HESI Pharmacology Review – 2025–2026
Edition Medication safety, therapeutic classes,
adverse effects, dosage considerations, and
NGN-aligned pharm reasoning.
HESI Pharmacology Review – 2025–2026 Edition
1. The nurse is preparing to administer a medication and finds the order to be unclear. What is
the nurse's best action?
A. Consult the unit's charge nurse for interpretation.
B. Contact the prescribing provider to clarify the order. ✓
C. Look up the medication in the pharmacy reference guide.
D. Ask a fellow nurse what they think the order means.
2. A patient is prescribed Lisinopril, an ACE inhibitor. The nurse should prioritize teaching the
patient about which potential adverse effect?
A. Hypokalemia
B. Persistent dry cough ✓
C. Tachycardia
D. Diarrhea
3. When administering Vancomycin IV, the nurse must monitor for which serious adverse
effect?
A. Red Man Syndrome and Ototoxicity ✓
B. Blue-Gray Skin Discoloration
C. Crystal-Induced Nephropathy
D. Tendon Rupture
4. The therapeutic effect of Metoprolol, a beta-blocker, is primarily to:
A. Increase heart rate and contractility.
B. Block beta-1 receptors, decreasing heart rate and blood pressure. ✓
C. Cause vasodilation of coronary arteries.
D. Inhibit the renin-angiotensin-aldosterone system.
5. A patient on Warfarin (Coumadin) should be advised to maintain a consistent intake of
foods rich in which vitamin?
A. Vitamin A
,B. Vitamin B12
C. Vitamin C
D. Vitamin K ✓
6. Which laboratory value is most critical to monitor for a patient receiving Heparin?
A. aPTT (activated Partial Thromboplastin Time) ✓
B. INR (International Normalized Ratio)
C. Hemoglobin and Hematocrit
D. Platelet Count
7. The nurse administers Furosemide (Lasix) to a patient. Which finding indicates a
therapeutic effect?
A. Decreased blood pressure and increased urine output ✓
B. Relief of chest pain
C. Slowed heart rate
D. Reduced anxiety
8. Before administering a dose of Digoxin, the nurse assesses the patient's apical pulse and
finds it to be 52 beats/minute. What is the nurse's priority action?
A. Administer the dose as ordered.
B. Withhold the dose and notify the provider. ✓
C. Recheck the pulse in 30 minutes.
D. Check the patient's blood pressure.
9. Which class of medications is considered first-line for the treatment of uncomplicated
hypertension?
A. Thiazide Diuretics ✓
B. Alpha-blockers
C. Loop Diuretics
D. Potassium-Sparing Diuretics
10. A patient taking an SSRI like Sertraline (Zoloft) should be educated about the risk of which
life-threatening condition if taken with other serotonergic drugs?
A. Neuroleptic Malignant Syndrome (NMS)
B. Serotonin Syndrome ✓
C. Tardive Dyskinesia
D. Agranulocytosis
11. Which medication requires frequent monitoring of thyroid and liver function tests?
A. Amiodarone ✓
,B. Atorvastatin
C. Metformin
D. Levothyroxine
12. The antidote for an opioid overdose, such as with Morphine, is:
A. Flumazenil
B. Naloxone (Narcan) ✓
C. Vitamin K
D. Acetylcysteine
13. A patient with Type 2 Diabetes is started on Metformin. The nurse should teach the
patient to report which potential adverse effect immediately?
A. Hypoglycemia
B. Metallic Taste
C. Lactic Acidosis (e.g., profound fatigue, myalgia, dyspnea) ✓
D. Weight Gain
14. Which instruction is most important for a patient starting on Atorvastatin (Lipitor) for
hyperlipidemia?
A. "Take the medication on an empty stomach."
B. "Report any unexplained muscle pain or weakness." ✓
C. "Avoid all dairy products while on this drug."
D. "Limit your fluid intake."
15. The primary reason to administer a "Proton Pump Inhibitor" (PPI) like Omeprazole is to:
A. Neutralize stomach acid quickly.
B. Provide a protective coating for the stomach lining.
C. Irreversibly inhibit gastric acid secretion. ✓
D. Increase gastrointestinal motility.
16. When teaching a patient about using an Albuterol inhaler for asthma, the nurse should
emphasize that it is used for:
A. Long-term control of inflammation.
B. Quick relief of acute bronchospasm. ✓
C. Preventing exercise-induced asthma if taken daily.
D. Treating respiratory infections.
17. Which medication is contraindicated in pregnancy due to the risk of teratogenic effects?
A. Prenatal Vitamins
B. Insulin
, C. Warfarin (Coumadin) ✓
D. Acetaminophen
18. A patient receiving a Phenytoin (Dilantin) IV push must be monitored for:
A. Hypertension
B. Cardiovascular collapse and hypotension ✓
C. Acute renal failure
D. Hypoglycemia
19. Which class of drugs ends in "-pril" (e.g., Lisinopril, Enalapril)?
A. Angiotensin II Receptor Blockers (ARBs)
B. Beta-Blockers
C. Calcium Channel Blockers (CCBs)
D. Angiotensin-Converting Enzyme (ACE) Inhibitors ✓
20. The nurse is preparing to administer Insulin Glargine (Lantus). Which action is correct?
A. Shake the vial vigorously to mix the suspension.
B. Administer it within 15 minutes of a meal.
C. Give it as a continuous IV infusion.
D. Administer it subcutaneously at the same time every day. ✓
21. A patient taking Levothyroxine (Synthroid) should be instructed to take the medication:
A. With food to avoid GI upset.
B. At bedtime.
C. On an empty stomach, usually in the morning. ✓
D. Only when they feel fatigued.
22. Which finding is a sign of neurotoxicity in a patient taking high-dose Acyclovir?
A. Hematuria
B. Tremors or confusion ✓
C. Photosensitivity
D. Tinnitus
23. A patient with Parkinson's disease is taking Carbidopa/Levodopa. The nurse should teach
the patient to avoid taking the medication with:
A. Grapefruit juice
B. High-protein meals ✓
C. Carbonated beverages
D. Caffeinated drinks
Edition Medication safety, therapeutic classes,
adverse effects, dosage considerations, and
NGN-aligned pharm reasoning.
HESI Pharmacology Review – 2025–2026 Edition
1. The nurse is preparing to administer a medication and finds the order to be unclear. What is
the nurse's best action?
A. Consult the unit's charge nurse for interpretation.
B. Contact the prescribing provider to clarify the order. ✓
C. Look up the medication in the pharmacy reference guide.
D. Ask a fellow nurse what they think the order means.
2. A patient is prescribed Lisinopril, an ACE inhibitor. The nurse should prioritize teaching the
patient about which potential adverse effect?
A. Hypokalemia
B. Persistent dry cough ✓
C. Tachycardia
D. Diarrhea
3. When administering Vancomycin IV, the nurse must monitor for which serious adverse
effect?
A. Red Man Syndrome and Ototoxicity ✓
B. Blue-Gray Skin Discoloration
C. Crystal-Induced Nephropathy
D. Tendon Rupture
4. The therapeutic effect of Metoprolol, a beta-blocker, is primarily to:
A. Increase heart rate and contractility.
B. Block beta-1 receptors, decreasing heart rate and blood pressure. ✓
C. Cause vasodilation of coronary arteries.
D. Inhibit the renin-angiotensin-aldosterone system.
5. A patient on Warfarin (Coumadin) should be advised to maintain a consistent intake of
foods rich in which vitamin?
A. Vitamin A
,B. Vitamin B12
C. Vitamin C
D. Vitamin K ✓
6. Which laboratory value is most critical to monitor for a patient receiving Heparin?
A. aPTT (activated Partial Thromboplastin Time) ✓
B. INR (International Normalized Ratio)
C. Hemoglobin and Hematocrit
D. Platelet Count
7. The nurse administers Furosemide (Lasix) to a patient. Which finding indicates a
therapeutic effect?
A. Decreased blood pressure and increased urine output ✓
B. Relief of chest pain
C. Slowed heart rate
D. Reduced anxiety
8. Before administering a dose of Digoxin, the nurse assesses the patient's apical pulse and
finds it to be 52 beats/minute. What is the nurse's priority action?
A. Administer the dose as ordered.
B. Withhold the dose and notify the provider. ✓
C. Recheck the pulse in 30 minutes.
D. Check the patient's blood pressure.
9. Which class of medications is considered first-line for the treatment of uncomplicated
hypertension?
A. Thiazide Diuretics ✓
B. Alpha-blockers
C. Loop Diuretics
D. Potassium-Sparing Diuretics
10. A patient taking an SSRI like Sertraline (Zoloft) should be educated about the risk of which
life-threatening condition if taken with other serotonergic drugs?
A. Neuroleptic Malignant Syndrome (NMS)
B. Serotonin Syndrome ✓
C. Tardive Dyskinesia
D. Agranulocytosis
11. Which medication requires frequent monitoring of thyroid and liver function tests?
A. Amiodarone ✓
,B. Atorvastatin
C. Metformin
D. Levothyroxine
12. The antidote for an opioid overdose, such as with Morphine, is:
A. Flumazenil
B. Naloxone (Narcan) ✓
C. Vitamin K
D. Acetylcysteine
13. A patient with Type 2 Diabetes is started on Metformin. The nurse should teach the
patient to report which potential adverse effect immediately?
A. Hypoglycemia
B. Metallic Taste
C. Lactic Acidosis (e.g., profound fatigue, myalgia, dyspnea) ✓
D. Weight Gain
14. Which instruction is most important for a patient starting on Atorvastatin (Lipitor) for
hyperlipidemia?
A. "Take the medication on an empty stomach."
B. "Report any unexplained muscle pain or weakness." ✓
C. "Avoid all dairy products while on this drug."
D. "Limit your fluid intake."
15. The primary reason to administer a "Proton Pump Inhibitor" (PPI) like Omeprazole is to:
A. Neutralize stomach acid quickly.
B. Provide a protective coating for the stomach lining.
C. Irreversibly inhibit gastric acid secretion. ✓
D. Increase gastrointestinal motility.
16. When teaching a patient about using an Albuterol inhaler for asthma, the nurse should
emphasize that it is used for:
A. Long-term control of inflammation.
B. Quick relief of acute bronchospasm. ✓
C. Preventing exercise-induced asthma if taken daily.
D. Treating respiratory infections.
17. Which medication is contraindicated in pregnancy due to the risk of teratogenic effects?
A. Prenatal Vitamins
B. Insulin
, C. Warfarin (Coumadin) ✓
D. Acetaminophen
18. A patient receiving a Phenytoin (Dilantin) IV push must be monitored for:
A. Hypertension
B. Cardiovascular collapse and hypotension ✓
C. Acute renal failure
D. Hypoglycemia
19. Which class of drugs ends in "-pril" (e.g., Lisinopril, Enalapril)?
A. Angiotensin II Receptor Blockers (ARBs)
B. Beta-Blockers
C. Calcium Channel Blockers (CCBs)
D. Angiotensin-Converting Enzyme (ACE) Inhibitors ✓
20. The nurse is preparing to administer Insulin Glargine (Lantus). Which action is correct?
A. Shake the vial vigorously to mix the suspension.
B. Administer it within 15 minutes of a meal.
C. Give it as a continuous IV infusion.
D. Administer it subcutaneously at the same time every day. ✓
21. A patient taking Levothyroxine (Synthroid) should be instructed to take the medication:
A. With food to avoid GI upset.
B. At bedtime.
C. On an empty stomach, usually in the morning. ✓
D. Only when they feel fatigued.
22. Which finding is a sign of neurotoxicity in a patient taking high-dose Acyclovir?
A. Hematuria
B. Tremors or confusion ✓
C. Photosensitivity
D. Tinnitus
23. A patient with Parkinson's disease is taking Carbidopa/Levodopa. The nurse should teach
the patient to avoid taking the medication with:
A. Grapefruit juice
B. High-protein meals ✓
C. Carbonated beverages
D. Caffeinated drinks
