HESI PHARMACOLOGY BSN 315 EXAM 2025
VERSION 1 WITH 200 EXAM PREP QUESTIONS
AND CORRECT ANSWERS WITH RATIONALES/
BSN 315 HESI PHARM EXAM 2024 (Nightingale)
Which statement by a client warrants further instruction by the nurse about the
changing insulin needs of a diabetic client during pregnancy?
1."Episodes of hypoglycemia are more likely to occur during the first 3 months."
2."I will increase my insulin dosage by 5 units each month during the first
trimester."
3."Insulin dosage will likely need to be increased during the second and third
trimesters."
4."Breastfeeding will decrease my insulin needs to lower than my pre-pregnancy
levels."
"I will increase my insulin dosage by 5 units each month during the first trimester."
Rationale
Insulin needs during pregnancy are determined individually according to the
client's glucose levels. Insulin needs in the first trimester may actually decrease, so
the client's statement about increasing her insulin dose, indicates the need for
reteaching.
A healthcare provider prescribes cefadroxil for a client with a postoperative
infection. It is most important for the nurse to assess for which additional drug
allergy before administering this prescription?
1.Penicillins.
2.Aminoglycosides.
3.Erythromycins.
4.Sulfonamides.
Penicillins.
Rationale
pg. 1
,Cross-allergies exist between penicillins and cephalosporins, such as cefadroxil, so
checking for penicillin allergy is a wise precaution before administering this drug.
What teaching should the nurse provide a client who has received a new
prescription for sildenafil? (Select all that apply.)
1.Frequent use can lead to the development of hypertension.
2.Most effective if taken after at least 6 hours of REM sleep.
3.Take within 30 to 60 minutes of sexual stimulation.
4.Report rebound priapism that occurs for 4 hours or more.
5.Can cause facial flushing and headache.
3.Take within 30 to 60 minutes of sexual stimulation.
4.Report rebound priapism that occurs for 4 hours or more.
5.Can cause facial flushing and headache.
Rationale
Sildenafil enhances the natural response to sexual stimuli, so a client should be
instructed to take Viagra within 30 to 60 minutes before sexual intercourse to
provide adequate time to enhance penile erection. Sildenafil does not cause
erection directly, but priapism can occur and should be reported to the healthcare
provider if it persists. Common side effects include headaches, facial flushing, and
diarrhea. Sildenafil can potentiate vasodilators, such as alpha-adrenergic blockers,
nitroglycerin, and other nitrates used for angina pectoris, and may cause
hypotension, which decreases perfusion to vital organs.
A resident of a long-term care facility is taking lithium carbonate to treat bipolar
disorder. Which instruction should the nurse provide to this client's caregivers?
1.Offer the morning dose of the medicine before breakfast.
2.Have the client chew the pill if it is difficult to swallow.
3.Encourage high energy fluid intake by providing sports drinks or sodas.
4.Report symptoms of hypothyroidism such as fatigue and constipation.
Report symptoms of hypothyroidism such as fatigue and constipation.
Rationale
Lithium carbonate causes hypothyroidism in 1 to 4% of those clients receiving the
pg. 2
,medication, so caregivers should assess for signs of hypothyroidism, including
fatigue and constipation (early signs) and myxedema or goiter (late symptoms).
A client receives a prescription for esomeprazole for heartburn. Which finding in
the client's history should the nurse report to the healthcare provider before
administering the prescription?
Eats spicy food three times a week.
History of deep vein thrombosis.
Drinks 2 alcoholic beverages on weekends.
Family history of diabetes mellitus.
History of deep vein thrombosis.
Rationale
Esomeprazole, a proton pump inhibitor (PPI), may increase the chance of bleeding
in a client who is taking both PPI and warfarin, which is used in the treatment of
deep vein thrombosis (DVT). The healthcare provider should be informed of the
client's recent history and treatment for DVT prior to giving the medication.
A client with chronic gouty arthritis takes allopurinol and experiences an acute
attack of gouty arthritis. The healthcare provider prescribes concurrent low-dose
colchicine. Which information should the nurse provide the client that best
explains the action of the colchicine?
1.Acts like aspirin to relieve pain.
2.Facilitates the excretion of uric acid.
3.Reduces inflammation at the affected site.
4.Prevents formation of uric acid crystals.
Reduces inflammation at the affected site.
Rationale
Allopurinol improves joint function in chronic gouty arthritis by reducing blood
uric acid levels to prevent and promote regression of tophi. Low-dose colchicine,
an antiinflammatory agent specific for gout, is used concurrently with allopurinol,
which can precipitate an incident of acute gouty arthritis.
The nurse is providing medication teaching for a client who has recently received a
prescription for clozapine. Which instruction should be included in this client's
pg. 3
, teaching plan?
1.Avoid prolonged sun exposure.
2.Rise slowly from a lying position.
3.Do not eat any aged cheese.
4.Take as needed for anxiety.
Rise slowly from a lying position.
Rationale
Orthostatic hypotension is a side effect of clozapine, so the client should be
instructed to rise slowly from a lying down or sitting position.
A client with Paget's disease is started on calcitonin 500 mcg subcutaneously daily.
During the initial treatment, which is the priority nursing action?
1.Assess the injection site for inflammation.
2.Evaluate the client's level of pain.
3.Monitor the client's alkaline phosphatase levels.
4.Observe the client for signs of hypersensitivity.
Observe the client for signs of hypersensitivity.
Rationale
Calcitonin is given to a client with Paget's disease to lower serum calcium levels.
The nurse's highest priority is to observe for signs of hypersensitivity, such as skin
rash, hives, or anaphylaxis. Upon initiation of treatment, emergency equipment
should be readily available.
A 48-year-old client is experiencing a severe anaphylactic reaction to an injection
of contrast media. Which pharmacologic agent is of greatest use in this situation?
1.Dopamine.
2.Loratadine.
3.Nitroprusside.
4.Epinephrine.
Epinephrine.
Rationale
pg. 4
VERSION 1 WITH 200 EXAM PREP QUESTIONS
AND CORRECT ANSWERS WITH RATIONALES/
BSN 315 HESI PHARM EXAM 2024 (Nightingale)
Which statement by a client warrants further instruction by the nurse about the
changing insulin needs of a diabetic client during pregnancy?
1."Episodes of hypoglycemia are more likely to occur during the first 3 months."
2."I will increase my insulin dosage by 5 units each month during the first
trimester."
3."Insulin dosage will likely need to be increased during the second and third
trimesters."
4."Breastfeeding will decrease my insulin needs to lower than my pre-pregnancy
levels."
"I will increase my insulin dosage by 5 units each month during the first trimester."
Rationale
Insulin needs during pregnancy are determined individually according to the
client's glucose levels. Insulin needs in the first trimester may actually decrease, so
the client's statement about increasing her insulin dose, indicates the need for
reteaching.
A healthcare provider prescribes cefadroxil for a client with a postoperative
infection. It is most important for the nurse to assess for which additional drug
allergy before administering this prescription?
1.Penicillins.
2.Aminoglycosides.
3.Erythromycins.
4.Sulfonamides.
Penicillins.
Rationale
pg. 1
,Cross-allergies exist between penicillins and cephalosporins, such as cefadroxil, so
checking for penicillin allergy is a wise precaution before administering this drug.
What teaching should the nurse provide a client who has received a new
prescription for sildenafil? (Select all that apply.)
1.Frequent use can lead to the development of hypertension.
2.Most effective if taken after at least 6 hours of REM sleep.
3.Take within 30 to 60 minutes of sexual stimulation.
4.Report rebound priapism that occurs for 4 hours or more.
5.Can cause facial flushing and headache.
3.Take within 30 to 60 minutes of sexual stimulation.
4.Report rebound priapism that occurs for 4 hours or more.
5.Can cause facial flushing and headache.
Rationale
Sildenafil enhances the natural response to sexual stimuli, so a client should be
instructed to take Viagra within 30 to 60 minutes before sexual intercourse to
provide adequate time to enhance penile erection. Sildenafil does not cause
erection directly, but priapism can occur and should be reported to the healthcare
provider if it persists. Common side effects include headaches, facial flushing, and
diarrhea. Sildenafil can potentiate vasodilators, such as alpha-adrenergic blockers,
nitroglycerin, and other nitrates used for angina pectoris, and may cause
hypotension, which decreases perfusion to vital organs.
A resident of a long-term care facility is taking lithium carbonate to treat bipolar
disorder. Which instruction should the nurse provide to this client's caregivers?
1.Offer the morning dose of the medicine before breakfast.
2.Have the client chew the pill if it is difficult to swallow.
3.Encourage high energy fluid intake by providing sports drinks or sodas.
4.Report symptoms of hypothyroidism such as fatigue and constipation.
Report symptoms of hypothyroidism such as fatigue and constipation.
Rationale
Lithium carbonate causes hypothyroidism in 1 to 4% of those clients receiving the
pg. 2
,medication, so caregivers should assess for signs of hypothyroidism, including
fatigue and constipation (early signs) and myxedema or goiter (late symptoms).
A client receives a prescription for esomeprazole for heartburn. Which finding in
the client's history should the nurse report to the healthcare provider before
administering the prescription?
Eats spicy food three times a week.
History of deep vein thrombosis.
Drinks 2 alcoholic beverages on weekends.
Family history of diabetes mellitus.
History of deep vein thrombosis.
Rationale
Esomeprazole, a proton pump inhibitor (PPI), may increase the chance of bleeding
in a client who is taking both PPI and warfarin, which is used in the treatment of
deep vein thrombosis (DVT). The healthcare provider should be informed of the
client's recent history and treatment for DVT prior to giving the medication.
A client with chronic gouty arthritis takes allopurinol and experiences an acute
attack of gouty arthritis. The healthcare provider prescribes concurrent low-dose
colchicine. Which information should the nurse provide the client that best
explains the action of the colchicine?
1.Acts like aspirin to relieve pain.
2.Facilitates the excretion of uric acid.
3.Reduces inflammation at the affected site.
4.Prevents formation of uric acid crystals.
Reduces inflammation at the affected site.
Rationale
Allopurinol improves joint function in chronic gouty arthritis by reducing blood
uric acid levels to prevent and promote regression of tophi. Low-dose colchicine,
an antiinflammatory agent specific for gout, is used concurrently with allopurinol,
which can precipitate an incident of acute gouty arthritis.
The nurse is providing medication teaching for a client who has recently received a
prescription for clozapine. Which instruction should be included in this client's
pg. 3
, teaching plan?
1.Avoid prolonged sun exposure.
2.Rise slowly from a lying position.
3.Do not eat any aged cheese.
4.Take as needed for anxiety.
Rise slowly from a lying position.
Rationale
Orthostatic hypotension is a side effect of clozapine, so the client should be
instructed to rise slowly from a lying down or sitting position.
A client with Paget's disease is started on calcitonin 500 mcg subcutaneously daily.
During the initial treatment, which is the priority nursing action?
1.Assess the injection site for inflammation.
2.Evaluate the client's level of pain.
3.Monitor the client's alkaline phosphatase levels.
4.Observe the client for signs of hypersensitivity.
Observe the client for signs of hypersensitivity.
Rationale
Calcitonin is given to a client with Paget's disease to lower serum calcium levels.
The nurse's highest priority is to observe for signs of hypersensitivity, such as skin
rash, hives, or anaphylaxis. Upon initiation of treatment, emergency equipment
should be readily available.
A 48-year-old client is experiencing a severe anaphylactic reaction to an injection
of contrast media. Which pharmacologic agent is of greatest use in this situation?
1.Dopamine.
2.Loratadine.
3.Nitroprusside.
4.Epinephrine.
Epinephrine.
Rationale
pg. 4
