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HESI Pharmacology Newest Exam Preparation With
Complete Questions And Correct Answers With Rationales
Already Graded A+ Brand New Version!!
QUESTION 1
A client receiving IV heparin for deep vein thrombosis has an aPTT of
110 seconds (control 30-40 seconds). Which action should the nurse
take FIRST?
A) Increase the heparin infusion rate
B) Notify the prescriber to adjust the dose
C) Administer protamine sulfate immediately
D) Document the finding as expected
Answer: B) Notify the prescriber to adjust the dose
Rationale: An aPTT of 110 seconds is above the therapeutic range
(typically 1.5 to 2.5 times control, approximately 45-80 seconds). The
nurse should notify the prescriber for dose adjustment. Protamine
sulfate is the antidote for heparin but is reserved for severe bleeding or
significant overdose, not as first-line intervention for a mildly
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supratherapeutic aPTT. Increasing the rate would worsen
anticoagulation and place the client at increased bleeding risk. This
finding is not expected and requires clinical intervention.
QUESTION 2
A client with heart failure is prescribed digoxin. Which finding indicates
digoxin toxicity?
A) Tachycardia
B) Visual disturbances such as yellow-green halos
C) Hyperkalemia
D) Hypertension
Answer: B) Visual disturbances such as yellow-green halos
Rationale: Visual disturbances, including yellow-green halos, blurred
vision, and photophobia, are classic signs of digoxin toxicity. Digoxin
toxicity typically causes bradycardia, not tachycardia, due to increased
vagal tone and decreased AV conduction. Hypokalemia, not
hyperkalemia, increases the risk of digoxin toxicity by enhancing the
drug's effect on the sodium-potassium pump. Digoxin does not typically
cause hypertension; it may actually cause hypotension in toxic doses.
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QUESTION 3
A client is prescribed amlodipine for hypertension. Which action should
the nurse implement to assess the effectiveness of this medication?
A) Measure the client's blood pressure
B) Assess the client's heart rate
C) Monitor the client's respiratory rate
D) Evaluate the client's urine output
Answer: A) Measure the client's blood pressure
Rationale: Amlodipine is a dihydropyridine calcium channel blocker
indicated for the treatment of hypertension and angina. The primary
therapeutic effect is vasodilation leading to decreased peripheral
vascular resistance and subsequent reduction in blood pressure.
Therefore, measuring blood pressure is the most direct assessment of
medication effectiveness. While amlodipine may cause reflex
tachycardia, heart rate assessment does not directly measure
therapeutic efficacy. Respiratory rate and urine output are not primary
indicators of amlodipine effectiveness.
QUESTION 4
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A client taking atorvastatin develops an increased serum creatine
phosphokinase (CK) level. The nurse should assess the client for the
onset of which problem?
A) Nausea and vomiting
B) Excessive bruising
C) Muscle tenderness
D) Peripheral edema
Answer: C) Muscle tenderness
Rationale: Statins such as atorvastatin can cause myopathy, which may
progress to rhabdomyolysis in severe cases. An elevated CK level often
signifies muscle injury. Muscle tenderness, especially in large muscle
groups such as the thighs and shoulders, is one of the earliest clinical
signs of myopathy. If untreated, severe myopathy can become life-
threatening. Nausea and vomiting, excessive bruising, and peripheral
edema are not the primary concerns associated with elevated CK levels
on statin therapy.
QUESTION 5
A client with a history of COPD receives a new prescription for an
ipratropium inhaler. Which action indicates to the nurse that additional
teaching is needed?
HESI Pharmacology Newest Exam Preparation With
Complete Questions And Correct Answers With Rationales
Already Graded A+ Brand New Version!!
QUESTION 1
A client receiving IV heparin for deep vein thrombosis has an aPTT of
110 seconds (control 30-40 seconds). Which action should the nurse
take FIRST?
A) Increase the heparin infusion rate
B) Notify the prescriber to adjust the dose
C) Administer protamine sulfate immediately
D) Document the finding as expected
Answer: B) Notify the prescriber to adjust the dose
Rationale: An aPTT of 110 seconds is above the therapeutic range
(typically 1.5 to 2.5 times control, approximately 45-80 seconds). The
nurse should notify the prescriber for dose adjustment. Protamine
sulfate is the antidote for heparin but is reserved for severe bleeding or
significant overdose, not as first-line intervention for a mildly
,2|Page
supratherapeutic aPTT. Increasing the rate would worsen
anticoagulation and place the client at increased bleeding risk. This
finding is not expected and requires clinical intervention.
QUESTION 2
A client with heart failure is prescribed digoxin. Which finding indicates
digoxin toxicity?
A) Tachycardia
B) Visual disturbances such as yellow-green halos
C) Hyperkalemia
D) Hypertension
Answer: B) Visual disturbances such as yellow-green halos
Rationale: Visual disturbances, including yellow-green halos, blurred
vision, and photophobia, are classic signs of digoxin toxicity. Digoxin
toxicity typically causes bradycardia, not tachycardia, due to increased
vagal tone and decreased AV conduction. Hypokalemia, not
hyperkalemia, increases the risk of digoxin toxicity by enhancing the
drug's effect on the sodium-potassium pump. Digoxin does not typically
cause hypertension; it may actually cause hypotension in toxic doses.
,3|Page
QUESTION 3
A client is prescribed amlodipine for hypertension. Which action should
the nurse implement to assess the effectiveness of this medication?
A) Measure the client's blood pressure
B) Assess the client's heart rate
C) Monitor the client's respiratory rate
D) Evaluate the client's urine output
Answer: A) Measure the client's blood pressure
Rationale: Amlodipine is a dihydropyridine calcium channel blocker
indicated for the treatment of hypertension and angina. The primary
therapeutic effect is vasodilation leading to decreased peripheral
vascular resistance and subsequent reduction in blood pressure.
Therefore, measuring blood pressure is the most direct assessment of
medication effectiveness. While amlodipine may cause reflex
tachycardia, heart rate assessment does not directly measure
therapeutic efficacy. Respiratory rate and urine output are not primary
indicators of amlodipine effectiveness.
QUESTION 4
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A client taking atorvastatin develops an increased serum creatine
phosphokinase (CK) level. The nurse should assess the client for the
onset of which problem?
A) Nausea and vomiting
B) Excessive bruising
C) Muscle tenderness
D) Peripheral edema
Answer: C) Muscle tenderness
Rationale: Statins such as atorvastatin can cause myopathy, which may
progress to rhabdomyolysis in severe cases. An elevated CK level often
signifies muscle injury. Muscle tenderness, especially in large muscle
groups such as the thighs and shoulders, is one of the earliest clinical
signs of myopathy. If untreated, severe myopathy can become life-
threatening. Nausea and vomiting, excessive bruising, and peripheral
edema are not the primary concerns associated with elevated CK levels
on statin therapy.
QUESTION 5
A client with a history of COPD receives a new prescription for an
ipratropium inhaler. Which action indicates to the nurse that additional
teaching is needed?
