1
HESI RN Pharmacology Exit
Exam 2025/2026 – 60 Verified
Questions and Correct
Answers | Complete Review
with Expert Rationales
1. A client is prescribed lisinopril for hypertension. Which side effect should the nurse
monitor?
a. Hyperkalemia
b. Hypoglycemia
c. Bradycardia
d. Weight loss
a. Hyperkalemia
Rationale: Lisinopril, an ACE inhibitor, reduces aldosterone production, leading to
potassium retention. Hyperkalemia is a common side effect, requiring monitoring of
serum potassium levels, per evidence-based pharmacology for safe medication
management.
2. A client receives morphine for pain. Which nursing action is the priority?
a. Monitor blood pressure
b. Assess respiratory rate
c. Check urine output
d. Evaluate pupil size
b. Assess respiratory rate
Rationale: Morphine, an opioid, can cause respiratory depression, a life-threatening side
effect. Monitoring respiratory rate is the priority to ensure client safety, per opioid
pharmacology guidelines.
3. A nurse is preparing to administer IV vancomycin. Which infusion time is most
appropriate?
a. Bolus over 5 minutes
b. Infuse over 60 minutes
c. Infuse over 4 hours
d. Infuse over 8 hours
b. Infuse over 60 minutes
Rationale: Vancomycin should be infused over at least 60 minutes to prevent red man
syndrome, a histamine-mediated reaction, per evidence-based IV administration
protocols.
, 2
4. A client is prescribed metformin for type 2 diabetes. Which laboratory value should
the nurse monitor?
a. Liver enzymes
b. Renal function
c. Platelet count
d. Blood glucose only
b. Renal function
Rationale: Metformin is excreted by the kidneys, and impaired renal function increases
the risk of lactic acidosis. Monitoring renal function (e.g., creatinine) is essential, per
pharmacology guidelines.
5. Which medication is contraindicated in a client with a sulfa allergy?
a. Furosemide
b. Sulfamethoxazole
c. Metoprolol
d. Lisinopril
b. Sulfamethoxazole
Rationale: Sulfamethoxazole is a sulfonamide antibiotic, contraindicated in clients with
sulfa allergies due to the risk of hypersensitivity reactions, per evidence-based
pharmacology.
6. A client is receiving heparin IV. Which laboratory value should the nurse monitor?
a. INR
b. aPTT
c. Platelet count
d. Both b and c
d. Both b and c
Rationale: Heparin’s anticoagulant effect is monitored via aPTT to ensure therapeutic
levels, and platelet count is checked for heparin-induced thrombocytopenia, per evidence-
based anticoagulation protocols.
7. A nurse administers digoxin to a client with heart failure. Which symptom indicates
toxicity?
a. Bradycardia
b. Hypertension
c. Hyperglycemia
d. Weight gain
a. Bradycardia
Rationale: Digoxin toxicity often presents with bradycardia, nausea, and visual
disturbances due to its narrow therapeutic index. Monitoring heart rate is critical, per
pharmacology guidelines.
8. A client is prescribed furosemide. Which electrolyte imbalance is most likely?
a. Hyperkalemia
b. Hypokalemia
c. Hypernatremia
d. Hypermagnesemia
b. Hypokalemia
Rationale: Furosemide, a loop diuretic, increases potassium excretion, leading to
HESI RN Pharmacology Exit
Exam 2025/2026 – 60 Verified
Questions and Correct
Answers | Complete Review
with Expert Rationales
1. A client is prescribed lisinopril for hypertension. Which side effect should the nurse
monitor?
a. Hyperkalemia
b. Hypoglycemia
c. Bradycardia
d. Weight loss
a. Hyperkalemia
Rationale: Lisinopril, an ACE inhibitor, reduces aldosterone production, leading to
potassium retention. Hyperkalemia is a common side effect, requiring monitoring of
serum potassium levels, per evidence-based pharmacology for safe medication
management.
2. A client receives morphine for pain. Which nursing action is the priority?
a. Monitor blood pressure
b. Assess respiratory rate
c. Check urine output
d. Evaluate pupil size
b. Assess respiratory rate
Rationale: Morphine, an opioid, can cause respiratory depression, a life-threatening side
effect. Monitoring respiratory rate is the priority to ensure client safety, per opioid
pharmacology guidelines.
3. A nurse is preparing to administer IV vancomycin. Which infusion time is most
appropriate?
a. Bolus over 5 minutes
b. Infuse over 60 minutes
c. Infuse over 4 hours
d. Infuse over 8 hours
b. Infuse over 60 minutes
Rationale: Vancomycin should be infused over at least 60 minutes to prevent red man
syndrome, a histamine-mediated reaction, per evidence-based IV administration
protocols.
, 2
4. A client is prescribed metformin for type 2 diabetes. Which laboratory value should
the nurse monitor?
a. Liver enzymes
b. Renal function
c. Platelet count
d. Blood glucose only
b. Renal function
Rationale: Metformin is excreted by the kidneys, and impaired renal function increases
the risk of lactic acidosis. Monitoring renal function (e.g., creatinine) is essential, per
pharmacology guidelines.
5. Which medication is contraindicated in a client with a sulfa allergy?
a. Furosemide
b. Sulfamethoxazole
c. Metoprolol
d. Lisinopril
b. Sulfamethoxazole
Rationale: Sulfamethoxazole is a sulfonamide antibiotic, contraindicated in clients with
sulfa allergies due to the risk of hypersensitivity reactions, per evidence-based
pharmacology.
6. A client is receiving heparin IV. Which laboratory value should the nurse monitor?
a. INR
b. aPTT
c. Platelet count
d. Both b and c
d. Both b and c
Rationale: Heparin’s anticoagulant effect is monitored via aPTT to ensure therapeutic
levels, and platelet count is checked for heparin-induced thrombocytopenia, per evidence-
based anticoagulation protocols.
7. A nurse administers digoxin to a client with heart failure. Which symptom indicates
toxicity?
a. Bradycardia
b. Hypertension
c. Hyperglycemia
d. Weight gain
a. Bradycardia
Rationale: Digoxin toxicity often presents with bradycardia, nausea, and visual
disturbances due to its narrow therapeutic index. Monitoring heart rate is critical, per
pharmacology guidelines.
8. A client is prescribed furosemide. Which electrolyte imbalance is most likely?
a. Hyperkalemia
b. Hypokalemia
c. Hypernatremia
d. Hypermagnesemia
b. Hypokalemia
Rationale: Furosemide, a loop diuretic, increases potassium excretion, leading to
