,HESI RN Pharmacology V2 Exam (3 Set Exams) | Actual
Exams with Rationales
HESI RN Pharmacology V2 Exam - Set 1
HESI RN Pharmacology V2 Exam - Set 2
HESI RN Pharmacology V2 Exam - Set 3
HESI RN Pharmacology V2 Exam - Set 1
Question 1: The nurse is caring for a client who has taken atenolol for 2 years. The
healthcare provider recently changed the medication to enalapril to manage the client's
blood pressure. Which instruction should the nurse provide the client regarding the new
medication?
A. Take the medication at bedtime.
B. Report presence of increased bruising.
C. Check pulse before taking medication.
D. Rise slowly when getting out of bed or chair.
Answer: D. Rise slowly when getting out of bed or chair.
Rationale: Enalapril (ACE inhibitor) can cause vasodilation and orthostatic hypotension.
Teaching the client to stand up slowly helps prevent dizziness or falls .
Question 2: A client is prescribed a medication with a half-life of 4 days. Based on this
half-life, the medication will most likely be prescribed:
A. Once a day
B. Twice a day
C. Three times a day
D. Four times a day
Answer: A. Once a day
,Rationale: Medications with long half-lives remain at therapeutic levels between doses
for extended periods, allowing for once-daily dosing. A half-life of 4 days is considered
long, making once-daily administration appropriate to maintain steady-state
concentrations .
Question 3: A client being discharged home is prescribed an antibiotic with a dosage
three times higher than it was administered when in the hospital. Which route of
administration should the nurse anticipate will be prescribed for the greatest first-pass
effect?
A. Oral
B. Sublingual
C. Intravenous
D. Subcutaneous
Answer: A. Oral
Rationale: Oral medications undergo extensive first-pass metabolism in the liver,
significantly reducing bioavailability before reaching systemic circulation. Higher oral
doses are often required to achieve the same therapeutic effect as IV administration due
to this first-pass effect .
Question 4: A client is receiving digoxin therapy for chronic heart failure. The nurse
notes a heart rate of 56 bpm, serum digoxin level of 2.8 ng/mL (therapeutic range 0.8–
2.0 ng/mL), and serum potassium of 3.2 mEq/L (normal 3.5–5.0 mEq/L). What is the
nurse's priority action?
A. Administer digoxin as ordered and observe the patient
B. Hold the digoxin dose and report toxicity signs to the provider immediately
C. Encourage the patient to take digoxin with food to reduce GI upset
D. Check potassium levels and remind the patient to avoid potassium-rich foods
Answer: B. Hold the digoxin dose and report toxicity signs to the provider
immediately
, Rationale: Serum digoxin level above 2.0 ng/mL, along with bradycardia and
hypokalemia, indicates digoxin toxicity. The medication should be withheld and the
provider notified immediately. Hypokalemia increases toxicity risk .
Question 5: A client has a prescription for theophylline (Theo-Dur) PO to be initiated in
the morning after IV theophylline is complete. The nurse determines that a theophylline
level drawn yesterday was 22 mcg/mL. Based on this information, which action should
the nurse implement?
A. Hold the theophylline dose and notify the healthcare provider
B. Start the client on a half-dose of theophylline PO
C. Initiate the theophylline dose as planned
D. The client is not ready to be weaned from IV to PO route
Answer: A. Hold the theophylline dose and notify the healthcare provider
Rationale: A theophylline level of 22 mcg/mL exceeds the therapeutic range (typically
10–20 mcg/mL) and indicates toxicity risk. The nurse must hold the dose and notify the
provider to prevent adverse effects such as cardiac arrhythmias or seizures .
Question 6: The nurse is preparing the 0900 dose of losartan (Cozaar), an ARB, for a
client with hypertension and heart failure. The nurse notes the serum potassium is 5.9
mEq/L. Which action should the nurse take first?
A. Withhold the scheduled dose
B. Check the client's apical pulse
C. Notify the healthcare provider
D. Repeat the serum potassium level
Answer: A. Withhold the scheduled dose
Rationale: Losartan can worsen hyperkalemia by reducing aldosterone. A potassium of
5.9 is significantly high. Holding the dose prevents further elevation. Next steps include
informing the provider, but the immediate priority is not to give the drug .
Exams with Rationales
HESI RN Pharmacology V2 Exam - Set 1
HESI RN Pharmacology V2 Exam - Set 2
HESI RN Pharmacology V2 Exam - Set 3
HESI RN Pharmacology V2 Exam - Set 1
Question 1: The nurse is caring for a client who has taken atenolol for 2 years. The
healthcare provider recently changed the medication to enalapril to manage the client's
blood pressure. Which instruction should the nurse provide the client regarding the new
medication?
A. Take the medication at bedtime.
B. Report presence of increased bruising.
C. Check pulse before taking medication.
D. Rise slowly when getting out of bed or chair.
Answer: D. Rise slowly when getting out of bed or chair.
Rationale: Enalapril (ACE inhibitor) can cause vasodilation and orthostatic hypotension.
Teaching the client to stand up slowly helps prevent dizziness or falls .
Question 2: A client is prescribed a medication with a half-life of 4 days. Based on this
half-life, the medication will most likely be prescribed:
A. Once a day
B. Twice a day
C. Three times a day
D. Four times a day
Answer: A. Once a day
,Rationale: Medications with long half-lives remain at therapeutic levels between doses
for extended periods, allowing for once-daily dosing. A half-life of 4 days is considered
long, making once-daily administration appropriate to maintain steady-state
concentrations .
Question 3: A client being discharged home is prescribed an antibiotic with a dosage
three times higher than it was administered when in the hospital. Which route of
administration should the nurse anticipate will be prescribed for the greatest first-pass
effect?
A. Oral
B. Sublingual
C. Intravenous
D. Subcutaneous
Answer: A. Oral
Rationale: Oral medications undergo extensive first-pass metabolism in the liver,
significantly reducing bioavailability before reaching systemic circulation. Higher oral
doses are often required to achieve the same therapeutic effect as IV administration due
to this first-pass effect .
Question 4: A client is receiving digoxin therapy for chronic heart failure. The nurse
notes a heart rate of 56 bpm, serum digoxin level of 2.8 ng/mL (therapeutic range 0.8–
2.0 ng/mL), and serum potassium of 3.2 mEq/L (normal 3.5–5.0 mEq/L). What is the
nurse's priority action?
A. Administer digoxin as ordered and observe the patient
B. Hold the digoxin dose and report toxicity signs to the provider immediately
C. Encourage the patient to take digoxin with food to reduce GI upset
D. Check potassium levels and remind the patient to avoid potassium-rich foods
Answer: B. Hold the digoxin dose and report toxicity signs to the provider
immediately
, Rationale: Serum digoxin level above 2.0 ng/mL, along with bradycardia and
hypokalemia, indicates digoxin toxicity. The medication should be withheld and the
provider notified immediately. Hypokalemia increases toxicity risk .
Question 5: A client has a prescription for theophylline (Theo-Dur) PO to be initiated in
the morning after IV theophylline is complete. The nurse determines that a theophylline
level drawn yesterday was 22 mcg/mL. Based on this information, which action should
the nurse implement?
A. Hold the theophylline dose and notify the healthcare provider
B. Start the client on a half-dose of theophylline PO
C. Initiate the theophylline dose as planned
D. The client is not ready to be weaned from IV to PO route
Answer: A. Hold the theophylline dose and notify the healthcare provider
Rationale: A theophylline level of 22 mcg/mL exceeds the therapeutic range (typically
10–20 mcg/mL) and indicates toxicity risk. The nurse must hold the dose and notify the
provider to prevent adverse effects such as cardiac arrhythmias or seizures .
Question 6: The nurse is preparing the 0900 dose of losartan (Cozaar), an ARB, for a
client with hypertension and heart failure. The nurse notes the serum potassium is 5.9
mEq/L. Which action should the nurse take first?
A. Withhold the scheduled dose
B. Check the client's apical pulse
C. Notify the healthcare provider
D. Repeat the serum potassium level
Answer: A. Withhold the scheduled dose
Rationale: Losartan can worsen hyperkalemia by reducing aldosterone. A potassium of
5.9 is significantly high. Holding the dose prevents further elevation. Next steps include
informing the provider, but the immediate priority is not to give the drug .
