PHARMACOLOGY HESI EXAM PREP -
ADVANCED LEVEL PHARM HESI
PRACTICE QUIZ: PAIN MANAGEMENT
& MEDICATION PROTOCOLS
1. A client is prescribed Digoxin for heart failure. Which electrolyte imbalance should the
nurse most closely monitor for as it significantly increases the risk of digoxin toxicity?
A. Hypercalcemia
B. Hyponatremia
C. Hypermagnesemia
D. Hypokalemia
Answer: D
Conceptual Explanation: Hypokalemia sensitizes the myocardium to digoxin, increasing
the risk of toxicity. The nurse must monitor potassium levels closely, especially if the client
is also taking loop diuretics.
,2. A patient is receiving intravenous Heparin for a pulmonary embolism. Which laboratory
value is the primary indicator of the drug’s therapeutic effectiveness?
A. Prothrombin Time (PT)
B. International Normalized Ratio (INR)
C. Platelet Count
D. Activated Partial Thromboplastin Time (aPTT)
Answer: D
Conceptual Explanation: aPTT is used to monitor the effectiveness of Heparin therapy. PT
and INR are used for Warfarin therapy monitoring.
3. The nurse is educating a client starting Lithium Carbonate for Bipolar Disorder. What
dietary instruction is critical for preventing lithium toxicity?
A. Consistent sodium intake and adequate hydration
B. Maintain a low-sodium diet
C. Increase intake of leafy green vegetables
D. Restrict fluid intake to 1 liter per day
Answer: A
Conceptual Explanation: Sodium depletion causes the kidneys to retain lithium, leading to
toxicity. Patients must maintain a consistent sodium intake and avoid dehydration.
, 4. A client receiving Vancomycin intravenously develops sudden hypotension, flushing, and a
rash on the face and neck. What is the nurse’s priority action?
A. Administer Epinephrine immediately
B. Slow the infusion rate and continue monitoring
C. Stop the infusion and notify the provider
D. Administer Diphenhydramine per standing orders
Answer: B
Conceptual Explanation: These symptoms characterize ‘Red Man Syndrome,’ which is
usually related to rapid infusion. Slowing the rate is the standard intervention, though
some protocols may require pausing and then restarting at a slower rate.
5. A client is prescribed an ACE inhibitor for hypertension. Which side effect, if reported,
requires the nurse to advise the client to stop the medication and seek immediate care?
A. Swelling of the tongue and lips
B. A persistent dry cough
C. Occasional dizziness when standing
D. Mild hyperkalemia
Answer: A
Conceptual Explanation: Swelling of the face, lips, or tongue indicates angioedema, a life-
threatening adverse effect of ACE inhibitors that can compromise the airway.
ADVANCED LEVEL PHARM HESI
PRACTICE QUIZ: PAIN MANAGEMENT
& MEDICATION PROTOCOLS
1. A client is prescribed Digoxin for heart failure. Which electrolyte imbalance should the
nurse most closely monitor for as it significantly increases the risk of digoxin toxicity?
A. Hypercalcemia
B. Hyponatremia
C. Hypermagnesemia
D. Hypokalemia
Answer: D
Conceptual Explanation: Hypokalemia sensitizes the myocardium to digoxin, increasing
the risk of toxicity. The nurse must monitor potassium levels closely, especially if the client
is also taking loop diuretics.
,2. A patient is receiving intravenous Heparin for a pulmonary embolism. Which laboratory
value is the primary indicator of the drug’s therapeutic effectiveness?
A. Prothrombin Time (PT)
B. International Normalized Ratio (INR)
C. Platelet Count
D. Activated Partial Thromboplastin Time (aPTT)
Answer: D
Conceptual Explanation: aPTT is used to monitor the effectiveness of Heparin therapy. PT
and INR are used for Warfarin therapy monitoring.
3. The nurse is educating a client starting Lithium Carbonate for Bipolar Disorder. What
dietary instruction is critical for preventing lithium toxicity?
A. Consistent sodium intake and adequate hydration
B. Maintain a low-sodium diet
C. Increase intake of leafy green vegetables
D. Restrict fluid intake to 1 liter per day
Answer: A
Conceptual Explanation: Sodium depletion causes the kidneys to retain lithium, leading to
toxicity. Patients must maintain a consistent sodium intake and avoid dehydration.
, 4. A client receiving Vancomycin intravenously develops sudden hypotension, flushing, and a
rash on the face and neck. What is the nurse’s priority action?
A. Administer Epinephrine immediately
B. Slow the infusion rate and continue monitoring
C. Stop the infusion and notify the provider
D. Administer Diphenhydramine per standing orders
Answer: B
Conceptual Explanation: These symptoms characterize ‘Red Man Syndrome,’ which is
usually related to rapid infusion. Slowing the rate is the standard intervention, though
some protocols may require pausing and then restarting at a slower rate.
5. A client is prescribed an ACE inhibitor for hypertension. Which side effect, if reported,
requires the nurse to advise the client to stop the medication and seek immediate care?
A. Swelling of the tongue and lips
B. A persistent dry cough
C. Occasional dizziness when standing
D. Mild hyperkalemia
Answer: A
Conceptual Explanation: Swelling of the face, lips, or tongue indicates angioedema, a life-
threatening adverse effect of ACE inhibitors that can compromise the airway.
