HESI Pharmacology V1 2026 Exam S | 200 High-
Yield Questions with Verified Answers & Detailed
Rationales | Scored 1162 Conversion Score | Complete
Study Guide for Nursing Pharmacology Success
SECTION 1: PHARMACOLOGIC PRINCIPLES AND MEDICATION ADMINISTRATION (Questions 1–
30)
1. A nurse is preparing to administer a medication that has a narrow therapeutic index. Which
action is most important?
A. Administer with food
B. Monitor serum drug levels
C. Administer at bedtime
D. Crush the medication
Correct Answer: B
Rationale: Medications with a narrow therapeutic index (e.g., digoxin, lithium, phenytoin,
warfarin) require close monitoring of serum drug levels because the difference between
therapeutic and toxic doses is small.
2. The nurse is reviewing the "rights" of medication administration. Which of the following is
NOT one of the traditional five rights?
A. Right patient
B. Right diagnosis
C. Right dose
D. Right route
Correct Answer: B
Rationale: The five rights are: right patient, right medication, right dose, right route, and right
time. Right diagnosis is not one of the traditional five rights, though it is an important
consideration.
,3. A nurse is preparing to administer an enteric-coated tablet. Which action is correct?
A. Crush the tablet
B. Administer whole
C. Dissolve in water
D. Split in half
Correct Answer: B
Rationale: Enteric-coated tablets should be administered whole. Crushing or dissolving destroys
the protective coating, which can cause gastric irritation and alter absorption.
4. A nurse is calculating a medication dose. The order is for 0.5 g. The medication is available
as 250 mg tablets. How many tablets should the nurse administer?
A. 1 tablet
B. 2 tablets
C. 3 tablets
D. 4 tablets
Correct Answer: B
Rationale: Convert 0.5 g to mg: 0.5 × 1,000 = 500 mg. 500 mg ÷ 250 mg/tablet = 2 tablets.
5. A nurse is preparing to administer a medication via the intramuscular route. Which needle
size is appropriate for an adult?
A. 18-gauge, 1-inch
B. 21-gauge, 1-inch
C. 23-gauge, 1.5-inch
D. 25-gauge, 5/8-inch
Correct Answer: C
Rationale: A 23-gauge, 1.5-inch needle is appropriate for adult IM injections to ensure the
medication reaches muscle tissue.
6. Which of the following is a contraindication to administering a medication orally?
,A. The patient is NPO
B. The patient has a headache
C. The patient is ambulatory
D. The patient has a fever
Correct Answer: A
Rationale: Oral medications are contraindicated when the patient is NPO (nothing by mouth),
has difficulty swallowing, is unconscious, or has severe nausea/vomiting.
7. A nurse is preparing to administer a subcutaneous injection of heparin. Which action is
correct?
A. Aspirate before injecting
B. Massage the site after injection
C. Inject at a 90-degree angle
D. Use a 1.5-inch needle
Correct Answer: C
Rationale: Heparin is administered subcutaneously at a 90-degree angle. Aspiration and
massage are not recommended as they can cause bleeding and hematoma.
8. A nurse is preparing to administer a medication via a nasogastric tube. Which action should
the nurse take FIRST?
A. Crush all medications together
B. Verify tube placement
C. Administer medications rapidly
D. Use a syringe with a needle
Correct Answer: B
Rationale: Verifying tube placement is the priority before administering any medication through
an NG tube. This prevents administration into the lungs.
9. A nurse is preparing to administer a medication that is a known photosensitizer. Which
instruction should the nurse include?
, A. "Avoid sun exposure and use sunscreen."
B. "Increase sun exposure for better effect."
C. "Take the medication at bedtime only."
D. "No precautions are needed."
Correct Answer: A
Rationale: Photosensitizing medications increase sensitivity to sunlight. Patients should avoid
sun exposure, use sunscreen, and wear protective clothing.
10. A nurse is preparing to administer a medication with a high first-pass effect. Which route
would avoid this effect?
A. Oral
B. Sublingual
C. Rectal
D. Intravenous
Correct Answer: D
Rationale: Intravenous administration bypasses first-pass metabolism entirely, delivering the
drug directly into systemic circulation.
11. A nurse is preparing to administer a medication that is a controlled substance. Which
action is required?
A. Count at the beginning and end of shift
B. Document in the patient's record only
C. Administer without a witness
D. Store at the bedside
Correct Answer: A
Rationale: Controlled substances must be counted at the beginning and end of each shift.
Documentation is required in both the patient's record and the controlled substance log.
12. A nurse is preparing to administer a medication via a metered-dose inhaler. Which
instruction should the nurse include?
Yield Questions with Verified Answers & Detailed
Rationales | Scored 1162 Conversion Score | Complete
Study Guide for Nursing Pharmacology Success
SECTION 1: PHARMACOLOGIC PRINCIPLES AND MEDICATION ADMINISTRATION (Questions 1–
30)
1. A nurse is preparing to administer a medication that has a narrow therapeutic index. Which
action is most important?
A. Administer with food
B. Monitor serum drug levels
C. Administer at bedtime
D. Crush the medication
Correct Answer: B
Rationale: Medications with a narrow therapeutic index (e.g., digoxin, lithium, phenytoin,
warfarin) require close monitoring of serum drug levels because the difference between
therapeutic and toxic doses is small.
2. The nurse is reviewing the "rights" of medication administration. Which of the following is
NOT one of the traditional five rights?
A. Right patient
B. Right diagnosis
C. Right dose
D. Right route
Correct Answer: B
Rationale: The five rights are: right patient, right medication, right dose, right route, and right
time. Right diagnosis is not one of the traditional five rights, though it is an important
consideration.
,3. A nurse is preparing to administer an enteric-coated tablet. Which action is correct?
A. Crush the tablet
B. Administer whole
C. Dissolve in water
D. Split in half
Correct Answer: B
Rationale: Enteric-coated tablets should be administered whole. Crushing or dissolving destroys
the protective coating, which can cause gastric irritation and alter absorption.
4. A nurse is calculating a medication dose. The order is for 0.5 g. The medication is available
as 250 mg tablets. How many tablets should the nurse administer?
A. 1 tablet
B. 2 tablets
C. 3 tablets
D. 4 tablets
Correct Answer: B
Rationale: Convert 0.5 g to mg: 0.5 × 1,000 = 500 mg. 500 mg ÷ 250 mg/tablet = 2 tablets.
5. A nurse is preparing to administer a medication via the intramuscular route. Which needle
size is appropriate for an adult?
A. 18-gauge, 1-inch
B. 21-gauge, 1-inch
C. 23-gauge, 1.5-inch
D. 25-gauge, 5/8-inch
Correct Answer: C
Rationale: A 23-gauge, 1.5-inch needle is appropriate for adult IM injections to ensure the
medication reaches muscle tissue.
6. Which of the following is a contraindication to administering a medication orally?
,A. The patient is NPO
B. The patient has a headache
C. The patient is ambulatory
D. The patient has a fever
Correct Answer: A
Rationale: Oral medications are contraindicated when the patient is NPO (nothing by mouth),
has difficulty swallowing, is unconscious, or has severe nausea/vomiting.
7. A nurse is preparing to administer a subcutaneous injection of heparin. Which action is
correct?
A. Aspirate before injecting
B. Massage the site after injection
C. Inject at a 90-degree angle
D. Use a 1.5-inch needle
Correct Answer: C
Rationale: Heparin is administered subcutaneously at a 90-degree angle. Aspiration and
massage are not recommended as they can cause bleeding and hematoma.
8. A nurse is preparing to administer a medication via a nasogastric tube. Which action should
the nurse take FIRST?
A. Crush all medications together
B. Verify tube placement
C. Administer medications rapidly
D. Use a syringe with a needle
Correct Answer: B
Rationale: Verifying tube placement is the priority before administering any medication through
an NG tube. This prevents administration into the lungs.
9. A nurse is preparing to administer a medication that is a known photosensitizer. Which
instruction should the nurse include?
, A. "Avoid sun exposure and use sunscreen."
B. "Increase sun exposure for better effect."
C. "Take the medication at bedtime only."
D. "No precautions are needed."
Correct Answer: A
Rationale: Photosensitizing medications increase sensitivity to sunlight. Patients should avoid
sun exposure, use sunscreen, and wear protective clothing.
10. A nurse is preparing to administer a medication with a high first-pass effect. Which route
would avoid this effect?
A. Oral
B. Sublingual
C. Rectal
D. Intravenous
Correct Answer: D
Rationale: Intravenous administration bypasses first-pass metabolism entirely, delivering the
drug directly into systemic circulation.
11. A nurse is preparing to administer a medication that is a controlled substance. Which
action is required?
A. Count at the beginning and end of shift
B. Document in the patient's record only
C. Administer without a witness
D. Store at the bedside
Correct Answer: A
Rationale: Controlled substances must be counted at the beginning and end of each shift.
Documentation is required in both the patient's record and the controlled substance log.
12. A nurse is preparing to administer a medication via a metered-dose inhaler. Which
instruction should the nurse include?
