COMPREHENSIVE PHARMACOLOGY
HESI PRACTICE EXAM 2026/2027
QUESTIONS AND ANSWERS WITH
VERIFIED SOLUTIONS 2026/2027
UPDATE. JUST RELEASED
1. A client is prescribed Digoxin 0.125 mg daily. Which finding should the nurse prioritize as
an early sign of toxicity?
A. Occasional premature ventricular contractions
B. Heart rate of 88 beats per minute
C. Anorexia and nausea
D. Facial flushing and headache
Answer: C
Conceptual Explanation: Gastrointestinal symptoms such as anorexia, nausea, and
vomiting are often the earliest signs of digoxin toxicity, preceding cardiac arrhythmias and
visual changes.
,2. When teaching a client about Lithium carbonate for bipolar disorder, which dietary
instruction is most critical?
A. Maintain a consistent intake of sodium and fluids
B. Strictly limit sodium intake to less than 2 grams per day
C. Avoid foods high in tyramine like aged cheeses
D. Increase intake of green leafy vegetables high in Vitamin K
Answer: A
Conceptual Explanation: Lithium is a salt; low sodium levels can lead to lithium retention
and toxicity, while high sodium can lower lithium levels. Consistency is key.
3. A nurse is preparing to administer Heparin subcutaneously. Which action is appropriate?
A. Aspirate for blood return before injecting
B. Use a 25-gauge needle and inject at a 45 to 90-degree angle
C. Massage the site after injection to speed absorption
D. Administer the injection within 1 inch of the umbilicus
Answer: B
Conceptual Explanation: Subcutaneous heparin should be given with a small gauge
needle at a 45-90 degree angle. Aspiration and massage are avoided to prevent hematoma
formation.
, 4. A client receiving Warfarin has an INR of 4.8 and is experiencing minor mucosal bleeding.
Which medication should the nurse anticipate?
A. Vitamin K (Phytonadione)
B. Protamine sulfate
C. Enoxaparin
D. Calcium gluconate
Answer: A
Conceptual Explanation: Vitamin K is the antidote for warfarin. An INR of 4.8 with
bleeding requires reversal of the anticoagulant effect.
5. A patient with heart failure is taking Furosemide. Which laboratory value requires
immediate follow-up?
A. Serum sodium of 138 mEq/L
B. Serum glucose of 110 mg/dL
C. Serum creatinine of 1.0 mg/dL
D. Serum potassium of 3.0 mEq/L
Answer: D
Conceptual Explanation: Furosemide is a loop diuretic that causes potassium wasting. A
level of 3.0 mEq/L indicates hypokalemia, which can lead to life-threatening arrhythmias.
HESI PRACTICE EXAM 2026/2027
QUESTIONS AND ANSWERS WITH
VERIFIED SOLUTIONS 2026/2027
UPDATE. JUST RELEASED
1. A client is prescribed Digoxin 0.125 mg daily. Which finding should the nurse prioritize as
an early sign of toxicity?
A. Occasional premature ventricular contractions
B. Heart rate of 88 beats per minute
C. Anorexia and nausea
D. Facial flushing and headache
Answer: C
Conceptual Explanation: Gastrointestinal symptoms such as anorexia, nausea, and
vomiting are often the earliest signs of digoxin toxicity, preceding cardiac arrhythmias and
visual changes.
,2. When teaching a client about Lithium carbonate for bipolar disorder, which dietary
instruction is most critical?
A. Maintain a consistent intake of sodium and fluids
B. Strictly limit sodium intake to less than 2 grams per day
C. Avoid foods high in tyramine like aged cheeses
D. Increase intake of green leafy vegetables high in Vitamin K
Answer: A
Conceptual Explanation: Lithium is a salt; low sodium levels can lead to lithium retention
and toxicity, while high sodium can lower lithium levels. Consistency is key.
3. A nurse is preparing to administer Heparin subcutaneously. Which action is appropriate?
A. Aspirate for blood return before injecting
B. Use a 25-gauge needle and inject at a 45 to 90-degree angle
C. Massage the site after injection to speed absorption
D. Administer the injection within 1 inch of the umbilicus
Answer: B
Conceptual Explanation: Subcutaneous heparin should be given with a small gauge
needle at a 45-90 degree angle. Aspiration and massage are avoided to prevent hematoma
formation.
, 4. A client receiving Warfarin has an INR of 4.8 and is experiencing minor mucosal bleeding.
Which medication should the nurse anticipate?
A. Vitamin K (Phytonadione)
B. Protamine sulfate
C. Enoxaparin
D. Calcium gluconate
Answer: A
Conceptual Explanation: Vitamin K is the antidote for warfarin. An INR of 4.8 with
bleeding requires reversal of the anticoagulant effect.
5. A patient with heart failure is taking Furosemide. Which laboratory value requires
immediate follow-up?
A. Serum sodium of 138 mEq/L
B. Serum glucose of 110 mg/dL
C. Serum creatinine of 1.0 mg/dL
D. Serum potassium of 3.0 mEq/L
Answer: D
Conceptual Explanation: Furosemide is a loop diuretic that causes potassium wasting. A
level of 3.0 mEq/L indicates hypokalemia, which can lead to life-threatening arrhythmias.
