BSN 315 HESI PHARMACOLOGY II EXAM
WITH QUESTIONS AND CORRECT
ANSWERS WITH RATIONALES
A patient is instructed to take warfarin. Which food would the nurse advice to eat
consistently because it affects INR?
A. Leafy green vegetables (consistent intake)
B. Grapefruit juice only when INR is high
C. High-potassium foods
D. Dairy foods
Answer: A. Leafy green vegetables (consistent intake)
Rationale: Vitamin K in leafy greens affects warfarin; counsel consistent intake to avoid
INR fluctuations.
Which inhaled medication is used for maintenance control of asthma and has an anti-
inflammatory effect?
A. Albuterol (SABA)
B. Fluticasone (inhaled corticosteroid)
C. Ipratropium (anticholinergic)
D. Montelukast (oral leukotriene antagonist)
Answer: B. Fluticasone (inhaled corticosteroid)
Rationale: Inhaled corticosteroids reduce airway inflammation and are first-line for persistent
asthma control.
A patient with type 2 diabetes is started on metformin. Which instruction is most important?
A. Take with full glass of grapefruit juice.
B. Discontinue before contrast dye procedures as ordered.
C. Expect rapid weight gain.
D. It causes hypoglycemia when used alone.
Answer: B. Discontinue before contrast dye procedures as ordered.
Rationale: Metformin risks lactic acidosis with iodinated contrast; stop per protocol. It is weight
neutral/helps weight loss and rarely causes hypoglycemia by itself.
Which medication class is contraindicated in pregnancy because of teratogenic effects on the
fetus?
A. Beta-blockers
B. ACE inhibitors (e.g., lisinopril)
, C. Methyldopa
D. Hydralazine
Answer: B. ACE inhibitors (e.g., lisinopril)
Rationale: ACE inhibitors cause fetal renal injury and are contraindicated in pregnancy.
A nurse is teaching a patient about oral contraceptives. Which is an important warning sign to
report? A. Mild nausea
B. Breakthrough bleeding
C. Severe calf pain or sudden shortness of breath
D. Headache that resolves in a day
Answer: C. Severe calf pain or sudden shortness of breath
Rationale: These suggest DVT/PE — estrogen-containing contraceptives increase thrombotic
risk.
A patient receiving heparin IV for DVT has a platelet drop >50%. The nurse suspects:
A. Heparin-induced thrombocytopenia (HIT)
B. Infection-related thrombocytopenia
C. Normal heparin effect
D. Vitamin K deficiency
Answer: A. Heparin-induced thrombocytopenia (HIT)
Rationale: Significant platelet drop after heparin suggests HIT; stop all heparin and use
alternative anticoagulant.
Which drug is indicated for status epilepticus and can be given IV for immediate effect?
A. Phenytoin only
B. Benzodiazepine (e.g., IV lorazepam)
C. Valproate oral syrup only
D. Carbamazepine oral pill
Answer: B. Benzodiazepine (e.g., IV lorazepam)
Rationale: IV benzodiazepines are first-line for immediate seizure control in status epilepticus.
A patient on isoniazid (INH) for TB should be taught to take which supplement to prevent
neuropathy?
A. Vitamin C
B. Pyridoxine (vitamin B6)
C. Folic acid
D. Calcium
Answer: B. Pyridoxine (vitamin B6)
WITH QUESTIONS AND CORRECT
ANSWERS WITH RATIONALES
A patient is instructed to take warfarin. Which food would the nurse advice to eat
consistently because it affects INR?
A. Leafy green vegetables (consistent intake)
B. Grapefruit juice only when INR is high
C. High-potassium foods
D. Dairy foods
Answer: A. Leafy green vegetables (consistent intake)
Rationale: Vitamin K in leafy greens affects warfarin; counsel consistent intake to avoid
INR fluctuations.
Which inhaled medication is used for maintenance control of asthma and has an anti-
inflammatory effect?
A. Albuterol (SABA)
B. Fluticasone (inhaled corticosteroid)
C. Ipratropium (anticholinergic)
D. Montelukast (oral leukotriene antagonist)
Answer: B. Fluticasone (inhaled corticosteroid)
Rationale: Inhaled corticosteroids reduce airway inflammation and are first-line for persistent
asthma control.
A patient with type 2 diabetes is started on metformin. Which instruction is most important?
A. Take with full glass of grapefruit juice.
B. Discontinue before contrast dye procedures as ordered.
C. Expect rapid weight gain.
D. It causes hypoglycemia when used alone.
Answer: B. Discontinue before contrast dye procedures as ordered.
Rationale: Metformin risks lactic acidosis with iodinated contrast; stop per protocol. It is weight
neutral/helps weight loss and rarely causes hypoglycemia by itself.
Which medication class is contraindicated in pregnancy because of teratogenic effects on the
fetus?
A. Beta-blockers
B. ACE inhibitors (e.g., lisinopril)
, C. Methyldopa
D. Hydralazine
Answer: B. ACE inhibitors (e.g., lisinopril)
Rationale: ACE inhibitors cause fetal renal injury and are contraindicated in pregnancy.
A nurse is teaching a patient about oral contraceptives. Which is an important warning sign to
report? A. Mild nausea
B. Breakthrough bleeding
C. Severe calf pain or sudden shortness of breath
D. Headache that resolves in a day
Answer: C. Severe calf pain or sudden shortness of breath
Rationale: These suggest DVT/PE — estrogen-containing contraceptives increase thrombotic
risk.
A patient receiving heparin IV for DVT has a platelet drop >50%. The nurse suspects:
A. Heparin-induced thrombocytopenia (HIT)
B. Infection-related thrombocytopenia
C. Normal heparin effect
D. Vitamin K deficiency
Answer: A. Heparin-induced thrombocytopenia (HIT)
Rationale: Significant platelet drop after heparin suggests HIT; stop all heparin and use
alternative anticoagulant.
Which drug is indicated for status epilepticus and can be given IV for immediate effect?
A. Phenytoin only
B. Benzodiazepine (e.g., IV lorazepam)
C. Valproate oral syrup only
D. Carbamazepine oral pill
Answer: B. Benzodiazepine (e.g., IV lorazepam)
Rationale: IV benzodiazepines are first-line for immediate seizure control in status epilepticus.
A patient on isoniazid (INH) for TB should be taught to take which supplement to prevent
neuropathy?
A. Vitamin C
B. Pyridoxine (vitamin B6)
C. Folic acid
D. Calcium
Answer: B. Pyridoxine (vitamin B6)
