1
RN Pharmacology HESI Exam 2025 – 250
Verified Questions with Rationalized
Answers | Complete Test Bank | 100%
Pass Guaranteed
1. A client is prescribed lisinopril for hypertension. What is the primary mechanism of
action of this medication?
A. Blocks beta-adrenergic receptors
B. Inhibits angiotensin-converting enzyme
C. Inhibits sodium reabsorption
D. Blocks calcium channels
Correct Answer: B
Rationale: Lisinopril, an ACE inhibitor, prevents the conversion of angiotensin I to
angiotensin II, reducing vasoconstriction and blood pressure.
2. A client receiving furosemide reports muscle cramps. What should the nurse monitor?
A. Serum potassium levels
B. Blood glucose levels
C. Platelet count
D. INR
Correct Answer: A
Rationale: Furosemide, a loop diuretic, can cause hypokalemia, leading to muscle
cramps due to electrolyte imbalance.
3. Which adverse effect is most commonly associated with metformin therapy?
A. Hypoglycemia
B. Lactic acidosis
C. Hyperkalemia
D. Weight gain
Correct Answer: B
, 2
Rationale: Metformin carries a rare risk of lactic acidosis, particularly in patients with
renal impairment or dehydration.
4. A client is prescribed warfarin. Which laboratory test is essential for monitoring?
A. Platelet count
B. International Normalized Ratio (INR)
C. Serum creatinine
D. Hemoglobin A1c
Correct Answer: B
Rationale: Warfarin’s anticoagulant effect is monitored via INR to maintain therapeutic
levels (typically 2.0–3.0) and prevent bleeding or thrombosis.
5. What is the primary therapeutic use of albuterol in asthma management?
A. Long-term control
B. Acute bronchospasm relief
C. Anti-inflammatory effect
D. Mucolytic action
Correct Answer: B
Rationale: Albuterol, a short-acting beta-2 agonist, rapidly relieves bronchospasm by
relaxing bronchial smooth muscle during acute asthma exacerbations.
6. A client on heparin develops a platelet count of 60,000/mm³. What is the most likely
diagnosis?
A. Anemia
B. Heparin-induced thrombocytopenia (HIT)
C. Leukopenia
D. Thrombocytosis
Correct Answer: B
Rationale: HIT is an immune-mediated complication of heparin therapy, causing a
significant drop in platelet count and increased thrombosis risk.
7. Which medication is contraindicated in patients with a sulfa allergy?
A. Lisinopril
B. Hydrochlorothiazide
C. Atorvastatin
D. Metformin
Correct Answer: B
Rationale: Hydrochlorothiazide, a thiazide diuretic, is a sulfonamide derivative and
contraindicated in patients with sulfa allergies due to hypersensitivity risk.
, 3
8. A client is prescribed digoxin. Which symptom indicates potential toxicity?
A. Increased appetite
B. Visual disturbances
C. Hypertension
D. Weight gain
Correct Answer: B
Rationale: Visual disturbances, such as yellow-green halos, are a hallmark of digoxin
toxicity, requiring immediate evaluation.
9. What is the mechanism of action of selective serotonin reuptake inhibitors (SSRIs)?
A. Block dopamine receptors
B. Inhibit serotonin reuptake
C. Enhance GABA activity
D. Stimulate norepinephrine release
Correct Answer: B
Rationale: SSRIs, such as fluoxetine, increase serotonin availability by inhibiting its
reuptake, improving mood in depression.
10. A client with type 2 diabetes is prescribed glipizide. What is the primary risk?
A. Hyperglycemia
B. Hypoglycemia
C. Weight loss
D. Hepatotoxicity
Correct Answer: B
Rationale: Glipizide, a sulfonylurea, stimulates insulin release, increasing the risk of
hypoglycemia, especially if meals are skipped.
11. Which medication is used to reverse opioid overdose?
A. Flumazenil
B. Naloxone
C. Protamine sulfate
D. Vitamin K
Correct Answer: B
Rationale: Naloxone, an opioid antagonist, rapidly reverses opioid-induced respiratory
depression by displacing opioids from mu receptors.
12. A client on levothyroxine reports tachycardia and weight loss. What is the likely cause?
A. Hypothyroidism
B. Iatrogenic hyperthyroidism
C. Adrenal insufficiency
, 4
D. Hypoglycemia
Correct Answer: B
Rationale: Excessive levothyroxine dosing can cause iatrogenic hyperthyroidism, leading
to symptoms like tachycardia and weight loss.
13. What is the primary adverse effect of long-term systemic corticosteroid use?
A. Hypoglycemia
B. Osteoporosis
C. Hyponatremia
D. Bradycardia
Correct Answer: B
Rationale: Long-term corticosteroids, like prednisone, inhibit osteoblast activity,
increasing bone resorption and osteoporosis risk.
14. Which medication is first-line for acute gout attacks?
A. Allopurinol
B. Colchicine
C. Febuxostat
D. Probenecid
Correct Answer: B
Rationale: Colchicine reduces inflammation by inhibiting microtubule polymerization,
providing rapid relief for acute gout flares.
15. A client is prescribed clopidogrel. What is the primary indication?
A. Heart failure
B. Stroke prevention
C. Asthma management
D. Diabetes control
Correct Answer: B
Rationale: Clopidogrel, an antiplatelet agent, prevents thrombotic events in patients
with a history of stroke or cardiovascular disease.
16. What is the mechanism of action of loop diuretics like furosemide?
A. Inhibit sodium-potassium ATPase
B. Block sodium reabsorption in the loop of Henle
C. Enhance potassium reabsorption
D. Stimulate aldosterone release
Correct Answer: B
Rationale: Loop diuretics inhibit the Na-K-2Cl cotransporter in the loop of Henle,
increasing sodium and water excretion.
RN Pharmacology HESI Exam 2025 – 250
Verified Questions with Rationalized
Answers | Complete Test Bank | 100%
Pass Guaranteed
1. A client is prescribed lisinopril for hypertension. What is the primary mechanism of
action of this medication?
A. Blocks beta-adrenergic receptors
B. Inhibits angiotensin-converting enzyme
C. Inhibits sodium reabsorption
D. Blocks calcium channels
Correct Answer: B
Rationale: Lisinopril, an ACE inhibitor, prevents the conversion of angiotensin I to
angiotensin II, reducing vasoconstriction and blood pressure.
2. A client receiving furosemide reports muscle cramps. What should the nurse monitor?
A. Serum potassium levels
B. Blood glucose levels
C. Platelet count
D. INR
Correct Answer: A
Rationale: Furosemide, a loop diuretic, can cause hypokalemia, leading to muscle
cramps due to electrolyte imbalance.
3. Which adverse effect is most commonly associated with metformin therapy?
A. Hypoglycemia
B. Lactic acidosis
C. Hyperkalemia
D. Weight gain
Correct Answer: B
, 2
Rationale: Metformin carries a rare risk of lactic acidosis, particularly in patients with
renal impairment or dehydration.
4. A client is prescribed warfarin. Which laboratory test is essential for monitoring?
A. Platelet count
B. International Normalized Ratio (INR)
C. Serum creatinine
D. Hemoglobin A1c
Correct Answer: B
Rationale: Warfarin’s anticoagulant effect is monitored via INR to maintain therapeutic
levels (typically 2.0–3.0) and prevent bleeding or thrombosis.
5. What is the primary therapeutic use of albuterol in asthma management?
A. Long-term control
B. Acute bronchospasm relief
C. Anti-inflammatory effect
D. Mucolytic action
Correct Answer: B
Rationale: Albuterol, a short-acting beta-2 agonist, rapidly relieves bronchospasm by
relaxing bronchial smooth muscle during acute asthma exacerbations.
6. A client on heparin develops a platelet count of 60,000/mm³. What is the most likely
diagnosis?
A. Anemia
B. Heparin-induced thrombocytopenia (HIT)
C. Leukopenia
D. Thrombocytosis
Correct Answer: B
Rationale: HIT is an immune-mediated complication of heparin therapy, causing a
significant drop in platelet count and increased thrombosis risk.
7. Which medication is contraindicated in patients with a sulfa allergy?
A. Lisinopril
B. Hydrochlorothiazide
C. Atorvastatin
D. Metformin
Correct Answer: B
Rationale: Hydrochlorothiazide, a thiazide diuretic, is a sulfonamide derivative and
contraindicated in patients with sulfa allergies due to hypersensitivity risk.
, 3
8. A client is prescribed digoxin. Which symptom indicates potential toxicity?
A. Increased appetite
B. Visual disturbances
C. Hypertension
D. Weight gain
Correct Answer: B
Rationale: Visual disturbances, such as yellow-green halos, are a hallmark of digoxin
toxicity, requiring immediate evaluation.
9. What is the mechanism of action of selective serotonin reuptake inhibitors (SSRIs)?
A. Block dopamine receptors
B. Inhibit serotonin reuptake
C. Enhance GABA activity
D. Stimulate norepinephrine release
Correct Answer: B
Rationale: SSRIs, such as fluoxetine, increase serotonin availability by inhibiting its
reuptake, improving mood in depression.
10. A client with type 2 diabetes is prescribed glipizide. What is the primary risk?
A. Hyperglycemia
B. Hypoglycemia
C. Weight loss
D. Hepatotoxicity
Correct Answer: B
Rationale: Glipizide, a sulfonylurea, stimulates insulin release, increasing the risk of
hypoglycemia, especially if meals are skipped.
11. Which medication is used to reverse opioid overdose?
A. Flumazenil
B. Naloxone
C. Protamine sulfate
D. Vitamin K
Correct Answer: B
Rationale: Naloxone, an opioid antagonist, rapidly reverses opioid-induced respiratory
depression by displacing opioids from mu receptors.
12. A client on levothyroxine reports tachycardia and weight loss. What is the likely cause?
A. Hypothyroidism
B. Iatrogenic hyperthyroidism
C. Adrenal insufficiency
, 4
D. Hypoglycemia
Correct Answer: B
Rationale: Excessive levothyroxine dosing can cause iatrogenic hyperthyroidism, leading
to symptoms like tachycardia and weight loss.
13. What is the primary adverse effect of long-term systemic corticosteroid use?
A. Hypoglycemia
B. Osteoporosis
C. Hyponatremia
D. Bradycardia
Correct Answer: B
Rationale: Long-term corticosteroids, like prednisone, inhibit osteoblast activity,
increasing bone resorption and osteoporosis risk.
14. Which medication is first-line for acute gout attacks?
A. Allopurinol
B. Colchicine
C. Febuxostat
D. Probenecid
Correct Answer: B
Rationale: Colchicine reduces inflammation by inhibiting microtubule polymerization,
providing rapid relief for acute gout flares.
15. A client is prescribed clopidogrel. What is the primary indication?
A. Heart failure
B. Stroke prevention
C. Asthma management
D. Diabetes control
Correct Answer: B
Rationale: Clopidogrel, an antiplatelet agent, prevents thrombotic events in patients
with a history of stroke or cardiovascular disease.
16. What is the mechanism of action of loop diuretics like furosemide?
A. Inhibit sodium-potassium ATPase
B. Block sodium reabsorption in the loop of Henle
C. Enhance potassium reabsorption
D. Stimulate aldosterone release
Correct Answer: B
Rationale: Loop diuretics inhibit the Na-K-2Cl cotransporter in the loop of Henle,
increasing sodium and water excretion.
