HESI RN PHARMACOLOGY
V3 EXAM (3 Set Exams)
(NGN style Qs & Case studies)
Actual Qs & Ans to Pass the Exam
This hesi test contains:
passing score Guarantee
Each Exam has 55 Ques and Ans
Format Set of Multiple-choice
questions with incorporating Next Generation
NCLEX (NGN) and Case studies questions
Expert-Verified Explanations & Solutions
,Contents
HESI RN PHARMACOLOGY V3 EXAM ...............................2
SET 1..................................................................................2
HESI RN PHARMACOLOGY V3 EXAM .............................42
SET 2................................................................................42
HESI RN PHARMACOLOGY V3 EXAM .............................78
SET 3................................................................................78
HESI RN PHARMACOLOGY V3 EXAM
SET 1
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1) CASE STUDY (NGN-Style Ques on)
────────────────────────────────────────────────────────
Q1. A 54-year-old client with hypertension (HTN) and type 2 diabetes mellitus
(T2DM) is preparing to take the first dose of captopril. His daily medica ons
include spironolactone 25 mg/day, me3ormin 500 mg twice a day, and insulin
glargine 25 units daily. The nurse outlines several instruc ons:
,• Instruc on 1: Increase the insulin glargine dose by 3 units on the morning of the
first dose.
• Instruc on 2: Limit fluids for several days before the first dose.
• Instruc on 3: Lie down if blood pressure drops quickly a=er the first dose.
• Instruc on 4: Monitor blood pressure for several hours a=er the first dose.
• Instruc on 5: Hold spironolactone for 3 days prior to the first dose.
Ques on: For each nursing instruc on below, indicate if it is Indicated
(safe/appropriate) or Contraindicated (unsafe/inappropriate) for a client star ng
captopril.
A. 1 and 2 are Indicated; 3, 4, 5 are Contraindicated
B. 1, 2, 5 are Contraindicated; 3, 4 are Indicated
C. 1, 4 are Indicated; 2, 3, 5 are Contraindicated
D. 3, 5 are Indicated; 1, 2, 4 are Contraindicated
Answer: B (Instruc ons #1, #2, #5 = Contraindicated; Instruc ons #3, #4 =
Indicated)
Expert-Verified Explana/on:
• Instruc on 1 (increasing insulin without proven need) is contraindicated.
• Instruc on 2 (limi ng fluids pre–first-dose ACE inhibitor) is contraindicated: risk
of dehydra on and severe hypotension.
,• Instruc on 3 (lie down if BP drops) is indicated for safety a=er first-dose
hypotension.
• Instruc on 4 (monitor BP for several hours) is indicated to assess first-dose
hypotension.
• Instruc on 5 (hold spironolactone for 3 days) is not rou nely required unless
hyperkalemia is an ac ve concern.
────────────────────────────────────────────────────────
2)
────────────────────────────────────────────────────────
Q2. A client with major depression is receiving a new prescrip on for duloxe ne.
Which informa on is MOST important for the nurse to obtain?
A. Family history of mental illness
B. Weight change in the last month
C. Liver func on laboratory results
D. Recent use of other an depressants
Answer: C. Liver func on laboratory results
Expert-Verified Explana/on:
Duloxe ne (an SNRI) can be hepatotoxic—checking liver enzymes (ALT, AST) is
crucial before therapy. Although a history of mental illness, weight changes, and
concurrent an depressants maMer, ensuring normal or monitored hepa c
func on is highest priority.
,────────────────────────────────────────────────────────
3)
────────────────────────────────────────────────────────
Q3. Which nursing ac on has the HIGHEST priority when administering a dose of
codeine with acetaminophen to a client?
A. Advise the client that the medica on should start working in about 30 minutes
B. Instruct the client to request assistance when ambula ng to the bathroom
C. Tell the client to no fy the nurse if the pain is not relieved
D. Administer a stool so=ener or laxa ve at the same me
Answer: B. Instruct the client to request assistance when ambula ng
Expert-Verified Explana/on:
Codeine can cause seda on and orthosta c hypotension. The top priority is
preven ng falls and injury by having the client call for help when geNng up.
────────────────────────────────────────────────────────
4) CASE STUDY (NGN-Style) - “Select All That Apply”
────────────────────────────────────────────────────────
Q4. A 54-year-old client with HTN and T2DM has labs sugges ve of possible
fluid/electrolyte changes. Which ques ons should the nurse ask? Select All That
Apply:
,A. “Have you no ced the need to urinate less o=en?”
B. “Are you taking any supplements?”
C. “Do you use any salt subs tutes?”
D. “Have you experienced urgency to urinate?”
E. “Have you experienced itching or hives?”
F. “Have you no ced that your skin is dry?”
Correct Answers: A, B, C, D
Expert-Verified Explana/on:
• Reduced urina on could mean fluid reten on/kidney changes.
• Supplements may add unexpected potassium or sodium.
• Salt subs tutes o=en contain potassium—important if on spironolactone.
• Urgency can indicate changes in fluid balance or glycemic control.
────────────────────────────────────────────────────────
5)
────────────────────────────────────────────────────────
Q5. A=er receiving five doses of filgras m, a client’s WBC count rises from
2,500/mm³ to 5,000/mm³. Which ac on should the nurse implement?
A. Inform the client that the medica on has been effec ve
B. Assess the client’s vital signs
C. Implement neutropenic precau ons
D. Review culture and sensi vity reports
,Answer: A. Inform the client the medica on has been effec ve
Expert-Verified Explana/on:
Filgras m helps s mulate neutrophil produc on. A WBC increase from low to
within normal range demonstrates therapeu c success.
────────────────────────────────────────────────────────
6)
────────────────────────────────────────────────────────
Q6. A client receives a new prescrip on for montelukast (Singulair). Which
teaching should the nurse provide?
A. The medica on contracts bronchial smooth muscle
B. Montelukast helps increase mucus in the lungs
C. Montelukast helps repair base-lung ssue
D. It prophylac cally limits the inflammatory response to allergens
Answer: D. It prophylac cally limits the inflammatory response to allergens
Expert-Verified Explana/on:
Montelukast is a leukotriene receptor antagonist used in asthma/allergic
condi ons to reduce inflamma on. It is not a bronchodilator and does not rebuild
damaged ssue.
,────────────────────────────────────────────────────────
7)
────────────────────────────────────────────────────────
Q7. A client with a renal transplant three months ago shows signs of gra=
rejec on. The client admits to taking St. John’s Wort on a friend’s advice. Which
finding is MOST significant?
A. Adding the herb decreases need for cor costeroids
B. St. John’s Wort can decrease plasma concentra ons of cyclosporine
C. The herb can reduce the client’s sodium intake
D. The client likely took it for depression
Answer: B. St. John’s Wort can decrease plasma concentra ons of cyclosporine
Expert-Verified Explana/on:
St. John’s Wort induces hepa c enzymes (e.g., CYP3A4), accelera ng cyclosporine
metabolism and risking subtherapeu c levels → poten al organ rejec on.
────────────────────────────────────────────────────────
8)
────────────────────────────────────────────────────────
Q8. A client is to receive dalteparin 2,500 units subcut, 2 hours pre-procedure. The
syringe is labeled “5,000 units in 0.2 mL.” How many mL to administer?
A. 0.05 mL
,B. 0.1 mL
C. 0.2 mL
D. 0.25 mL
Answer: B. 0.1 mL
Expert-Verified Explana/on:
You need half the total units in the syringe. 5,000 → 2,500 is half, so 0.2 mL → 0.1
mL.
────────────────────────────────────────────────────────
9)
────────────────────────────────────────────────────────
Q9. A client with benign prosta c hyperplasia (BPH) is prescribed tamsulosin.
Which adverse effect should be monitored?
A. Urine output
B. Daily weights
C. Bladder scan results
D. Blood pressure
Answer: D. Blood pressure
Expert-Verified Explana/on:
, Tamsulosin is an α1-blocker that can lower BP, causing orthosta c hypotension.
Monitoring BP is essen al.
────────────────────────────────────────────────────────
10)
────────────────────────────────────────────────────────
Q10. A client with heart failure and hyperaldosteronism is prescribed
spironolactone. Which instruc on is MOST important?
A. Monitor for excessive bruising
B. Protect your skin from sunlight
C. Limit high-potassium foods
D. Replace salt with salt subs tute
Answer: C. Limit high-potassium foods
Expert-Verified Explana/on:
Spironolactone is potassium-sparing, raising hyperkalemia risk. Pa ents must
avoid excessive dietary potassium or potassium-containing salt subs tutes.
────────────────────────────────────────────────────────
11)
────────────────────────────────────────────────────────
Q11. A client receiving IV vancomycin requires a peak and trough level. When are
these drawn?
V3 EXAM (3 Set Exams)
(NGN style Qs & Case studies)
Actual Qs & Ans to Pass the Exam
This hesi test contains:
passing score Guarantee
Each Exam has 55 Ques and Ans
Format Set of Multiple-choice
questions with incorporating Next Generation
NCLEX (NGN) and Case studies questions
Expert-Verified Explanations & Solutions
,Contents
HESI RN PHARMACOLOGY V3 EXAM ...............................2
SET 1..................................................................................2
HESI RN PHARMACOLOGY V3 EXAM .............................42
SET 2................................................................................42
HESI RN PHARMACOLOGY V3 EXAM .............................78
SET 3................................................................................78
HESI RN PHARMACOLOGY V3 EXAM
SET 1
──────────────────────────────────────────────────────
1) CASE STUDY (NGN-Style Ques on)
────────────────────────────────────────────────────────
Q1. A 54-year-old client with hypertension (HTN) and type 2 diabetes mellitus
(T2DM) is preparing to take the first dose of captopril. His daily medica ons
include spironolactone 25 mg/day, me3ormin 500 mg twice a day, and insulin
glargine 25 units daily. The nurse outlines several instruc ons:
,• Instruc on 1: Increase the insulin glargine dose by 3 units on the morning of the
first dose.
• Instruc on 2: Limit fluids for several days before the first dose.
• Instruc on 3: Lie down if blood pressure drops quickly a=er the first dose.
• Instruc on 4: Monitor blood pressure for several hours a=er the first dose.
• Instruc on 5: Hold spironolactone for 3 days prior to the first dose.
Ques on: For each nursing instruc on below, indicate if it is Indicated
(safe/appropriate) or Contraindicated (unsafe/inappropriate) for a client star ng
captopril.
A. 1 and 2 are Indicated; 3, 4, 5 are Contraindicated
B. 1, 2, 5 are Contraindicated; 3, 4 are Indicated
C. 1, 4 are Indicated; 2, 3, 5 are Contraindicated
D. 3, 5 are Indicated; 1, 2, 4 are Contraindicated
Answer: B (Instruc ons #1, #2, #5 = Contraindicated; Instruc ons #3, #4 =
Indicated)
Expert-Verified Explana/on:
• Instruc on 1 (increasing insulin without proven need) is contraindicated.
• Instruc on 2 (limi ng fluids pre–first-dose ACE inhibitor) is contraindicated: risk
of dehydra on and severe hypotension.
,• Instruc on 3 (lie down if BP drops) is indicated for safety a=er first-dose
hypotension.
• Instruc on 4 (monitor BP for several hours) is indicated to assess first-dose
hypotension.
• Instruc on 5 (hold spironolactone for 3 days) is not rou nely required unless
hyperkalemia is an ac ve concern.
────────────────────────────────────────────────────────
2)
────────────────────────────────────────────────────────
Q2. A client with major depression is receiving a new prescrip on for duloxe ne.
Which informa on is MOST important for the nurse to obtain?
A. Family history of mental illness
B. Weight change in the last month
C. Liver func on laboratory results
D. Recent use of other an depressants
Answer: C. Liver func on laboratory results
Expert-Verified Explana/on:
Duloxe ne (an SNRI) can be hepatotoxic—checking liver enzymes (ALT, AST) is
crucial before therapy. Although a history of mental illness, weight changes, and
concurrent an depressants maMer, ensuring normal or monitored hepa c
func on is highest priority.
,────────────────────────────────────────────────────────
3)
────────────────────────────────────────────────────────
Q3. Which nursing ac on has the HIGHEST priority when administering a dose of
codeine with acetaminophen to a client?
A. Advise the client that the medica on should start working in about 30 minutes
B. Instruct the client to request assistance when ambula ng to the bathroom
C. Tell the client to no fy the nurse if the pain is not relieved
D. Administer a stool so=ener or laxa ve at the same me
Answer: B. Instruct the client to request assistance when ambula ng
Expert-Verified Explana/on:
Codeine can cause seda on and orthosta c hypotension. The top priority is
preven ng falls and injury by having the client call for help when geNng up.
────────────────────────────────────────────────────────
4) CASE STUDY (NGN-Style) - “Select All That Apply”
────────────────────────────────────────────────────────
Q4. A 54-year-old client with HTN and T2DM has labs sugges ve of possible
fluid/electrolyte changes. Which ques ons should the nurse ask? Select All That
Apply:
,A. “Have you no ced the need to urinate less o=en?”
B. “Are you taking any supplements?”
C. “Do you use any salt subs tutes?”
D. “Have you experienced urgency to urinate?”
E. “Have you experienced itching or hives?”
F. “Have you no ced that your skin is dry?”
Correct Answers: A, B, C, D
Expert-Verified Explana/on:
• Reduced urina on could mean fluid reten on/kidney changes.
• Supplements may add unexpected potassium or sodium.
• Salt subs tutes o=en contain potassium—important if on spironolactone.
• Urgency can indicate changes in fluid balance or glycemic control.
────────────────────────────────────────────────────────
5)
────────────────────────────────────────────────────────
Q5. A=er receiving five doses of filgras m, a client’s WBC count rises from
2,500/mm³ to 5,000/mm³. Which ac on should the nurse implement?
A. Inform the client that the medica on has been effec ve
B. Assess the client’s vital signs
C. Implement neutropenic precau ons
D. Review culture and sensi vity reports
,Answer: A. Inform the client the medica on has been effec ve
Expert-Verified Explana/on:
Filgras m helps s mulate neutrophil produc on. A WBC increase from low to
within normal range demonstrates therapeu c success.
────────────────────────────────────────────────────────
6)
────────────────────────────────────────────────────────
Q6. A client receives a new prescrip on for montelukast (Singulair). Which
teaching should the nurse provide?
A. The medica on contracts bronchial smooth muscle
B. Montelukast helps increase mucus in the lungs
C. Montelukast helps repair base-lung ssue
D. It prophylac cally limits the inflammatory response to allergens
Answer: D. It prophylac cally limits the inflammatory response to allergens
Expert-Verified Explana/on:
Montelukast is a leukotriene receptor antagonist used in asthma/allergic
condi ons to reduce inflamma on. It is not a bronchodilator and does not rebuild
damaged ssue.
,────────────────────────────────────────────────────────
7)
────────────────────────────────────────────────────────
Q7. A client with a renal transplant three months ago shows signs of gra=
rejec on. The client admits to taking St. John’s Wort on a friend’s advice. Which
finding is MOST significant?
A. Adding the herb decreases need for cor costeroids
B. St. John’s Wort can decrease plasma concentra ons of cyclosporine
C. The herb can reduce the client’s sodium intake
D. The client likely took it for depression
Answer: B. St. John’s Wort can decrease plasma concentra ons of cyclosporine
Expert-Verified Explana/on:
St. John’s Wort induces hepa c enzymes (e.g., CYP3A4), accelera ng cyclosporine
metabolism and risking subtherapeu c levels → poten al organ rejec on.
────────────────────────────────────────────────────────
8)
────────────────────────────────────────────────────────
Q8. A client is to receive dalteparin 2,500 units subcut, 2 hours pre-procedure. The
syringe is labeled “5,000 units in 0.2 mL.” How many mL to administer?
A. 0.05 mL
,B. 0.1 mL
C. 0.2 mL
D. 0.25 mL
Answer: B. 0.1 mL
Expert-Verified Explana/on:
You need half the total units in the syringe. 5,000 → 2,500 is half, so 0.2 mL → 0.1
mL.
────────────────────────────────────────────────────────
9)
────────────────────────────────────────────────────────
Q9. A client with benign prosta c hyperplasia (BPH) is prescribed tamsulosin.
Which adverse effect should be monitored?
A. Urine output
B. Daily weights
C. Bladder scan results
D. Blood pressure
Answer: D. Blood pressure
Expert-Verified Explana/on:
, Tamsulosin is an α1-blocker that can lower BP, causing orthosta c hypotension.
Monitoring BP is essen al.
────────────────────────────────────────────────────────
10)
────────────────────────────────────────────────────────
Q10. A client with heart failure and hyperaldosteronism is prescribed
spironolactone. Which instruc on is MOST important?
A. Monitor for excessive bruising
B. Protect your skin from sunlight
C. Limit high-potassium foods
D. Replace salt with salt subs tute
Answer: C. Limit high-potassium foods
Expert-Verified Explana/on:
Spironolactone is potassium-sparing, raising hyperkalemia risk. Pa ents must
avoid excessive dietary potassium or potassium-containing salt subs tutes.
────────────────────────────────────────────────────────
11)
────────────────────────────────────────────────────────
Q11. A client receiving IV vancomycin requires a peak and trough level. When are
these drawn?
