HESI BSN 315 EAQ Page |1
HESI BSN 315 EAQ Practice Test 2 Questions and
Correct Answers with Rationales/ Nightingale
BSN 315 Pharmacology II HESI Practice Exam
Latest (New!) graded A+ GUARANTEED PASS–
Correctly Answers Questions with Rationales
A client with metastatic breast cancer who has been using morphine patches for several weeks
reports to the nurse that the medication is not effectively controlling the pain. Which action should
the nurse initiate?
a. Instruct the client about the indications of opioid dependence.
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, HESI BSN 315 EAQ Page |2
b. Monitor the client for symptoms of acute opioid withdrawal.
c. Notify the health care provider of the need to increase the dose.
d. Administer naloxone doses per protocol as needed for reversal. –
Correct Answer :c. Notify the health care provider of the need to increase the dose.
Rationale:
Clients can develop a tolerance to the analgesic effect of opioids and may require an increased dose
for effective long-term pain relief. The client is not exhibiting indications of dependence, withdrawal or
toxicity.
A client has been using bimatoprost eye drops for several months. Which change is the nurse most
likely to note with this client?
a. The pupils are dilated.
b. The eyelash hairs are missing.
c. The pupils do not accommodate.
d. The iris has become browner in color. –
Correct Answer :d. The iris has become browner in color.
Rationale:
Long-term use of bimatoprost to treat glaucoma can cause the iris to form increased brown
pigmentation. The pupils do not dilate and their ability to accommodate does not change. Eyelash
hairs actually have increased growth.
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, HESI BSN 315 EAQ Page |3
A client diagnosed with essential hypertension is prescribed phenylephrine for nasal congestion as
needed every 4 hours. The client is complaining about nasal congestion. Which nursing action should
the practical nurse (PN) do next?
a. Administer the medication as prescribed.
b. Instruct the client to gently blow nose prior to administration of medication.
c. Perform nasal irrigation prior to administration.
d. Hold the medication and consult with the charge nurse. –
Correct Answer :d. Hold the medication and consult with the charge nurse.
Rationale:
Phenylephrine can cause transient hypertension and should not be taken by a client with
hypertension. The PN should hold the medication and consult with the charge nurse about the client's
diagnosed hypertension and prescribed medication.
The nurse will be administering an intramuscular injection of iron to a client who experienced a
postpartum blood loss and is refusing a blood transfusion, citing religious objections. Which action
should the nurse take when administering this medication?
a. Use the Z-track method of administration.
b. Use the deltoid muscle to avoid exposure of the gluteal area.
c. After the injection, massage the injection site to enhance absorption.
d. Inject some of the medication subcutaneously to avoid skin stains. –
Correct Answer :a. Use the Z-track method of administration.
Rationale:
The nurse should use the Z-track method to administer the medication into the deep gluteal muscles.
The deltoid site is not of adequate size, and dark iron stains would be more visible. The nurse should
not massage the injection site because this can cause the dark iron liquid to become closer to the skin.
The nurse should avoid injecting the dark iron liquid into the subcutaneous tissue to avoid iron stains
under the skin.
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, HESI BSN 315 EAQ Page |4
A child has swallowed medication he found in his grandmother's purse. The grandmother had several
tablets of pyridostigmine bromide she had been taking to treat myasthenia gravis. The nurse should
observe for which indication of toxicity from this medication?
a. Dry eyes
b. Constipation
c. Bradycardia
d. Hypertension –
Correct Answer :c. Bradycardia
Rationale:
The child should be observed for bradycardia, diarrhea, hypotension, and lacrimation as signs of
medication excess (cholinergic crisis).
A client receiving the antibiotic vancomycin is prescribed to have a peak and trough level done with
the next dose. What time should the practical nurse obtain the blood specimen for the trough level?
a. 60 minutes after the antibiotic dose is administered.
b. Immediately before the next antibiotic dose is given.
c. When the next blood glucose level is to be checked.
d. 30 minutes before the next antibiotic dose is given. –
Correct Answer :b. Immediately before the next antibiotic dose is given.
Rationale:
Trough levels are drawn when the blood level is at its lowest, which is typically just before the next
dose is given. The PN needs to wait for the lab results of the trough level from the lab before
administering the scheduled antibiotic. If the trough level is above the recommended levels, the
medication needs to be held and the health care provider needs to be notified.
P a g e 4 | 89
HESI BSN 315 EAQ Practice Test 2 Questions and
Correct Answers with Rationales/ Nightingale
BSN 315 Pharmacology II HESI Practice Exam
Latest (New!) graded A+ GUARANTEED PASS–
Correctly Answers Questions with Rationales
A client with metastatic breast cancer who has been using morphine patches for several weeks
reports to the nurse that the medication is not effectively controlling the pain. Which action should
the nurse initiate?
a. Instruct the client about the indications of opioid dependence.
P a g e 1 | 89
, HESI BSN 315 EAQ Page |2
b. Monitor the client for symptoms of acute opioid withdrawal.
c. Notify the health care provider of the need to increase the dose.
d. Administer naloxone doses per protocol as needed for reversal. –
Correct Answer :c. Notify the health care provider of the need to increase the dose.
Rationale:
Clients can develop a tolerance to the analgesic effect of opioids and may require an increased dose
for effective long-term pain relief. The client is not exhibiting indications of dependence, withdrawal or
toxicity.
A client has been using bimatoprost eye drops for several months. Which change is the nurse most
likely to note with this client?
a. The pupils are dilated.
b. The eyelash hairs are missing.
c. The pupils do not accommodate.
d. The iris has become browner in color. –
Correct Answer :d. The iris has become browner in color.
Rationale:
Long-term use of bimatoprost to treat glaucoma can cause the iris to form increased brown
pigmentation. The pupils do not dilate and their ability to accommodate does not change. Eyelash
hairs actually have increased growth.
P a g e 2 | 89
, HESI BSN 315 EAQ Page |3
A client diagnosed with essential hypertension is prescribed phenylephrine for nasal congestion as
needed every 4 hours. The client is complaining about nasal congestion. Which nursing action should
the practical nurse (PN) do next?
a. Administer the medication as prescribed.
b. Instruct the client to gently blow nose prior to administration of medication.
c. Perform nasal irrigation prior to administration.
d. Hold the medication and consult with the charge nurse. –
Correct Answer :d. Hold the medication and consult with the charge nurse.
Rationale:
Phenylephrine can cause transient hypertension and should not be taken by a client with
hypertension. The PN should hold the medication and consult with the charge nurse about the client's
diagnosed hypertension and prescribed medication.
The nurse will be administering an intramuscular injection of iron to a client who experienced a
postpartum blood loss and is refusing a blood transfusion, citing religious objections. Which action
should the nurse take when administering this medication?
a. Use the Z-track method of administration.
b. Use the deltoid muscle to avoid exposure of the gluteal area.
c. After the injection, massage the injection site to enhance absorption.
d. Inject some of the medication subcutaneously to avoid skin stains. –
Correct Answer :a. Use the Z-track method of administration.
Rationale:
The nurse should use the Z-track method to administer the medication into the deep gluteal muscles.
The deltoid site is not of adequate size, and dark iron stains would be more visible. The nurse should
not massage the injection site because this can cause the dark iron liquid to become closer to the skin.
The nurse should avoid injecting the dark iron liquid into the subcutaneous tissue to avoid iron stains
under the skin.
P a g e 3 | 89
, HESI BSN 315 EAQ Page |4
A child has swallowed medication he found in his grandmother's purse. The grandmother had several
tablets of pyridostigmine bromide she had been taking to treat myasthenia gravis. The nurse should
observe for which indication of toxicity from this medication?
a. Dry eyes
b. Constipation
c. Bradycardia
d. Hypertension –
Correct Answer :c. Bradycardia
Rationale:
The child should be observed for bradycardia, diarrhea, hypotension, and lacrimation as signs of
medication excess (cholinergic crisis).
A client receiving the antibiotic vancomycin is prescribed to have a peak and trough level done with
the next dose. What time should the practical nurse obtain the blood specimen for the trough level?
a. 60 minutes after the antibiotic dose is administered.
b. Immediately before the next antibiotic dose is given.
c. When the next blood glucose level is to be checked.
d. 30 minutes before the next antibiotic dose is given. –
Correct Answer :b. Immediately before the next antibiotic dose is given.
Rationale:
Trough levels are drawn when the blood level is at its lowest, which is typically just before the next
dose is given. The PN needs to wait for the lab results of the trough level from the lab before
administering the scheduled antibiotic. If the trough level is above the recommended levels, the
medication needs to be held and the health care provider needs to be notified.
P a g e 4 | 89
