FORTIS COLLEGE NUR100 HESI
PHARMACOLOGY EXAM V1: 250 PRACTICE
QUESTIONS WITH ANSWERS & RATIONALES|
LATEST 2026/2027| PASS GUARANTEE
Cardiovascular & Anticoagulant Medications
1. A patient is receiving a continuous IV heparin infusion. The aPTT is 95
seconds. What action should the nurse take?
A) Increase the heparin infusion rate
B) Decrease the heparin infusion rate
C) Administer vitamin K
D) Continue the infusion as ordered
Answer: B) Decrease the heparin infusion rate
Rationale: The therapeutic aPTT for heparin therapy is typically 1.5-2.5 times the
normal control (approximately 60-100 seconds depending on the lab). An aPTT of 95
seconds is above the therapeutic range, indicating a risk for hemorrhage. The
infusion rate should be decreased. Vitamin K is not used for heparin reversal;
protamine sulfate is the specific antidote.
2. What is the antidote for heparin overdose?
A) Vitamin K
B) Protamine sulfate
C) Naloxone
D) Flumazenil
Answer: B) Protamine sulfate
Rationale: Protamine sulfate binds to and inactivates heparin, reversing its
anticoagulant effects. It is administered IV and takes effect within minutes. Vitamin K
reverses warfarin (Coumadin) effects. Naloxone is the antidote for opioids, and
flumazenil reverses benzodiazepines.
,3. A client prescribed clopidogrel (Plavix) following coronary stent placement
asks about the medication's purpose. Which explanation is correct?
A) "This medication prevents the formation of blood clots in your stent."
B) "This medication dissolves any clots that might form in your stent."
C) "This medication dilates your blood vessels to improve blood flow."
D) "This medication lowers your cholesterol to prevent plaque buildup."
Answer: A) "This medication prevents the formation of blood clots in your
stent."
Rationale: Clopidogrel is an antiplatelet medication that prevents platelets from
sticking together, thereby preventing clot formation in coronary stents. This reduces
the risk of stent thrombosis and subsequent heart attack. It is typically prescribed
with aspirin for dual antiplatelet therapy.
4. A patient scheduled for surgery is taking clopidogrel (Plavix). When should
the nurse instruct the patient to stop this medication before surgery?
A) 1 day before surgery
B) 3 days before surgery
C) 5-7 days before surgery
D) 14 days before surgery
Answer: C) 5-7 days before surgery
Rationale: Clopidogrel should be stopped 5-7 days before surgery to reduce the risk
of excessive bleeding during the procedure. Patients should not stop the medication
without provider guidance.
5. A client is prescribed enoxaparin (Lovenox). Which statement is correct
regarding this medication?
A) Routine aPTT monitoring is required.
B) The medication is given orally.
C) It prevents clot formation by inhibiting factor Xa.
D) It should be massaged into the injection site.
,Answer: C) It prevents clot formation by inhibiting factor Xa.
Rationale: Enoxaparin is a low molecular weight heparin (LMWH) given
subcutaneously (usually in the abdomen). It does not require routine aPTT
monitoring and should not be massaged after injection. It prevents clot formation by
inhibiting factor Xa.
Cardiac & Antihypertensive Medications
6. A patient prescribed lisinopril (an ACE inhibitor) develops a dry, persistent
cough. What is the nurse's best response?
A) "This is a sign of medication allergy requiring immediate discontinuation."
B) "This is a common side effect; report it to your healthcare provider for possible
medication change."
C) "This indicates the medication is not working properly."
D) "Take an over-the-counter cough suppressant to manage this symptom."
Answer: B) "This is a common side effect; report it to your healthcare provider
for possible medication change."
Rationale: A dry, persistent cough is a well-known side effect of ACE inhibitors
(lisinopril, enalapril, captopril) occurring in approximately 10-20% of patients due to
bradykinin accumulation. While not life-threatening, patients should report it to their
provider for evaluation and possible switching to an ARB.
7. A client prescribed lisinopril (Zestril). Which adverse effect requires
immediate intervention?
A) Dry cough
B) Angioedema (swelling of lips/tongue)
C) Dizziness
D) Headache
Answer: B) Angioedema (swelling of lips/tongue)
Rationale: Angioedema is a life-threatening allergic reaction to ACE inhibitors that
requires immediate discontinuation and emergency treatment. While dry cough is a
common side effect, angioedema indicates a severe allergic response.
, 8. A client with heart failure is prescribed furosemide (Lasix). Which electrolyte
imbalance should the nurse monitor most closely?
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypocalcemia
Answer: B) Hypokalemia
Rationale: Furosemide is a loop diuretic that causes potassium wasting in the distal
tubule. Hypokalemia increases the risk of digoxin toxicity and cardiac arrhythmias.
Patients should be monitored for low potassium levels and may require potassium
supplementation.
9. A nurse should withhold digoxin if which apical pulse is noted?
A) 92 bpm
B) 84 bpm
C) 72 bpm
D) 52 bpm
Answer: D) 52 bpm
Rationale: Digoxin should be withheld if the apical pulse is below 60 bpm in adults
due to the risk of bradycardia. The medication decreases heart rate and increases the
force of contraction, so a slow heart rate indicates potential toxicity.
10. Early signs of digoxin toxicity include:
A) Heart rate 72 bpm
B) Anorexia, nausea, and blurred vision
C) Blood pressure 120/80 mmHg
D) Serum digoxin level 1.0 ng/mL
Answer: B) Anorexia, nausea, and blurred vision
PHARMACOLOGY EXAM V1: 250 PRACTICE
QUESTIONS WITH ANSWERS & RATIONALES|
LATEST 2026/2027| PASS GUARANTEE
Cardiovascular & Anticoagulant Medications
1. A patient is receiving a continuous IV heparin infusion. The aPTT is 95
seconds. What action should the nurse take?
A) Increase the heparin infusion rate
B) Decrease the heparin infusion rate
C) Administer vitamin K
D) Continue the infusion as ordered
Answer: B) Decrease the heparin infusion rate
Rationale: The therapeutic aPTT for heparin therapy is typically 1.5-2.5 times the
normal control (approximately 60-100 seconds depending on the lab). An aPTT of 95
seconds is above the therapeutic range, indicating a risk for hemorrhage. The
infusion rate should be decreased. Vitamin K is not used for heparin reversal;
protamine sulfate is the specific antidote.
2. What is the antidote for heparin overdose?
A) Vitamin K
B) Protamine sulfate
C) Naloxone
D) Flumazenil
Answer: B) Protamine sulfate
Rationale: Protamine sulfate binds to and inactivates heparin, reversing its
anticoagulant effects. It is administered IV and takes effect within minutes. Vitamin K
reverses warfarin (Coumadin) effects. Naloxone is the antidote for opioids, and
flumazenil reverses benzodiazepines.
,3. A client prescribed clopidogrel (Plavix) following coronary stent placement
asks about the medication's purpose. Which explanation is correct?
A) "This medication prevents the formation of blood clots in your stent."
B) "This medication dissolves any clots that might form in your stent."
C) "This medication dilates your blood vessels to improve blood flow."
D) "This medication lowers your cholesterol to prevent plaque buildup."
Answer: A) "This medication prevents the formation of blood clots in your
stent."
Rationale: Clopidogrel is an antiplatelet medication that prevents platelets from
sticking together, thereby preventing clot formation in coronary stents. This reduces
the risk of stent thrombosis and subsequent heart attack. It is typically prescribed
with aspirin for dual antiplatelet therapy.
4. A patient scheduled for surgery is taking clopidogrel (Plavix). When should
the nurse instruct the patient to stop this medication before surgery?
A) 1 day before surgery
B) 3 days before surgery
C) 5-7 days before surgery
D) 14 days before surgery
Answer: C) 5-7 days before surgery
Rationale: Clopidogrel should be stopped 5-7 days before surgery to reduce the risk
of excessive bleeding during the procedure. Patients should not stop the medication
without provider guidance.
5. A client is prescribed enoxaparin (Lovenox). Which statement is correct
regarding this medication?
A) Routine aPTT monitoring is required.
B) The medication is given orally.
C) It prevents clot formation by inhibiting factor Xa.
D) It should be massaged into the injection site.
,Answer: C) It prevents clot formation by inhibiting factor Xa.
Rationale: Enoxaparin is a low molecular weight heparin (LMWH) given
subcutaneously (usually in the abdomen). It does not require routine aPTT
monitoring and should not be massaged after injection. It prevents clot formation by
inhibiting factor Xa.
Cardiac & Antihypertensive Medications
6. A patient prescribed lisinopril (an ACE inhibitor) develops a dry, persistent
cough. What is the nurse's best response?
A) "This is a sign of medication allergy requiring immediate discontinuation."
B) "This is a common side effect; report it to your healthcare provider for possible
medication change."
C) "This indicates the medication is not working properly."
D) "Take an over-the-counter cough suppressant to manage this symptom."
Answer: B) "This is a common side effect; report it to your healthcare provider
for possible medication change."
Rationale: A dry, persistent cough is a well-known side effect of ACE inhibitors
(lisinopril, enalapril, captopril) occurring in approximately 10-20% of patients due to
bradykinin accumulation. While not life-threatening, patients should report it to their
provider for evaluation and possible switching to an ARB.
7. A client prescribed lisinopril (Zestril). Which adverse effect requires
immediate intervention?
A) Dry cough
B) Angioedema (swelling of lips/tongue)
C) Dizziness
D) Headache
Answer: B) Angioedema (swelling of lips/tongue)
Rationale: Angioedema is a life-threatening allergic reaction to ACE inhibitors that
requires immediate discontinuation and emergency treatment. While dry cough is a
common side effect, angioedema indicates a severe allergic response.
, 8. A client with heart failure is prescribed furosemide (Lasix). Which electrolyte
imbalance should the nurse monitor most closely?
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypocalcemia
Answer: B) Hypokalemia
Rationale: Furosemide is a loop diuretic that causes potassium wasting in the distal
tubule. Hypokalemia increases the risk of digoxin toxicity and cardiac arrhythmias.
Patients should be monitored for low potassium levels and may require potassium
supplementation.
9. A nurse should withhold digoxin if which apical pulse is noted?
A) 92 bpm
B) 84 bpm
C) 72 bpm
D) 52 bpm
Answer: D) 52 bpm
Rationale: Digoxin should be withheld if the apical pulse is below 60 bpm in adults
due to the risk of bradycardia. The medication decreases heart rate and increases the
force of contraction, so a slow heart rate indicates potential toxicity.
10. Early signs of digoxin toxicity include:
A) Heart rate 72 bpm
B) Anorexia, nausea, and blurred vision
C) Blood pressure 120/80 mmHg
D) Serum digoxin level 1.0 ng/mL
Answer: B) Anorexia, nausea, and blurred vision
