BSN 315 HESI Pharmacology II Exam
3 Versions, Latest Update 2026/2027 | 200 Questions and Verified
Answers | Nightingale College Complete Q&A Guide | A+ Graded
VERSION 1: CARDIOVASCULAR & RENAL PHARMACOLOGY (Questions 1–67)
1. A client with heart failure is prescribed digoxin. Which finding indicates digoxin toxicity?
A) Heart rate 72 beats/min
B) Anorexia, nausea, and vomiting
C) Blood pressure 130/80 mmHg
D) Respiratory rate 18 breaths/min
Correct Answer: B
Rationale: Gastrointestinal symptoms, including anorexia, nausea, vomiting, and diarrhea, are early signs
of digoxin toxicity. Bradycardia is also a common sign. A heart rate of 72 is normal. Blood pressure and
respiratory rate are within normal limits.
2. A nurse is preparing to administer digoxin to a client with heart failure. The client's apical pulse is 52
beats/min. What is the priority nursing action?
A) Administer the digoxin as ordered
B) Hold the digoxin and notify the healthcare provider
C) Recheck the pulse in 30 minutes
D) Administer atropine to increase the heart rate
Correct Answer: B
,Rationale: Digoxin is contraindicated in bradycardia (typically pulse <60 beats/min in adults). The nurse
should withhold the medication and notify the provider for further instructions.
3. A client is prescribed furosemide (Lasix). Which laboratory value should the nurse monitor most
closely?
A) Serum sodium
B) Serum potassium
C) Serum calcium
D) Serum magnesium
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium wasting, leading to hypokalemia.
Hypokalemia increases the risk of cardiac dysrhythmias and digoxin toxicity.
4. A client with heart failure is prescribed furosemide (Lasix) IV. Which finding indicates the medication
is having the desired effect?
A) Decreased crackles in the lung bases
B) Increased blood pressure
C) Increased jugular venous distention
D) Decreased urinary output
Correct Answer: A
Rationale: Furosemide reduces preload, relieving pulmonary congestion (crackles). Urine output should
increase. Blood pressure may decrease. Jugular venous distention should decrease.
,5. A client is prescribed spironolactone for heart failure. Which finding should be reported to the
provider immediately?
A) Urine output 30 mL/hour
B) Serum potassium 5.8 mEq/L
C) Blood pressure 110/70 mmHg
D) Weight gain of 1 lb in 24 hours
Correct Answer: B
Rationale: Spironolactone is a potassiumsparing diuretic. Hyperkalemia (K >5.0 mEq/L) can cause
lifethreatening cardiac dysrhythmias and requires immediate intervention.
6. A client is prescribed hydrochlorothiazide (HCTZ) for hypertension. Which teaching point is most
important for the nurse to include?
A) "Take this medication at bedtime to avoid dizziness."
B) "You may experience an increased appetite while taking this medication."
C) "This medication may increase your blood potassium level."
D) "You may notice that you urinate more frequently, especially when you first start the medication."
Correct Answer: D
Rationale: HCTZ is a thiazide diuretic that increases urine output. The client should be advised that
increased urination is expected and that they may need to take the medication earlier in the day to
avoid nocturia. HCTZ can cause hypokalemia (not hyperkalemia).
, 7. A client is prescribed warfarin (Coumadin) for atrial fibrillation. Which laboratory test should the
nurse monitor to evaluate therapeutic effectiveness?
A) aPTT
B) INR
C) Platelet count
D) Bleeding time
Correct Answer: B
Rationale: The International Normalized Ratio (INR) is used to monitor warfarin therapy. The therapeutic
target for atrial fibrillation is typically an INR of 2.0–3.0.
8. A client is prescribed enoxaparin (Lovenox). How should the nurse administer this medication?
A) Intravenously over 2 minutes
B) Intramuscularly in the deltoid
C) Subcutaneously in the abdomen
D) Orally with a full glass of water
Correct Answer: C
Rationale: Enoxaparin is a lowmolecularweight heparin administered subcutaneously, typically in the
abdomen. The injection site should not be massaged.
9. A client is prescribed clopidogrel (Plavix). Which laboratory value should the nurse monitor?
3 Versions, Latest Update 2026/2027 | 200 Questions and Verified
Answers | Nightingale College Complete Q&A Guide | A+ Graded
VERSION 1: CARDIOVASCULAR & RENAL PHARMACOLOGY (Questions 1–67)
1. A client with heart failure is prescribed digoxin. Which finding indicates digoxin toxicity?
A) Heart rate 72 beats/min
B) Anorexia, nausea, and vomiting
C) Blood pressure 130/80 mmHg
D) Respiratory rate 18 breaths/min
Correct Answer: B
Rationale: Gastrointestinal symptoms, including anorexia, nausea, vomiting, and diarrhea, are early signs
of digoxin toxicity. Bradycardia is also a common sign. A heart rate of 72 is normal. Blood pressure and
respiratory rate are within normal limits.
2. A nurse is preparing to administer digoxin to a client with heart failure. The client's apical pulse is 52
beats/min. What is the priority nursing action?
A) Administer the digoxin as ordered
B) Hold the digoxin and notify the healthcare provider
C) Recheck the pulse in 30 minutes
D) Administer atropine to increase the heart rate
Correct Answer: B
,Rationale: Digoxin is contraindicated in bradycardia (typically pulse <60 beats/min in adults). The nurse
should withhold the medication and notify the provider for further instructions.
3. A client is prescribed furosemide (Lasix). Which laboratory value should the nurse monitor most
closely?
A) Serum sodium
B) Serum potassium
C) Serum calcium
D) Serum magnesium
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium wasting, leading to hypokalemia.
Hypokalemia increases the risk of cardiac dysrhythmias and digoxin toxicity.
4. A client with heart failure is prescribed furosemide (Lasix) IV. Which finding indicates the medication
is having the desired effect?
A) Decreased crackles in the lung bases
B) Increased blood pressure
C) Increased jugular venous distention
D) Decreased urinary output
Correct Answer: A
Rationale: Furosemide reduces preload, relieving pulmonary congestion (crackles). Urine output should
increase. Blood pressure may decrease. Jugular venous distention should decrease.
,5. A client is prescribed spironolactone for heart failure. Which finding should be reported to the
provider immediately?
A) Urine output 30 mL/hour
B) Serum potassium 5.8 mEq/L
C) Blood pressure 110/70 mmHg
D) Weight gain of 1 lb in 24 hours
Correct Answer: B
Rationale: Spironolactone is a potassiumsparing diuretic. Hyperkalemia (K >5.0 mEq/L) can cause
lifethreatening cardiac dysrhythmias and requires immediate intervention.
6. A client is prescribed hydrochlorothiazide (HCTZ) for hypertension. Which teaching point is most
important for the nurse to include?
A) "Take this medication at bedtime to avoid dizziness."
B) "You may experience an increased appetite while taking this medication."
C) "This medication may increase your blood potassium level."
D) "You may notice that you urinate more frequently, especially when you first start the medication."
Correct Answer: D
Rationale: HCTZ is a thiazide diuretic that increases urine output. The client should be advised that
increased urination is expected and that they may need to take the medication earlier in the day to
avoid nocturia. HCTZ can cause hypokalemia (not hyperkalemia).
, 7. A client is prescribed warfarin (Coumadin) for atrial fibrillation. Which laboratory test should the
nurse monitor to evaluate therapeutic effectiveness?
A) aPTT
B) INR
C) Platelet count
D) Bleeding time
Correct Answer: B
Rationale: The International Normalized Ratio (INR) is used to monitor warfarin therapy. The therapeutic
target for atrial fibrillation is typically an INR of 2.0–3.0.
8. A client is prescribed enoxaparin (Lovenox). How should the nurse administer this medication?
A) Intravenously over 2 minutes
B) Intramuscularly in the deltoid
C) Subcutaneously in the abdomen
D) Orally with a full glass of water
Correct Answer: C
Rationale: Enoxaparin is a lowmolecularweight heparin administered subcutaneously, typically in the
abdomen. The injection site should not be massaged.
9. A client is prescribed clopidogrel (Plavix). Which laboratory value should the nurse monitor?
