HESI RN PHARMACOLOGY VERSION 5 LATEST
EXAM | All 70 QUESTIONS AND CORRECT
DETAILED ANSWERS | LATEST UPDATE 2024 |
ALREADY GRADED A+ | PROFEFESSOR VERIFIED
Introduction
This HESI RN Pharmacology Version 5 simulation reproduces the rigor and breadth of
the live 2024 pharmacology examination. Content spans pharmacokinetics/dynamics,
medication safety, drug calculations, and major drug classes (cardiovascular, CNS,
antimicrobial, endocrine, GI). Every item is original, scenario-based, and aligned with
current HESI and NCLEX-RN® expectations to support mastery-level performance.
Examination (Questions 1 – 70)
Question 1:
A 68-year-old (70 kg) with heart failure receives digoxin 0.25 mg PO daily. Which serum
level indicates toxicity?
A. 0.8 ng/mL
B. 1.2 ng/mL
C. 2.1 ng/mL
D. 1.8 ng/mL
Answer: C. 2.1 ng/mL
Solution: Therapeutic digoxin range 0.8–2.0 ng/mL; levels ≥ 2.1 suggest toxicity
(nausea, visual halos, arrhythmias).
Question 2:
A client on IV heparin has aPTT 96 seconds (control 30 s). Which action is priority?
A. Stop infusion immediately
B. Reduce rate by 50 % and re-check in 6 h
C. Continue current rate
D. Administer protamine 1 mg IV
Answer: A. Stop infusion immediately
Solution: aPTT > 3 × control (90 s) indicates overdose – stop infusion, call prescriber,
monitor for bleeding.
pg. 1
,Question 3:
A 5-year-old (20 kg) is prescribed amoxicillin 45 mg/kg/day divided BID. How many mg
per dose?
A. 225 mg
B. 450 mg
C. 900 mg
D. 450 mg total daily
Answer: B. 450 mg
Solution: 45 mg/kg × 20 kg = 900 mg/day ÷ 2 doses = 450 mg per dose.
Question 4:
A client receives metoprolol 50 mg BID. Which finding requires immediate intervention?
A. HR 58 bpm
B. BP 110/70 mmHg
C. RR 16/min
D. HR 42 bpm, dizzy
Answer: D. HR 42 bpm, dizzy
Solution: Severe bradycardia + symptoms = hold dose, assess for toxicity, possible ECG.
Question 5:
Which instruction is correct for oral potassium chloride 20 mEq?
A. Take on an empty stomach to enhance absorption
B. Dissolve in cold juice and sip slowly
C. Crush tablets for faster effect
D. Take with only water to avoid GI upset
Answer: B. Dissolve in cold juice and sip slowly
Solution: Diluting in juice masks taste, reduces gastric irritation; crushing causes
ulceration, empty stomach increases nausea.
Question 6:
A client on lithium has serum level 1.5 mEq/L (normal 0.6–1.2). Which food is most
concerning?
A. 2 L/day water intake
B. Caffeinated coffee 4 cups
C. Low-sodium diet
D. Cranberry juice 500 mL
pg. 2
, Answer: C. Low-sodium diet
Solution: Low Na⁺ increases lithium reabsorption → toxicity; maintain consistent
moderate sodium intake.
Question 7:
A nurse prepares insulin aspart 8 units. Which syringe is appropriate?
A. 1 mL tuberculin syringe
B. 0.5 mL insulin syringe (50 units)
C. 3 mL syringe with 25-gauge needle
D. 1 mL syringe with 18-gauge needle
Answer: B. 0.5 mL insulin syringe (50 units)
Solution: U-100 insulin syringes provide unit-scale graduations; 0.5 mL size allows
accurate 8-unit draw.
Question 8:
A client receives morphine 10 mg IV. Which adverse effect is most critical to monitor
first?
A. Pruritus
B. Urinary retention
C. Respiratory rate 8/min
D. Nausea
Answer: C. Respiratory rate 8/min
Solution: Respiratory depression is life-threatening; naloxone 0.4 mg IV may be
required, monitor O₂ saturation.
Question 9:
A client is started on warfarin 5 mg daily. Which lab value best guides initial dosing?
A. aPTT
B. INR
C. Platelet count
D. Bleeding time
Answer: B. INR
Solution: INR measures warfarin effect; target 2.0–3.0 for most indications; aPTT
monitors heparin.
Question 10:
A client on furosemide 40 mg BID reports muscle cramps. Which electrolyte is most
pg. 3
EXAM | All 70 QUESTIONS AND CORRECT
DETAILED ANSWERS | LATEST UPDATE 2024 |
ALREADY GRADED A+ | PROFEFESSOR VERIFIED
Introduction
This HESI RN Pharmacology Version 5 simulation reproduces the rigor and breadth of
the live 2024 pharmacology examination. Content spans pharmacokinetics/dynamics,
medication safety, drug calculations, and major drug classes (cardiovascular, CNS,
antimicrobial, endocrine, GI). Every item is original, scenario-based, and aligned with
current HESI and NCLEX-RN® expectations to support mastery-level performance.
Examination (Questions 1 – 70)
Question 1:
A 68-year-old (70 kg) with heart failure receives digoxin 0.25 mg PO daily. Which serum
level indicates toxicity?
A. 0.8 ng/mL
B. 1.2 ng/mL
C. 2.1 ng/mL
D. 1.8 ng/mL
Answer: C. 2.1 ng/mL
Solution: Therapeutic digoxin range 0.8–2.0 ng/mL; levels ≥ 2.1 suggest toxicity
(nausea, visual halos, arrhythmias).
Question 2:
A client on IV heparin has aPTT 96 seconds (control 30 s). Which action is priority?
A. Stop infusion immediately
B. Reduce rate by 50 % and re-check in 6 h
C. Continue current rate
D. Administer protamine 1 mg IV
Answer: A. Stop infusion immediately
Solution: aPTT > 3 × control (90 s) indicates overdose – stop infusion, call prescriber,
monitor for bleeding.
pg. 1
,Question 3:
A 5-year-old (20 kg) is prescribed amoxicillin 45 mg/kg/day divided BID. How many mg
per dose?
A. 225 mg
B. 450 mg
C. 900 mg
D. 450 mg total daily
Answer: B. 450 mg
Solution: 45 mg/kg × 20 kg = 900 mg/day ÷ 2 doses = 450 mg per dose.
Question 4:
A client receives metoprolol 50 mg BID. Which finding requires immediate intervention?
A. HR 58 bpm
B. BP 110/70 mmHg
C. RR 16/min
D. HR 42 bpm, dizzy
Answer: D. HR 42 bpm, dizzy
Solution: Severe bradycardia + symptoms = hold dose, assess for toxicity, possible ECG.
Question 5:
Which instruction is correct for oral potassium chloride 20 mEq?
A. Take on an empty stomach to enhance absorption
B. Dissolve in cold juice and sip slowly
C. Crush tablets for faster effect
D. Take with only water to avoid GI upset
Answer: B. Dissolve in cold juice and sip slowly
Solution: Diluting in juice masks taste, reduces gastric irritation; crushing causes
ulceration, empty stomach increases nausea.
Question 6:
A client on lithium has serum level 1.5 mEq/L (normal 0.6–1.2). Which food is most
concerning?
A. 2 L/day water intake
B. Caffeinated coffee 4 cups
C. Low-sodium diet
D. Cranberry juice 500 mL
pg. 2
, Answer: C. Low-sodium diet
Solution: Low Na⁺ increases lithium reabsorption → toxicity; maintain consistent
moderate sodium intake.
Question 7:
A nurse prepares insulin aspart 8 units. Which syringe is appropriate?
A. 1 mL tuberculin syringe
B. 0.5 mL insulin syringe (50 units)
C. 3 mL syringe with 25-gauge needle
D. 1 mL syringe with 18-gauge needle
Answer: B. 0.5 mL insulin syringe (50 units)
Solution: U-100 insulin syringes provide unit-scale graduations; 0.5 mL size allows
accurate 8-unit draw.
Question 8:
A client receives morphine 10 mg IV. Which adverse effect is most critical to monitor
first?
A. Pruritus
B. Urinary retention
C. Respiratory rate 8/min
D. Nausea
Answer: C. Respiratory rate 8/min
Solution: Respiratory depression is life-threatening; naloxone 0.4 mg IV may be
required, monitor O₂ saturation.
Question 9:
A client is started on warfarin 5 mg daily. Which lab value best guides initial dosing?
A. aPTT
B. INR
C. Platelet count
D. Bleeding time
Answer: B. INR
Solution: INR measures warfarin effect; target 2.0–3.0 for most indications; aPTT
monitors heparin.
Question 10:
A client on furosemide 40 mg BID reports muscle cramps. Which electrolyte is most
pg. 3
