ESTUDYR
BSN 315 HESI PHARMACOLOGY MOST TESTED QUESTIONS
AND ANSWERS GRADED A+ WITH RATIONALES
A client is scheduled for a spiral CT with contrast to evaluate for PE. Which history item requires
follow-up by the nurse?
A. Prior hay fever
B. Vegetarian diet
C. Takes metformin hydrochloride for type 2 DM.
D. Recent travel abroad
Rationale: Metformin must be held around contrast studies due to risk of lactic acidosis if renal function
is affected; the provider may need to adjust timing.
A client with MS self-injects beta-1a interferon and reports increasing depression. What should the
nurse do?
A. Encourage exercise
B. Give teaching on injection technique
C. Monitor mood weekly
D. Notify the healthcare provider of the findings immediately.
Rationale: Interferons can cause or worsen depression and suicidal ideation; prompt provider
notification is necessary.
Before giving the initial dose of sumatriptan for migraine, the nurse should determine if the client has
a history of:
A. Diabetes
B. Asthma
C. Coronary artery disease (CAD)
D. Hypothyroidism
Rationale: Sumatriptan causes vasoconstriction and is contraindicated in CAD due to risk of myocardial
ischemia.
Ciprofloxacin 400 mg IV in D5W 200 mL to infuse over 1 hour. What mL/hr is required?
A. 100 mL/hr
B. 150 mL/hr
C. 200 mL/hr
D. 400 mL/hr
Rationale: 200 mL over 1 hour = 200 mL/hr.
Before administering a laxative to a bedfast client the nurse should first:
A. Assess heart rate
B. Determine frequency and consistency of bowel movements
C. Check skin turgor
,ESTUDYR
D. Measure intake for 24 hours
Rationale: Bowel history guides need for and timing/type of laxative and reduces risk of adverse effects.
A client on levothyroxine should report which symptom that indicates excess dosing?
A. Weight gain
B. Cold intolerance
C. Bradycardia
D. Restlessness
Rationale: Signs of overreplacement (thyrotoxicosis) include restlessness, tachycardia, and heat
intolerance.
A male client plans to stop high-dose corticosteroids because of GI distress. The nurse’s most
important action is to:
A. Suggest OTC antacids
B. Encourage immediate discontinuation
C. Advise that medication should be tapered rather than stopped abruptly
D. Call family for support
Rationale: Abrupt steroid cessation can precipitate adrenal insufficiency; tapering is required.
A client using pilocarpine eye drops reports difficulty seeing at night. The nurse explains:
A. It improves night vision
B. It slows pupil dilation needed to see in darkness
C. It causes permanent blindness
D. It has no ocular side effects
Rationale: Pilocarpine produces miosis and can impair night/dim-light vision.
A client on rifampin reports yellow sclera. The nurse should:
A. Reassure the client
B. Increase rifampin dose
C. Notify the healthcare provider — possible hepatotoxicity
D. Tell the client to stop medication immediately
Rationale: Jaundice suggests liver injury; rifampin can cause hepatotoxicity and requires provider
evaluation.
To assess effectiveness of amlodipine (a CCB) the nurse should:
A. Measure pulmonary function
B. Check blood glucose
C. Measure the client’s blood pressure
D. Assess tendon reflexes
Rationale: Amlodipine lowers BP — taking blood pressure evaluates therapeutic effect.
After several days of gentamicin IV, which observation indicates possible adverse effect?
A. Red skin rash
B. Decreased hearing
, ESTUDYR
C. Elevated temperature
D. Elevated urine output
Rationale: Gentamicin is ototoxic; hearing loss is a concerning adverse effect.
An older adult with restless legs starts melatonin at bedtime. To evaluate effectiveness the nurse
should:
A. Check CBC
B. Measure blood pressure
C. Determine sleep patterns
D. Assess gait
Rationale: Melatonin’s intended benefit is improved sleep onset/quality; sleep pattern assessment
measures effect.
A client’s vital signs before giving oral labetalol are: T 37.2°C, HR 48 bpm, RR 16, BP 150/90. What
should the nurse do?
A. Give the dose as ordered
B. Give half the dose
C. Withhold the scheduled dose and notify the provider
D. Call pharmacy
Rationale: Bradycardia (HR 48) is a contraindication to giving beta/alpha blocker without provider
review.
Discharge teaching for a client with new insulin glargine should include:
A. Only oral medication education
B. Avoid injections ever
C. Self-injection skills for daily subcutaneous administration
D. Mix glargine with regular insulin in same syringe
Rationale: Glargine is a long-acting basal insulin requiring daily subcutaneous administration and proper
injection technique.
A client taking methotrexate is starting adalimumab. What instruction should the nurse provide first?
A. Begin vaccinations immediately
B. Reduce methotrexate dose abruptly
C. Have a chest x-ray prior to your first dose
D. Stop all other medications
Rationale: TNF-alpha inhibitors increase TB reactivation risk; baseline chest x-ray to screen for latent TB
is indicated.
Discharge teaching for gabapentin 300 mg TID — what symptom to report?
A. Improved sleep
B. Dry mouth
C. Gastric irritation
BSN 315 HESI PHARMACOLOGY MOST TESTED QUESTIONS
AND ANSWERS GRADED A+ WITH RATIONALES
A client is scheduled for a spiral CT with contrast to evaluate for PE. Which history item requires
follow-up by the nurse?
A. Prior hay fever
B. Vegetarian diet
C. Takes metformin hydrochloride for type 2 DM.
D. Recent travel abroad
Rationale: Metformin must be held around contrast studies due to risk of lactic acidosis if renal function
is affected; the provider may need to adjust timing.
A client with MS self-injects beta-1a interferon and reports increasing depression. What should the
nurse do?
A. Encourage exercise
B. Give teaching on injection technique
C. Monitor mood weekly
D. Notify the healthcare provider of the findings immediately.
Rationale: Interferons can cause or worsen depression and suicidal ideation; prompt provider
notification is necessary.
Before giving the initial dose of sumatriptan for migraine, the nurse should determine if the client has
a history of:
A. Diabetes
B. Asthma
C. Coronary artery disease (CAD)
D. Hypothyroidism
Rationale: Sumatriptan causes vasoconstriction and is contraindicated in CAD due to risk of myocardial
ischemia.
Ciprofloxacin 400 mg IV in D5W 200 mL to infuse over 1 hour. What mL/hr is required?
A. 100 mL/hr
B. 150 mL/hr
C. 200 mL/hr
D. 400 mL/hr
Rationale: 200 mL over 1 hour = 200 mL/hr.
Before administering a laxative to a bedfast client the nurse should first:
A. Assess heart rate
B. Determine frequency and consistency of bowel movements
C. Check skin turgor
,ESTUDYR
D. Measure intake for 24 hours
Rationale: Bowel history guides need for and timing/type of laxative and reduces risk of adverse effects.
A client on levothyroxine should report which symptom that indicates excess dosing?
A. Weight gain
B. Cold intolerance
C. Bradycardia
D. Restlessness
Rationale: Signs of overreplacement (thyrotoxicosis) include restlessness, tachycardia, and heat
intolerance.
A male client plans to stop high-dose corticosteroids because of GI distress. The nurse’s most
important action is to:
A. Suggest OTC antacids
B. Encourage immediate discontinuation
C. Advise that medication should be tapered rather than stopped abruptly
D. Call family for support
Rationale: Abrupt steroid cessation can precipitate adrenal insufficiency; tapering is required.
A client using pilocarpine eye drops reports difficulty seeing at night. The nurse explains:
A. It improves night vision
B. It slows pupil dilation needed to see in darkness
C. It causes permanent blindness
D. It has no ocular side effects
Rationale: Pilocarpine produces miosis and can impair night/dim-light vision.
A client on rifampin reports yellow sclera. The nurse should:
A. Reassure the client
B. Increase rifampin dose
C. Notify the healthcare provider — possible hepatotoxicity
D. Tell the client to stop medication immediately
Rationale: Jaundice suggests liver injury; rifampin can cause hepatotoxicity and requires provider
evaluation.
To assess effectiveness of amlodipine (a CCB) the nurse should:
A. Measure pulmonary function
B. Check blood glucose
C. Measure the client’s blood pressure
D. Assess tendon reflexes
Rationale: Amlodipine lowers BP — taking blood pressure evaluates therapeutic effect.
After several days of gentamicin IV, which observation indicates possible adverse effect?
A. Red skin rash
B. Decreased hearing
, ESTUDYR
C. Elevated temperature
D. Elevated urine output
Rationale: Gentamicin is ototoxic; hearing loss is a concerning adverse effect.
An older adult with restless legs starts melatonin at bedtime. To evaluate effectiveness the nurse
should:
A. Check CBC
B. Measure blood pressure
C. Determine sleep patterns
D. Assess gait
Rationale: Melatonin’s intended benefit is improved sleep onset/quality; sleep pattern assessment
measures effect.
A client’s vital signs before giving oral labetalol are: T 37.2°C, HR 48 bpm, RR 16, BP 150/90. What
should the nurse do?
A. Give the dose as ordered
B. Give half the dose
C. Withhold the scheduled dose and notify the provider
D. Call pharmacy
Rationale: Bradycardia (HR 48) is a contraindication to giving beta/alpha blocker without provider
review.
Discharge teaching for a client with new insulin glargine should include:
A. Only oral medication education
B. Avoid injections ever
C. Self-injection skills for daily subcutaneous administration
D. Mix glargine with regular insulin in same syringe
Rationale: Glargine is a long-acting basal insulin requiring daily subcutaneous administration and proper
injection technique.
A client taking methotrexate is starting adalimumab. What instruction should the nurse provide first?
A. Begin vaccinations immediately
B. Reduce methotrexate dose abruptly
C. Have a chest x-ray prior to your first dose
D. Stop all other medications
Rationale: TNF-alpha inhibitors increase TB reactivation risk; baseline chest x-ray to screen for latent TB
is indicated.
Discharge teaching for gabapentin 300 mg TID — what symptom to report?
A. Improved sleep
B. Dry mouth
C. Gastric irritation
