HESI RN Pharmacology Proctored Exam Test Bank 2023
(37 Exam Versions) / RN HESI Pharmacology Proctored
Exam Test Bank 2023 / Pharmacology HESI RN Proctored
Exam | Exam + Practice Exam
SECTION 1: Cardiovascular & Renal Pharmacology (Questions 1–30)
1. A client is prescribed digoxin (Lanoxin) 0.25 mg PO daily. Which assessment finding should
the nurse report immediately?
A. Heart rate of 58 beats/min
B. Serum potassium of 3.2 mEq/L
C. Serum digoxin level of 0.8 ng/mL
D. Blood pressure of 118/72 mm Hg
Correct Answer: B
Rationale: Hypokalemia (K+ < 3.5 mEq/L) increases the risk of digoxin toxicity because
digoxin and potassium compete for binding sites. A serum potassium of 3.2 mEq/L places the
client at high risk for toxicity. A HR of 58 is slightly low but not immediately dangerous;
therapeutic digoxin level is 0.5–2.0 ng/mL; BP is normal.
2. Which client is at highest risk for digoxin toxicity?
A. A client with hypertension taking lisinopril
B. A client with heart failure taking furosemide
C. A client with atrial fibrillation taking warfarin
D. A client with angina taking nitroglycerin
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium loss. Hypokalemia
predisposes to digoxin toxicity. The other medications do not significantly alter digoxin risk.
3. A nurse is teaching a client about lisinopril (Zestril). Which statement by the client indicates
understanding?
A. "I should take this medication with a potassium supplement."
B. "I need to report a persistent dry cough to my provider."
,C. "This medication will increase my heart rate."
D. "I can stop taking this once my blood pressure is normal."
Correct Answer: B
Rationale: ACE inhibitors like lisinopril commonly cause a dry, persistent cough due to
bradykinin accumulation. Clients should report this. Potassium supplements are contraindicated
(risk of hyperkalemia). ACE inhibitors don't typically increase HR. Hypertension medication is
lifelong.
4. SATA: A client is receiving metoprolol (Lopressor). Which findings require nursing
intervention? Select all that apply.
A. Heart rate 52 beats/min
B. Blood pressure 88/54 mm Hg
C. Blood glucose 110 mg/dL
D. Wheezing on auscultation
E. Serum potassium 4.0 mEq/L
Correct Answers: A, B, D
Rationale: Beta-blockers can cause bradycardia (HR < 60), hypotension, and
bronchoconstriction (wheezing) — especially in clients with asthma/COPD. Glucose 110 and K+
4.0 are normal.
5. A client on warfarin (Coumadin) has an INR of 5.8. Which action should the nurse take first?
A. Administer vitamin K (phytonadione)
B. Hold the warfarin dose and notify the provider
C. Prepare to administer fresh frozen plasma
D. Encourage the client to increase vitamin K intake
Correct Answer: B
Rationale: The first action is to hold the medication and notify the provider. Vitamin K is the
antidote but requires a provider order. FFP is for active bleeding. Dietary vitamin K is not an
acute intervention.
6. Which instruction should the nurse include for a client taking atorvastatin (Lipitor)?
A. "Take this medication in the morning with breakfast."
B. "Report unexplained muscle pain or weakness."
,C. "Avoid grapefruit juice only if you have diabetes."
D. "This medication replaces the need for diet and exercise."
Correct Answer: B
Rationale: Statins can cause myopathy/rhabdomyolysis. Unexplained muscle pain must be
reported. Statins are typically taken in the evening. Grapefruit juice should be avoided
regardless of diabetes. Diet and exercise remain essential.
7. A client is prescribed furosemide (Lasix) 40 mg IV push. Which lab value should the nurse
monitor most closely?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
Correct Answer: B
Rationale: Loop diuretics cause significant potassium loss, leading to hypokalemia. While
other electrolytes can be affected, potassium is the priority due to cardiac risk.
8. SATA: Which findings indicate a client is experiencing digoxin toxicity? Select all that apply.
A. Visual disturbances (yellow halos)
B. Bradycardia
C. Nausea and vomiting
D. Hypertension
E. Confusion
Correct Answers: A, B, C, E
Rationale: Digoxin toxicity manifestations include visual changes (yellow-green halos),
bradycardia, GI upset, and CNS changes (confusion). Hypertension is not typical; hypotension
may occur.
9. A client is started on amiodarone (Cordarone). Which baseline assessment is most
important?
A. Thyroid function tests
B. Serum glucose
, C. CBC with differential
D. Urinalysis
Correct Answer: A
Rationale: Amiodarone contains iodine and can cause hyper- or hypothyroidism. Baseline
and periodic thyroid function tests are essential. Pulmonary function tests and liver function
tests are also important, but thyroid is the classic priority.
10. A nurse is administering heparin subcutaneously. Which action is correct?
A. Aspirate before injecting
B. Massage the injection site after injection
C. Use a 25- to 27-gauge needle
D. Inject into the deltoid muscle
Correct Answer: C
Rationale: Heparin subQ uses a small-gauge needle (25–27G). Do not aspirate or massage
(risk of hematoma). Injection sites are the abdomen, not the deltoid.
11. A client on enoxaparin (Lovenox) has a platelet count of 95,000/mm³. Which action should
the nurse take?
A. Administer the medication as ordered
B. Hold the medication and notify the provider
C. Administer vitamin K
D. Increase the dose
Correct Answer: B
Rationale: Heparin-induced thrombocytopenia (HIT) is a risk with enoxaparin. A platelet
count < 100,000/mm³ warrants holding the drug and notifying the provider.
12. Which client should the nurse question receiving a beta-blocker?
A. Client with asthma
B. Client with diabetes
C. Client with hypertension
D. Client with angina
(37 Exam Versions) / RN HESI Pharmacology Proctored
Exam Test Bank 2023 / Pharmacology HESI RN Proctored
Exam | Exam + Practice Exam
SECTION 1: Cardiovascular & Renal Pharmacology (Questions 1–30)
1. A client is prescribed digoxin (Lanoxin) 0.25 mg PO daily. Which assessment finding should
the nurse report immediately?
A. Heart rate of 58 beats/min
B. Serum potassium of 3.2 mEq/L
C. Serum digoxin level of 0.8 ng/mL
D. Blood pressure of 118/72 mm Hg
Correct Answer: B
Rationale: Hypokalemia (K+ < 3.5 mEq/L) increases the risk of digoxin toxicity because
digoxin and potassium compete for binding sites. A serum potassium of 3.2 mEq/L places the
client at high risk for toxicity. A HR of 58 is slightly low but not immediately dangerous;
therapeutic digoxin level is 0.5–2.0 ng/mL; BP is normal.
2. Which client is at highest risk for digoxin toxicity?
A. A client with hypertension taking lisinopril
B. A client with heart failure taking furosemide
C. A client with atrial fibrillation taking warfarin
D. A client with angina taking nitroglycerin
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium loss. Hypokalemia
predisposes to digoxin toxicity. The other medications do not significantly alter digoxin risk.
3. A nurse is teaching a client about lisinopril (Zestril). Which statement by the client indicates
understanding?
A. "I should take this medication with a potassium supplement."
B. "I need to report a persistent dry cough to my provider."
,C. "This medication will increase my heart rate."
D. "I can stop taking this once my blood pressure is normal."
Correct Answer: B
Rationale: ACE inhibitors like lisinopril commonly cause a dry, persistent cough due to
bradykinin accumulation. Clients should report this. Potassium supplements are contraindicated
(risk of hyperkalemia). ACE inhibitors don't typically increase HR. Hypertension medication is
lifelong.
4. SATA: A client is receiving metoprolol (Lopressor). Which findings require nursing
intervention? Select all that apply.
A. Heart rate 52 beats/min
B. Blood pressure 88/54 mm Hg
C. Blood glucose 110 mg/dL
D. Wheezing on auscultation
E. Serum potassium 4.0 mEq/L
Correct Answers: A, B, D
Rationale: Beta-blockers can cause bradycardia (HR < 60), hypotension, and
bronchoconstriction (wheezing) — especially in clients with asthma/COPD. Glucose 110 and K+
4.0 are normal.
5. A client on warfarin (Coumadin) has an INR of 5.8. Which action should the nurse take first?
A. Administer vitamin K (phytonadione)
B. Hold the warfarin dose and notify the provider
C. Prepare to administer fresh frozen plasma
D. Encourage the client to increase vitamin K intake
Correct Answer: B
Rationale: The first action is to hold the medication and notify the provider. Vitamin K is the
antidote but requires a provider order. FFP is for active bleeding. Dietary vitamin K is not an
acute intervention.
6. Which instruction should the nurse include for a client taking atorvastatin (Lipitor)?
A. "Take this medication in the morning with breakfast."
B. "Report unexplained muscle pain or weakness."
,C. "Avoid grapefruit juice only if you have diabetes."
D. "This medication replaces the need for diet and exercise."
Correct Answer: B
Rationale: Statins can cause myopathy/rhabdomyolysis. Unexplained muscle pain must be
reported. Statins are typically taken in the evening. Grapefruit juice should be avoided
regardless of diabetes. Diet and exercise remain essential.
7. A client is prescribed furosemide (Lasix) 40 mg IV push. Which lab value should the nurse
monitor most closely?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
Correct Answer: B
Rationale: Loop diuretics cause significant potassium loss, leading to hypokalemia. While
other electrolytes can be affected, potassium is the priority due to cardiac risk.
8. SATA: Which findings indicate a client is experiencing digoxin toxicity? Select all that apply.
A. Visual disturbances (yellow halos)
B. Bradycardia
C. Nausea and vomiting
D. Hypertension
E. Confusion
Correct Answers: A, B, C, E
Rationale: Digoxin toxicity manifestations include visual changes (yellow-green halos),
bradycardia, GI upset, and CNS changes (confusion). Hypertension is not typical; hypotension
may occur.
9. A client is started on amiodarone (Cordarone). Which baseline assessment is most
important?
A. Thyroid function tests
B. Serum glucose
, C. CBC with differential
D. Urinalysis
Correct Answer: A
Rationale: Amiodarone contains iodine and can cause hyper- or hypothyroidism. Baseline
and periodic thyroid function tests are essential. Pulmonary function tests and liver function
tests are also important, but thyroid is the classic priority.
10. A nurse is administering heparin subcutaneously. Which action is correct?
A. Aspirate before injecting
B. Massage the injection site after injection
C. Use a 25- to 27-gauge needle
D. Inject into the deltoid muscle
Correct Answer: C
Rationale: Heparin subQ uses a small-gauge needle (25–27G). Do not aspirate or massage
(risk of hematoma). Injection sites are the abdomen, not the deltoid.
11. A client on enoxaparin (Lovenox) has a platelet count of 95,000/mm³. Which action should
the nurse take?
A. Administer the medication as ordered
B. Hold the medication and notify the provider
C. Administer vitamin K
D. Increase the dose
Correct Answer: B
Rationale: Heparin-induced thrombocytopenia (HIT) is a risk with enoxaparin. A platelet
count < 100,000/mm³ warrants holding the drug and notifying the provider.
12. Which client should the nurse question receiving a beta-blocker?
A. Client with asthma
B. Client with diabetes
C. Client with hypertension
D. Client with angina
