NIGHTINGALE BSN 315
PHARMACOLOGY II NEW HESI
EXAM – QUESTIONS WITH
ANSWERS & RATIONALES
(LATEST 2026/2027) INSTANT
PDF DOWNLOAD
Core Domains
• Pharmacokinetics and Pharmacodynamics
• Medication Safety and High-Alert Medications
• Cardiovascular and Hematologic Pharmacology
• Anti-Infective Therapy and Antimicrobial
Stewardship
• Endocrine and Metabolic Pharmacology
• Neurologic and Psychiatric Pharmacology
• Pain Management and Opioid Therapy
• Gastrointestinal and Respiratory Pharmacology
• Dosage Calculations and Pediatric Dosing
Introduction
The BSN 315 Pharmacology II HESI examination
assesses the registered nursing student’s mastery of
advanced pharmacologic principles essential for safe,
effective medication administration across the health
continuum. This comprehensive assessment evaluates
knowledge of drug classifications, mechanisms of action,
therapeutic effects, adverse reactions, and nursing
interventions. Questions are structured as multiple-
choice and scenario-based items requiring clinical
judgment and decision-making. Emphasis is placed on
, real-world application, prioritization, patient safety,
regulatory compliance, and the nurse’s role as advocate
and educator in pharmacologic therapy
.
Section One: Questions 1–100
1. A nurse is reviewing the pharmacokinetic properties of a
newly prescribed medication. Which statement correctly
defines the term bioavailability?
A. The rate at which a drug is metabolized by the liver
B. The fraction of an administered dose that reaches systemic
circulation in active form
C. The time required for a drug to exert its therapeutic effect
D. The amount of drug eliminated by the kidneys per hour
Correct answer: B
RATIONALE: Bioavailability refers to the proportion of a drug
dose that enters the systemic circulation in an active form after
administration. Intravenous administration provides 100%
bioavailability, whereas oral medications are subject to first-pass
metabolism, reducing bioavailability .
2. A patient is prescribed digoxin for heart failure. Which
assessment finding indicates a therapeutic response to the
medication?
A. Increased heart rate and increased urine output
B. Decreased shortness of breath and decreased peripheral
edema
C. Weight gain and increased appetite
,D. Elevated blood pressure and bounding pulses
Correct answer: B
RATIONALE: Digoxin increases myocardial contractility
through inhibition of the sodium-potassium ATPase pump,
improving cardiac output. Enhanced perfusion reduces pulmonary
congestion (dyspnea) and peripheral edema .
3. A nurse is preparing to administer warfarin to a patient
with atrial fibrillation. Which laboratory value should the
nurse monitor to evaluate therapeutic effectiveness?
A. Platelet count
B. Activated partial thromboplastin time (aPTT)
C. International normalized ratio (INR)
D. Serum potassium level
Correct answer: C
RATIONALE: Warfarin inhibits vitamin K-dependent clotting
factors (II, VII, IX, X). The INR measures the extrinsic pathway
and is the standard monitoring parameter for warfarin therapy .
4. A patient receiving furosemide reports muscle cramps
and generalized weakness. Which electrolyte imbalance
should the nurse suspect?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypercalcemia
Correct answer: B
, RATIONALE: Furosemide is a loop diuretic that promotes
potassium excretion in the distal tubule. Hypokalemia manifests
as muscle cramps, weakness, and fatigue. Serum potassium
levels should be monitored closely .
5. A client taking lisinopril develops swelling of the lips
and tongue with difficulty breathing. What is the nurse’s
priority action?
A. Administer the next dose with food to reduce adverse effects
B. Hold the medication and notify the healthcare provider
immediately
C. Elevate the head of the bed and encourage oral fluids
D. Document the findings and reassess in one hour
Correct answer: B
RATIONALE: Angioedema is a potentially life-threatening
adverse effect of ACE inhibitors. The medication must be withheld
immediately, and emergency treatment should be initiated.
Airway management is the priority .
6. A patient is prescribed metformin for type 2 diabetes
mellitus. Which condition is an absolute contraindication to
metformin therapy?
A. Hypertension
B. Renal impairment
C. Hyperlipidemia
D. Obesity
Correct answer: B
PHARMACOLOGY II NEW HESI
EXAM – QUESTIONS WITH
ANSWERS & RATIONALES
(LATEST 2026/2027) INSTANT
PDF DOWNLOAD
Core Domains
• Pharmacokinetics and Pharmacodynamics
• Medication Safety and High-Alert Medications
• Cardiovascular and Hematologic Pharmacology
• Anti-Infective Therapy and Antimicrobial
Stewardship
• Endocrine and Metabolic Pharmacology
• Neurologic and Psychiatric Pharmacology
• Pain Management and Opioid Therapy
• Gastrointestinal and Respiratory Pharmacology
• Dosage Calculations and Pediatric Dosing
Introduction
The BSN 315 Pharmacology II HESI examination
assesses the registered nursing student’s mastery of
advanced pharmacologic principles essential for safe,
effective medication administration across the health
continuum. This comprehensive assessment evaluates
knowledge of drug classifications, mechanisms of action,
therapeutic effects, adverse reactions, and nursing
interventions. Questions are structured as multiple-
choice and scenario-based items requiring clinical
judgment and decision-making. Emphasis is placed on
, real-world application, prioritization, patient safety,
regulatory compliance, and the nurse’s role as advocate
and educator in pharmacologic therapy
.
Section One: Questions 1–100
1. A nurse is reviewing the pharmacokinetic properties of a
newly prescribed medication. Which statement correctly
defines the term bioavailability?
A. The rate at which a drug is metabolized by the liver
B. The fraction of an administered dose that reaches systemic
circulation in active form
C. The time required for a drug to exert its therapeutic effect
D. The amount of drug eliminated by the kidneys per hour
Correct answer: B
RATIONALE: Bioavailability refers to the proportion of a drug
dose that enters the systemic circulation in an active form after
administration. Intravenous administration provides 100%
bioavailability, whereas oral medications are subject to first-pass
metabolism, reducing bioavailability .
2. A patient is prescribed digoxin for heart failure. Which
assessment finding indicates a therapeutic response to the
medication?
A. Increased heart rate and increased urine output
B. Decreased shortness of breath and decreased peripheral
edema
C. Weight gain and increased appetite
,D. Elevated blood pressure and bounding pulses
Correct answer: B
RATIONALE: Digoxin increases myocardial contractility
through inhibition of the sodium-potassium ATPase pump,
improving cardiac output. Enhanced perfusion reduces pulmonary
congestion (dyspnea) and peripheral edema .
3. A nurse is preparing to administer warfarin to a patient
with atrial fibrillation. Which laboratory value should the
nurse monitor to evaluate therapeutic effectiveness?
A. Platelet count
B. Activated partial thromboplastin time (aPTT)
C. International normalized ratio (INR)
D. Serum potassium level
Correct answer: C
RATIONALE: Warfarin inhibits vitamin K-dependent clotting
factors (II, VII, IX, X). The INR measures the extrinsic pathway
and is the standard monitoring parameter for warfarin therapy .
4. A patient receiving furosemide reports muscle cramps
and generalized weakness. Which electrolyte imbalance
should the nurse suspect?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypercalcemia
Correct answer: B
, RATIONALE: Furosemide is a loop diuretic that promotes
potassium excretion in the distal tubule. Hypokalemia manifests
as muscle cramps, weakness, and fatigue. Serum potassium
levels should be monitored closely .
5. A client taking lisinopril develops swelling of the lips
and tongue with difficulty breathing. What is the nurse’s
priority action?
A. Administer the next dose with food to reduce adverse effects
B. Hold the medication and notify the healthcare provider
immediately
C. Elevate the head of the bed and encourage oral fluids
D. Document the findings and reassess in one hour
Correct answer: B
RATIONALE: Angioedema is a potentially life-threatening
adverse effect of ACE inhibitors. The medication must be withheld
immediately, and emergency treatment should be initiated.
Airway management is the priority .
6. A patient is prescribed metformin for type 2 diabetes
mellitus. Which condition is an absolute contraindication to
metformin therapy?
A. Hypertension
B. Renal impairment
C. Hyperlipidemia
D. Obesity
Correct answer: B
