,BSN HESI 315 Exam 2026 – Complete 200-Question
Test Bank with Verified Answers & Detailed Rationales
| Nightingale College | Updated 2026/2027 Edition |
100% Pass Guarantee
Core Topics Covered
Section Topic Area Questions
I Pharmacology Fundamentals 1–25
II Cardiovascular & Hematologic Agents 26–50
III Endocrine & Metabolic Agents 51–75
IV Neurologic & Psychiatric Agents 76–100
V Anti-Infective & Antiviral Agents 101–125
VI Respiratory, GI, & Pain Management 126–150
VII Maternal-Newborn & Pediatric Nursing 151–175
VIII NGN Case Studies & Prioritization 176–200
✅ FULL 200-QUESTION PRACTICE EXAM
,SECTION I: PHARMACOLOGY FUNDAMENTALS (Questions 1–25)
Question 1
A nurse is preparing to administer a medication to a client. Which action is most
important to prevent medication errors?
A. Check the client's diagnosis
B. Use the "Rights" of medication administration
C. Ask the client if they have had the medication before
D. Check the expiration date
Correct Answer: B
Rationale: The "Rights" of medication administration (right client, drug, dose, route,
time, documentation, etc.) are the foundation of safe medication administration.
Checking diagnosis (A), asking the client (C), and checking expiration (D) are important
but are part of the broader rights framework.
Question 2
A client with renal impairment is prescribed a medication that is primarily excreted by
the kidneys. The nurse should anticipate:
A. A lower dose or longer interval between doses
B. A higher dose to achieve therapeutic effect
C. No change in dosing
D. A different route of administration
Correct Answer: A
Rationale: In renal impairment, drug excretion is reduced, leading to drug
accumulation. The dose should be reduced or the dosing interval extended to prevent
toxicity. A higher dose (B) would increase the risk of toxicity. No change (C) is unsafe. A
different route (D) does not address the underlying issue.
, Question 3
A client is taking two medications that compete for the same protein-binding sites. The
nurse should monitor for:
A. Decreased effectiveness of both drugs
B. Increased risk of toxicity of one or both drugs
C. No change in drug effects
D. Increased excretion of both drugs
Correct Answer: B
Rationale: When two drugs compete for the same protein-binding sites, one drug may
displace the other, increasing the concentration of free (active) drug and the risk of
toxicity. Decreased effectiveness (A) is not typical. No change (C) is incorrect. Excretion
(D) is not directly affected.
Question 4
A client is prescribed a medication with a narrow therapeutic index. Which nursing
action is most important?
A. Monitor serum drug levels regularly
B. Administer the medication with food
C. Encourage the client to increase fluid intake
D. Monitor for allergic reactions only
Correct Answer: A
Rationale: A narrow therapeutic index means there is a small margin between
therapeutic and toxic doses. Regular monitoring of serum drug levels is essential to
prevent toxicity. Administering with food (B), increasing fluids (C), and monitoring for
allergies (D) are important but not the priority.
Question 5
A nurse is teaching a client about the first-pass effect. Which route of administration
avoids the first-pass effect?
A. Oral
B. Sublingual
C. Rectal
D. Enteral
Test Bank with Verified Answers & Detailed Rationales
| Nightingale College | Updated 2026/2027 Edition |
100% Pass Guarantee
Core Topics Covered
Section Topic Area Questions
I Pharmacology Fundamentals 1–25
II Cardiovascular & Hematologic Agents 26–50
III Endocrine & Metabolic Agents 51–75
IV Neurologic & Psychiatric Agents 76–100
V Anti-Infective & Antiviral Agents 101–125
VI Respiratory, GI, & Pain Management 126–150
VII Maternal-Newborn & Pediatric Nursing 151–175
VIII NGN Case Studies & Prioritization 176–200
✅ FULL 200-QUESTION PRACTICE EXAM
,SECTION I: PHARMACOLOGY FUNDAMENTALS (Questions 1–25)
Question 1
A nurse is preparing to administer a medication to a client. Which action is most
important to prevent medication errors?
A. Check the client's diagnosis
B. Use the "Rights" of medication administration
C. Ask the client if they have had the medication before
D. Check the expiration date
Correct Answer: B
Rationale: The "Rights" of medication administration (right client, drug, dose, route,
time, documentation, etc.) are the foundation of safe medication administration.
Checking diagnosis (A), asking the client (C), and checking expiration (D) are important
but are part of the broader rights framework.
Question 2
A client with renal impairment is prescribed a medication that is primarily excreted by
the kidneys. The nurse should anticipate:
A. A lower dose or longer interval between doses
B. A higher dose to achieve therapeutic effect
C. No change in dosing
D. A different route of administration
Correct Answer: A
Rationale: In renal impairment, drug excretion is reduced, leading to drug
accumulation. The dose should be reduced or the dosing interval extended to prevent
toxicity. A higher dose (B) would increase the risk of toxicity. No change (C) is unsafe. A
different route (D) does not address the underlying issue.
, Question 3
A client is taking two medications that compete for the same protein-binding sites. The
nurse should monitor for:
A. Decreased effectiveness of both drugs
B. Increased risk of toxicity of one or both drugs
C. No change in drug effects
D. Increased excretion of both drugs
Correct Answer: B
Rationale: When two drugs compete for the same protein-binding sites, one drug may
displace the other, increasing the concentration of free (active) drug and the risk of
toxicity. Decreased effectiveness (A) is not typical. No change (C) is incorrect. Excretion
(D) is not directly affected.
Question 4
A client is prescribed a medication with a narrow therapeutic index. Which nursing
action is most important?
A. Monitor serum drug levels regularly
B. Administer the medication with food
C. Encourage the client to increase fluid intake
D. Monitor for allergic reactions only
Correct Answer: A
Rationale: A narrow therapeutic index means there is a small margin between
therapeutic and toxic doses. Regular monitoring of serum drug levels is essential to
prevent toxicity. Administering with food (B), increasing fluids (C), and monitoring for
allergies (D) are important but not the priority.
Question 5
A nurse is teaching a client about the first-pass effect. Which route of administration
avoids the first-pass effect?
A. Oral
B. Sublingual
C. Rectal
D. Enteral
