HESI PHARMACOLOGY (EVOLVE) 2025
COMPLETE STUDY GUIDE & LEARNING
OUTLINE || UPDATED VERSION
Section 1: Foundational Principles (Pharmacokinetics, Dynamics, Nursing Care)
1. What is the study of how the body absorbs, distributes, metabolizes, and excretes a drug?
A. Pharmacotherapeutics
B. Pharmacokinetics
C. Pharmacodynamics
D. Pharmacogenetics
2. The therapeutic range of a drug is best defined as:
A. The dosage required to cause toxicity.
B. The plasma concentration between the minimum effective concentration and the toxic
concentration.
C. The time it takes for half of the drug to be eliminated.
D. The peak plasma level of a single dose.
3. The first-pass effect primarily affects drugs administered via which route?
A. Intravenous (IV)
B. Oral (PO)
C. Intramuscular (IM)
D. Subcutaneous (SubQ)
4. A drug with a high affinity for receptor sites and which triggers a strong response is called
a(n):
A. Antagonist
B. Partial agonist
C. Agonist
D. Inhibitor
5. The nurse administers an opioid analgesic to a patient. Which assessment is the priority?
A. Pain level using a scale
B. Respiratory rate
,C. Bowel sounds
D. Blood pressure
6. What is the primary purpose of a "black box warning" on a drug?
A. Indicates a generic formulation.
B. Alerts to the highest level of FDA warning about life-threatening risks.
C. Means the drug is available over-the-counter.
D. Identifies the drug is contraindicated in pregnancy.
7. Tachyphylaxis refers to:
A. An allergic reaction to a medication.
B. A rapidly occurring tolerance to a drug after a few doses.
C. The expected, predictable side effects of a drug.
D. The toxic accumulation of a drug in the body.
8. When two drugs are given together and their combined effect is greater than the sum of
their individual effects, this is called:
A. Antagonism
B. Synergism
C. Potentiation
D. Incompatibility
9. The best method for a nurse to identify a patient before administering medication is to:
A. Ask the patient their name.
B. Check the name on the door or bed.
C. Use two patient identifiers (e.g., name & date of birth) and compare to the MAR.
D. Ask the roommate to confirm the patient's identity.
10. The "Rights of Medication Administration" include all EXCEPT:
A. Right patient, drug, dose, route, time
B. Right documentation and assessment
C. Right to refuse and right education
D. Right based on cost-effectiveness
Section 2: Autonomic Nervous System & Cardiovascular Drugs
11. A patient is prescribed Atropine. The nurse anticipates which therapeutic effect?
A. Increased heart rate (tachycardia)
B. Bronchoconstriction
C. Increased gastric secretions
D. Hypotension
,12. A beta-1 adrenergic agonist like Dobutamine primarily affects:
A. The lungs, causing bronchodilation.
B. The heart, increasing contractility and heart rate.
C. The bladder, causing relaxation.
D. The pupils, causing dilation.
13. Which finding is a priority for the nurse to report in a patient starting on Lisinopril (an ACE
inhibitor)?
A. Dry, nagging cough
B. Persistent headache
C. Angioedema (swelling of face/lips)
D. Mild hyperkalemia
14. Furosemide (Lasix) is a loop diuretic. The nurse should closely monitor for:
A. Hyperkalemia and weight gain
B. Hypokalemia and dehydration
C. Hypercalcemia and bradycardia
D. Hyponatremia and constipation
15. The mechanism of action for Metoprolol (a beta-blocker) is to:
A. Block angiotensin II receptors.
B. Block beta-1 adrenergic receptors in the heart, decreasing HR and contractility.
C. Inhibit the sodium-potassium pump.
D. Block calcium channels in vascular smooth muscle.
16. The therapeutic effect of Nitroglycerin is primarily to:
A. Reduce afterload and treat hypertension.
B. Dilate coronary arteries and reduce preload, relieving myocardial ischemia.
C. Inotropic strengthening of the heartbeat.
D. Prevent clot formation in stents.
17. Heparin and Warfarin (Coumadin) are both anticoagulants. The major difference is:
A. Heparin is oral, Warfarin is IV.
B. Heparin's effect is reversed with Vitamin K.
C. Heparin acts immediately and is monitored by aPTT; Warfarin is oral and monitored by INR.
D. Warfarin has no antidote.
18. Which laboratory value is most critical to monitor for a patient on Simvastatin (a statin)?
A. Serum creatinine
, B. Liver function tests (LFTs) and creatine kinase (CK)
C. International Normalized Ratio (INR)
D. Serum sodium
19. Digoxin toxicity is suspected with which symptoms?
A. Hypertension and tachycardia
B. Anorexia, nausea, visual disturbances (yellow halos), and bradycardia
C. Polyuria and polydipsia
D. Bronchospasm and urticaria
20. What is the antidote for Heparin overdose?
A. Vitamin K
B. Protamine sulfate
C. Naloxone
D. Flumazenil
Section 3: Central Nervous System Drugs
21. Benzodiazepines (e.g., Lorazepam) are used for anxiety and sedation. Their major risk is:
A. Hypertension
B. Respiratory depression, especially with opioids.
C. Acute renal failure
D. Hyperglycemia
22. The antidote for Benzodiazepine overdose is:
A. Naloxone (Narcan)
B. Flumazenil (Romazicon)
C. Physostigmine
D. Activated charcoal
23. Selective Serotonin Reuptake Inhibitors (SSRIs) like Sertraline have a black box warning
for:
A. Hepatotoxicity
B. Increased risk of suicidal thinking in children and young adults.
C. Severe hypertension
D. Tardive dyskinesia
24. A key teaching point for patients on Phenytoin (Dilantin) is:
A. Avoid sunlight due to photosensitivity.
B. Maintain meticulous oral hygiene due to risk of gingival hyperplasia.
COMPLETE STUDY GUIDE & LEARNING
OUTLINE || UPDATED VERSION
Section 1: Foundational Principles (Pharmacokinetics, Dynamics, Nursing Care)
1. What is the study of how the body absorbs, distributes, metabolizes, and excretes a drug?
A. Pharmacotherapeutics
B. Pharmacokinetics
C. Pharmacodynamics
D. Pharmacogenetics
2. The therapeutic range of a drug is best defined as:
A. The dosage required to cause toxicity.
B. The plasma concentration between the minimum effective concentration and the toxic
concentration.
C. The time it takes for half of the drug to be eliminated.
D. The peak plasma level of a single dose.
3. The first-pass effect primarily affects drugs administered via which route?
A. Intravenous (IV)
B. Oral (PO)
C. Intramuscular (IM)
D. Subcutaneous (SubQ)
4. A drug with a high affinity for receptor sites and which triggers a strong response is called
a(n):
A. Antagonist
B. Partial agonist
C. Agonist
D. Inhibitor
5. The nurse administers an opioid analgesic to a patient. Which assessment is the priority?
A. Pain level using a scale
B. Respiratory rate
,C. Bowel sounds
D. Blood pressure
6. What is the primary purpose of a "black box warning" on a drug?
A. Indicates a generic formulation.
B. Alerts to the highest level of FDA warning about life-threatening risks.
C. Means the drug is available over-the-counter.
D. Identifies the drug is contraindicated in pregnancy.
7. Tachyphylaxis refers to:
A. An allergic reaction to a medication.
B. A rapidly occurring tolerance to a drug after a few doses.
C. The expected, predictable side effects of a drug.
D. The toxic accumulation of a drug in the body.
8. When two drugs are given together and their combined effect is greater than the sum of
their individual effects, this is called:
A. Antagonism
B. Synergism
C. Potentiation
D. Incompatibility
9. The best method for a nurse to identify a patient before administering medication is to:
A. Ask the patient their name.
B. Check the name on the door or bed.
C. Use two patient identifiers (e.g., name & date of birth) and compare to the MAR.
D. Ask the roommate to confirm the patient's identity.
10. The "Rights of Medication Administration" include all EXCEPT:
A. Right patient, drug, dose, route, time
B. Right documentation and assessment
C. Right to refuse and right education
D. Right based on cost-effectiveness
Section 2: Autonomic Nervous System & Cardiovascular Drugs
11. A patient is prescribed Atropine. The nurse anticipates which therapeutic effect?
A. Increased heart rate (tachycardia)
B. Bronchoconstriction
C. Increased gastric secretions
D. Hypotension
,12. A beta-1 adrenergic agonist like Dobutamine primarily affects:
A. The lungs, causing bronchodilation.
B. The heart, increasing contractility and heart rate.
C. The bladder, causing relaxation.
D. The pupils, causing dilation.
13. Which finding is a priority for the nurse to report in a patient starting on Lisinopril (an ACE
inhibitor)?
A. Dry, nagging cough
B. Persistent headache
C. Angioedema (swelling of face/lips)
D. Mild hyperkalemia
14. Furosemide (Lasix) is a loop diuretic. The nurse should closely monitor for:
A. Hyperkalemia and weight gain
B. Hypokalemia and dehydration
C. Hypercalcemia and bradycardia
D. Hyponatremia and constipation
15. The mechanism of action for Metoprolol (a beta-blocker) is to:
A. Block angiotensin II receptors.
B. Block beta-1 adrenergic receptors in the heart, decreasing HR and contractility.
C. Inhibit the sodium-potassium pump.
D. Block calcium channels in vascular smooth muscle.
16. The therapeutic effect of Nitroglycerin is primarily to:
A. Reduce afterload and treat hypertension.
B. Dilate coronary arteries and reduce preload, relieving myocardial ischemia.
C. Inotropic strengthening of the heartbeat.
D. Prevent clot formation in stents.
17. Heparin and Warfarin (Coumadin) are both anticoagulants. The major difference is:
A. Heparin is oral, Warfarin is IV.
B. Heparin's effect is reversed with Vitamin K.
C. Heparin acts immediately and is monitored by aPTT; Warfarin is oral and monitored by INR.
D. Warfarin has no antidote.
18. Which laboratory value is most critical to monitor for a patient on Simvastatin (a statin)?
A. Serum creatinine
, B. Liver function tests (LFTs) and creatine kinase (CK)
C. International Normalized Ratio (INR)
D. Serum sodium
19. Digoxin toxicity is suspected with which symptoms?
A. Hypertension and tachycardia
B. Anorexia, nausea, visual disturbances (yellow halos), and bradycardia
C. Polyuria and polydipsia
D. Bronchospasm and urticaria
20. What is the antidote for Heparin overdose?
A. Vitamin K
B. Protamine sulfate
C. Naloxone
D. Flumazenil
Section 3: Central Nervous System Drugs
21. Benzodiazepines (e.g., Lorazepam) are used for anxiety and sedation. Their major risk is:
A. Hypertension
B. Respiratory depression, especially with opioids.
C. Acute renal failure
D. Hyperglycemia
22. The antidote for Benzodiazepine overdose is:
A. Naloxone (Narcan)
B. Flumazenil (Romazicon)
C. Physostigmine
D. Activated charcoal
23. Selective Serotonin Reuptake Inhibitors (SSRIs) like Sertraline have a black box warning
for:
A. Hepatotoxicity
B. Increased risk of suicidal thinking in children and young adults.
C. Severe hypertension
D. Tardive dyskinesia
24. A key teaching point for patients on Phenytoin (Dilantin) is:
A. Avoid sunlight due to photosensitivity.
B. Maintain meticulous oral hygiene due to risk of gingival hyperplasia.
