HESI Pharmacology Exam Questions and Answers
2025/2026 | Comprehensive Nursing Prep
250 high-yield HESI-style questions • larger answer dots • correct answer shown with a green tick inside an empty
box
Important: These are original practice questions, not leaked or reproduced HESI exam items. They are modeled on publicly described
HESI/NCLEX-style pharmacology domains such as medication safety, pharmacokinetics/dynamics, major drug classes, adverse effects,
patient teaching, calculations, and priority questions.
Clinical visual — patient identification and medication-safety workflow
Two identifiers • allergies • medication • dose • route • time • response
Clinical visual — medication-label verification
DRUG Verify label against MAR at required checkpoints.
Clinical visual — respiratory pharmacology
Controller vs rescue therapy • inhaler technique • mouth care
HESI Pharmacology Exam Questions & Answers 2025/2026 — original HESI-style practice Page 1
, HIGH-YIELD VISUAL REVIEW
Clinical visual — cardiovascular monitoring
Correlate rate/rhythm and symptoms when giving cardiovascular drugs.
Clinical visual — renal elimination
Renal impairment can prolong drug half-life and require dose adjustment.
Clinical visual — insulin safety
Verify insulin type, concentration, dose, glucose and timing.
Answer format: incorrect options begin with a large dot. The correct option replaces the dot with a larger empty box containing a green
tick.
HESI Pharmacology Exam Questions & Answers 2025/2026 — original HESI-style practice Page 2
, 1. A client taking warfarin has an INR of 5.2. Which action is the priority?
• Administer the next dose with food
Hold the medication and notify the provider
• Encourage a high-vitamin-K meal
•Rationale: An INR of 5.2 indicates excessive anticoagulation and increased bleeding risk; the dose should be held and the prescriber
Give aspirin for headache
notified.
2. Which finding in a client receiving digoxin requires immediate follow-up?
• Apical pulse 88/min
• Mild fatigue after activity
Yellow-green visual halos
•Rationale: Visual disturbances can indicate digoxin toxicity and require prompt evaluation.
Potassium 4.2 mEq/L
3. Which laboratory value is most important to monitor for a client receiving heparin?
• INR
aPTT
• HbA1c
•Rationale: Unfractionated heparin is commonly titrated using the aPTT or an institution-specific anti-Xa protocol.
Serum amylase
4. A client taking lisinopril reports swelling of the lips and tongue. What should the nurse do first?
• Give the next dose
• Place the client supine and reassess later
Hold the medication and obtain urgent medical assistance
•Rationale: Facial or tongue swelling may represent angioedema, a potentially life-threatening reaction.
Offer potassium-rich foods
5. Which assessment is most important before administering metoprolol?
• Bowel sounds
Heart rate and blood pressure
• Pupil size
•Rationale: Beta blockers can lower heart rate and blood pressure; these should be assessed before administration.
Skin turgor
6. A client taking furosemide has potassium 2.8 mEq/L. Which action is best?
• Administer furosemide as prescribed
Hold the medication and notify the provider
• Encourage sodium restriction only
•Rationale: Loop diuretics can worsen hypokalemia; severe hypokalemia increases dysrhythmia risk.
Give an antacid
7. Which instruction is appropriate for a client taking spironolactone?
• Use potassium-based salt substitutes freely
Avoid excessive potassium intake
• Take extra potassium daily
•Rationale: Spironolactone is potassium-sparing and can cause hyperkalemia.
Stop the medication when edema improves
8. Which adverse effect is most concerning in a client receiving amiodarone?
• Mild constipation
Progressive shortness of breath
• Increased appetite
•Rationale: Amiodarone can cause pulmonary toxicity; new dyspnea requires evaluation.
Temporary thirst
9. A client taking atorvastatin reports severe muscle pain and dark urine. What is the priority action?
HESI Pharmacology Exam Questions & Answers 2025/2026 — original HESI-style practice Page 3
, • Encourage strenuous exercise
Notify the provider promptly
• Tell the client this is expected
•Rationale: Severe myalgia with dark urine suggests rhabdomyolysis and requires prompt evaluation.
Give a potassium supplement
10. Which medication is a loop diuretic?
• Hydrochlorothiazide
Furosemide
• Spironolactone
•Rationale: Furosemide is a loop diuretic that inhibits sodium-potassium-chloride reabsorption in the loop of Henle.
Amiloride
11. Which medication is an ACE inhibitor?
• Losartan
Lisinopril
• Metoprolol
•Rationale: Lisinopril inhibits angiotensin-converting enzyme.
Amlodipine
12. A client taking losartan should be monitored for which electrolyte problem?
• Hypocalcemia
Hyperkalemia
• Hypernatremia
•Rationale: ARBs can decrease aldosterone activity and increase serum potassium.
Hypophosphatemia
13. Which medication is a calcium-channel blocker?
Amlodipine
• Lisinopril
• Furosemide
•Rationale: Amlodipine is a dihydropyridine calcium-channel blocker.
Digoxin
14. Which teaching is appropriate for nitroglycerin sublingual tablets?
• Swallow the tablet whole
• Take it while standing
Sit down before taking the dose
•Rationale: Nitroglycerin can cause dizziness and hypotension; sitting reduces fall risk.
Store it in the bathroom
15. A client using nitroglycerin asks about sildenafil. What is the best response?
• They can be taken together
Sildenafil may cause dangerous hypotension with nitrates
• Take sildenafil first
•Rationale: PDE-5 inhibitors and nitrates can produce profound hypotension and should not be combined.
Only take both with food
16. Which adverse effect should a client taking hydrochlorothiazide report?
• Increased urination
Muscle weakness or palpitations
• Mild thirst
•Rationale: Thiazides can cause hypokalemia, which may present with weakness or dysrhythmias.
Improved blood pressure
17. A client receiving vancomycin develops flushing and hypotension during a rapid infusion. Which reaction is
most likely?
Red man syndrome
HESI Pharmacology Exam Questions & Answers 2025/2026 — original HESI-style practice Page 4
2025/2026 | Comprehensive Nursing Prep
250 high-yield HESI-style questions • larger answer dots • correct answer shown with a green tick inside an empty
box
Important: These are original practice questions, not leaked or reproduced HESI exam items. They are modeled on publicly described
HESI/NCLEX-style pharmacology domains such as medication safety, pharmacokinetics/dynamics, major drug classes, adverse effects,
patient teaching, calculations, and priority questions.
Clinical visual — patient identification and medication-safety workflow
Two identifiers • allergies • medication • dose • route • time • response
Clinical visual — medication-label verification
DRUG Verify label against MAR at required checkpoints.
Clinical visual — respiratory pharmacology
Controller vs rescue therapy • inhaler technique • mouth care
HESI Pharmacology Exam Questions & Answers 2025/2026 — original HESI-style practice Page 1
, HIGH-YIELD VISUAL REVIEW
Clinical visual — cardiovascular monitoring
Correlate rate/rhythm and symptoms when giving cardiovascular drugs.
Clinical visual — renal elimination
Renal impairment can prolong drug half-life and require dose adjustment.
Clinical visual — insulin safety
Verify insulin type, concentration, dose, glucose and timing.
Answer format: incorrect options begin with a large dot. The correct option replaces the dot with a larger empty box containing a green
tick.
HESI Pharmacology Exam Questions & Answers 2025/2026 — original HESI-style practice Page 2
, 1. A client taking warfarin has an INR of 5.2. Which action is the priority?
• Administer the next dose with food
Hold the medication and notify the provider
• Encourage a high-vitamin-K meal
•Rationale: An INR of 5.2 indicates excessive anticoagulation and increased bleeding risk; the dose should be held and the prescriber
Give aspirin for headache
notified.
2. Which finding in a client receiving digoxin requires immediate follow-up?
• Apical pulse 88/min
• Mild fatigue after activity
Yellow-green visual halos
•Rationale: Visual disturbances can indicate digoxin toxicity and require prompt evaluation.
Potassium 4.2 mEq/L
3. Which laboratory value is most important to monitor for a client receiving heparin?
• INR
aPTT
• HbA1c
•Rationale: Unfractionated heparin is commonly titrated using the aPTT or an institution-specific anti-Xa protocol.
Serum amylase
4. A client taking lisinopril reports swelling of the lips and tongue. What should the nurse do first?
• Give the next dose
• Place the client supine and reassess later
Hold the medication and obtain urgent medical assistance
•Rationale: Facial or tongue swelling may represent angioedema, a potentially life-threatening reaction.
Offer potassium-rich foods
5. Which assessment is most important before administering metoprolol?
• Bowel sounds
Heart rate and blood pressure
• Pupil size
•Rationale: Beta blockers can lower heart rate and blood pressure; these should be assessed before administration.
Skin turgor
6. A client taking furosemide has potassium 2.8 mEq/L. Which action is best?
• Administer furosemide as prescribed
Hold the medication and notify the provider
• Encourage sodium restriction only
•Rationale: Loop diuretics can worsen hypokalemia; severe hypokalemia increases dysrhythmia risk.
Give an antacid
7. Which instruction is appropriate for a client taking spironolactone?
• Use potassium-based salt substitutes freely
Avoid excessive potassium intake
• Take extra potassium daily
•Rationale: Spironolactone is potassium-sparing and can cause hyperkalemia.
Stop the medication when edema improves
8. Which adverse effect is most concerning in a client receiving amiodarone?
• Mild constipation
Progressive shortness of breath
• Increased appetite
•Rationale: Amiodarone can cause pulmonary toxicity; new dyspnea requires evaluation.
Temporary thirst
9. A client taking atorvastatin reports severe muscle pain and dark urine. What is the priority action?
HESI Pharmacology Exam Questions & Answers 2025/2026 — original HESI-style practice Page 3
, • Encourage strenuous exercise
Notify the provider promptly
• Tell the client this is expected
•Rationale: Severe myalgia with dark urine suggests rhabdomyolysis and requires prompt evaluation.
Give a potassium supplement
10. Which medication is a loop diuretic?
• Hydrochlorothiazide
Furosemide
• Spironolactone
•Rationale: Furosemide is a loop diuretic that inhibits sodium-potassium-chloride reabsorption in the loop of Henle.
Amiloride
11. Which medication is an ACE inhibitor?
• Losartan
Lisinopril
• Metoprolol
•Rationale: Lisinopril inhibits angiotensin-converting enzyme.
Amlodipine
12. A client taking losartan should be monitored for which electrolyte problem?
• Hypocalcemia
Hyperkalemia
• Hypernatremia
•Rationale: ARBs can decrease aldosterone activity and increase serum potassium.
Hypophosphatemia
13. Which medication is a calcium-channel blocker?
Amlodipine
• Lisinopril
• Furosemide
•Rationale: Amlodipine is a dihydropyridine calcium-channel blocker.
Digoxin
14. Which teaching is appropriate for nitroglycerin sublingual tablets?
• Swallow the tablet whole
• Take it while standing
Sit down before taking the dose
•Rationale: Nitroglycerin can cause dizziness and hypotension; sitting reduces fall risk.
Store it in the bathroom
15. A client using nitroglycerin asks about sildenafil. What is the best response?
• They can be taken together
Sildenafil may cause dangerous hypotension with nitrates
• Take sildenafil first
•Rationale: PDE-5 inhibitors and nitrates can produce profound hypotension and should not be combined.
Only take both with food
16. Which adverse effect should a client taking hydrochlorothiazide report?
• Increased urination
Muscle weakness or palpitations
• Mild thirst
•Rationale: Thiazides can cause hypokalemia, which may present with weakness or dysrhythmias.
Improved blood pressure
17. A client receiving vancomycin develops flushing and hypotension during a rapid infusion. Which reaction is
most likely?
Red man syndrome
HESI Pharmacology Exam Questions & Answers 2025/2026 — original HESI-style practice Page 4
