BSN 315 HESI Pharmacology Exam
2026/2027| A Brand-New Comprehensive
Review of 200 Real Questions and
Multichoice Answers with Clinical Rationale|
Guaranteed Pass
Introduction
This comprehensive pharmacology examination has been designed to assess
nursing students' knowledge and clinical reasoning abilities in medication
administration, monitoring, and patient education. The questions encompass a wide
range of pharmacological concepts including drug classifications, adverse effects,
therapeutic responses, nursing interventions, and patient teaching priorities. Each
question is accompanied by a detailed rationale to enhance understanding and
promote evidence-based practice. This examination aligns with the HESI testing
format and is suitable for nursing students preparing for licensure examinations.
1. A client with multiple sclerosis who self-administers interferon beta-1a
reports feeling increasingly depressed over the past week. Which action
should the nurse implement?
A. Continue to monitor the patient and reassess in 1 hour
B. Document the findings and take no further action
C. Notify the healthcare provider of the findings immediately
D. Administer PRN medication and reassess later
Answer: C. Notify the healthcare provider of the findings immediately
Rationale: Interferon beta-1a can cause or exacerbate depression, which is a
significant adverse effect requiring immediate attention. The healthcare provider
should be notified promptly to evaluate the patient's mental status and consider
dosage adjustment or alternative therapy. Depression in MS patients can lead to
suicidal ideation, making this a priority concern.
,2. Before administering the initial dose of sumatriptan succinate to a client
with a migraine headache, it is most important to determine if the client's
history includes which condition?
A. Chronic Obstructive Pulmonary Disease (COPD)
B. Congestive Heart Failure (CHF)
C. Coronary Artery Disease (CAD)
D. Chronic Kidney Disease (CKD)
Answer: C. Coronary Artery Disease (CAD)
Rationale: Sumatriptan is contraindicated in patients with coronary artery disease,
history of myocardial infarction, or uncontrolled hypertension due to its
vasoconstrictive effects on coronary arteries. The medication can cause coronary
vasospasm and is absolutely contraindicated in patients with ischemic heart
disease.
3. A client receives a prescription for ciprofloxacin 400 mg intravenously (IV)
every 12 hours, to be infused over one hour. The IV bag contains ciprofloxacin
400 mg in dextrose 5% in water (D5W) 200 mL. How many mL/hr should the
nurse program the infusion pump to deliver?
A. 50 mL/hr
B. 100 mL/hr
C. 150 mL/hr
D. 200 mL/hr
Answer: D. 200 mL/hr
Rationale: To infuse 200 mL over 1 hour, the pump should be set at 200 mL/hr
(200 mL ÷ 1 hour = 200 mL/hr). This calculation ensures the entire dose is
administered within the prescribed time frame.
4. Before administering a laxative to a bedfast client, it is most important for
the nurse to perform which assessment?
,A. Encourage increased fluid intake
B. Administer stool softener as ordered
C. Determine the frequency and consistency of bowel movements
D. Promote early ambulation
Answer: C. Determine the frequency and consistency of bowel movements
Rationale: Assessing baseline bowel patterns is essential before administering
laxatives to determine if constipation actually exists and to evaluate the
effectiveness of the medication. This assessment helps prevent unnecessary
administration and potential complications such as diarrhea or electrolyte
imbalances.
5. A client with hypothyroidism is prescribed levothyroxine sodium. The nurse
should instruct the client to report which symptom because it indicates the
dosage may be too high?
A. Restlessness
B. Fatigue
C. Calmness
D. Drowsiness
Answer: A. Restlessness
Rationale: Restlessness, anxiety, palpitations, tremors, and insomnia are signs of
hyperthyroidism resulting from excessive levothyroxine dosage. These symptoms
indicate that the medication dose is too high and requires adjustment to prevent
complications such as cardiac arrhythmias.
6. A male client reports experiencing gastrointestinal distress from a high dose
of a corticosteroid and is planning to stop taking the medication. Which
nursing action is most important to implement?
A. Advise the client that medication should be gradually stopped rather than
abruptly
B. Instruct the client to stop the medication immediately if feeling better
, C. Skip doses occasionally to reduce side effects
D. Double the dose if a dose is missed
Answer: A. Advise the client that medication should be gradually stopped
rather than abruptly
Rationale: Corticosteroids must be tapered gradually to prevent adrenal
insufficiency. Abrupt discontinuation can precipitate adrenal crisis, a life-
threatening emergency characterized by hypotension, weakness, and electrolyte
imbalances. The client should never stop corticosteroid therapy without healthcare
provider guidance.
7. A client receiving pilocarpine hydrochloride ophthalmic drops for glaucoma
reports difficulty seeing at night. Which explanation should the nurse
provide?
A. The eye drops increase tear production for lubrication
B. The eye drops reduce intraocular pressure
C. The eye drops improve visual acuity in bright light
D. The eye drops slow pupil response to accommodate for darkness
Answer: D. The eye drops slow pupil response to accommodate for darkness
Rationale: Pilocarpine is a miotic agent that causes miosis (pupil constriction),
which impairs dark adaptation and night vision. This is a normal and expected side
effect of the medication as it works to reduce intraocular pressure by increasing
aqueous humor outflow.
8. A client receiving rifampin for tuberculosis reports which finding that
requires immediate healthcare provider notification?
A. Reports that the sclera are yellow
B. States that vision is blurry
C. Complains of eye dryness
D. Notes redness in the conjunctiva
Answer: A. Reports that the sclera are yellow
2026/2027| A Brand-New Comprehensive
Review of 200 Real Questions and
Multichoice Answers with Clinical Rationale|
Guaranteed Pass
Introduction
This comprehensive pharmacology examination has been designed to assess
nursing students' knowledge and clinical reasoning abilities in medication
administration, monitoring, and patient education. The questions encompass a wide
range of pharmacological concepts including drug classifications, adverse effects,
therapeutic responses, nursing interventions, and patient teaching priorities. Each
question is accompanied by a detailed rationale to enhance understanding and
promote evidence-based practice. This examination aligns with the HESI testing
format and is suitable for nursing students preparing for licensure examinations.
1. A client with multiple sclerosis who self-administers interferon beta-1a
reports feeling increasingly depressed over the past week. Which action
should the nurse implement?
A. Continue to monitor the patient and reassess in 1 hour
B. Document the findings and take no further action
C. Notify the healthcare provider of the findings immediately
D. Administer PRN medication and reassess later
Answer: C. Notify the healthcare provider of the findings immediately
Rationale: Interferon beta-1a can cause or exacerbate depression, which is a
significant adverse effect requiring immediate attention. The healthcare provider
should be notified promptly to evaluate the patient's mental status and consider
dosage adjustment or alternative therapy. Depression in MS patients can lead to
suicidal ideation, making this a priority concern.
,2. Before administering the initial dose of sumatriptan succinate to a client
with a migraine headache, it is most important to determine if the client's
history includes which condition?
A. Chronic Obstructive Pulmonary Disease (COPD)
B. Congestive Heart Failure (CHF)
C. Coronary Artery Disease (CAD)
D. Chronic Kidney Disease (CKD)
Answer: C. Coronary Artery Disease (CAD)
Rationale: Sumatriptan is contraindicated in patients with coronary artery disease,
history of myocardial infarction, or uncontrolled hypertension due to its
vasoconstrictive effects on coronary arteries. The medication can cause coronary
vasospasm and is absolutely contraindicated in patients with ischemic heart
disease.
3. A client receives a prescription for ciprofloxacin 400 mg intravenously (IV)
every 12 hours, to be infused over one hour. The IV bag contains ciprofloxacin
400 mg in dextrose 5% in water (D5W) 200 mL. How many mL/hr should the
nurse program the infusion pump to deliver?
A. 50 mL/hr
B. 100 mL/hr
C. 150 mL/hr
D. 200 mL/hr
Answer: D. 200 mL/hr
Rationale: To infuse 200 mL over 1 hour, the pump should be set at 200 mL/hr
(200 mL ÷ 1 hour = 200 mL/hr). This calculation ensures the entire dose is
administered within the prescribed time frame.
4. Before administering a laxative to a bedfast client, it is most important for
the nurse to perform which assessment?
,A. Encourage increased fluid intake
B. Administer stool softener as ordered
C. Determine the frequency and consistency of bowel movements
D. Promote early ambulation
Answer: C. Determine the frequency and consistency of bowel movements
Rationale: Assessing baseline bowel patterns is essential before administering
laxatives to determine if constipation actually exists and to evaluate the
effectiveness of the medication. This assessment helps prevent unnecessary
administration and potential complications such as diarrhea or electrolyte
imbalances.
5. A client with hypothyroidism is prescribed levothyroxine sodium. The nurse
should instruct the client to report which symptom because it indicates the
dosage may be too high?
A. Restlessness
B. Fatigue
C. Calmness
D. Drowsiness
Answer: A. Restlessness
Rationale: Restlessness, anxiety, palpitations, tremors, and insomnia are signs of
hyperthyroidism resulting from excessive levothyroxine dosage. These symptoms
indicate that the medication dose is too high and requires adjustment to prevent
complications such as cardiac arrhythmias.
6. A male client reports experiencing gastrointestinal distress from a high dose
of a corticosteroid and is planning to stop taking the medication. Which
nursing action is most important to implement?
A. Advise the client that medication should be gradually stopped rather than
abruptly
B. Instruct the client to stop the medication immediately if feeling better
, C. Skip doses occasionally to reduce side effects
D. Double the dose if a dose is missed
Answer: A. Advise the client that medication should be gradually stopped
rather than abruptly
Rationale: Corticosteroids must be tapered gradually to prevent adrenal
insufficiency. Abrupt discontinuation can precipitate adrenal crisis, a life-
threatening emergency characterized by hypotension, weakness, and electrolyte
imbalances. The client should never stop corticosteroid therapy without healthcare
provider guidance.
7. A client receiving pilocarpine hydrochloride ophthalmic drops for glaucoma
reports difficulty seeing at night. Which explanation should the nurse
provide?
A. The eye drops increase tear production for lubrication
B. The eye drops reduce intraocular pressure
C. The eye drops improve visual acuity in bright light
D. The eye drops slow pupil response to accommodate for darkness
Answer: D. The eye drops slow pupil response to accommodate for darkness
Rationale: Pilocarpine is a miotic agent that causes miosis (pupil constriction),
which impairs dark adaptation and night vision. This is a normal and expected side
effect of the medication as it works to reduce intraocular pressure by increasing
aqueous humor outflow.
8. A client receiving rifampin for tuberculosis reports which finding that
requires immediate healthcare provider notification?
A. Reports that the sclera are yellow
B. States that vision is blurry
C. Complains of eye dryness
D. Notes redness in the conjunctiva
Answer: A. Reports that the sclera are yellow
