BSN315 Final Exam Actual Exam Style V1
| BSN 315 HESI RN Specialty
Pharmacology Exam | Nightingale
1. A nurse is preparing to administer heparin subcutaneously to a client. Which of the
following actions should the nurse take?
A. Massage the injection site to increase absorption.
B. Aspirate before injecting the medication.
C. Use a 22-gauge needle that is 1.5 inches long.
D. Inject the medication into the abdomen at least 2 inches from the umbilicus.
Answer: D
Rationale: Heparin should be administered in the subcutaneous tissue of the abdomen
while maintaining distance from the umbilicus. Massaging the site is contraindicated as it
can cause hematomas or bruising. Aspiration is not required for subcutaneous heparin and
can cause tissue damage.
2. A client is prescribed lisinopril for hypertension. Which of the following adverse effects
should the nurse monitor for?
A. Hypokalemia
B. Peripheral edema
C. Tachycardia
,D. Dry, persistent cough
Answer: D
Rationale: ACE inhibitors like lisinopril are well-known for causing a dry, non-productive
cough due to the accumulation of bradykinin. This side effect is a common reason for
patients to switch to an Angiotensin II Receptor Blocker (ARB). The nurse should also
monitor for hyperkalemia and angioedema while the client is on this medication.
3. A nurse is teaching a client about the use of a nitroglycerin patch. Which of the following
instructions should be included?
A. Remove the patch for 10 to 12 hours each day.
B. Apply a new patch every 48 hours.
C. Place the patch on the same site every time.
D. Cut the patch in half if a lower dose is needed.
Answer: A
Rationale: Nitroglycerin patches require a nitrate-free interval of 10 to 12 hours daily to
prevent the development of drug tolerance. Clients should rotate the application site to
prevent skin irritation and ensure the skin is clean and dry. Cutting the patch is prohibited
as it alters the delivery mechanism of the medication.
4. A client with heart failure is taking digoxin. Which of the following findings should indicate
to the nurse that the client is experiencing digoxin toxicity?
A. Visual disturbances like yellow-green halos
, B. Increased appetite
C. Hypertension
D. Constipation
Answer: A
Rationale: Classic signs of digoxin toxicity include gastrointestinal upset, bradycardia, and
visual changes such as blurred vision or yellow-green halos. The nurse must check the
apical pulse for a full minute before administration and hold the dose if the rate is below 60
bpm. Serum potassium levels should also be monitored because hypokalemia increases the
risk of toxicity.
5. A nurse is reviewing the laboratory results for a client receiving warfarin. Which of the
following values indicates a therapeutic effect?
A. PTT of 60 seconds
B. INR of 2.5
C. Hgb of 10 g/dL
D. Platelets of 100,000/mm3
Answer: B
Rationale: The International Normalized Ratio (INR) is the standard measurement used to
monitor the effectiveness of warfarin therapy. For most conditions like atrial fibrillation or
| BSN 315 HESI RN Specialty
Pharmacology Exam | Nightingale
1. A nurse is preparing to administer heparin subcutaneously to a client. Which of the
following actions should the nurse take?
A. Massage the injection site to increase absorption.
B. Aspirate before injecting the medication.
C. Use a 22-gauge needle that is 1.5 inches long.
D. Inject the medication into the abdomen at least 2 inches from the umbilicus.
Answer: D
Rationale: Heparin should be administered in the subcutaneous tissue of the abdomen
while maintaining distance from the umbilicus. Massaging the site is contraindicated as it
can cause hematomas or bruising. Aspiration is not required for subcutaneous heparin and
can cause tissue damage.
2. A client is prescribed lisinopril for hypertension. Which of the following adverse effects
should the nurse monitor for?
A. Hypokalemia
B. Peripheral edema
C. Tachycardia
,D. Dry, persistent cough
Answer: D
Rationale: ACE inhibitors like lisinopril are well-known for causing a dry, non-productive
cough due to the accumulation of bradykinin. This side effect is a common reason for
patients to switch to an Angiotensin II Receptor Blocker (ARB). The nurse should also
monitor for hyperkalemia and angioedema while the client is on this medication.
3. A nurse is teaching a client about the use of a nitroglycerin patch. Which of the following
instructions should be included?
A. Remove the patch for 10 to 12 hours each day.
B. Apply a new patch every 48 hours.
C. Place the patch on the same site every time.
D. Cut the patch in half if a lower dose is needed.
Answer: A
Rationale: Nitroglycerin patches require a nitrate-free interval of 10 to 12 hours daily to
prevent the development of drug tolerance. Clients should rotate the application site to
prevent skin irritation and ensure the skin is clean and dry. Cutting the patch is prohibited
as it alters the delivery mechanism of the medication.
4. A client with heart failure is taking digoxin. Which of the following findings should indicate
to the nurse that the client is experiencing digoxin toxicity?
A. Visual disturbances like yellow-green halos
, B. Increased appetite
C. Hypertension
D. Constipation
Answer: A
Rationale: Classic signs of digoxin toxicity include gastrointestinal upset, bradycardia, and
visual changes such as blurred vision or yellow-green halos. The nurse must check the
apical pulse for a full minute before administration and hold the dose if the rate is below 60
bpm. Serum potassium levels should also be monitored because hypokalemia increases the
risk of toxicity.
5. A nurse is reviewing the laboratory results for a client receiving warfarin. Which of the
following values indicates a therapeutic effect?
A. PTT of 60 seconds
B. INR of 2.5
C. Hgb of 10 g/dL
D. Platelets of 100,000/mm3
Answer: B
Rationale: The International Normalized Ratio (INR) is the standard measurement used to
monitor the effectiveness of warfarin therapy. For most conditions like atrial fibrillation or
