BSN 315 HESI
PHARMACOLOGY II
EXAM
Nightingale College
Actual Qs & Verified Ans to Pass the Exam
This Hesi test contains:
, passing score Guarantee
Format Set of Multiple-choice
questions with incorporating Next Generation NCLEX
(NGN) and Case scenarios questions
Expert-Verified Explanations & Solutions
1. A client with peptic ulcer disease receives a new prescription for cimetidine. Which statement
provided by the client requires additional instruction by the nurse?
A. Notify the healthcare provider of lethargy.
B. Monitor for any signs of sexual dysfunction.
C. Decrease cigarette use to a pack per day.
D. Take the medication an hour after antacids.
Correct Answer: A
Expert Rationale:
, Lethargy is not a common or expected side effect of cimetidine and warrants further evaluation for possible
CNS reactions or other causes, demanding patient education. Sexual dysfunction can occur due to
cimetidine’s antiandrogen effects and should be monitored. Smoking aggravates ulcer disease and
decreasing use is recommended. Antacids interfere with cimetidine absorption, so spacing administration
by one hour is appropriate.
2. A client with a history of chronic obstructive pulmonary disease (COPD) receives a new
prescription for an ipratropium inhaler. Which action indicates to the nurse that additional teaching
is needed?
A. Primes the inhaler with 7 pumps.
B. Attaches the spacer device to the inhaler.
C. Rinses the mouth after each use.
D. Stores the medication at room temperature.
Correct Answer: A
Expert Rationale:
Ipratropium inhalers typically require only 2 to 3 initial test sprays to prime the device—not 7. Overpriming
can lead to unnecessary medication loss and confusion around dosing. Using a spacer is appropriate to
improve drug delivery in COPD, and rinsing the mouth helps reduce dry mouth or irritation. Storing at room
temperature is standard for preservative-containing inhalers. Therefore, priming with 7 pumps indicates
misunderstanding requiring further teaching.
---
3. A client with heart failure (HF) develops hyperaldosteronism and spironolactone is prescribed.
Which instruction should the nurse include in this client's plan of care?
A. Cover your skin before going outside.
B. Limit intake of high-potassium foods.
C. Replace salt with a salt substitute.
D. Monitor skin for excessive bruising.
Correct Answer: B
Expert Rationale:
Spironolactone is a potassium-sparing diuretic, increasing the risk of hyperkalemia. Patients should avoid
excess potassium intake to prevent potentially fatal cardiac dysrhythmias. Salt substitutes often contain
potassium chloride and should be avoided. Skin protection and bruising monitoring are unrelated direct
concerns for spironolactone therapy in this context.
---
Patient Scenario:
4: A 72-year-old patient with atrial fibrillation is prescribed digoxin. The latest blood work shows a
digoxin level of 2.5 ng/mL (therapeutic range: 0.8–2.0 ng/mL). The patient reports nausea, blurred
vision, and fatigue.
Nurse Note: What is the nurse’s best response?
Options:
A. Administer the digoxin as ordered and monitor vitals closely.
B. Hold the digoxin dose and report toxicity signs to the provider immediately.
PHARMACOLOGY II
EXAM
Nightingale College
Actual Qs & Verified Ans to Pass the Exam
This Hesi test contains:
, passing score Guarantee
Format Set of Multiple-choice
questions with incorporating Next Generation NCLEX
(NGN) and Case scenarios questions
Expert-Verified Explanations & Solutions
1. A client with peptic ulcer disease receives a new prescription for cimetidine. Which statement
provided by the client requires additional instruction by the nurse?
A. Notify the healthcare provider of lethargy.
B. Monitor for any signs of sexual dysfunction.
C. Decrease cigarette use to a pack per day.
D. Take the medication an hour after antacids.
Correct Answer: A
Expert Rationale:
, Lethargy is not a common or expected side effect of cimetidine and warrants further evaluation for possible
CNS reactions or other causes, demanding patient education. Sexual dysfunction can occur due to
cimetidine’s antiandrogen effects and should be monitored. Smoking aggravates ulcer disease and
decreasing use is recommended. Antacids interfere with cimetidine absorption, so spacing administration
by one hour is appropriate.
2. A client with a history of chronic obstructive pulmonary disease (COPD) receives a new
prescription for an ipratropium inhaler. Which action indicates to the nurse that additional teaching
is needed?
A. Primes the inhaler with 7 pumps.
B. Attaches the spacer device to the inhaler.
C. Rinses the mouth after each use.
D. Stores the medication at room temperature.
Correct Answer: A
Expert Rationale:
Ipratropium inhalers typically require only 2 to 3 initial test sprays to prime the device—not 7. Overpriming
can lead to unnecessary medication loss and confusion around dosing. Using a spacer is appropriate to
improve drug delivery in COPD, and rinsing the mouth helps reduce dry mouth or irritation. Storing at room
temperature is standard for preservative-containing inhalers. Therefore, priming with 7 pumps indicates
misunderstanding requiring further teaching.
---
3. A client with heart failure (HF) develops hyperaldosteronism and spironolactone is prescribed.
Which instruction should the nurse include in this client's plan of care?
A. Cover your skin before going outside.
B. Limit intake of high-potassium foods.
C. Replace salt with a salt substitute.
D. Monitor skin for excessive bruising.
Correct Answer: B
Expert Rationale:
Spironolactone is a potassium-sparing diuretic, increasing the risk of hyperkalemia. Patients should avoid
excess potassium intake to prevent potentially fatal cardiac dysrhythmias. Salt substitutes often contain
potassium chloride and should be avoided. Skin protection and bruising monitoring are unrelated direct
concerns for spironolactone therapy in this context.
---
Patient Scenario:
4: A 72-year-old patient with atrial fibrillation is prescribed digoxin. The latest blood work shows a
digoxin level of 2.5 ng/mL (therapeutic range: 0.8–2.0 ng/mL). The patient reports nausea, blurred
vision, and fatigue.
Nurse Note: What is the nurse’s best response?
Options:
A. Administer the digoxin as ordered and monitor vitals closely.
B. Hold the digoxin dose and report toxicity signs to the provider immediately.
