PHARMACOLOGY HESI FINAL EXAM
PREPARATION QUESTIONS AND
ANSWERS WITH VERIFIED SOLUTIONS
2026/2027 UPDATE. JUST RELEASED
1. A client is receiving Digoxin for heart failure. Which clinical manifestation should the nurse
identify as an early sign of Digoxin toxicity?
A. Anorexia, nausea, and vomiting
B. Photophobia and blurred vision
C. Hyperkalemia and muscle weakness
D. Tachycardia and palpitations
Answer: A
Conceptual Explanation: Gastrointestinal symptoms like anorexia, nausea, and vomiting
are typically the earliest signs of Digoxin toxicity, whereas visual disturbances like halos
occur later.
2. Which lab value is most critical to monitor for a client newly prescribed Lithium Carbonate
for Bipolar Disorder?
A. Serum calcium levels
B. Prothrombin time
,C. Serum sodium levels
D. Liver enzymes
Answer: C
Conceptual Explanation: Lithium is a salt, and its excretion is dependent on sodium
levels; hyponatremia can lead to decreased lithium excretion and toxicity.
3. A patient receiving Warfarin therapy has an INR of 5.2 and reports dark, tarry stools. Which
medication should the nurse expect to administer?
A. Protamine sulfate
B. Vitamin K (Phytonadione)
C. Glucagon
D. Calcium gluconate
Answer: B
Conceptual Explanation: Vitamin K is the specific antidote for Warfarin. Protamine sulfate
is for heparin, and Calcium gluconate is for magnesium toxicity.
4. A client taking Lisinopril for hypertension develops a persistent, dry, non-productive cough.
What is the most likely cause of this side effect?
A. Inhibition of aldosterone release
B. Development of pulmonary edema
C. Hypersensitivity to the coating of the tablet
, D. Accumulation of bradykinin in the lungs
Answer: D
Conceptual Explanation: ACE inhibitors prevent the breakdown of bradykinin, which can
accumulate in the respiratory tract and trigger a dry cough.
5. Which nursing intervention is a priority for a client receiving Furosemide intravenously?
A. Assessing for symptoms of hyperkalemia
B. Monitoring for ototoxicity if administered too rapidly
C. Checking blood pressure every 8 hours
D. Restricting fluid intake to 1000 mL per day
Answer: B
Conceptual Explanation: High doses or rapid IV administration of loop diuretics like
Furosemide can cause transient or permanent hearing loss (ototoxicity).
6. A diabetic patient is administered NPH insulin at 0800. At what time is the patient at the
highest risk for a hypoglycemic reaction?
A. Between 0900 and 1000
B. At 2200 when sleep begins
C. Between 1000 and 1200
D. Between 1400 and 2000
PREPARATION QUESTIONS AND
ANSWERS WITH VERIFIED SOLUTIONS
2026/2027 UPDATE. JUST RELEASED
1. A client is receiving Digoxin for heart failure. Which clinical manifestation should the nurse
identify as an early sign of Digoxin toxicity?
A. Anorexia, nausea, and vomiting
B. Photophobia and blurred vision
C. Hyperkalemia and muscle weakness
D. Tachycardia and palpitations
Answer: A
Conceptual Explanation: Gastrointestinal symptoms like anorexia, nausea, and vomiting
are typically the earliest signs of Digoxin toxicity, whereas visual disturbances like halos
occur later.
2. Which lab value is most critical to monitor for a client newly prescribed Lithium Carbonate
for Bipolar Disorder?
A. Serum calcium levels
B. Prothrombin time
,C. Serum sodium levels
D. Liver enzymes
Answer: C
Conceptual Explanation: Lithium is a salt, and its excretion is dependent on sodium
levels; hyponatremia can lead to decreased lithium excretion and toxicity.
3. A patient receiving Warfarin therapy has an INR of 5.2 and reports dark, tarry stools. Which
medication should the nurse expect to administer?
A. Protamine sulfate
B. Vitamin K (Phytonadione)
C. Glucagon
D. Calcium gluconate
Answer: B
Conceptual Explanation: Vitamin K is the specific antidote for Warfarin. Protamine sulfate
is for heparin, and Calcium gluconate is for magnesium toxicity.
4. A client taking Lisinopril for hypertension develops a persistent, dry, non-productive cough.
What is the most likely cause of this side effect?
A. Inhibition of aldosterone release
B. Development of pulmonary edema
C. Hypersensitivity to the coating of the tablet
, D. Accumulation of bradykinin in the lungs
Answer: D
Conceptual Explanation: ACE inhibitors prevent the breakdown of bradykinin, which can
accumulate in the respiratory tract and trigger a dry cough.
5. Which nursing intervention is a priority for a client receiving Furosemide intravenously?
A. Assessing for symptoms of hyperkalemia
B. Monitoring for ototoxicity if administered too rapidly
C. Checking blood pressure every 8 hours
D. Restricting fluid intake to 1000 mL per day
Answer: B
Conceptual Explanation: High doses or rapid IV administration of loop diuretics like
Furosemide can cause transient or permanent hearing loss (ototoxicity).
6. A diabetic patient is administered NPH insulin at 0800. At what time is the patient at the
highest risk for a hypoglycemic reaction?
A. Between 0900 and 1000
B. At 2200 when sleep begins
C. Between 1000 and 1200
D. Between 1400 and 2000
