PHARM HESI FINAL EXAM REVIEW
QUESTIONS AND ANSWERS WITH
VERIFIED SOLUTIONS 2026/2027
UPDATE. JUST RELEASED
1. A patient with heart failure is taking Digoxin 0.125 mg daily. The nurse identifies which of
the following as the earliest sign of digoxin toxicity?
A. Yellow-green halos in vision
B. Sinus bradycardia
C. Second-degree heart block
D. Anorexia and nausea
Answer: D
Conceptual Explanation: Gastrointestinal symptoms such as anorexia, nausea, and
vomiting are typically the earliest signs of digoxin toxicity, preceding cardiac and visual
disturbances.
2. A patient is prescribed Warfarin for atrial fibrillation. Which laboratory value should the
nurse monitor to evaluate the effectiveness of the therapy?
A. Activated Partial Thromboplastin Time (aPTT)
B. Platelet count
,C. International Normalized Ratio (INR)
D. Bleeding time
Answer: C
Conceptual Explanation: INR is the standard laboratory test used to monitor the
therapeutic effect of Warfarin. aPTT is used for Heparin.
3. A patient is receiving Furosemide 40 mg IV push. Which electrolyte imbalance is the patient
at highest risk for?
A. Hyperkalemia
B. Hypocalcemia
C. Hypernatremia
D. Hypokalemia
Answer: D
Conceptual Explanation: Furosemide is a loop diuretic that causes the excretion of
potassium along with water and sodium, leading to hypokalemia.
4. A patient starting Lisinopril for hypertension reports a persistent, dry, non-productive
cough. What is the nurse’s best action?
A. Instruct the patient to use an over-the-counter cough suppressant
B. Inform the patient that this is a common side effect that will subside in a week
C. Notify the provider as the medication may need to be changed to an ARB
, D. Advise the patient to increase fluid intake
Answer: C
Conceptual Explanation: ACE inhibitors can cause a buildup of bradykinin, leading to a
persistent cough. If intolerable, patients are often switched to Angiotensin II Receptor
Blockers (ARBs).
5. Which of the following dietary instructions is most important for a patient taking Lithium
Carbonate for Bipolar Disorder?
A. Restrict sodium intake to less than 2 grams per day
B. Avoid foods high in potassium
C. Maintain a consistent sodium intake
D. Limit fluid intake to 1 liter per day
Answer: C
Conceptual Explanation: Lithium is a salt; low sodium levels can cause the kidneys to
retain lithium, leading to toxicity. Consistent sodium and fluid intake are required.
6. When teaching a patient how to mix Regular insulin and NPH insulin in one syringe, which
step is correct?
A. Draw up the NPH insulin first
B. Draw up the Regular insulin first
C. Draw each into separate syringes and then combine
QUESTIONS AND ANSWERS WITH
VERIFIED SOLUTIONS 2026/2027
UPDATE. JUST RELEASED
1. A patient with heart failure is taking Digoxin 0.125 mg daily. The nurse identifies which of
the following as the earliest sign of digoxin toxicity?
A. Yellow-green halos in vision
B. Sinus bradycardia
C. Second-degree heart block
D. Anorexia and nausea
Answer: D
Conceptual Explanation: Gastrointestinal symptoms such as anorexia, nausea, and
vomiting are typically the earliest signs of digoxin toxicity, preceding cardiac and visual
disturbances.
2. A patient is prescribed Warfarin for atrial fibrillation. Which laboratory value should the
nurse monitor to evaluate the effectiveness of the therapy?
A. Activated Partial Thromboplastin Time (aPTT)
B. Platelet count
,C. International Normalized Ratio (INR)
D. Bleeding time
Answer: C
Conceptual Explanation: INR is the standard laboratory test used to monitor the
therapeutic effect of Warfarin. aPTT is used for Heparin.
3. A patient is receiving Furosemide 40 mg IV push. Which electrolyte imbalance is the patient
at highest risk for?
A. Hyperkalemia
B. Hypocalcemia
C. Hypernatremia
D. Hypokalemia
Answer: D
Conceptual Explanation: Furosemide is a loop diuretic that causes the excretion of
potassium along with water and sodium, leading to hypokalemia.
4. A patient starting Lisinopril for hypertension reports a persistent, dry, non-productive
cough. What is the nurse’s best action?
A. Instruct the patient to use an over-the-counter cough suppressant
B. Inform the patient that this is a common side effect that will subside in a week
C. Notify the provider as the medication may need to be changed to an ARB
, D. Advise the patient to increase fluid intake
Answer: C
Conceptual Explanation: ACE inhibitors can cause a buildup of bradykinin, leading to a
persistent cough. If intolerable, patients are often switched to Angiotensin II Receptor
Blockers (ARBs).
5. Which of the following dietary instructions is most important for a patient taking Lithium
Carbonate for Bipolar Disorder?
A. Restrict sodium intake to less than 2 grams per day
B. Avoid foods high in potassium
C. Maintain a consistent sodium intake
D. Limit fluid intake to 1 liter per day
Answer: C
Conceptual Explanation: Lithium is a salt; low sodium levels can cause the kidneys to
retain lithium, leading to toxicity. Consistent sodium and fluid intake are required.
6. When teaching a patient how to mix Regular insulin and NPH insulin in one syringe, which
step is correct?
A. Draw up the NPH insulin first
B. Draw up the Regular insulin first
C. Draw each into separate syringes and then combine
