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BSN HESI 315 Pharmacology Exam V2 EXAM QUESTIONS AND
CORRECT VERIFIED SOLUTIONS LATEST UPDATE THIS YEAR –
JUST RELEASED
BSN HESI 315 Pharmacology Exam V2
10-Line Exam Coverage in Points Form
1. Cardiovascular Medications – Digoxin toxicity (hypokalemia potentiates, nausea/visual
disturbances/arrhythmias, hold for apical pulse <60 bpm, therapeutic level 0.8-2.0
ng/mL) , heparin (aPTT monitoring, 1.5-2.5x control therapeutic, protamine sulfate
antidote) , warfarin (INR target 2-3, vitamin K antidote) , nitroglycerin sublingual (three
tablets q5min, maximum three doses) , amlodipine (blood pressure monitoring for
effectiveness) , metoprolol (hold if pulse <60, asthma/COPD caution) , atorvastatin
(muscle pain/tenderness reporting, CK monitoring) .
2. Anticoagulant & Antiplatelet Therapy – Clopidogrel (hold 5-7 days before surgery,
P2Y12 inhibitor) , enoxaparin (subcutaneous injection with air bubble retention, no
aspiration) , protamine sulfate (heparin reversal), vitamin K (warfarin reversal) .
3. Endocrine & Metabolic Medications – Insulin lispro (Humalog) rapid-acting (onset 15
min, peak 1 hour, administer with meals) , metformin (GI side effects minimized with
food, contraindicated in renal impairment due to lactic acidosis risk) , levothyroxine
(morning administration on empty stomach, signs of hyperthyroidism indicate
overdose) , spironolactone (potassium-sparing diuretic, avoid potassium-rich foods) .
4. Anti-infective Agents – Tetracycline (avoid dairy products, use sun protection, oral
candidiasis risk) , gentamicin (monitor peak/trough, nephrotoxicity, ototoxicity) ,
vancomycin (trough monitoring 10-20 mcg/mL, nephrotoxicity, ototoxicity) , TMP-
SMX/Bactrim (synergistic combination to reduce resistance, increase fluids to prevent
crystalluria) , ciprofloxacin (tendonitis/tendon rupture risk - black box warning) .
5. Neurological & Psychiatric Medications – Haloperidol (EPS symptoms like jaw
tightness/stiff neck, treat with diphenhydramine) , metoclopramide (extrapyramidal
symptoms monitoring) , clonazepam (slurred speech side effect, avoid alcohol) ,
rivastigmine (Alzheimer's treatment, insomnia side effect) , phenelzine (MAOI, tyramine-
restricted diet for hypertensive crisis prevention) .
6. Pain Management & Emergency Medications – Naloxone (opioid overdose reversal,
administer if comatose) , fentanyl (respiratory depression assessment) , morphine PCA
pump (two-nurse verification, wasting controlled substances) , acetaminophen toxicity
treatment with acetylcysteine , NSAIDs (GI bleeding risk assessment) .
7. Respiratory & Gastrointestinal Pharmacology – Theophylline (therapeutic range 10-20
mcg/mL, toxicity >22 mcg/mL) , albuterol (short-acting beta-2 agonist) , metronidazole
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(avoid alcohol, disulfiram-like reaction) , cimetidine (take 1 hour after antacids, lethargy
requires evaluation) , misoprostol (check pregnancy status before administration) .
8. Medication Administration Safety – Five Rights of Medication Administration , enteric-
coated tablets (should not be crushed/chewed) , first-pass effect (hepatic metabolism
reduces bioavailability) , half-life determination (guides dosing intervals) , creatinine
clearance for renal dosing , synergy vs antagonism , Z-track IM injection technique .
9. Critical Adverse Effects & Monitoring – Hypokalemia (increases digoxin toxicity and
neuromuscular blockade risk) , ACE inhibitors (persistent dry cough, hyperkalemia) ,
methemoglobinemia (dizziness/palpitations with normal O₂ sat, treat with methylene
blue) , spironolactone (limit potassium-rich foods) , amiodarone (pulmonary toxicity
monitoring, hypotension/bradycardia) .
10. Patient Education & Nursing Interventions – Superinfection signs (oral soreness
indicates fungal infection) , antidiuretic hormone for diabetes insipidus (monitor serum
osmolality) , tamsulosin (alpha-blocker, sit/stand slowly to prevent orthostatic
hypotension) , bulk-forming laxatives (take with additional glass of water) , ribavirin
(monitor hemoglobin for anemia) , filgrastim (monitor white blood cell count for
effectiveness) .
250 MCQ Questions with Rationales
Question 1
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
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Rationale: A theophylline level of 22 mcg/mL exceeds the therapeutic range of 10-20 mcg/mL
and indicates 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 would be unsafe and could cause patient harm.
Question 2
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
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 and can lead to dangerous complications during
procedures requiring paralysis .
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Question 3
The nurse is preparing a child for transport to the operating room for an emergency
appendectomy. The anesthesiologist prescribes atropine sulfate 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
Rationale: Atropine is an anticholinergic drug that is administered preoperatively to decrease
oral and respiratory secretions, reducing the risk of aspiration during anesthesia. While it may
have other effects, reducing secretions is the primary purpose in this scenario to maintain a
clear airway during surgery .
Question 4
When caring for a client on digoxin (Lanoxin) therapy, the nurse knows to be alert for digoxin
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
BSN HESI 315 Pharmacology Exam V2 EXAM QUESTIONS AND
CORRECT VERIFIED SOLUTIONS LATEST UPDATE THIS YEAR –
JUST RELEASED
BSN HESI 315 Pharmacology Exam V2
10-Line Exam Coverage in Points Form
1. Cardiovascular Medications – Digoxin toxicity (hypokalemia potentiates, nausea/visual
disturbances/arrhythmias, hold for apical pulse <60 bpm, therapeutic level 0.8-2.0
ng/mL) , heparin (aPTT monitoring, 1.5-2.5x control therapeutic, protamine sulfate
antidote) , warfarin (INR target 2-3, vitamin K antidote) , nitroglycerin sublingual (three
tablets q5min, maximum three doses) , amlodipine (blood pressure monitoring for
effectiveness) , metoprolol (hold if pulse <60, asthma/COPD caution) , atorvastatin
(muscle pain/tenderness reporting, CK monitoring) .
2. Anticoagulant & Antiplatelet Therapy – Clopidogrel (hold 5-7 days before surgery,
P2Y12 inhibitor) , enoxaparin (subcutaneous injection with air bubble retention, no
aspiration) , protamine sulfate (heparin reversal), vitamin K (warfarin reversal) .
3. Endocrine & Metabolic Medications – Insulin lispro (Humalog) rapid-acting (onset 15
min, peak 1 hour, administer with meals) , metformin (GI side effects minimized with
food, contraindicated in renal impairment due to lactic acidosis risk) , levothyroxine
(morning administration on empty stomach, signs of hyperthyroidism indicate
overdose) , spironolactone (potassium-sparing diuretic, avoid potassium-rich foods) .
4. Anti-infective Agents – Tetracycline (avoid dairy products, use sun protection, oral
candidiasis risk) , gentamicin (monitor peak/trough, nephrotoxicity, ototoxicity) ,
vancomycin (trough monitoring 10-20 mcg/mL, nephrotoxicity, ototoxicity) , TMP-
SMX/Bactrim (synergistic combination to reduce resistance, increase fluids to prevent
crystalluria) , ciprofloxacin (tendonitis/tendon rupture risk - black box warning) .
5. Neurological & Psychiatric Medications – Haloperidol (EPS symptoms like jaw
tightness/stiff neck, treat with diphenhydramine) , metoclopramide (extrapyramidal
symptoms monitoring) , clonazepam (slurred speech side effect, avoid alcohol) ,
rivastigmine (Alzheimer's treatment, insomnia side effect) , phenelzine (MAOI, tyramine-
restricted diet for hypertensive crisis prevention) .
6. Pain Management & Emergency Medications – Naloxone (opioid overdose reversal,
administer if comatose) , fentanyl (respiratory depression assessment) , morphine PCA
pump (two-nurse verification, wasting controlled substances) , acetaminophen toxicity
treatment with acetylcysteine , NSAIDs (GI bleeding risk assessment) .
7. Respiratory & Gastrointestinal Pharmacology – Theophylline (therapeutic range 10-20
mcg/mL, toxicity >22 mcg/mL) , albuterol (short-acting beta-2 agonist) , metronidazole
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(avoid alcohol, disulfiram-like reaction) , cimetidine (take 1 hour after antacids, lethargy
requires evaluation) , misoprostol (check pregnancy status before administration) .
8. Medication Administration Safety – Five Rights of Medication Administration , enteric-
coated tablets (should not be crushed/chewed) , first-pass effect (hepatic metabolism
reduces bioavailability) , half-life determination (guides dosing intervals) , creatinine
clearance for renal dosing , synergy vs antagonism , Z-track IM injection technique .
9. Critical Adverse Effects & Monitoring – Hypokalemia (increases digoxin toxicity and
neuromuscular blockade risk) , ACE inhibitors (persistent dry cough, hyperkalemia) ,
methemoglobinemia (dizziness/palpitations with normal O₂ sat, treat with methylene
blue) , spironolactone (limit potassium-rich foods) , amiodarone (pulmonary toxicity
monitoring, hypotension/bradycardia) .
10. Patient Education & Nursing Interventions – Superinfection signs (oral soreness
indicates fungal infection) , antidiuretic hormone for diabetes insipidus (monitor serum
osmolality) , tamsulosin (alpha-blocker, sit/stand slowly to prevent orthostatic
hypotension) , bulk-forming laxatives (take with additional glass of water) , ribavirin
(monitor hemoglobin for anemia) , filgrastim (monitor white blood cell count for
effectiveness) .
250 MCQ Questions with Rationales
Question 1
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
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Rationale: A theophylline level of 22 mcg/mL exceeds the therapeutic range of 10-20 mcg/mL
and indicates 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 would be unsafe and could cause patient harm.
Question 2
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
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 and can lead to dangerous complications during
procedures requiring paralysis .
, Page 4 of 138
Question 3
The nurse is preparing a child for transport to the operating room for an emergency
appendectomy. The anesthesiologist prescribes atropine sulfate 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
Rationale: Atropine is an anticholinergic drug that is administered preoperatively to decrease
oral and respiratory secretions, reducing the risk of aspiration during anesthesia. While it may
have other effects, reducing secretions is the primary purpose in this scenario to maintain a
clear airway during surgery .
Question 4
When caring for a client on digoxin (Lanoxin) therapy, the nurse knows to be alert for digoxin
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
