BSN HESI 315 Pharmacology Exam V1 – (2026/2027) Actual
Questions with Revised Answers, 100% Verified Nightingale
College Study & Prep Guide
1. A patient is receiving an intravenous (IV) infusion of
vancomycin. The nurse notes the client has developed a sudden
onset of "red man syndrome." What is the priority nursing
intervention?
A. Stop the infusion immediately and notify the provider.
B. Slow the infusion rate and administer diphenhydramine as
prescribed.
C. Apply oxygen via nasal cannula at 2 L/min.
D. Stop the infusion and administer epinephrine
intramuscularly.
Answer: B
Rationale: Red man syndrome is a rate-related infusion reaction
to vancomycin caused by histamine release. The priority
intervention is to slow the infusion rate (usually over 60-90
minutes) and administer an antihistamine (diphenhydramine).
Stopping the infusion completely is usually unnecessary unless
symptoms are severe.
,2. A client is prescribed furosemide 40 mg IV daily. Which
laboratory value requires the most immediate intervention by
the nurse?
A. Sodium 135 mEq/L
B. Potassium 2.9 mEq/L
C. Chloride 100 mEq/L
D. Magnesium 1.8 mg/dL
Answer: B
Rationale: Furosemide is a loop diuretic that wastes potassium.
A potassium level of 2.9 mEq/L is critically low (hypokalemia)
and puts the client at high risk for life-threatening cardiac
dysrhythmias. This requires the most immediate intervention.
3. A nurse is preparing to administer digoxin to a client with
atrial fibrillation. The client’s apical heart rate is 52 bpm. What
is the nurse’s best action?
A. Administer the medication as prescribed.
B. Administer half of the prescribed dose.
C. Withhold the medication and notify the provider.
D. Administer atropine 1 mg IV push.
Answer: C
,Rationale: Digoxin slows the heart rate. If the apical pulse is less
than 60 bpm, the nurse must withhold the medication and
notify the provider to prevent severe bradycardia and digoxin
toxicity.
4. A client is starting therapy with an angiotensin-converting
enzyme (ACE) inhibitor, lisinopril. What side effect should the
nurse instruct the client to report immediately to the provider?
A. Dry, persistent cough
B. Frequent urination
C. Constipation
D. Increased appetite
Answer: A
Rationale: A dry, persistent cough is a very common side effect
of ACE inhibitors due to the buildup of bradykinin in the lungs.
While not immediately life-threatening, it is bothersome and
usually requires switching the patient to an ARB.
5. A patient receiving heparin therapy for a deep vein
thrombosis (DVT) has an activated partial thromboplastin time
(aPTT) of 110 seconds (normal range 30-40 seconds). Which
medication should the nurse anticipate administering?
, A. Vitamin K
B. Protamine sulfate
C. Flumazenil
D. Acetylcysteine
Answer: B
Rationale: Protamine sulfate is the specific antidote for heparin.
An aPTT of 110 seconds indicates excessive anticoagulation and
a high risk for bleeding. Vitamin K is the antidote for warfarin.
6. A client is prescribed phenytoin for seizure control. The nurse
observes that the IV infusion site is swollen, red, and painful.
The IV pump is running correctly. What is the nurse's priority
action?
A. Elevate the extremity and apply a warm compress.
B. Stop the IV infusion and notify the provider immediately.
C. Slow the infusion rate and assess for complications.
D. Flush the IV line with normal saline.
Answer: B
Rationale: Phenytoin is highly alkaline and very vesicant. The
swelling and pain indicate infiltration and potential tissue
Questions with Revised Answers, 100% Verified Nightingale
College Study & Prep Guide
1. A patient is receiving an intravenous (IV) infusion of
vancomycin. The nurse notes the client has developed a sudden
onset of "red man syndrome." What is the priority nursing
intervention?
A. Stop the infusion immediately and notify the provider.
B. Slow the infusion rate and administer diphenhydramine as
prescribed.
C. Apply oxygen via nasal cannula at 2 L/min.
D. Stop the infusion and administer epinephrine
intramuscularly.
Answer: B
Rationale: Red man syndrome is a rate-related infusion reaction
to vancomycin caused by histamine release. The priority
intervention is to slow the infusion rate (usually over 60-90
minutes) and administer an antihistamine (diphenhydramine).
Stopping the infusion completely is usually unnecessary unless
symptoms are severe.
,2. A client is prescribed furosemide 40 mg IV daily. Which
laboratory value requires the most immediate intervention by
the nurse?
A. Sodium 135 mEq/L
B. Potassium 2.9 mEq/L
C. Chloride 100 mEq/L
D. Magnesium 1.8 mg/dL
Answer: B
Rationale: Furosemide is a loop diuretic that wastes potassium.
A potassium level of 2.9 mEq/L is critically low (hypokalemia)
and puts the client at high risk for life-threatening cardiac
dysrhythmias. This requires the most immediate intervention.
3. A nurse is preparing to administer digoxin to a client with
atrial fibrillation. The client’s apical heart rate is 52 bpm. What
is the nurse’s best action?
A. Administer the medication as prescribed.
B. Administer half of the prescribed dose.
C. Withhold the medication and notify the provider.
D. Administer atropine 1 mg IV push.
Answer: C
,Rationale: Digoxin slows the heart rate. If the apical pulse is less
than 60 bpm, the nurse must withhold the medication and
notify the provider to prevent severe bradycardia and digoxin
toxicity.
4. A client is starting therapy with an angiotensin-converting
enzyme (ACE) inhibitor, lisinopril. What side effect should the
nurse instruct the client to report immediately to the provider?
A. Dry, persistent cough
B. Frequent urination
C. Constipation
D. Increased appetite
Answer: A
Rationale: A dry, persistent cough is a very common side effect
of ACE inhibitors due to the buildup of bradykinin in the lungs.
While not immediately life-threatening, it is bothersome and
usually requires switching the patient to an ARB.
5. A patient receiving heparin therapy for a deep vein
thrombosis (DVT) has an activated partial thromboplastin time
(aPTT) of 110 seconds (normal range 30-40 seconds). Which
medication should the nurse anticipate administering?
, A. Vitamin K
B. Protamine sulfate
C. Flumazenil
D. Acetylcysteine
Answer: B
Rationale: Protamine sulfate is the specific antidote for heparin.
An aPTT of 110 seconds indicates excessive anticoagulation and
a high risk for bleeding. Vitamin K is the antidote for warfarin.
6. A client is prescribed phenytoin for seizure control. The nurse
observes that the IV infusion site is swollen, red, and painful.
The IV pump is running correctly. What is the nurse's priority
action?
A. Elevate the extremity and apply a warm compress.
B. Stop the IV infusion and notify the provider immediately.
C. Slow the infusion rate and assess for complications.
D. Flush the IV line with normal saline.
Answer: B
Rationale: Phenytoin is highly alkaline and very vesicant. The
swelling and pain indicate infiltration and potential tissue
