correct Answer: A. Decrease the oral secretions
Expert Rationale:
Atropine is an anticholinergic given preoperatively to reduce salivary and
respiratory secretions, minimizing the risk of aspiration during anesthesia. It
does not reduce anxiety or potentiate opioids, nor does it prevent
peritonitis.
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10. When caring for a client on digoxin (Lanoxin) therapy, the nurse
knows to be alert for digoxin (Lanoxin) toxicity. Which finding would
predispose this client to developing digoxin toxicity?
A. Low serum sodium level
B. High serum sodium level
C. Low serum potassium level
D. High serum potassium level
Correct Answer: C. Low serum potassium level
Expert Rationale:
Hypokalemia potentiates digoxin toxicity because potassium and digoxin
compete for binding sites on the sodium-potassium ATPase pump. Low
potassium levels increase digoxin binding and toxicity risk. Monitoring and
correcting electrolytes are critical in patients on digoxin.
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