HESI PHARMACOLOGY EXAM – QUESTIONS AND ANSWERS | VERIFIED AND WELL
DETAILED ANSWERS | PLUS RATIONALES | GUARANTEED PASS | LATEST EXAM UPDATE
Core Domains
• Pharmacokinetics and Pharmacodynamics
• Medication Administration and Safety
• Regulatory and Legal Compliance
• Ethics and Professional Standards
• Drug Classifications and Therapeutic Actions
• Patient Education and Monitoring
• Adverse Drug Reactions and Interactions
• Pediatric and Geriatric Pharmacology
• Introduction
•
• *The purpose of this examination is to evaluate the student's mastery of
pharmacology principles essential for safe and effective nursing practice. The
assessment covers fundamental theory, drug classifications, and the application of
clinical knowledge to diverse patient scenarios. Designed to test critical thinking, the
exam includes a variety of multiple-choice and scenario-based questions that require
synthesis of knowledge regarding drug interactions, side effects, and regulatory
compliance. The exam emphasizes real-world decision-making, ensuring that the
clinician can prioritize interventions, monitor therapeutic responses, and advocate
for patient safety in complex healthcare environments.*
Section One: Questions 1–100
1. A nurse is preparing to administer warfarin to a patient with a history of deep vein
thrombosis. Which laboratory value should the nurse review before administration?
A. Prothrombin time (PT/INR) B. Activated partial thromboplastin time (aPTT) C. Platelet
count D. Hemoglobin and hematocrit
A. Prothrombin time (PT/INR)
Explanation: Warfarin therapy is monitored using the International Normalized Ratio
(INR), which is derived from the Prothrombin Time (PT) test.
2. A patient is prescribed lisinopril for hypertension. The nurse should instruct the
patient to contact the healthcare provider immediately if they experience:
,A. A dry, hacking cough B. Swelling of the face, tongue, or lips C. Mild dizziness upon
standing D. A headache
B. Swelling of the face, tongue, or lips
Explanation: Angioedema is a rare but life-threatening side effect of ACE inhibitors like
lisinopril and requires immediate medical intervention.
3. Which of the following is the priority nursing intervention when administering
intravenous vancomycin to a patient?
A. Monitor the patient for a metallic taste B. Infuse the medication slowly to prevent red
man syndrome C. Ensure the patient has a high-protein diet D. Check the blood glucose level
before administration
B. Infuse the medication slowly to prevent red man syndrome
Explanation: Rapid infusion of vancomycin can cause histamine release, leading to red
man syndrome, characterized by hypotension, flushing, and pruritus.
4. A patient is receiving digoxin for heart failure. Which clinical finding should prompt
the nurse to withhold the medication?
A. An apical pulse of 52 beats per minute B. A potassium level of 4.2 mEq/L C. A blood
pressure of 110/70 mmHg D. Slight yellow-tinged vision
A. An apical pulse of 52 beats per minute
Explanation: Digoxin is a cardiac glycoside that slows the heart rate; it should typically be
withheld if the apical pulse is less than 60 beats per minute in adults.
5. Which class of medication is commonly used to treat symptoms of benign prostatic
hyperplasia (BPH) by relaxing smooth muscle in the prostate?
A. Beta-blockers B. Alpha-1 adrenergic blockers C. Calcium channel blockers D. ACE inhibitors
B. Alpha-1 adrenergic blockers
Explanation: Alpha-1 adrenergic blockers (e.g., tamsulosin) cause relaxation of the
smooth muscles in the bladder neck and prostate, improving urine flow.
6. A nurse is teaching a patient about taking levothyroxine. Which statement indicates
the patient understands the instructions?
A. I should take this medication with breakfast B. I will take this medication on an empty
stomach in the morning C. I can stop taking this if I feel better D. This medication will start
working within 24 hours
B. I will take this medication on an empty stomach in the morning
, Explanation: Levothyroxine absorption is significantly reduced by food; it must be taken
on an empty stomach, usually 30-60 minutes before breakfast.
7. Which nursing action is most appropriate when administering an enteric-coated
medication?
A. Crush the tablet to make it easier to swallow B. Administer the tablet with a full glass of
water C. Instruct the patient to chew the tablet thoroughly D. Mix the medication in
applesauce
B. Administer the tablet with a full glass of water
Explanation: Enteric-coated tablets are designed to dissolve in the small intestine, not
the stomach. Crushing or chewing them destroys this property.
8. A patient is experiencing an acute asthma attack. Which medication should the nurse
anticipate administering first?
A. Salmeterol B. Albuterol C. Fluticasone D. Montelukast
B. Albuterol
Explanation: Albuterol is a short-acting beta-2 agonist (SABA) used as a rescue
medication for rapid bronchodilation during an acute asthma attack.
9. Which finding in a patient taking atorvastatin requires immediate reporting to the
healthcare provider?
A. Muscle pain and weakness B. Mild constipation C. Increased appetite D. Occasional
heartburn
A. Muscle pain and weakness
Explanation: Statin medications can cause rhabdomyolysis, a serious condition indicated
by unexplained muscle pain, tenderness, or weakness.
10. A nurse is caring for a patient who has been on long-term corticosteroid therapy. The
nurse knows that the patient is at risk for:
A. Hypoglycemia B. Adrenal insufficiency C. Hypertension D. Hyperkalemia
B. Adrenal insufficiency
Explanation: Long-term exogenous corticosteroid use suppresses the hypothalamic-
pituitary-adrenal axis, putting the patient at risk for adrenal crisis if the medication is
stopped abruptly.
11. Which medication is contraindicated for a patient taking sildenafil?
, A. Metformin B. Nitroglycerin C. Lisinopril D. Atorvastatin
B. Nitroglycerin
Explanation: Sildenafil and other phosphodiesterase-5 inhibitors are strictly
contraindicated with nitrates like nitroglycerin due to the risk of severe, life-threatening
hypotension.
12. A nurse is reviewing medication orders. Which drug classification is primarily used to
treat patients with gastroesophageal reflux disease (GERD) by reducing gastric acid
production?
A. Proton pump inhibitors B. Bulk-forming laxatives C. Anticholinergics D. Serotonin receptor
antagonists
A. Proton pump inhibitors
Explanation: Proton pump inhibitors (e.g., omeprazole) block the enzyme in the stomach
wall that produces acid, making them highly effective for GERD.
13. A patient is prescribed lithium carbonate for bipolar disorder. The nurse monitors the
patient for which sign of lithium toxicity?
A. Constipation B. Coarse hand tremors C. Increased thirst D. Bradycardia
B. Coarse hand tremors
Explanation: Early signs of lithium toxicity include coarse hand tremors, confusion,
polyuria, and gastrointestinal distress.
14. Which nursing assessment is critical before administering a dose of morphine
sulfate?
A. Check the patient's blood pressure B. Assess the patient's respiratory rate C. Determine
the patient’s last bowel movement D. Evaluate the patient’s skin turgor
B. Assess the patient's respiratory rate
Explanation: Morphine is an opioid analgesic that depresses the central nervous system,
with respiratory depression being the most serious side effect.
15. A patient is being treated with rifampin for tuberculosis. What patient teaching is
essential?
A. The medication may cause orange-colored urine and tears B. You should take this
medication with dairy products C. You should stop taking the drug if you develop a rash D.
This medication will prevent the transmission of TB to others immediately
A. The medication may cause orange-colored urine and tears
DETAILED ANSWERS | PLUS RATIONALES | GUARANTEED PASS | LATEST EXAM UPDATE
Core Domains
• Pharmacokinetics and Pharmacodynamics
• Medication Administration and Safety
• Regulatory and Legal Compliance
• Ethics and Professional Standards
• Drug Classifications and Therapeutic Actions
• Patient Education and Monitoring
• Adverse Drug Reactions and Interactions
• Pediatric and Geriatric Pharmacology
• Introduction
•
• *The purpose of this examination is to evaluate the student's mastery of
pharmacology principles essential for safe and effective nursing practice. The
assessment covers fundamental theory, drug classifications, and the application of
clinical knowledge to diverse patient scenarios. Designed to test critical thinking, the
exam includes a variety of multiple-choice and scenario-based questions that require
synthesis of knowledge regarding drug interactions, side effects, and regulatory
compliance. The exam emphasizes real-world decision-making, ensuring that the
clinician can prioritize interventions, monitor therapeutic responses, and advocate
for patient safety in complex healthcare environments.*
Section One: Questions 1–100
1. A nurse is preparing to administer warfarin to a patient with a history of deep vein
thrombosis. Which laboratory value should the nurse review before administration?
A. Prothrombin time (PT/INR) B. Activated partial thromboplastin time (aPTT) C. Platelet
count D. Hemoglobin and hematocrit
A. Prothrombin time (PT/INR)
Explanation: Warfarin therapy is monitored using the International Normalized Ratio
(INR), which is derived from the Prothrombin Time (PT) test.
2. A patient is prescribed lisinopril for hypertension. The nurse should instruct the
patient to contact the healthcare provider immediately if they experience:
,A. A dry, hacking cough B. Swelling of the face, tongue, or lips C. Mild dizziness upon
standing D. A headache
B. Swelling of the face, tongue, or lips
Explanation: Angioedema is a rare but life-threatening side effect of ACE inhibitors like
lisinopril and requires immediate medical intervention.
3. Which of the following is the priority nursing intervention when administering
intravenous vancomycin to a patient?
A. Monitor the patient for a metallic taste B. Infuse the medication slowly to prevent red
man syndrome C. Ensure the patient has a high-protein diet D. Check the blood glucose level
before administration
B. Infuse the medication slowly to prevent red man syndrome
Explanation: Rapid infusion of vancomycin can cause histamine release, leading to red
man syndrome, characterized by hypotension, flushing, and pruritus.
4. A patient is receiving digoxin for heart failure. Which clinical finding should prompt
the nurse to withhold the medication?
A. An apical pulse of 52 beats per minute B. A potassium level of 4.2 mEq/L C. A blood
pressure of 110/70 mmHg D. Slight yellow-tinged vision
A. An apical pulse of 52 beats per minute
Explanation: Digoxin is a cardiac glycoside that slows the heart rate; it should typically be
withheld if the apical pulse is less than 60 beats per minute in adults.
5. Which class of medication is commonly used to treat symptoms of benign prostatic
hyperplasia (BPH) by relaxing smooth muscle in the prostate?
A. Beta-blockers B. Alpha-1 adrenergic blockers C. Calcium channel blockers D. ACE inhibitors
B. Alpha-1 adrenergic blockers
Explanation: Alpha-1 adrenergic blockers (e.g., tamsulosin) cause relaxation of the
smooth muscles in the bladder neck and prostate, improving urine flow.
6. A nurse is teaching a patient about taking levothyroxine. Which statement indicates
the patient understands the instructions?
A. I should take this medication with breakfast B. I will take this medication on an empty
stomach in the morning C. I can stop taking this if I feel better D. This medication will start
working within 24 hours
B. I will take this medication on an empty stomach in the morning
, Explanation: Levothyroxine absorption is significantly reduced by food; it must be taken
on an empty stomach, usually 30-60 minutes before breakfast.
7. Which nursing action is most appropriate when administering an enteric-coated
medication?
A. Crush the tablet to make it easier to swallow B. Administer the tablet with a full glass of
water C. Instruct the patient to chew the tablet thoroughly D. Mix the medication in
applesauce
B. Administer the tablet with a full glass of water
Explanation: Enteric-coated tablets are designed to dissolve in the small intestine, not
the stomach. Crushing or chewing them destroys this property.
8. A patient is experiencing an acute asthma attack. Which medication should the nurse
anticipate administering first?
A. Salmeterol B. Albuterol C. Fluticasone D. Montelukast
B. Albuterol
Explanation: Albuterol is a short-acting beta-2 agonist (SABA) used as a rescue
medication for rapid bronchodilation during an acute asthma attack.
9. Which finding in a patient taking atorvastatin requires immediate reporting to the
healthcare provider?
A. Muscle pain and weakness B. Mild constipation C. Increased appetite D. Occasional
heartburn
A. Muscle pain and weakness
Explanation: Statin medications can cause rhabdomyolysis, a serious condition indicated
by unexplained muscle pain, tenderness, or weakness.
10. A nurse is caring for a patient who has been on long-term corticosteroid therapy. The
nurse knows that the patient is at risk for:
A. Hypoglycemia B. Adrenal insufficiency C. Hypertension D. Hyperkalemia
B. Adrenal insufficiency
Explanation: Long-term exogenous corticosteroid use suppresses the hypothalamic-
pituitary-adrenal axis, putting the patient at risk for adrenal crisis if the medication is
stopped abruptly.
11. Which medication is contraindicated for a patient taking sildenafil?
, A. Metformin B. Nitroglycerin C. Lisinopril D. Atorvastatin
B. Nitroglycerin
Explanation: Sildenafil and other phosphodiesterase-5 inhibitors are strictly
contraindicated with nitrates like nitroglycerin due to the risk of severe, life-threatening
hypotension.
12. A nurse is reviewing medication orders. Which drug classification is primarily used to
treat patients with gastroesophageal reflux disease (GERD) by reducing gastric acid
production?
A. Proton pump inhibitors B. Bulk-forming laxatives C. Anticholinergics D. Serotonin receptor
antagonists
A. Proton pump inhibitors
Explanation: Proton pump inhibitors (e.g., omeprazole) block the enzyme in the stomach
wall that produces acid, making them highly effective for GERD.
13. A patient is prescribed lithium carbonate for bipolar disorder. The nurse monitors the
patient for which sign of lithium toxicity?
A. Constipation B. Coarse hand tremors C. Increased thirst D. Bradycardia
B. Coarse hand tremors
Explanation: Early signs of lithium toxicity include coarse hand tremors, confusion,
polyuria, and gastrointestinal distress.
14. Which nursing assessment is critical before administering a dose of morphine
sulfate?
A. Check the patient's blood pressure B. Assess the patient's respiratory rate C. Determine
the patient’s last bowel movement D. Evaluate the patient’s skin turgor
B. Assess the patient's respiratory rate
Explanation: Morphine is an opioid analgesic that depresses the central nervous system,
with respiratory depression being the most serious side effect.
15. A patient is being treated with rifampin for tuberculosis. What patient teaching is
essential?
A. The medication may cause orange-colored urine and tears B. You should take this
medication with dairy products C. You should stop taking the drug if you develop a rash D.
This medication will prevent the transmission of TB to others immediately
A. The medication may cause orange-colored urine and tears
