BSN HESI 315 Pharmacology Exam Prep | Comprehensive
Questions, Answers & Rationales for Nursing Students
NursePrepHub
THIS EXAM EXAM CONTAINS THE FOLLOWING CATEGORIES
❖ Anticoagulants & Reversal Agents…………………………. 1-3, 61-63, 95, 96, 101
❖ Cardiac & Hypertension Medications……………………. 4-9, 73-75, 115-116
❖ Diabetes Medications…………………………………………… 10-11, 76-78, 99, 128
❖ CNS & Psychiatric Medications……………………………… 12-16, 69-72, 119, 143-144
❖ Antibiotics & Anti-infectives…………………………………. 17-21, 66-68, 102, 117, 139
❖ Respiratory Medications………………………………………. 31-33, 64-65, 113-114
❖ GI & Nutrition Medications…………………………………… 34-37, 105-106
❖ Pain Management………………………………………………… 38-40, 98
❖ Endocrine & Hormonal Medications……………………… 41-43, 103-104
❖ Antiepileptics……………………………………………………….. 44-46, 134
❖ Immunosuppressants & Biologics…………………………. 47-48, 79-82, 135-136, 145
❖ Reproductive & Urological Medications……………….. 49-50, 91-92
❖ Dermatological & Topical Medications………………….. 51-52
❖ Electrolytes & Fluids…………………………………………….. 83-84, 129
❖ Medication Administration & Safety ……………………… 53-56, 85-86
❖ Pediatric & Geriatric Considerations……………………… 57-58, 117-120
,Anticoagulants & Reversal Agents
1. A client receiving warfarin is admitted with a major bleed. Which medication
will the nurse expect to be ordered immediately?
A. Vitamin B12
B. Protamine sulfate
C. Vitamin K (phytonadione)
D. Fresh frozen plasma (FFP) only
Answer: C. Vitamin K (phytonadione)
Rationale: Vitamin K is the specific antidote for warfarin. It reverses the
anticoagulant effect by promoting the synthesis of clotting factors. In major
bleeding, IV vitamin K is often given along with FFP or prothrombin complex
concentrates for immediate reversal .
2. Which medication is most appropriate for immediate reversal of heparin
anticoagulation in a patient with active bleeding?
A. Vitamin K
B. Protamine sulfate
C. Idarucizumab
D. Tranexamic acid
Answer: B. Protamine sulfate
Rationale: Protamine sulfate is a specific antagonist that binds to heparin,
neutralizing its anticoagulant effects. Idarucizumab is used to reverse dabigatran,
a direct thrombin inhibitor, not heparin .
3. A patient receiving heparin IV for DVT has a platelet drop >50%. The nurse
suspects:
A. Heparin-induced thrombocytopenia (HIT)
B. Infection-related thrombocytopenia
C. Normal heparin effect
D. Vitamin K deficiency
Answer: A. Heparin-induced thrombocytopenia (HIT)
Rationale: HIT is a serious, immune-mediated adverse reaction to heparin
,characterized by a significant drop in platelet count (often >50% from baseline). It
can lead to paradoxical thrombosis and requires immediate discontinuation of all
heparin products .
Cardiac & Hypertension Medications
4. Which change in data indicates to the nurse that the desired effect of the
angiotensin II receptor antagonist valsartan has been achieved?
A. Dependent edema reduced from +3 to +1
B. Serum HDL increased from 35 to 55 mg/dl
C. Pulse rate reduced from 150 to 90 beats/minute
D. Blood pressure reduced from 160/90 to 130/80 mmHg
Answer: D. Blood pressure reduced from 160/90 to 130/80 mmHg
Rationale: Valsartan is an angiotensin II receptor blocker (ARB) used primarily to
treat hypertension. The desired therapeutic effect is a reduction in blood pressure
to a target goal .
5. The nurse is administering furosemide (Lasix) to a client with congestive heart
failure. Which assessment finding is most important to check before giving the
dose?
A. Blood glucose
B. Serum potassium
C. Respiratory rate
D. Liver enzymes
Answer: B. Serum potassium
Rationale: Furosemide is a loop diuretic that causes significant excretion of
potassium, leading to hypokalemia. Low potassium levels can increase the risk of
digoxin toxicity and cardiac arrhythmias, making it the priority assessment .
6. A nurse is planning to administer amlodipine (Norvasc) to a client. The nurse
plans to check which of the following before giving the medication?
A. Respiratory rate
B. Blood pressure and heart rate
, C. Heart rate and respiratory rate
D. Level of consciousness and blood pressure
Answer: B. Blood pressure and heart rate
Rationale: Amlodipine is a calcium channel blocker that decreases the force of
cardiac contraction and reduces peripheral vascular resistance. This can lead to
hypotension and bradycardia, so these vital signs must be assessed prior to
administration .
7. A client who takes digoxin develops nausea, visual changes (yellow halos),
and bradycardia. The nurse recognizes this as:
A. Signs of hypokalemia
B. Normal side effects
C. Signs of digoxin toxicity
D. An allergic reaction
Answer: C. Signs of digoxin toxicity
Rationale: Classic signs of digoxin toxicity include gastrointestinal symptoms
(nausea, vomiting, anorexia), visual disturbances (yellow or green halos, blurred
vision), and cardiac arrhythmias like bradycardia. The nurse should hold the dose
and check the digoxin level .
8. The nitrate isosorbide dinitrate is prescribed for a client with angina. Which
instruction should the nurse include in this client's discharge teaching plan?
A. Quit taking the medication if dizziness occurs.
B. Do not get up quickly. Always rise slowly.
C. Take the medication with food only.
D. Increase your intake of potassium-rich foods.
Answer: B. Do not get up quickly. Always rise slowly.
Rationale: Nitrates cause vasodilation, which can lead to orthostatic hypotension.
Clients should be taught to change positions slowly to prevent dizziness and falls .
9. A nurse teaching about nitroglycerin transdermal patches should include
which instruction?
A. "Apply to oily skin for better absorption."
Questions, Answers & Rationales for Nursing Students
NursePrepHub
THIS EXAM EXAM CONTAINS THE FOLLOWING CATEGORIES
❖ Anticoagulants & Reversal Agents…………………………. 1-3, 61-63, 95, 96, 101
❖ Cardiac & Hypertension Medications……………………. 4-9, 73-75, 115-116
❖ Diabetes Medications…………………………………………… 10-11, 76-78, 99, 128
❖ CNS & Psychiatric Medications……………………………… 12-16, 69-72, 119, 143-144
❖ Antibiotics & Anti-infectives…………………………………. 17-21, 66-68, 102, 117, 139
❖ Respiratory Medications………………………………………. 31-33, 64-65, 113-114
❖ GI & Nutrition Medications…………………………………… 34-37, 105-106
❖ Pain Management………………………………………………… 38-40, 98
❖ Endocrine & Hormonal Medications……………………… 41-43, 103-104
❖ Antiepileptics……………………………………………………….. 44-46, 134
❖ Immunosuppressants & Biologics…………………………. 47-48, 79-82, 135-136, 145
❖ Reproductive & Urological Medications……………….. 49-50, 91-92
❖ Dermatological & Topical Medications………………….. 51-52
❖ Electrolytes & Fluids…………………………………………….. 83-84, 129
❖ Medication Administration & Safety ……………………… 53-56, 85-86
❖ Pediatric & Geriatric Considerations……………………… 57-58, 117-120
,Anticoagulants & Reversal Agents
1. A client receiving warfarin is admitted with a major bleed. Which medication
will the nurse expect to be ordered immediately?
A. Vitamin B12
B. Protamine sulfate
C. Vitamin K (phytonadione)
D. Fresh frozen plasma (FFP) only
Answer: C. Vitamin K (phytonadione)
Rationale: Vitamin K is the specific antidote for warfarin. It reverses the
anticoagulant effect by promoting the synthesis of clotting factors. In major
bleeding, IV vitamin K is often given along with FFP or prothrombin complex
concentrates for immediate reversal .
2. Which medication is most appropriate for immediate reversal of heparin
anticoagulation in a patient with active bleeding?
A. Vitamin K
B. Protamine sulfate
C. Idarucizumab
D. Tranexamic acid
Answer: B. Protamine sulfate
Rationale: Protamine sulfate is a specific antagonist that binds to heparin,
neutralizing its anticoagulant effects. Idarucizumab is used to reverse dabigatran,
a direct thrombin inhibitor, not heparin .
3. A patient receiving heparin IV for DVT has a platelet drop >50%. The nurse
suspects:
A. Heparin-induced thrombocytopenia (HIT)
B. Infection-related thrombocytopenia
C. Normal heparin effect
D. Vitamin K deficiency
Answer: A. Heparin-induced thrombocytopenia (HIT)
Rationale: HIT is a serious, immune-mediated adverse reaction to heparin
,characterized by a significant drop in platelet count (often >50% from baseline). It
can lead to paradoxical thrombosis and requires immediate discontinuation of all
heparin products .
Cardiac & Hypertension Medications
4. Which change in data indicates to the nurse that the desired effect of the
angiotensin II receptor antagonist valsartan has been achieved?
A. Dependent edema reduced from +3 to +1
B. Serum HDL increased from 35 to 55 mg/dl
C. Pulse rate reduced from 150 to 90 beats/minute
D. Blood pressure reduced from 160/90 to 130/80 mmHg
Answer: D. Blood pressure reduced from 160/90 to 130/80 mmHg
Rationale: Valsartan is an angiotensin II receptor blocker (ARB) used primarily to
treat hypertension. The desired therapeutic effect is a reduction in blood pressure
to a target goal .
5. The nurse is administering furosemide (Lasix) to a client with congestive heart
failure. Which assessment finding is most important to check before giving the
dose?
A. Blood glucose
B. Serum potassium
C. Respiratory rate
D. Liver enzymes
Answer: B. Serum potassium
Rationale: Furosemide is a loop diuretic that causes significant excretion of
potassium, leading to hypokalemia. Low potassium levels can increase the risk of
digoxin toxicity and cardiac arrhythmias, making it the priority assessment .
6. A nurse is planning to administer amlodipine (Norvasc) to a client. The nurse
plans to check which of the following before giving the medication?
A. Respiratory rate
B. Blood pressure and heart rate
, C. Heart rate and respiratory rate
D. Level of consciousness and blood pressure
Answer: B. Blood pressure and heart rate
Rationale: Amlodipine is a calcium channel blocker that decreases the force of
cardiac contraction and reduces peripheral vascular resistance. This can lead to
hypotension and bradycardia, so these vital signs must be assessed prior to
administration .
7. A client who takes digoxin develops nausea, visual changes (yellow halos),
and bradycardia. The nurse recognizes this as:
A. Signs of hypokalemia
B. Normal side effects
C. Signs of digoxin toxicity
D. An allergic reaction
Answer: C. Signs of digoxin toxicity
Rationale: Classic signs of digoxin toxicity include gastrointestinal symptoms
(nausea, vomiting, anorexia), visual disturbances (yellow or green halos, blurred
vision), and cardiac arrhythmias like bradycardia. The nurse should hold the dose
and check the digoxin level .
8. The nitrate isosorbide dinitrate is prescribed for a client with angina. Which
instruction should the nurse include in this client's discharge teaching plan?
A. Quit taking the medication if dizziness occurs.
B. Do not get up quickly. Always rise slowly.
C. Take the medication with food only.
D. Increase your intake of potassium-rich foods.
Answer: B. Do not get up quickly. Always rise slowly.
Rationale: Nitrates cause vasodilation, which can lead to orthostatic hypotension.
Clients should be taught to change positions slowly to prevent dizziness and falls .
9. A nurse teaching about nitroglycerin transdermal patches should include
which instruction?
A. "Apply to oily skin for better absorption."
