BSN 315 Pharmacology Exam HESI V1-
NIGHTINGALE -NEWEST UPDATE 2026-
2027
Question 1
A nurse is preparing to administer digoxin 0.25 mg PO to a patient with heart failure.
Before administration, which assessment is the PRIORITY?
A. Check the patient's blood pressure
B. Assess the apical pulse for 1 full minute
C. Monitor the patient's respiratory rate
D. Check the patient's oxygen saturation
Correct Answer: B
Rationale: Before administering digoxin, the nurse must assess the apical pulse for a
full minute. If the pulse is <60 bpm in an adult, the medication should be held and
the provider notified due to risk of bradycardia and digoxin toxicity. Blood pressure,
respiratory rate, and SpO2 are important but not the priority assessment before
digoxin.
Question 2
The nurse is administering a medication via the intramuscular (IM) route. Which
muscle is the preferred site for IM injections in adults receiving medications that may
cause tissue irritation?
A. Deltoid muscle
B. Vastus lateralis
C. Ventrogluteal muscle
D. Dorsogluteal muscle
Correct Answer: C
1
, Rationale: The ventrogluteal muscle is the preferred IM injection site for adults
because it is free of major nerves and blood vessels, has a thick muscle mass, and can
accommodate larger volumes (up to 2.5 mL). The deltoid is for smaller volumes (≤1
mL). The dorsogluteal site is no longer recommended due to risk of sciatic nerve
injury. Vastus lateralis is preferred in infants.
Question 3
A patient is prescribed warfarin 5 mg daily. The nurse reviews the patient's INR, which
is 3.8. The therapeutic range for this patient is 2.0-3.0. What is the nurse's PRIORITY
action?
A. Administer the warfarin as ordered and document the INR
B. Hold the warfarin and notify the provider immediately
C. Administer vitamin K 10 mg IV immediately
D. Recheck the INR in 2 hours
Correct Answer: B
Rationale: An INR of 3.8 is above the therapeutic range of 2.0-3.0. The nurse should
HOLD the warfarin dose and notify the provider. The provider will determine if a
dose adjustment is needed. Vitamin K is reserved for INR >10 or active bleeding.
Rechecking in 2 hours is not appropriate without provider notification.
Question 4
The nurse is preparing to administer insulin glargine (Lantus) at 2100. Which
statement by the nurse indicates correct understanding of this medication?
A. I will mix the Lantus with regular insulin in the same syringe
B. I will administer this at the same time every day to maintain steady blood levels
C. I will give this when the patient's blood glucose is >200 mg/dL
D. I will hold this dose if the patient skips dinner
Correct Answer: B
2
NIGHTINGALE -NEWEST UPDATE 2026-
2027
Question 1
A nurse is preparing to administer digoxin 0.25 mg PO to a patient with heart failure.
Before administration, which assessment is the PRIORITY?
A. Check the patient's blood pressure
B. Assess the apical pulse for 1 full minute
C. Monitor the patient's respiratory rate
D. Check the patient's oxygen saturation
Correct Answer: B
Rationale: Before administering digoxin, the nurse must assess the apical pulse for a
full minute. If the pulse is <60 bpm in an adult, the medication should be held and
the provider notified due to risk of bradycardia and digoxin toxicity. Blood pressure,
respiratory rate, and SpO2 are important but not the priority assessment before
digoxin.
Question 2
The nurse is administering a medication via the intramuscular (IM) route. Which
muscle is the preferred site for IM injections in adults receiving medications that may
cause tissue irritation?
A. Deltoid muscle
B. Vastus lateralis
C. Ventrogluteal muscle
D. Dorsogluteal muscle
Correct Answer: C
1
, Rationale: The ventrogluteal muscle is the preferred IM injection site for adults
because it is free of major nerves and blood vessels, has a thick muscle mass, and can
accommodate larger volumes (up to 2.5 mL). The deltoid is for smaller volumes (≤1
mL). The dorsogluteal site is no longer recommended due to risk of sciatic nerve
injury. Vastus lateralis is preferred in infants.
Question 3
A patient is prescribed warfarin 5 mg daily. The nurse reviews the patient's INR, which
is 3.8. The therapeutic range for this patient is 2.0-3.0. What is the nurse's PRIORITY
action?
A. Administer the warfarin as ordered and document the INR
B. Hold the warfarin and notify the provider immediately
C. Administer vitamin K 10 mg IV immediately
D. Recheck the INR in 2 hours
Correct Answer: B
Rationale: An INR of 3.8 is above the therapeutic range of 2.0-3.0. The nurse should
HOLD the warfarin dose and notify the provider. The provider will determine if a
dose adjustment is needed. Vitamin K is reserved for INR >10 or active bleeding.
Rechecking in 2 hours is not appropriate without provider notification.
Question 4
The nurse is preparing to administer insulin glargine (Lantus) at 2100. Which
statement by the nurse indicates correct understanding of this medication?
A. I will mix the Lantus with regular insulin in the same syringe
B. I will administer this at the same time every day to maintain steady blood levels
C. I will give this when the patient's blood glucose is >200 mg/dL
D. I will hold this dose if the patient skips dinner
Correct Answer: B
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