1
BSN HESI 315 Pharmacology Exam V1 Study Guide | Comprehensive
Nursing Pharmacology Exam Prep | Practice Questions with Detailed Answer
Explanations & Rationales | Medication Classifications, Drug Actions, Side
Effects, Dosage Calculations, Patient Safety & NCLEX-Style Review | Digital
PDF Download | Latest Updated Edition
QUESTION 1
A client with heart failure is prescribed digoxin and furosemide. Which laboratory value should
the nurse monitor most closely to prevent digoxin toxicity?
a) Serum sodium
b) Serum potassium
c) Serum calcium
d) Serum magnesium
Correct Answer: b) Serum potassium
Rationale: Furosemide is a loop diuretic that causes potassium loss through the kidneys;
hypokalemia increases the risk of digoxin toxicity by enhancing the drug's effect on cardiac
muscle, potentially leading to fatal dysrhythmias; the nurse must monitor potassium levels
closely and report values below 3.5 mEq/L to the healthcare provider immediately.
QUESTION 2
A client receives a new prescription for lisinopril. Which adverse effect should the nurse instruct
the client to report immediately?
a) Dry cough
b) Dizziness
,2
c) Angioedema
d) Headache
Correct Answer: c) Angioedema
Rationale: Angioedema is a life-threatening adverse reaction to ACE inhibitors like lisinopril
that causes swelling of the face, lips, tongue, and throat potentially leading to airway
obstruction; clients should seek emergency care immediately if they experience any swelling or
difficulty breathing, while dry cough and dizziness are common but not immediately life-
threatening side effects.
QUESTION 3
A postoperative client is receiving morphine sulfate via patient-controlled analgesia. Which
assessment finding indicates the client is experiencing an adverse effect of the medication?
a) Respiratory rate of 22 breaths per minute
b) Blood pressure of 130/80 mmHg
c) Pupils constricted bilaterally
d) Bowel sounds hyperactive
Correct Answer: c) Pupils constricted bilaterally
Rationale: Morphine causes miosis or pinpoint pupils as a classic sign of opioid effect or
toxicity; constricted pupils along with respiratory depression and decreased level of
consciousness indicate opioid overdose, whereas respiratory rate of 22 is normal, blood pressure
of 130/80 is within acceptable range, and hyperactive bowel sounds are not typical of morphine
which actually slows gastrointestinal motility.
QUESTION 4
The nurse is preparing to administer vancomycin IV to a client with a severe infection. Which
intervention is most important to prevent a serious adverse reaction?
,3
a) Administer the medication over at least 60 minutes
b) Monitor serum creatinine and BUN levels
c) Assess for hearing loss before administration
d) Check the client's temperature before infusion
Correct Answer: a) Administer the medication over at least 60 minutes
Rationale: Rapid IV infusion of vancomycin can cause red man syndrome characterized by
flushing, hypotension, and rash due to histamine release; infusing over 60 minutes or longer
minimizes this reaction, while monitoring renal function is important but secondary to preventing
the immediate infusion-related reaction that can be life-threatening.
QUESTION 5
A client with type 2 diabetes is prescribed metformin. Which instruction should the nurse include
in the discharge teaching?
a) Take the medication with meals to reduce gastrointestinal upset
b) Monitor blood glucose levels only once daily
c) Expect weight gain as a common side effect
d) Avoid all carbohydrates while taking this medication
Correct Answer: a) Take the medication with meals to reduce gastrointestinal upset
Rationale: Metformin commonly causes gastrointestinal distress including nausea, diarrhea,
and abdominal cramping; taking the medication with food significantly reduces these symptoms,
while metformin is actually associated with weight loss or neutral weight effect and clients
should monitor glucose as prescribed and maintain a balanced carbohydrate intake rather than
avoiding carbohydrates completely.
QUESTION 6
A client receiving warfarin therapy has an international normalized ratio of 4.5. Which action
should the nurse take first?
, 4
a) Administer vitamin K as prescribed
b) Notify the healthcare provider immediately
c) Hold the next scheduled dose of warfarin
d) Assess the client for signs of bleeding
Correct Answer: d) Assess the client for signs of bleeding
Rationale: An INR of 4.5 indicates therapeutic range for some conditions but may increase
bleeding risk depending on the target range; the nurse should first assess the client for signs of
bleeding such as petechiae, ecchymosis, or bleeding gums before notifying the provider or
holding the dose; vitamin K is the antidote but should only be administered with specific
provider orders for significant bleeding or extremely elevated INR values.
QUESTION 7
Which medication should the nurse anticipate administering to a client experiencing an acute
exacerbation of asthma with bronchospasm?
a) Montelukast
b) Theophylline
c) Albuterol
d) Prednisone
Correct Answer: c) Albuterol
Rationale: Albuterol is a short-acting beta-2 agonist that provides rapid bronchodilation within
minutes, making it the first-line treatment for acute asthma exacerbations; montelukast is a
maintenance medication that takes days to work, theophylline has a narrow therapeutic range
and is not used for acute symptoms, and prednisone is a corticosteroid that reduces inflammation
but does not provide immediate bronchodilation.
QUESTION 8
BSN HESI 315 Pharmacology Exam V1 Study Guide | Comprehensive
Nursing Pharmacology Exam Prep | Practice Questions with Detailed Answer
Explanations & Rationales | Medication Classifications, Drug Actions, Side
Effects, Dosage Calculations, Patient Safety & NCLEX-Style Review | Digital
PDF Download | Latest Updated Edition
QUESTION 1
A client with heart failure is prescribed digoxin and furosemide. Which laboratory value should
the nurse monitor most closely to prevent digoxin toxicity?
a) Serum sodium
b) Serum potassium
c) Serum calcium
d) Serum magnesium
Correct Answer: b) Serum potassium
Rationale: Furosemide is a loop diuretic that causes potassium loss through the kidneys;
hypokalemia increases the risk of digoxin toxicity by enhancing the drug's effect on cardiac
muscle, potentially leading to fatal dysrhythmias; the nurse must monitor potassium levels
closely and report values below 3.5 mEq/L to the healthcare provider immediately.
QUESTION 2
A client receives a new prescription for lisinopril. Which adverse effect should the nurse instruct
the client to report immediately?
a) Dry cough
b) Dizziness
,2
c) Angioedema
d) Headache
Correct Answer: c) Angioedema
Rationale: Angioedema is a life-threatening adverse reaction to ACE inhibitors like lisinopril
that causes swelling of the face, lips, tongue, and throat potentially leading to airway
obstruction; clients should seek emergency care immediately if they experience any swelling or
difficulty breathing, while dry cough and dizziness are common but not immediately life-
threatening side effects.
QUESTION 3
A postoperative client is receiving morphine sulfate via patient-controlled analgesia. Which
assessment finding indicates the client is experiencing an adverse effect of the medication?
a) Respiratory rate of 22 breaths per minute
b) Blood pressure of 130/80 mmHg
c) Pupils constricted bilaterally
d) Bowel sounds hyperactive
Correct Answer: c) Pupils constricted bilaterally
Rationale: Morphine causes miosis or pinpoint pupils as a classic sign of opioid effect or
toxicity; constricted pupils along with respiratory depression and decreased level of
consciousness indicate opioid overdose, whereas respiratory rate of 22 is normal, blood pressure
of 130/80 is within acceptable range, and hyperactive bowel sounds are not typical of morphine
which actually slows gastrointestinal motility.
QUESTION 4
The nurse is preparing to administer vancomycin IV to a client with a severe infection. Which
intervention is most important to prevent a serious adverse reaction?
,3
a) Administer the medication over at least 60 minutes
b) Monitor serum creatinine and BUN levels
c) Assess for hearing loss before administration
d) Check the client's temperature before infusion
Correct Answer: a) Administer the medication over at least 60 minutes
Rationale: Rapid IV infusion of vancomycin can cause red man syndrome characterized by
flushing, hypotension, and rash due to histamine release; infusing over 60 minutes or longer
minimizes this reaction, while monitoring renal function is important but secondary to preventing
the immediate infusion-related reaction that can be life-threatening.
QUESTION 5
A client with type 2 diabetes is prescribed metformin. Which instruction should the nurse include
in the discharge teaching?
a) Take the medication with meals to reduce gastrointestinal upset
b) Monitor blood glucose levels only once daily
c) Expect weight gain as a common side effect
d) Avoid all carbohydrates while taking this medication
Correct Answer: a) Take the medication with meals to reduce gastrointestinal upset
Rationale: Metformin commonly causes gastrointestinal distress including nausea, diarrhea,
and abdominal cramping; taking the medication with food significantly reduces these symptoms,
while metformin is actually associated with weight loss or neutral weight effect and clients
should monitor glucose as prescribed and maintain a balanced carbohydrate intake rather than
avoiding carbohydrates completely.
QUESTION 6
A client receiving warfarin therapy has an international normalized ratio of 4.5. Which action
should the nurse take first?
, 4
a) Administer vitamin K as prescribed
b) Notify the healthcare provider immediately
c) Hold the next scheduled dose of warfarin
d) Assess the client for signs of bleeding
Correct Answer: d) Assess the client for signs of bleeding
Rationale: An INR of 4.5 indicates therapeutic range for some conditions but may increase
bleeding risk depending on the target range; the nurse should first assess the client for signs of
bleeding such as petechiae, ecchymosis, or bleeding gums before notifying the provider or
holding the dose; vitamin K is the antidote but should only be administered with specific
provider orders for significant bleeding or extremely elevated INR values.
QUESTION 7
Which medication should the nurse anticipate administering to a client experiencing an acute
exacerbation of asthma with bronchospasm?
a) Montelukast
b) Theophylline
c) Albuterol
d) Prednisone
Correct Answer: c) Albuterol
Rationale: Albuterol is a short-acting beta-2 agonist that provides rapid bronchodilation within
minutes, making it the first-line treatment for acute asthma exacerbations; montelukast is a
maintenance medication that takes days to work, theophylline has a narrow therapeutic range
and is not used for acute symptoms, and prednisone is a corticosteroid that reduces inflammation
but does not provide immediate bronchodilation.
QUESTION 8
