PHARMACOLOGY HESI EXAM 2026/2027 - COMPREHENSIVE
EXAM QUESTIONS 1-200 COMMONLY TESTED QUESTIONS
COMPLETE WITH 100% VERIFIED ANSWERS AND DETAILED
RATIONALES
Question 1
A client prescribed warfarin (Coumadin) has an international normalized
ratio (INR) of 5.2. Which action should the nurse take first?
A) Administer vitamin K as prescribed
B) Hold the next dose of warfarin
C) Notify the healthcare provider
D) Assess the client for signs of bleeding
E) Increase the client's fluid intake
Correct Answer: D) Assess the client for signs of bleeding
Rationale: An INR of 5.2 is significantly above the therapeutic range (2-3
for most indications), indicating increased bleeding risk. The nurse's
priority is to assess for active bleeding signs (hematuria, hematemesis,
melena, petechiae) before notifying the provider. Safety assessment
precedes intervention.
Question 2
A client with heart failure is receiving digoxin (Lanoxin) 0.25 mg daily.
Which assessment finding indicates digoxin toxicity?
A) Heart rate of 72 beats per minute
,B) Blood pressure of 128/76 mmHg
C) Visual disturbances with yellow halos around lights
D) Increased urine output
E) Weight loss of 1 kg in 24 hours
Correct Answer: C) Visual disturbances with yellow halos around lights
Rationale: Visual disturbances, particularly seeing yellow-green halos
around lights, are classic signs of digoxin toxicity. Other signs include
nausea, vomiting, anorexia, and cardiac arrhythmias. The nurse must
monitor digoxin levels and assess for toxicity.
Question 3
A client is prescribed furosemide (Lasix) 40 mg IV push. Which
laboratory value should the nurse monitor most closely?
A) Serum sodium
B) Serum potassium
C) Serum calcium
D) Serum magnesium
E) Serum chloride
Correct Answer: B) Serum potassium
Rationale: Furosemide is a loop diuretic that causes significant
potassium loss through the kidneys, leading to hypokalemia. This can
precipitate cardiac arrhythmias, especially in clients taking digoxin.
Potassium levels should be monitored frequently.
,Question 4
The nurse administers morphine sulfate 4 mg IV to a client reporting
postoperative pain. Which side effect requires immediate intervention?
A) Nausea
B) Drowsiness
C) Respiratory rate of 8 breaths per minute
D) Constipation
E) Urinary retention
Correct Answer: C) Respiratory rate of 8 breaths per minute
Rationale: Morphine is a potent opioid agonist that can cause
respiratory depression. A respiratory rate of 8 breaths per minute
indicates severe respiratory depression requiring immediate
intervention, including administration of naloxone (Narcan) if indicated.
Question 5
A client with type 2 diabetes is prescribed metformin (Glucophage).
Which instruction should the nurse include in the teaching plan?
A) Take the medication with meals to reduce gastrointestinal upset
B) Expect weight gain as a common side effect
C) Monitor for signs of hypoglycemia frequently
D) Avoid taking the medication with grapefruit juice
E) Take the medication on an empty stomach for best absorption
Correct Answer: A) Take the medication with meals to reduce
gastrointestinal upset
Rationale: Metformin commonly causes gastrointestinal distress
including nausea, diarrhea, and abdominal discomfort. Taking it with
, meals significantly reduces these effects. Metformin does not cause
hypoglycemia when used alone.
Question 6
A client is receiving heparin sodium via continuous IV infusion. Which
laboratory test should the nurse monitor to evaluate therapeutic effect?
A) Prothrombin time (PT)
B) International normalized ratio (INR)
C) Activated partial thromboplastin time (aPTT)
D) Platelet count
E) Hemoglobin and hematocrit
Correct Answer: C) Activated partial thromboplastin time (aPTT)
Rationale: Heparin's therapeutic effect is monitored by aPTT, which
should be 1.5-2.5 times the normal control value. PT and INR monitor
warfarin therapy. Platelet count is monitored for heparin-induced
thrombocytopenia (HIT).
Question 7
The nurse is preparing to administer an antipsychotic medication to a
client. Which assessment finding would indicate a need to withhold the
medication?
A) Blood pressure of 110/70 mmHg
B) Temperature of 37.2°C
C) Muscle rigidity and temperature of 39.5°C
D) Heart rate of 82 beats per minute
E) Respiratory rate of 18 breaths per minute
EXAM QUESTIONS 1-200 COMMONLY TESTED QUESTIONS
COMPLETE WITH 100% VERIFIED ANSWERS AND DETAILED
RATIONALES
Question 1
A client prescribed warfarin (Coumadin) has an international normalized
ratio (INR) of 5.2. Which action should the nurse take first?
A) Administer vitamin K as prescribed
B) Hold the next dose of warfarin
C) Notify the healthcare provider
D) Assess the client for signs of bleeding
E) Increase the client's fluid intake
Correct Answer: D) Assess the client for signs of bleeding
Rationale: An INR of 5.2 is significantly above the therapeutic range (2-3
for most indications), indicating increased bleeding risk. The nurse's
priority is to assess for active bleeding signs (hematuria, hematemesis,
melena, petechiae) before notifying the provider. Safety assessment
precedes intervention.
Question 2
A client with heart failure is receiving digoxin (Lanoxin) 0.25 mg daily.
Which assessment finding indicates digoxin toxicity?
A) Heart rate of 72 beats per minute
,B) Blood pressure of 128/76 mmHg
C) Visual disturbances with yellow halos around lights
D) Increased urine output
E) Weight loss of 1 kg in 24 hours
Correct Answer: C) Visual disturbances with yellow halos around lights
Rationale: Visual disturbances, particularly seeing yellow-green halos
around lights, are classic signs of digoxin toxicity. Other signs include
nausea, vomiting, anorexia, and cardiac arrhythmias. The nurse must
monitor digoxin levels and assess for toxicity.
Question 3
A client is prescribed furosemide (Lasix) 40 mg IV push. Which
laboratory value should the nurse monitor most closely?
A) Serum sodium
B) Serum potassium
C) Serum calcium
D) Serum magnesium
E) Serum chloride
Correct Answer: B) Serum potassium
Rationale: Furosemide is a loop diuretic that causes significant
potassium loss through the kidneys, leading to hypokalemia. This can
precipitate cardiac arrhythmias, especially in clients taking digoxin.
Potassium levels should be monitored frequently.
,Question 4
The nurse administers morphine sulfate 4 mg IV to a client reporting
postoperative pain. Which side effect requires immediate intervention?
A) Nausea
B) Drowsiness
C) Respiratory rate of 8 breaths per minute
D) Constipation
E) Urinary retention
Correct Answer: C) Respiratory rate of 8 breaths per minute
Rationale: Morphine is a potent opioid agonist that can cause
respiratory depression. A respiratory rate of 8 breaths per minute
indicates severe respiratory depression requiring immediate
intervention, including administration of naloxone (Narcan) if indicated.
Question 5
A client with type 2 diabetes is prescribed metformin (Glucophage).
Which instruction should the nurse include in the teaching plan?
A) Take the medication with meals to reduce gastrointestinal upset
B) Expect weight gain as a common side effect
C) Monitor for signs of hypoglycemia frequently
D) Avoid taking the medication with grapefruit juice
E) Take the medication on an empty stomach for best absorption
Correct Answer: A) Take the medication with meals to reduce
gastrointestinal upset
Rationale: Metformin commonly causes gastrointestinal distress
including nausea, diarrhea, and abdominal discomfort. Taking it with
, meals significantly reduces these effects. Metformin does not cause
hypoglycemia when used alone.
Question 6
A client is receiving heparin sodium via continuous IV infusion. Which
laboratory test should the nurse monitor to evaluate therapeutic effect?
A) Prothrombin time (PT)
B) International normalized ratio (INR)
C) Activated partial thromboplastin time (aPTT)
D) Platelet count
E) Hemoglobin and hematocrit
Correct Answer: C) Activated partial thromboplastin time (aPTT)
Rationale: Heparin's therapeutic effect is monitored by aPTT, which
should be 1.5-2.5 times the normal control value. PT and INR monitor
warfarin therapy. Platelet count is monitored for heparin-induced
thrombocytopenia (HIT).
Question 7
The nurse is preparing to administer an antipsychotic medication to a
client. Which assessment finding would indicate a need to withhold the
medication?
A) Blood pressure of 110/70 mmHg
B) Temperature of 37.2°C
C) Muscle rigidity and temperature of 39.5°C
D) Heart rate of 82 beats per minute
E) Respiratory rate of 18 breaths per minute
