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ESI Pharmacology Exit Exam 2025 – Real
H
Drug Scenarios & Expert-Ranked Questions &
Answers in Full with Rationales | 100%
Verified | Graded A+
Student Name:_________________________ Date:_______________
Time Limit:80 minutesTotal Questions:65
Instructions
omplete all 65 questions within the 80-minute time limit. Questions include multiple-choice (MCQ),
C
select-all-that-apply (SATA), and IV flow rate calculation formats, reflecting real-world clinical
pharmacology scenarios. Read each question carefully, select the single best answer for MCQs, all correct
options for SATA, and show work for calculations. Topics cover Cardiac Meds, Pain Management,
Antibiotics & Resistance, and IV Flow Rate Problems. Calculators are permitted for calculations. Good
luck!
Cardiac Medications (Questions 1–20)
Question 1
client with heart failure is prescribed digoxin. What is the mechanism of action of this medication?
A
A. Blocks sodium-potassium ATPase, increasing cardiac contractility
B. Inhibits beta-adrenergic receptors, reducing heart rate
C. Dilates coronary arteries, improving myocardial oxygen supply
D. Inhibits angiotensin-converting enzyme, reducing preload
orrect Answer:A. Blocks sodium-potassium ATPase, increasing cardiac contractility
C
Rationale: Digoxin inhibits sodium-potassium ATPase,increasing intracellular calcium, which enhances
,c ardiac contractility (positive inotropic effect). Beta-blockers (B) reduce heart rate, nitrates (C) dilate
coronary arteries, and ACE inhibitors (D) reduce preload.
Question 2
client receiving lisinopril reports a dry cough. What should the nurse do?
A
A.Consider switching to an ARB
B. Continue the medication and monitor
C. Administer an antihistamine
D. Increase the lisinopril dose
orrect Answer:A. Consider switching to an ARB
C
Rationale: Dry cough is a common adverse effect ofACE inhibitors like lisinopril due to bradykinin
accumulation, often warranting a switch to an angiotensin receptor blocker (ARB). Continuing (B),
antihistamines (C), or increasing the dose (D) is inappropriate.
Question 3 (SATA)
hich adverse effects should the nurse monitor for in a client receiving metoprolol? (Select all that
W
apply.)
A.Bradycardia
B.Hypotension
C. Hyperglycemia
D.Bronchospasm
E.Fatigue
orrect Answers:A, B, D, E
C
Rationale: Metoprolol, a beta-blocker, can causebradycardia (A), hypotension (B), bronchospasm (D) in
asthmatics, and fatigue (E). Hyperglycemia (C) is not a primary adverse effect.
Question 4
client with atrial fibrillation is prescribed amiodarone. What should the nurse monitor?
A
A.Pulmonary toxicity
B. Hypoglycemia
C. Hypertension
D. Renal failure
, orrect Answer:A. Pulmonary toxicity
C
Rationale: Amiodarone can cause pulmonary toxicity(e.g., pneumonitis, fibrosis), a serious adverse
effect. Hypoglycemia (B), hypertension (C), and renal failure (D) are not primary concerns.
Question 5
client is prescribed furosemide for heart failure. What electrolyte imbalance is most likely?
A
A.Hypokalemia
B. Hypernatremia
C. Hypermagnesemia
D. Hypercalcemia
orrect Answer:A. Hypokalemia
C
Rationale: Furosemide, a loop diuretic, increasespotassium excretion, causing hypokalemia.
Hypernatremia (B), hypermagnesemia (C), and hypercalcemia (D) are less likely.
Question 6
client receiving warfarin has an INR of 5.2. What is the nurse’s priority action?
A
A.Hold the dose and notify the provider
B. Administer the next dose as scheduled
C. Administer vitamin K without an order
D. Monitor for 24 hours
orrect Answer:A. Hold the dose and notify the provider
C
Rationale: An INR >4.5 indicates excessive anticoagulation,increasing bleeding risk, requiring dose
withholding and provider notification. Continuing (B), administering vitamin K (C) without an order, or
monitoring (D) is unsafe.
Question 7
client with hypertension is prescribed losartan. What is its mechanism of action?
A
A. Inhibits ACE, reducing angiotensin II
B.Blocks angiotensin II receptors
C. Inhibits calcium channels, reducing vascular tone
D. Blocks beta receptors, reducing cardiac output
orrect Answer:B. Blocks angiotensin II receptors
C
Rationale: Losartan, an ARB, blocks angiotensin IIreceptors, reducing vasoconstriction and preload.
ESI Pharmacology Exit Exam 2025 – Real
H
Drug Scenarios & Expert-Ranked Questions &
Answers in Full with Rationales | 100%
Verified | Graded A+
Student Name:_________________________ Date:_______________
Time Limit:80 minutesTotal Questions:65
Instructions
omplete all 65 questions within the 80-minute time limit. Questions include multiple-choice (MCQ),
C
select-all-that-apply (SATA), and IV flow rate calculation formats, reflecting real-world clinical
pharmacology scenarios. Read each question carefully, select the single best answer for MCQs, all correct
options for SATA, and show work for calculations. Topics cover Cardiac Meds, Pain Management,
Antibiotics & Resistance, and IV Flow Rate Problems. Calculators are permitted for calculations. Good
luck!
Cardiac Medications (Questions 1–20)
Question 1
client with heart failure is prescribed digoxin. What is the mechanism of action of this medication?
A
A. Blocks sodium-potassium ATPase, increasing cardiac contractility
B. Inhibits beta-adrenergic receptors, reducing heart rate
C. Dilates coronary arteries, improving myocardial oxygen supply
D. Inhibits angiotensin-converting enzyme, reducing preload
orrect Answer:A. Blocks sodium-potassium ATPase, increasing cardiac contractility
C
Rationale: Digoxin inhibits sodium-potassium ATPase,increasing intracellular calcium, which enhances
,c ardiac contractility (positive inotropic effect). Beta-blockers (B) reduce heart rate, nitrates (C) dilate
coronary arteries, and ACE inhibitors (D) reduce preload.
Question 2
client receiving lisinopril reports a dry cough. What should the nurse do?
A
A.Consider switching to an ARB
B. Continue the medication and monitor
C. Administer an antihistamine
D. Increase the lisinopril dose
orrect Answer:A. Consider switching to an ARB
C
Rationale: Dry cough is a common adverse effect ofACE inhibitors like lisinopril due to bradykinin
accumulation, often warranting a switch to an angiotensin receptor blocker (ARB). Continuing (B),
antihistamines (C), or increasing the dose (D) is inappropriate.
Question 3 (SATA)
hich adverse effects should the nurse monitor for in a client receiving metoprolol? (Select all that
W
apply.)
A.Bradycardia
B.Hypotension
C. Hyperglycemia
D.Bronchospasm
E.Fatigue
orrect Answers:A, B, D, E
C
Rationale: Metoprolol, a beta-blocker, can causebradycardia (A), hypotension (B), bronchospasm (D) in
asthmatics, and fatigue (E). Hyperglycemia (C) is not a primary adverse effect.
Question 4
client with atrial fibrillation is prescribed amiodarone. What should the nurse monitor?
A
A.Pulmonary toxicity
B. Hypoglycemia
C. Hypertension
D. Renal failure
, orrect Answer:A. Pulmonary toxicity
C
Rationale: Amiodarone can cause pulmonary toxicity(e.g., pneumonitis, fibrosis), a serious adverse
effect. Hypoglycemia (B), hypertension (C), and renal failure (D) are not primary concerns.
Question 5
client is prescribed furosemide for heart failure. What electrolyte imbalance is most likely?
A
A.Hypokalemia
B. Hypernatremia
C. Hypermagnesemia
D. Hypercalcemia
orrect Answer:A. Hypokalemia
C
Rationale: Furosemide, a loop diuretic, increasespotassium excretion, causing hypokalemia.
Hypernatremia (B), hypermagnesemia (C), and hypercalcemia (D) are less likely.
Question 6
client receiving warfarin has an INR of 5.2. What is the nurse’s priority action?
A
A.Hold the dose and notify the provider
B. Administer the next dose as scheduled
C. Administer vitamin K without an order
D. Monitor for 24 hours
orrect Answer:A. Hold the dose and notify the provider
C
Rationale: An INR >4.5 indicates excessive anticoagulation,increasing bleeding risk, requiring dose
withholding and provider notification. Continuing (B), administering vitamin K (C) without an order, or
monitoring (D) is unsafe.
Question 7
client with hypertension is prescribed losartan. What is its mechanism of action?
A
A. Inhibits ACE, reducing angiotensin II
B.Blocks angiotensin II receptors
C. Inhibits calcium channels, reducing vascular tone
D. Blocks beta receptors, reducing cardiac output
orrect Answer:B. Blocks angiotensin II receptors
C
Rationale: Losartan, an ARB, blocks angiotensin IIreceptors, reducing vasoconstriction and preload.
