BSN HESI Pharmacology Practice Exam verified correct answers A+
Graded with rationales 2026/2027 version
1. A client is prescribed digoxin 0.125 mg PO daily. Before administering the
medication, the nurse obtains an apical pulse of 54 beats/minute. What is the
nurse's priority action?
A. Administer the medication with breakfast.
B. Hold the medication and notify the healthcare provider.
C. Give half the prescribed dose.
D. Reassess the pulse after exercise.
✅ Correct Answer: B
Rationale: Digoxin slows the heart rate. An apical pulse below the prescriber's or institution's
specified threshold (commonly <60 beats/minute in adults) warrants holding the dose and
notifying the provider.
2. A client taking furosemide reports muscle weakness and leg cramps. Which
laboratory value requires immediate attention?
A. Sodium 139 mEq/L
B. Potassium 2.8 mEq/L
C. Glucose 104 mg/dL
D. Calcium 9.0 mg/dL
✅ Correct Answer: B
Rationale: Furosemide is a loop diuretic that can cause hypokalemia, increasing the risk of
dysrhythmias and muscle weakness.
3. Which assessment finding indicates therapeutic effectiveness of nitroglycerin
during an episode of angina?
A. Blood pressure increases.
B. Chest pain is relieved.
C. Heart rate decreases below 50 bpm.
D. Respiratory rate increases.
✅ Correct Answer: B
,Rationale: Nitroglycerin dilates coronary arteries and reduces myocardial oxygen demand,
relieving ischemic chest pain.
4. A client taking warfarin reports black, tarry stools. What should the nurse do
first?
A. Document the finding.
B. Notify the healthcare provider immediately.
C. Encourage increased fiber intake.
D. Reassure the client.
✅ Correct Answer: B
Rationale: Black, tarry stools (melena) may indicate gastrointestinal bleeding, a serious
complication of anticoagulation.
5. Which laboratory value should be monitored most closely in a client receiving
unfractionated heparin?
A. INR
B. aPTT
C. Hemoglobin A1c
D. Troponin
✅ Correct Answer: B
Rationale: Activated partial thromboplastin time (aPTT) is used to monitor unfractionated
heparin therapy.
6. Which medication is the antidote for heparin overdose?
A. Vitamin K
B. Protamine sulfate
C. Naloxone
D. Acetylcysteine
✅ Correct Answer: B
Rationale: Protamine sulfate neutralizes the effects of heparin.
,7. Which medication is the antidote for warfarin overdose?
A. Vitamin K (phytonadione)
B. Protamine sulfate
C. Flumazenil
D. Naloxone
✅ Correct Answer: A
Rationale: Vitamin K reverses the anticoagulant effects of warfarin.
8. A client is taking lisinopril. Which adverse effect should the nurse instruct the
client to report?
A. Dry, persistent cough
B. Constipation
C. Weight gain of 1 lb
D. Dry skin
✅ Correct Answer: A
Rationale: ACE inhibitors commonly cause a persistent dry cough and can also cause
angioedema.
9. Which laboratory value should be monitored in a client taking spironolactone?
A. Potassium
B. Calcium
C. Hemoglobin
D. Platelets
✅ Correct Answer: A
Rationale: Spironolactone is a potassium-sparing diuretic and may cause hyperkalemia.
10. A client receiving atorvastatin reports muscle pain and dark urine. Which
complication should the nurse suspect?
, A. Pancreatitis
B. Rhabdomyolysis
C. Pneumonia
D. Hypoglycemia
✅ Correct Answer: B
Rationale: Severe muscle pain with dark urine suggests rhabdomyolysis, a rare but life-
threatening adverse effect of statins.
11. Which instruction is most important for a client prescribed sublingual
nitroglycerin?
A. Swallow the tablet with water.
B. Store the tablets in the original dark glass container.
C. Refrigerate the medication.
D. Take one tablet every morning.
✅ Correct Answer: B
Rationale: Nitroglycerin is sensitive to heat, light, and moisture. Proper storage preserves
potency.
12. A client taking metoprolol has a heart rate of 48 beats/minute. What is the
nurse's priority action?
A. Administer the medication.
B. Hold the medication and notify the healthcare provider.
C. Encourage exercise.
D. Give the medication with food.
✅ Correct Answer: B
Rationale: Beta-blockers can cause significant bradycardia. A heart rate below the prescribed
threshold generally requires withholding the medication.
13. Which medication should not be stopped abruptly because of the risk of
rebound hypertension and tachycardia?
Graded with rationales 2026/2027 version
1. A client is prescribed digoxin 0.125 mg PO daily. Before administering the
medication, the nurse obtains an apical pulse of 54 beats/minute. What is the
nurse's priority action?
A. Administer the medication with breakfast.
B. Hold the medication and notify the healthcare provider.
C. Give half the prescribed dose.
D. Reassess the pulse after exercise.
✅ Correct Answer: B
Rationale: Digoxin slows the heart rate. An apical pulse below the prescriber's or institution's
specified threshold (commonly <60 beats/minute in adults) warrants holding the dose and
notifying the provider.
2. A client taking furosemide reports muscle weakness and leg cramps. Which
laboratory value requires immediate attention?
A. Sodium 139 mEq/L
B. Potassium 2.8 mEq/L
C. Glucose 104 mg/dL
D. Calcium 9.0 mg/dL
✅ Correct Answer: B
Rationale: Furosemide is a loop diuretic that can cause hypokalemia, increasing the risk of
dysrhythmias and muscle weakness.
3. Which assessment finding indicates therapeutic effectiveness of nitroglycerin
during an episode of angina?
A. Blood pressure increases.
B. Chest pain is relieved.
C. Heart rate decreases below 50 bpm.
D. Respiratory rate increases.
✅ Correct Answer: B
,Rationale: Nitroglycerin dilates coronary arteries and reduces myocardial oxygen demand,
relieving ischemic chest pain.
4. A client taking warfarin reports black, tarry stools. What should the nurse do
first?
A. Document the finding.
B. Notify the healthcare provider immediately.
C. Encourage increased fiber intake.
D. Reassure the client.
✅ Correct Answer: B
Rationale: Black, tarry stools (melena) may indicate gastrointestinal bleeding, a serious
complication of anticoagulation.
5. Which laboratory value should be monitored most closely in a client receiving
unfractionated heparin?
A. INR
B. aPTT
C. Hemoglobin A1c
D. Troponin
✅ Correct Answer: B
Rationale: Activated partial thromboplastin time (aPTT) is used to monitor unfractionated
heparin therapy.
6. Which medication is the antidote for heparin overdose?
A. Vitamin K
B. Protamine sulfate
C. Naloxone
D. Acetylcysteine
✅ Correct Answer: B
Rationale: Protamine sulfate neutralizes the effects of heparin.
,7. Which medication is the antidote for warfarin overdose?
A. Vitamin K (phytonadione)
B. Protamine sulfate
C. Flumazenil
D. Naloxone
✅ Correct Answer: A
Rationale: Vitamin K reverses the anticoagulant effects of warfarin.
8. A client is taking lisinopril. Which adverse effect should the nurse instruct the
client to report?
A. Dry, persistent cough
B. Constipation
C. Weight gain of 1 lb
D. Dry skin
✅ Correct Answer: A
Rationale: ACE inhibitors commonly cause a persistent dry cough and can also cause
angioedema.
9. Which laboratory value should be monitored in a client taking spironolactone?
A. Potassium
B. Calcium
C. Hemoglobin
D. Platelets
✅ Correct Answer: A
Rationale: Spironolactone is a potassium-sparing diuretic and may cause hyperkalemia.
10. A client receiving atorvastatin reports muscle pain and dark urine. Which
complication should the nurse suspect?
, A. Pancreatitis
B. Rhabdomyolysis
C. Pneumonia
D. Hypoglycemia
✅ Correct Answer: B
Rationale: Severe muscle pain with dark urine suggests rhabdomyolysis, a rare but life-
threatening adverse effect of statins.
11. Which instruction is most important for a client prescribed sublingual
nitroglycerin?
A. Swallow the tablet with water.
B. Store the tablets in the original dark glass container.
C. Refrigerate the medication.
D. Take one tablet every morning.
✅ Correct Answer: B
Rationale: Nitroglycerin is sensitive to heat, light, and moisture. Proper storage preserves
potency.
12. A client taking metoprolol has a heart rate of 48 beats/minute. What is the
nurse's priority action?
A. Administer the medication.
B. Hold the medication and notify the healthcare provider.
C. Encourage exercise.
D. Give the medication with food.
✅ Correct Answer: B
Rationale: Beta-blockers can cause significant bradycardia. A heart rate below the prescribed
threshold generally requires withholding the medication.
13. Which medication should not be stopped abruptly because of the risk of
rebound hypertension and tachycardia?
