PHARM HESI EXAM COMPREHENSIVE
STUDY GUIDE 2026/2027 QUESTIONS
AND ANSWERS WITH VERIFIED
SOLUTIONS 2026/2027 UPDATE. JUST
RELEASED
1. A patient with heart failure is receiving Digoxin. Which laboratory result would most
significantly increase the risk for Digoxin toxicity?
A. Serum sodium level of 135 mEq/L
B. Serum calcium level of 9.0 mg/dL
C. Serum potassium level of 3.2 mEq/L
D. Serum magnesium level of 2.0 mEq/L
Answer: C
Conceptual Explanation: Hypokalemia (low potassium) sensitizes the myocardium to
digoxin, significantly increasing the risk of toxicity even if digoxin levels are within the
therapeutic range.
2. A client is prescribed Warfarin for chronic atrial fibrillation. Which lab value should the
nurse monitor to evaluate the effectiveness of this therapy?
A. International Normalized Ratio (INR)
,B. Platelet count
C. Activated Partial Thromboplastin Time (aPTT)
D. Bleeding time
Answer: A
Conceptual Explanation: INR is the standard laboratory test used to monitor the
therapeutic effect of Warfarin. aPTT is used for heparin monitoring.
3. A patient is receiving a continuous intravenous infusion of Heparin. The nurse notes the
aPTT is 110 seconds. What is the priority nursing action?
A. Increase the infusion rate
B. Continue the infusion at the current rate
C. Stop the infusion and notify the healthcare provider
D. Administer Vitamin K intramuscularly
Answer: C
Conceptual Explanation: An aPTT of 110 seconds is well above the therapeutic range
(typically 60-80 seconds). The infusion must be stopped to prevent hemorrhage, and the
provider notified. Vitamin K is the antidote for Warfarin, not Heparin.
4. Which instruction should a nurse provide to a patient starting an ACE inhibitor such as
Lisinopril?
A. Increase intake of potassium-rich foods like bananas
, B. Report a persistent dry cough to the healthcare provider
C. Expect a yellow-green halo in your vision
D. Take the medication with an antacid to prevent GI upset
Answer: B
Conceptual Explanation: A common and bothersome side effect of ACE inhibitors is a
persistent dry cough caused by the accumulation of bradykinin. Potassium should be
limited, not increased, due to the risk of hyperkalemia.
5. A client diagnosed with bipolar disorder is prescribed Lithium. The nurse should emphasize
the importance of maintaining a consistent intake of which substance?
A. Sodium
B. Protein
C. Vitamin C
D. Calcium
Answer: A
Conceptual Explanation: Lithium is a salt. If sodium intake decreases or sodium is lost
through sweating/diarrhea, the kidneys retain Lithium, leading to toxicity. Consistent
sodium and fluid intake are vital.
STUDY GUIDE 2026/2027 QUESTIONS
AND ANSWERS WITH VERIFIED
SOLUTIONS 2026/2027 UPDATE. JUST
RELEASED
1. A patient with heart failure is receiving Digoxin. Which laboratory result would most
significantly increase the risk for Digoxin toxicity?
A. Serum sodium level of 135 mEq/L
B. Serum calcium level of 9.0 mg/dL
C. Serum potassium level of 3.2 mEq/L
D. Serum magnesium level of 2.0 mEq/L
Answer: C
Conceptual Explanation: Hypokalemia (low potassium) sensitizes the myocardium to
digoxin, significantly increasing the risk of toxicity even if digoxin levels are within the
therapeutic range.
2. A client is prescribed Warfarin for chronic atrial fibrillation. Which lab value should the
nurse monitor to evaluate the effectiveness of this therapy?
A. International Normalized Ratio (INR)
,B. Platelet count
C. Activated Partial Thromboplastin Time (aPTT)
D. Bleeding time
Answer: A
Conceptual Explanation: INR is the standard laboratory test used to monitor the
therapeutic effect of Warfarin. aPTT is used for heparin monitoring.
3. A patient is receiving a continuous intravenous infusion of Heparin. The nurse notes the
aPTT is 110 seconds. What is the priority nursing action?
A. Increase the infusion rate
B. Continue the infusion at the current rate
C. Stop the infusion and notify the healthcare provider
D. Administer Vitamin K intramuscularly
Answer: C
Conceptual Explanation: An aPTT of 110 seconds is well above the therapeutic range
(typically 60-80 seconds). The infusion must be stopped to prevent hemorrhage, and the
provider notified. Vitamin K is the antidote for Warfarin, not Heparin.
4. Which instruction should a nurse provide to a patient starting an ACE inhibitor such as
Lisinopril?
A. Increase intake of potassium-rich foods like bananas
, B. Report a persistent dry cough to the healthcare provider
C. Expect a yellow-green halo in your vision
D. Take the medication with an antacid to prevent GI upset
Answer: B
Conceptual Explanation: A common and bothersome side effect of ACE inhibitors is a
persistent dry cough caused by the accumulation of bradykinin. Potassium should be
limited, not increased, due to the risk of hyperkalemia.
5. A client diagnosed with bipolar disorder is prescribed Lithium. The nurse should emphasize
the importance of maintaining a consistent intake of which substance?
A. Sodium
B. Protein
C. Vitamin C
D. Calcium
Answer: A
Conceptual Explanation: Lithium is a salt. If sodium intake decreases or sodium is lost
through sweating/diarrhea, the kidneys retain Lithium, leading to toxicity. Consistent
sodium and fluid intake are vital.
