1
RN HESI PHARMACOLOGY V1 ACTUAL EXAM 2026/2027 |
Actual Questions with Rationales | Verified Q&A | Pass
Guaranteed - A+ Graded
Section 1: Cardiovascular Medications (Questions 1-12)
Question 1
A patient newly prescribed lisinopril asks about common side effects. The nurse
should include which teaching point?
A. "You may experience a persistent dry cough, which is common with ACE
inhibitors." [CORRECT]
B. "You should avoid all potassium-rich foods because this medication causes
hyperkalemia."
C. "This medication works by blocking angiotensin II receptors directly."
D. "Take this medication with grapefruit juice to enhance absorption."
Rationale: ACE inhibitors like lisinopril commonly cause a dry, nonproductive cough
due to bradykinin accumulation; this is a class effect, not an allergy. While
hyperkalemia is possible, patients are advised to avoid excessive potassium
supplements, not all potassium-rich foods. ACE inhibitors block ACE, not angiotensin
II receptors directly (that's ARBs). Grapefruit juice interacts with calcium channel
blockers, not ACE inhibitors.
Correct Answer: A
Question 2
A patient on metoprolol 50 mg twice daily reports dizziness and fatigue. Blood
pressure is 92/58 mmHg, heart rate 52 bpm. Which action should the nurse take
first?
,2
A. Hold the dose and notify the prescriber; bradycardia and hypotension indicate
beta-blocker toxicity [CORRECT]
B. Encourage the patient to stand up slowly to prevent orthostatic hypotension
C. Administer the next dose early to stabilize heart rate
D. Switch the patient to a calcium channel blocker without consulting the prescriber
Rationale: Metoprolol is a beta-1 selective blocker that can cause bradycardia and
hypotension; heart rate <60 bpm with symptomatic hypotension requires holding
the dose and prescriber notification. Standing slowly is preventive but does not
address acute toxicity; early dosing worsens bradycardia; nurses cannot
independently switch medications.
Correct Answer: A
Question 3
A patient on amlodipine 5 mg daily reports bilateral ankle edema. The patient denies
shortness of breath or chest pain. Which explanation should the nurse provide?
A. "This is a sign of heart failure; you need an echocardiogram immediately."
B. "Peripheral edema is a common side effect of dihydropyridine calcium channel
blockers due to arteriolar vasodilation and capillary pressure changes." [CORRECT]
C. "This indicates an allergic reaction; stop the medication immediately."
D. "You need to restrict all fluids to prevent worsening edema."
Rationale: Amlodipine, a dihydropyridine calcium channel blocker, commonly causes
peripheral edema (not heart failure) due to preferential arteriolar vasodilation
increasing hydrostatic pressure in capillaries; it is dose-dependent and not an allergic
reaction. Fluid restriction is unnecessary unless heart failure is present.
Correct Answer: B
Question 4
, 3
A patient on hydrochlorothiazide 25 mg daily has a serum potassium of 3.2 mEq/L.
Which dietary instruction should the nurse reinforce?
A. "Increase your intake of bananas, oranges, potatoes, and spinach." [CORRECT]
B. "Avoid all salt substitutes because they contain potassium."
C. "This is normal; thiazide diuretics always cause hyperkalemia."
D. "You should take a potassium supplement without consulting your provider."
Rationale: Thiazide diuretics cause potassium wasting, leading to hypokalemia;
patients should increase dietary potassium intake. Salt substitutes often contain
potassium and are actually recommended for some patients, but the patient should
consult their provider. Thiazides cause hypokalemia, not hyperkalemia; potassium
supplements require provider orders.
Correct Answer: A
Question 5
A patient on warfarin 5 mg daily has an INR of 4.2 (therapeutic range 2.0-3.0). The
patient has no active bleeding. Which action is most appropriate?
A. Administer vitamin K 10 mg IV immediately
B. Hold the next dose, recheck INR in 24 hours, and notify the prescriber [CORRECT]
C. Continue the current dose; INR fluctuations are normal
D. Switch to apixaban without provider consultation
Rationale: An INR of 4.2 without bleeding in a patient on warfarin requires holding
the next dose and rechecking INR in 24 hours with prescriber notification; vitamin K
is reserved for INR >10 or active bleeding. Continuing the dose risks bleeding; nurses
cannot independently switch anticoagulants.
Correct Answer: B
Question 6
RN HESI PHARMACOLOGY V1 ACTUAL EXAM 2026/2027 |
Actual Questions with Rationales | Verified Q&A | Pass
Guaranteed - A+ Graded
Section 1: Cardiovascular Medications (Questions 1-12)
Question 1
A patient newly prescribed lisinopril asks about common side effects. The nurse
should include which teaching point?
A. "You may experience a persistent dry cough, which is common with ACE
inhibitors." [CORRECT]
B. "You should avoid all potassium-rich foods because this medication causes
hyperkalemia."
C. "This medication works by blocking angiotensin II receptors directly."
D. "Take this medication with grapefruit juice to enhance absorption."
Rationale: ACE inhibitors like lisinopril commonly cause a dry, nonproductive cough
due to bradykinin accumulation; this is a class effect, not an allergy. While
hyperkalemia is possible, patients are advised to avoid excessive potassium
supplements, not all potassium-rich foods. ACE inhibitors block ACE, not angiotensin
II receptors directly (that's ARBs). Grapefruit juice interacts with calcium channel
blockers, not ACE inhibitors.
Correct Answer: A
Question 2
A patient on metoprolol 50 mg twice daily reports dizziness and fatigue. Blood
pressure is 92/58 mmHg, heart rate 52 bpm. Which action should the nurse take
first?
,2
A. Hold the dose and notify the prescriber; bradycardia and hypotension indicate
beta-blocker toxicity [CORRECT]
B. Encourage the patient to stand up slowly to prevent orthostatic hypotension
C. Administer the next dose early to stabilize heart rate
D. Switch the patient to a calcium channel blocker without consulting the prescriber
Rationale: Metoprolol is a beta-1 selective blocker that can cause bradycardia and
hypotension; heart rate <60 bpm with symptomatic hypotension requires holding
the dose and prescriber notification. Standing slowly is preventive but does not
address acute toxicity; early dosing worsens bradycardia; nurses cannot
independently switch medications.
Correct Answer: A
Question 3
A patient on amlodipine 5 mg daily reports bilateral ankle edema. The patient denies
shortness of breath or chest pain. Which explanation should the nurse provide?
A. "This is a sign of heart failure; you need an echocardiogram immediately."
B. "Peripheral edema is a common side effect of dihydropyridine calcium channel
blockers due to arteriolar vasodilation and capillary pressure changes." [CORRECT]
C. "This indicates an allergic reaction; stop the medication immediately."
D. "You need to restrict all fluids to prevent worsening edema."
Rationale: Amlodipine, a dihydropyridine calcium channel blocker, commonly causes
peripheral edema (not heart failure) due to preferential arteriolar vasodilation
increasing hydrostatic pressure in capillaries; it is dose-dependent and not an allergic
reaction. Fluid restriction is unnecessary unless heart failure is present.
Correct Answer: B
Question 4
, 3
A patient on hydrochlorothiazide 25 mg daily has a serum potassium of 3.2 mEq/L.
Which dietary instruction should the nurse reinforce?
A. "Increase your intake of bananas, oranges, potatoes, and spinach." [CORRECT]
B. "Avoid all salt substitutes because they contain potassium."
C. "This is normal; thiazide diuretics always cause hyperkalemia."
D. "You should take a potassium supplement without consulting your provider."
Rationale: Thiazide diuretics cause potassium wasting, leading to hypokalemia;
patients should increase dietary potassium intake. Salt substitutes often contain
potassium and are actually recommended for some patients, but the patient should
consult their provider. Thiazides cause hypokalemia, not hyperkalemia; potassium
supplements require provider orders.
Correct Answer: A
Question 5
A patient on warfarin 5 mg daily has an INR of 4.2 (therapeutic range 2.0-3.0). The
patient has no active bleeding. Which action is most appropriate?
A. Administer vitamin K 10 mg IV immediately
B. Hold the next dose, recheck INR in 24 hours, and notify the prescriber [CORRECT]
C. Continue the current dose; INR fluctuations are normal
D. Switch to apixaban without provider consultation
Rationale: An INR of 4.2 without bleeding in a patient on warfarin requires holding
the next dose and rechecking INR in 24 hours with prescriber notification; vitamin K
is reserved for INR >10 or active bleeding. Continuing the dose risks bleeding; nurses
cannot independently switch anticoagulants.
Correct Answer: B
Question 6
