HESI Advanced Pharmacology Exam
Question and correct answers (verified
answers 100%) Q&A
2026/2027 INSTANT DOWNLOAD PDF
1. A client taking warfarin has an INR of 5.8 and reports bleeding gums. Which action should
the nurse anticipate?
A. Administer the next dose as scheduled
B. Hold warfarin and notify the provider
C. Give aspirin immediately
D. Encourage foods high in vitamin K
Correct Answer: B
Rationale: An elevated INR with active bleeding indicates excessive anticoagulation. Warfarin
should be withheld and the provider notified for further management.
2. Which assessment is most important before administering digoxin?
A. Respiratory rate
B. Apical pulse
C. Temperature
D. Blood pressure in both arms
Correct Answer: B
Rationale: Digoxin can cause bradycardia. The nurse should assess the apical pulse for a full
minute before administration.
3. A client taking lisinopril develops swelling of the lips and tongue. What is the priority
action?
,A. Give the next dose with food
B. Document the expected adverse effect
C. Hold the medication and seek emergency treatment
D. Encourage increased fluid intake
Correct Answer: C
Rationale: Facial and tongue swelling can indicate angioedema, a potentially life-threatening
reaction that can compromise the airway.
4. Which laboratory value is especially important for a client receiving heparin therapy?
A. aPTT
B. Hemoglobin A1c
C. Serum calcium
D. ALT
Correct Answer: A
Rationale: Unfractionated heparin therapy is commonly monitored using activated partial
thromboplastin time (aPTT).
5. A client receiving gentamicin should be monitored closely for which adverse effects?
A. Hepatotoxicity and constipation
B. Nephrotoxicity and ototoxicity
C. Hyperglycemia and rash
D. Bradycardia and hypertension
Correct Answer: B
Rationale: Aminoglycosides such as gentamicin can cause kidney injury and damage to the
auditory or vestibular systems.
6. Which medication reverses the effects of opioid overdose?
A. Flumazenil
B. Naloxone
C. Protamine sulfate
D. Vitamin K
,Correct Answer: B
Rationale: Naloxone is an opioid antagonist used to rapidly reverse opioid-induced respiratory
depression.
7. Which medication is used to reverse benzodiazepine effects in selected situations?
A. Naloxone
B. Flumazenil
C. Atropine
D. Acetylcysteine
Correct Answer: B
Rationale: Flumazenil is a benzodiazepine antagonist, although it must be used cautiously
because it can precipitate seizures in some patients.
8. A client taking lithium reports severe diarrhea, coarse tremors, and confusion. What should
the nurse do?
A. Administer the medication with milk
B. Hold lithium and notify the provider
C. Encourage strenuous exercise
D. Give the medication early
Correct Answer: B
Rationale: Severe gastrointestinal symptoms, coarse tremors, and confusion may indicate
lithium toxicity and require prompt evaluation.
9. Which instruction is most important for a client taking lithium?
A. Maintain consistent fluid and sodium intake
B. Avoid all carbohydrates
C. Restrict fluids to 1 L/day
D. Increase caffeine intake
Correct Answer: A
, Rationale: Changes in sodium and fluid balance can significantly alter lithium concentrations
and increase toxicity risk.
10. A client taking phenytoin should receive which teaching?
A. Stop brushing the teeth
B. Maintain good oral hygiene
C. Avoid all protein
D. Double the dose after a missed dose
Correct Answer: B
Rationale: Phenytoin can cause gingival hyperplasia. Regular brushing, flossing, and dental care
help reduce complications.
11. Which adverse effect is associated with vancomycin infusion that occurs too rapidly?
A. Red-man syndrome
B. Stevens-Johnson syndrome
C. Tardive dyskinesia
D. Serotonin syndrome
Correct Answer: A
Rationale: Rapid IV administration of vancomycin can cause flushing, erythema, hypotension,
and other manifestations known as red-man syndrome.
12. Which finding in a client receiving vancomycin requires close monitoring?
A. Kidney function
B. Visual acuity only
C. Blood glucose only
D. Serum sodium only
Correct Answer: A
Rationale: Vancomycin can cause nephrotoxicity, so renal function should be monitored.
13. A client receiving morphine has a respiratory rate of 8/min. Which action is appropriate?
Question and correct answers (verified
answers 100%) Q&A
2026/2027 INSTANT DOWNLOAD PDF
1. A client taking warfarin has an INR of 5.8 and reports bleeding gums. Which action should
the nurse anticipate?
A. Administer the next dose as scheduled
B. Hold warfarin and notify the provider
C. Give aspirin immediately
D. Encourage foods high in vitamin K
Correct Answer: B
Rationale: An elevated INR with active bleeding indicates excessive anticoagulation. Warfarin
should be withheld and the provider notified for further management.
2. Which assessment is most important before administering digoxin?
A. Respiratory rate
B. Apical pulse
C. Temperature
D. Blood pressure in both arms
Correct Answer: B
Rationale: Digoxin can cause bradycardia. The nurse should assess the apical pulse for a full
minute before administration.
3. A client taking lisinopril develops swelling of the lips and tongue. What is the priority
action?
,A. Give the next dose with food
B. Document the expected adverse effect
C. Hold the medication and seek emergency treatment
D. Encourage increased fluid intake
Correct Answer: C
Rationale: Facial and tongue swelling can indicate angioedema, a potentially life-threatening
reaction that can compromise the airway.
4. Which laboratory value is especially important for a client receiving heparin therapy?
A. aPTT
B. Hemoglobin A1c
C. Serum calcium
D. ALT
Correct Answer: A
Rationale: Unfractionated heparin therapy is commonly monitored using activated partial
thromboplastin time (aPTT).
5. A client receiving gentamicin should be monitored closely for which adverse effects?
A. Hepatotoxicity and constipation
B. Nephrotoxicity and ototoxicity
C. Hyperglycemia and rash
D. Bradycardia and hypertension
Correct Answer: B
Rationale: Aminoglycosides such as gentamicin can cause kidney injury and damage to the
auditory or vestibular systems.
6. Which medication reverses the effects of opioid overdose?
A. Flumazenil
B. Naloxone
C. Protamine sulfate
D. Vitamin K
,Correct Answer: B
Rationale: Naloxone is an opioid antagonist used to rapidly reverse opioid-induced respiratory
depression.
7. Which medication is used to reverse benzodiazepine effects in selected situations?
A. Naloxone
B. Flumazenil
C. Atropine
D. Acetylcysteine
Correct Answer: B
Rationale: Flumazenil is a benzodiazepine antagonist, although it must be used cautiously
because it can precipitate seizures in some patients.
8. A client taking lithium reports severe diarrhea, coarse tremors, and confusion. What should
the nurse do?
A. Administer the medication with milk
B. Hold lithium and notify the provider
C. Encourage strenuous exercise
D. Give the medication early
Correct Answer: B
Rationale: Severe gastrointestinal symptoms, coarse tremors, and confusion may indicate
lithium toxicity and require prompt evaluation.
9. Which instruction is most important for a client taking lithium?
A. Maintain consistent fluid and sodium intake
B. Avoid all carbohydrates
C. Restrict fluids to 1 L/day
D. Increase caffeine intake
Correct Answer: A
, Rationale: Changes in sodium and fluid balance can significantly alter lithium concentrations
and increase toxicity risk.
10. A client taking phenytoin should receive which teaching?
A. Stop brushing the teeth
B. Maintain good oral hygiene
C. Avoid all protein
D. Double the dose after a missed dose
Correct Answer: B
Rationale: Phenytoin can cause gingival hyperplasia. Regular brushing, flossing, and dental care
help reduce complications.
11. Which adverse effect is associated with vancomycin infusion that occurs too rapidly?
A. Red-man syndrome
B. Stevens-Johnson syndrome
C. Tardive dyskinesia
D. Serotonin syndrome
Correct Answer: A
Rationale: Rapid IV administration of vancomycin can cause flushing, erythema, hypotension,
and other manifestations known as red-man syndrome.
12. Which finding in a client receiving vancomycin requires close monitoring?
A. Kidney function
B. Visual acuity only
C. Blood glucose only
D. Serum sodium only
Correct Answer: A
Rationale: Vancomycin can cause nephrotoxicity, so renal function should be monitored.
13. A client receiving morphine has a respiratory rate of 8/min. Which action is appropriate?
