HESI RN Pharmacology Exit Exam
V2 2025 – Verified Questions and
Correct Answers with Rationales
Question 1
A client is prescribed digoxin 0.25 mg daily for heart failure. Which finding indicates digoxin
toxicity?
a) Heart rate of 80 bpm
b) Serum potassium of 4.5 mEq/L
c) Visual disturbances and nausea
d) Blood pressure of 120/80 mmHg
Correct Answer: c) Visual disturbances and nausea
Rationale: Digoxin toxicity can manifest as visual disturbances (e.g., yellow-green halos),
nausea, vomiting, and arrhythmias. A heart rate of 80 bpm and blood pressure of 120/80 mmHg
are normal, and a potassium level of 4.5 mEq/L is within the normal range, though hypokalemia
increases toxicity risk.
Question 2
A nurse is administering heparin to a client with deep vein thrombosis. What laboratory value
should be monitored?
a) Platelet count
b) Prothrombin time (PT)
c) Activated partial thromboplastin time (aPTT)
d) International normalized ratio (INR)
Correct Answer: c) Activated partial thromboplastin time (aPTT)
Rationale: Heparin, an anticoagulant, is monitored using aPTT to ensure therapeutic levels
(typically 1.5–2.5 times the control value). PT and INR are used for warfarin, and while platelet
count is monitored for heparin-induced thrombocytopenia, aPTT is the primary measure.
Question 3
,A client is prescribed metformin for type 2 diabetes. What should the nurse instruct the client to
avoid?
a) High-fiber foods
b) Excessive alcohol intake
c) Dairy products
d) Caffeine
Correct Answer: b) Excessive alcohol intake
Rationale: Excessive alcohol intake with metformin increases the risk of lactic acidosis, a rare
but serious complication. High-fiber foods may enhance glycemic control, and dairy or caffeine
do not have significant interactions with metformin.
Question 4
Which medication is contraindicated in a client with a sulfa allergy?
a) Furosemide
b) Hydrochlorothiazide
c) Sulfamethoxazole-trimethoprim
d) Lisinopril
Correct Answer: c) Sulfamethoxazole-trimethoprim
Rationale: Sulfamethoxazole-trimethoprim is a sulfonamide antibiotic, contraindicated in clients
with sulfa allergies due to the risk of allergic reactions. Furosemide and hydrochlorothiazide are
diuretics with sulfa-like structures but are not absolute contraindications; lisinopril is an ACE
inhibitor.
Question 5
A client is receiving morphine for severe pain. What is the priority nursing assessment?
a) Blood pressure
b) Respiratory rate
c) Temperature
d) Pulse rate
Correct Answer: b) Respiratory rate
Rationale: Morphine, an opioid, can cause respiratory depression, a life-threatening side effect.
Monitoring respiratory rate is the priority to ensure client safety. Blood pressure, temperature,
and pulse are also monitored but are secondary to respiratory status.
, Question 6
A nurse is preparing to administer insulin glargine to a client. What is the correct administration
time?
a) With meals
b) At bedtime
c) Every 6 hours
d) Before exercise
Correct Answer: b) At bedtime
Rationale: Insulin glargine, a long-acting insulin, is typically administered once daily at bedtime
to provide steady glucose control over 24 hours. It is not given with meals, every 6 hours, or
before exercise, as those apply to short-acting insulins.
Question 7
A client is prescribed warfarin. Which food should the nurse instruct the client to limit?
a) Green leafy vegetables
b) Citrus fruits
c) Red meat
d) Dairy products
Correct Answer: a) Green leafy vegetables
Rationale: Green leafy vegetables are high in vitamin K, which can antagonize warfarin’s
anticoagulant effect, requiring consistent intake to maintain stable INR levels. Citrus fruits, red
meat, and dairy have minimal impact on warfarin.
Question 8
What is the antidote for heparin overdose?
a) Vitamin K
b) Protamine sulfate
c) Naloxone
d) Flumazenil
Correct Answer: b) Protamine sulfate
Rationale: Protamine sulfate is the antidote for heparin overdose, neutralizing its anticoagulant
effects. Vitamin K is used for warfarin, naloxone for opioids, and flumazenil for
benzodiazepines.
V2 2025 – Verified Questions and
Correct Answers with Rationales
Question 1
A client is prescribed digoxin 0.25 mg daily for heart failure. Which finding indicates digoxin
toxicity?
a) Heart rate of 80 bpm
b) Serum potassium of 4.5 mEq/L
c) Visual disturbances and nausea
d) Blood pressure of 120/80 mmHg
Correct Answer: c) Visual disturbances and nausea
Rationale: Digoxin toxicity can manifest as visual disturbances (e.g., yellow-green halos),
nausea, vomiting, and arrhythmias. A heart rate of 80 bpm and blood pressure of 120/80 mmHg
are normal, and a potassium level of 4.5 mEq/L is within the normal range, though hypokalemia
increases toxicity risk.
Question 2
A nurse is administering heparin to a client with deep vein thrombosis. What laboratory value
should be monitored?
a) Platelet count
b) Prothrombin time (PT)
c) Activated partial thromboplastin time (aPTT)
d) International normalized ratio (INR)
Correct Answer: c) Activated partial thromboplastin time (aPTT)
Rationale: Heparin, an anticoagulant, is monitored using aPTT to ensure therapeutic levels
(typically 1.5–2.5 times the control value). PT and INR are used for warfarin, and while platelet
count is monitored for heparin-induced thrombocytopenia, aPTT is the primary measure.
Question 3
,A client is prescribed metformin for type 2 diabetes. What should the nurse instruct the client to
avoid?
a) High-fiber foods
b) Excessive alcohol intake
c) Dairy products
d) Caffeine
Correct Answer: b) Excessive alcohol intake
Rationale: Excessive alcohol intake with metformin increases the risk of lactic acidosis, a rare
but serious complication. High-fiber foods may enhance glycemic control, and dairy or caffeine
do not have significant interactions with metformin.
Question 4
Which medication is contraindicated in a client with a sulfa allergy?
a) Furosemide
b) Hydrochlorothiazide
c) Sulfamethoxazole-trimethoprim
d) Lisinopril
Correct Answer: c) Sulfamethoxazole-trimethoprim
Rationale: Sulfamethoxazole-trimethoprim is a sulfonamide antibiotic, contraindicated in clients
with sulfa allergies due to the risk of allergic reactions. Furosemide and hydrochlorothiazide are
diuretics with sulfa-like structures but are not absolute contraindications; lisinopril is an ACE
inhibitor.
Question 5
A client is receiving morphine for severe pain. What is the priority nursing assessment?
a) Blood pressure
b) Respiratory rate
c) Temperature
d) Pulse rate
Correct Answer: b) Respiratory rate
Rationale: Morphine, an opioid, can cause respiratory depression, a life-threatening side effect.
Monitoring respiratory rate is the priority to ensure client safety. Blood pressure, temperature,
and pulse are also monitored but are secondary to respiratory status.
, Question 6
A nurse is preparing to administer insulin glargine to a client. What is the correct administration
time?
a) With meals
b) At bedtime
c) Every 6 hours
d) Before exercise
Correct Answer: b) At bedtime
Rationale: Insulin glargine, a long-acting insulin, is typically administered once daily at bedtime
to provide steady glucose control over 24 hours. It is not given with meals, every 6 hours, or
before exercise, as those apply to short-acting insulins.
Question 7
A client is prescribed warfarin. Which food should the nurse instruct the client to limit?
a) Green leafy vegetables
b) Citrus fruits
c) Red meat
d) Dairy products
Correct Answer: a) Green leafy vegetables
Rationale: Green leafy vegetables are high in vitamin K, which can antagonize warfarin’s
anticoagulant effect, requiring consistent intake to maintain stable INR levels. Citrus fruits, red
meat, and dairy have minimal impact on warfarin.
Question 8
What is the antidote for heparin overdose?
a) Vitamin K
b) Protamine sulfate
c) Naloxone
d) Flumazenil
Correct Answer: b) Protamine sulfate
Rationale: Protamine sulfate is the antidote for heparin overdose, neutralizing its anticoagulant
effects. Vitamin K is used for warfarin, naloxone for opioids, and flumazenil for
benzodiazepines.
