BSN HESI 315 Pharmacology Exam V2
Evaluation |Nightingale College BSN
Pharmacology Program | 2026/2027
Academic Year |Verified Questions
and Answers for Baccalaureate Nursing
Students
Domain 1: Medication Safety & Administration (Questions 1–10)
1. A nurse is preparing to administer IV potassium chloride.
Which action is absolutely contraindicated?
A) Diluting in normal saline
B) Using an infusion pump
C) Administering via IV push
D) Monitoring the IV site for phlebitis
Answer: C
Rationale: IV push potassium chloride can cause fatal cardiac
arrest due to rapid hyperkalemia. It must always be diluted and
infused slowly via an electronic pump.
2. A patient receiving digoxin reports seeing yellow halos around
lights. What is the nurse’s priority action?
A) Administer the next dose
B) Check the apical pulse for 1 minute
C) Hold the dose and notify the provider
D) Document as a normal side effect
,Answer: C
Rationale: Visual disturbances (yellow/green halos) are classic
signs of digoxin toxicity. The dose must be held immediately to
prevent life-threatening dysrhythmias.
3. Which antidote should be readily available for a patient
receiving a continuous IV heparin infusion?
A) Vitamin K
B) Protamine sulfate
C) Naloxone
D) Flumazenil
Answer: B
Rationale: Protamine sulfate is the specific reversal agent for
unfractionated heparin. Vitamin K reverses warfarin; Naloxone
reverses opioids.
4. A patient is prescribed warfarin. Which dietary instruction is
most important?
A) Increase leafy green vegetables
B) Maintain a consistent intake of vitamin K
C) Avoid all fruits
D) Double the dose if a meal is missed
Answer: B
Rationale: Warfarin works by antagonizing vitamin K. Sudden
increases or decreases in vitamin K intake cause erratic INR
levels. Consistency is key.
5. When mixing Regular insulin and NPH insulin, what is the
correct sequence?
,A) Draw up NPH first, then Regular
B) Draw up Regular first, then NPH
C) Mix in any order
D) They cannot be mixed
Answer: B
Rationale: "Clear before cloudy." Drawing the clear Regular
insulin first prevents contaminating it with the cloudy NPH, which
would alter the onset of action.
6. A patient on an MAOI asks about diet. Which food must be
avoided?
A) Aged cheese and cured meats
B) Fresh fruits
C) Whole grain bread
D) Lean poultry
Answer: A
Rationale: Aged cheeses and cured meats contain tyramine.
Combined with MAOIs, tyramine can cause a hypertensive crisis
(severe headache, stroke risk).
7. A patient receiving IV vancomycin develops flushing of the face,
neck, and chest. What is the nurse’s best action?
A) Stop the infusion and call a code
B) Slow the infusion rate
C) Administer epinephrine
D) Document as an expected finding
Answer: B
, Rationale: This is "Red Man Syndrome," a histamine-mediated
reaction caused by infusing vancomycin too rapidly. Slowing the
rate usually resolves it.
8. Which instruction is correct for sublingual nitroglycerin?
A) Swallow the tablet with water
B) Take up to 3 tablets, 5 minutes apart, while sitting down
C) Store in a clear plastic pillbox
D) Chew the tablet for faster absorption
Answer: B
Rationale: Sitting prevents orthostatic hypotension. If pain
persists after 3 doses (15 mins), call 911. It must be stored in its
original dark glass bottle to prevent degradation.
9. A nurse notes a patient’s apical pulse is 54 bpm before
administering metoprolol. What should the nurse do?
A) Administer the dose
B) Hold the dose and notify the provider
C) Give half the dose
D) Administer with atropine
Answer: B
Rationale: Beta-blockers lower heart rate. Holding the dose is
required when HR is <60 bpm (or per specific provider
parameters) to prevent severe bradycardia.
10. Which high-alert medication requires independent double-
check by two nurses before administration?
A) Acetaminophen
B) Insulin
Evaluation |Nightingale College BSN
Pharmacology Program | 2026/2027
Academic Year |Verified Questions
and Answers for Baccalaureate Nursing
Students
Domain 1: Medication Safety & Administration (Questions 1–10)
1. A nurse is preparing to administer IV potassium chloride.
Which action is absolutely contraindicated?
A) Diluting in normal saline
B) Using an infusion pump
C) Administering via IV push
D) Monitoring the IV site for phlebitis
Answer: C
Rationale: IV push potassium chloride can cause fatal cardiac
arrest due to rapid hyperkalemia. It must always be diluted and
infused slowly via an electronic pump.
2. A patient receiving digoxin reports seeing yellow halos around
lights. What is the nurse’s priority action?
A) Administer the next dose
B) Check the apical pulse for 1 minute
C) Hold the dose and notify the provider
D) Document as a normal side effect
,Answer: C
Rationale: Visual disturbances (yellow/green halos) are classic
signs of digoxin toxicity. The dose must be held immediately to
prevent life-threatening dysrhythmias.
3. Which antidote should be readily available for a patient
receiving a continuous IV heparin infusion?
A) Vitamin K
B) Protamine sulfate
C) Naloxone
D) Flumazenil
Answer: B
Rationale: Protamine sulfate is the specific reversal agent for
unfractionated heparin. Vitamin K reverses warfarin; Naloxone
reverses opioids.
4. A patient is prescribed warfarin. Which dietary instruction is
most important?
A) Increase leafy green vegetables
B) Maintain a consistent intake of vitamin K
C) Avoid all fruits
D) Double the dose if a meal is missed
Answer: B
Rationale: Warfarin works by antagonizing vitamin K. Sudden
increases or decreases in vitamin K intake cause erratic INR
levels. Consistency is key.
5. When mixing Regular insulin and NPH insulin, what is the
correct sequence?
,A) Draw up NPH first, then Regular
B) Draw up Regular first, then NPH
C) Mix in any order
D) They cannot be mixed
Answer: B
Rationale: "Clear before cloudy." Drawing the clear Regular
insulin first prevents contaminating it with the cloudy NPH, which
would alter the onset of action.
6. A patient on an MAOI asks about diet. Which food must be
avoided?
A) Aged cheese and cured meats
B) Fresh fruits
C) Whole grain bread
D) Lean poultry
Answer: A
Rationale: Aged cheeses and cured meats contain tyramine.
Combined with MAOIs, tyramine can cause a hypertensive crisis
(severe headache, stroke risk).
7. A patient receiving IV vancomycin develops flushing of the face,
neck, and chest. What is the nurse’s best action?
A) Stop the infusion and call a code
B) Slow the infusion rate
C) Administer epinephrine
D) Document as an expected finding
Answer: B
, Rationale: This is "Red Man Syndrome," a histamine-mediated
reaction caused by infusing vancomycin too rapidly. Slowing the
rate usually resolves it.
8. Which instruction is correct for sublingual nitroglycerin?
A) Swallow the tablet with water
B) Take up to 3 tablets, 5 minutes apart, while sitting down
C) Store in a clear plastic pillbox
D) Chew the tablet for faster absorption
Answer: B
Rationale: Sitting prevents orthostatic hypotension. If pain
persists after 3 doses (15 mins), call 911. It must be stored in its
original dark glass bottle to prevent degradation.
9. A nurse notes a patient’s apical pulse is 54 bpm before
administering metoprolol. What should the nurse do?
A) Administer the dose
B) Hold the dose and notify the provider
C) Give half the dose
D) Administer with atropine
Answer: B
Rationale: Beta-blockers lower heart rate. Holding the dose is
required when HR is <60 bpm (or per specific provider
parameters) to prevent severe bradycardia.
10. Which high-alert medication requires independent double-
check by two nurses before administration?
A) Acetaminophen
B) Insulin
