BSN 315 Pharmacology HESI V6 — COMPREHENSIVE
EXAM QUESTIONS AND ANSWERS|NEW 2026-2027
UPDATE
Question 1
A patient with GERD has failed lifestyle modifications. Which medication class is first-
line for healing erosive esophagitis?
A. H2 receptor antagonists (famotidine)
B. Proton pump inhibitors (omeprazole)
C. Antacids (calcium carbonate)
D. Prokinetic agents (metoclopramide)
Correct Answer: B
Rationale: PPIs (omeprazole, esomeprazole, pantoprazole) are the most potent acid
suppressors and are first-line for GERD symptom relief and healing erosive
esophagitis. They inhibit the H+/K+ ATPase proton pump in parietal cells. H2 blockers
are less effective for severe disease. Antacids provide temporary relief. Prokinetics
have limited efficacy and significant side effects (tardive dyskinesia with
metoclopramide).
Question 2
A patient with peptic ulcer disease tests positive for H. pylori. Which regimen is
recommended as first-line therapy?
A. PPI + amoxicillin + clarithromycin for 14 days (if local clarithromycin resistance
<15%) or bismuth quadruple therapy for 14 days
B. PPI alone for 8 weeks
C. H2 receptor antagonist alone for 12 weeks
D. Sucralfate alone for 4 weeks
Correct Answer: A
, Rationale: First-line H. pylori eradication: 14-day bismuth-based quadruple therapy
(PPI + bismuth + tetracycline + metronidazole) is preferred where clarithromycin
resistance is high (>15%). 14-day clarithromycin-based triple therapy (PPI +
amoxicillin + clarithromycin) is acceptable if local resistance is low and no prior
macrolide exposure. PPI or H2 blockers alone heal ulcers but do NOT eradicate H.
pylori, leading to high recurrence.
Question 3
A patient with nausea and vomiting after chemotherapy is prescribed ondansetron 8
mg PO. The nurse understands that ondansetron works by:
A. Blocking dopamine D2 receptors in the chemoreceptor trigger zone
B. Blocking serotonin 5-HT3 receptors in the GI tract and CNS
C. Blocking histamine H1 receptors in the vestibular nucleus
D. Blocking muscarinic cholinergic receptors
Correct Answer: B
Rationale: Ondansetron is a 5-HT3 receptor antagonist that blocks serotonin
receptors in the GI tract (enterochromaffin cells) and the CNS (chemoreceptor trigger
zone, vomiting center). It is highly effective for chemotherapy-induced and
postoperative nausea/vomiting. Dopamine antagonists: metoclopramide,
prochlorperazine. H1 antagonists: dimenhydrinate, meclizine. Muscarinic
antagonists: scopolamine.
Question 4
A patient with inflammatory bowel disease (Crohn's disease) is prescribed infliximab
(Remicade) IV infusion. The nurse should monitor for which adverse effect DURING
the infusion?
A. Hyperglycemia
B. Infusion reaction: fever, chills, hypotension, urticaria, or anaphylaxis
C. Bradycardia
EXAM QUESTIONS AND ANSWERS|NEW 2026-2027
UPDATE
Question 1
A patient with GERD has failed lifestyle modifications. Which medication class is first-
line for healing erosive esophagitis?
A. H2 receptor antagonists (famotidine)
B. Proton pump inhibitors (omeprazole)
C. Antacids (calcium carbonate)
D. Prokinetic agents (metoclopramide)
Correct Answer: B
Rationale: PPIs (omeprazole, esomeprazole, pantoprazole) are the most potent acid
suppressors and are first-line for GERD symptom relief and healing erosive
esophagitis. They inhibit the H+/K+ ATPase proton pump in parietal cells. H2 blockers
are less effective for severe disease. Antacids provide temporary relief. Prokinetics
have limited efficacy and significant side effects (tardive dyskinesia with
metoclopramide).
Question 2
A patient with peptic ulcer disease tests positive for H. pylori. Which regimen is
recommended as first-line therapy?
A. PPI + amoxicillin + clarithromycin for 14 days (if local clarithromycin resistance
<15%) or bismuth quadruple therapy for 14 days
B. PPI alone for 8 weeks
C. H2 receptor antagonist alone for 12 weeks
D. Sucralfate alone for 4 weeks
Correct Answer: A
, Rationale: First-line H. pylori eradication: 14-day bismuth-based quadruple therapy
(PPI + bismuth + tetracycline + metronidazole) is preferred where clarithromycin
resistance is high (>15%). 14-day clarithromycin-based triple therapy (PPI +
amoxicillin + clarithromycin) is acceptable if local resistance is low and no prior
macrolide exposure. PPI or H2 blockers alone heal ulcers but do NOT eradicate H.
pylori, leading to high recurrence.
Question 3
A patient with nausea and vomiting after chemotherapy is prescribed ondansetron 8
mg PO. The nurse understands that ondansetron works by:
A. Blocking dopamine D2 receptors in the chemoreceptor trigger zone
B. Blocking serotonin 5-HT3 receptors in the GI tract and CNS
C. Blocking histamine H1 receptors in the vestibular nucleus
D. Blocking muscarinic cholinergic receptors
Correct Answer: B
Rationale: Ondansetron is a 5-HT3 receptor antagonist that blocks serotonin
receptors in the GI tract (enterochromaffin cells) and the CNS (chemoreceptor trigger
zone, vomiting center). It is highly effective for chemotherapy-induced and
postoperative nausea/vomiting. Dopamine antagonists: metoclopramide,
prochlorperazine. H1 antagonists: dimenhydrinate, meclizine. Muscarinic
antagonists: scopolamine.
Question 4
A patient with inflammatory bowel disease (Crohn's disease) is prescribed infliximab
(Remicade) IV infusion. The nurse should monitor for which adverse effect DURING
the infusion?
A. Hyperglycemia
B. Infusion reaction: fever, chills, hypotension, urticaria, or anaphylaxis
C. Bradycardia
