EVOLVE HESI PHARM EXAM (2026) UPDATED
STUDY & PREP GUIDE WITH VERIFIED CONCEPT
REVIEW || 100% SUCCESS TRACK <UPDATED
VERSION>
HESI Pharmacology Concept Review & Practice Questions
I. Pharmacological Principles & Safety
1. The nurse is administering a drug that is known to be a teratogen. What is the primary
implication of this?
A. The drug is likely to be carcinogenic.
B. The drug may cause genetic mutations.
C. The drug may cause birth defects.
D. The drug is highly addictive.
Answer: C ✓
2. A patient with liver cirrhosis has a prolonged prothrombin time (PT) while on warfarin. The
nurse understands this is likely due to:
A. Impaired renal excretion of the drug.
B. Impaired metabolism of the drug by the liver.
C. Increased absorption of the drug in the gut.
D. An allergic reaction to the drug.
Answer: B ✓
3. The "first-pass effect" primarily occurs in which organ?
A. Kidneys
B. Liver
C. Stomach
D. Small Intestine
Answer: B ✓
4. What is the primary goal of the nursing assessment before administering a new
medication?
A. To complete the paperwork.
B. To identify any potential contraindications or interactions.
C. To delegate the task to a nursing assistant.
,D. To determine the cost of the medication.
Answer: B ✓
5. A drug with a half-life of 4 hours will be at what percentage of its original concentration
after 12 hours?
A. 50%
B. 25%
C. 12.5%
D. 6.25%
Answer: C ✓
6. Which patient finding is the most critical for the nurse to report before administering
Lisinopril, an ACE inhibitor?
A. Blood pressure of 118/78.
B. Heart rate of 68 bpm.
C. Non-productive cough.
D. Blood pressure of 88/50.
Answer: D ✓
7. When teaching a patient about enteric-coated tablets, the nurse should include which
instruction?
A. "You can crush or chew this pill if you have trouble swallowing."
B. "This pill is designed to dissolve quickly in the stomach."
C. "Take this medication with an antacid to improve absorption."
D. "Swallow this pill whole; do not crush or chew it."
Answer: D ✓
8. A patient is receiving a drug via the sublingual route. The nurse understands the primary
advantage of this route is:
A. Avoidance of the first-pass effect.
B. Ease of administration.
C. Prolonged duration of action.
D. Minimal risk of infection.
Answer: A ✓
9. The nurse administers an IV push medication too rapidly. The patient complains of dizziness
and ringing in the ears (tinnitus). The nurse's priority action is to:
A. Document the reaction in the chart.
B. Stop the infusion immediately and assess the patient.
C. Notify the pharmacy.
,D. Slow the infusion rate and reassess in 5 minutes.
Answer: B ✓
10. What is the correct sequence of the nursing process?
A. Assessment, Diagnosis, Planning, Implementation, Evaluation
B. Diagnosis, Assessment, Planning, Implementation, Evaluation
C. Planning, Assessment, Diagnosis, Evaluation, Implementation
D. Evaluation, Assessment, Diagnosis, Planning, Implementation
Answer: A ✓
II. Cardiovascular & Renal Medications
11. A patient on Furosemide (Lasix) should be monitored for which common adverse effect?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hypermagnesemia
Answer: B ✓
12. The therapeutic effect of Atorvastatin (Lipitor) is:
A. To lower blood pressure.
B. To prevent clot formation.
C. To lower cholesterol levels.
D. To slow the heart rate.
Answer: C ✓
13. When teaching a patient about Warfarin (Coumadin), which statement by the patient
indicates a need for further teaching?
A. "I will use a soft-bristled toothbrush."
B. "I will avoid eating green leafy vegetables."
C. "I will get my INR levels checked regularly."
D. "I will take Ibuprofen for my headaches."
Answer: D ✓
14. The nurse should hold the dose of Metoprolol (a beta-blocker) and notify the provider for
which vital sign?
A. Blood pressure 150/90
B. Heart rate 45 bpm
C. Respiratory rate 18
, D. Temperature 38.2°C (100.8°F)
Answer: B ✓
15. Which medication is classified as an ACE inhibitor?
A. Metoprolol
B. Lisinopril
C. Amlodipine
D. Furosemide
Answer: B ✓
16. A patient taking Nitroglycerin sublingual tablets for chest pain should be instructed to
seek emergency help if:
A. Pain is relieved after one tablet.
B. Pain is not relieved after three tablets, 5 minutes apart.
C. They experience a headache after taking the tablet.
D. They feel dizzy after taking the tablet.
Answer: B ✓
17. What is the antidote for Heparin overdose?
A. Vitamin K
B. Naloxone (Narcan)
C. Protamine Sulfate
D. Flumazenil (Romazicon)
Answer: C ✓
18. Spironolactone (Aldactone) is a potassium-sparing diuretic. The nurse should advise the
patient to avoid which of the following?
A. Potassium-rich foods and salt substitutes.
B. High-sodium foods.
C. Calcium-rich foods.
D. Magnesium supplements.
Answer: A ✓
19. Digoxin (Lanoxin) toxicity is often associated with which electrolyte imbalance?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hypomagnesemia
Answer: B ✓
STUDY & PREP GUIDE WITH VERIFIED CONCEPT
REVIEW || 100% SUCCESS TRACK <UPDATED
VERSION>
HESI Pharmacology Concept Review & Practice Questions
I. Pharmacological Principles & Safety
1. The nurse is administering a drug that is known to be a teratogen. What is the primary
implication of this?
A. The drug is likely to be carcinogenic.
B. The drug may cause genetic mutations.
C. The drug may cause birth defects.
D. The drug is highly addictive.
Answer: C ✓
2. A patient with liver cirrhosis has a prolonged prothrombin time (PT) while on warfarin. The
nurse understands this is likely due to:
A. Impaired renal excretion of the drug.
B. Impaired metabolism of the drug by the liver.
C. Increased absorption of the drug in the gut.
D. An allergic reaction to the drug.
Answer: B ✓
3. The "first-pass effect" primarily occurs in which organ?
A. Kidneys
B. Liver
C. Stomach
D. Small Intestine
Answer: B ✓
4. What is the primary goal of the nursing assessment before administering a new
medication?
A. To complete the paperwork.
B. To identify any potential contraindications or interactions.
C. To delegate the task to a nursing assistant.
,D. To determine the cost of the medication.
Answer: B ✓
5. A drug with a half-life of 4 hours will be at what percentage of its original concentration
after 12 hours?
A. 50%
B. 25%
C. 12.5%
D. 6.25%
Answer: C ✓
6. Which patient finding is the most critical for the nurse to report before administering
Lisinopril, an ACE inhibitor?
A. Blood pressure of 118/78.
B. Heart rate of 68 bpm.
C. Non-productive cough.
D. Blood pressure of 88/50.
Answer: D ✓
7. When teaching a patient about enteric-coated tablets, the nurse should include which
instruction?
A. "You can crush or chew this pill if you have trouble swallowing."
B. "This pill is designed to dissolve quickly in the stomach."
C. "Take this medication with an antacid to improve absorption."
D. "Swallow this pill whole; do not crush or chew it."
Answer: D ✓
8. A patient is receiving a drug via the sublingual route. The nurse understands the primary
advantage of this route is:
A. Avoidance of the first-pass effect.
B. Ease of administration.
C. Prolonged duration of action.
D. Minimal risk of infection.
Answer: A ✓
9. The nurse administers an IV push medication too rapidly. The patient complains of dizziness
and ringing in the ears (tinnitus). The nurse's priority action is to:
A. Document the reaction in the chart.
B. Stop the infusion immediately and assess the patient.
C. Notify the pharmacy.
,D. Slow the infusion rate and reassess in 5 minutes.
Answer: B ✓
10. What is the correct sequence of the nursing process?
A. Assessment, Diagnosis, Planning, Implementation, Evaluation
B. Diagnosis, Assessment, Planning, Implementation, Evaluation
C. Planning, Assessment, Diagnosis, Evaluation, Implementation
D. Evaluation, Assessment, Diagnosis, Planning, Implementation
Answer: A ✓
II. Cardiovascular & Renal Medications
11. A patient on Furosemide (Lasix) should be monitored for which common adverse effect?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hypermagnesemia
Answer: B ✓
12. The therapeutic effect of Atorvastatin (Lipitor) is:
A. To lower blood pressure.
B. To prevent clot formation.
C. To lower cholesterol levels.
D. To slow the heart rate.
Answer: C ✓
13. When teaching a patient about Warfarin (Coumadin), which statement by the patient
indicates a need for further teaching?
A. "I will use a soft-bristled toothbrush."
B. "I will avoid eating green leafy vegetables."
C. "I will get my INR levels checked regularly."
D. "I will take Ibuprofen for my headaches."
Answer: D ✓
14. The nurse should hold the dose of Metoprolol (a beta-blocker) and notify the provider for
which vital sign?
A. Blood pressure 150/90
B. Heart rate 45 bpm
C. Respiratory rate 18
, D. Temperature 38.2°C (100.8°F)
Answer: B ✓
15. Which medication is classified as an ACE inhibitor?
A. Metoprolol
B. Lisinopril
C. Amlodipine
D. Furosemide
Answer: B ✓
16. A patient taking Nitroglycerin sublingual tablets for chest pain should be instructed to
seek emergency help if:
A. Pain is relieved after one tablet.
B. Pain is not relieved after three tablets, 5 minutes apart.
C. They experience a headache after taking the tablet.
D. They feel dizzy after taking the tablet.
Answer: B ✓
17. What is the antidote for Heparin overdose?
A. Vitamin K
B. Naloxone (Narcan)
C. Protamine Sulfate
D. Flumazenil (Romazicon)
Answer: C ✓
18. Spironolactone (Aldactone) is a potassium-sparing diuretic. The nurse should advise the
patient to avoid which of the following?
A. Potassium-rich foods and salt substitutes.
B. High-sodium foods.
C. Calcium-rich foods.
D. Magnesium supplements.
Answer: A ✓
19. Digoxin (Lanoxin) toxicity is often associated with which electrolyte imbalance?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hypomagnesemia
Answer: B ✓
