RN HESI Pharmacology V2 Style – Comprehensive Practice Exam 80 Questions With Answers & Rationales

RN HESI Pharmacology V2 Style –
Comprehensive Practice Exam 80 Questions
With Answers & Rationales



SECTION 1: Cardiovascular Medications (Questions 1–12)

1. A client with heart failure is prescribed digoxin (Lanoxin). Which assessment finding requires
immediate intervention?

 A) Apical pulse of 58 beats per minute

 B) Serum potassium level of 3.2 mEq/L

 C) Nausea and vomiting

 D) Blurred yellow vision

Correct Answer: D
Rationale: Blurred yellow vision (xanthopsia) is a classic sign of digoxin toxicity and requires immediate
intervention. A pulse of 58 may be acceptable if it's the client's baseline, but digoxin is typically held for
pulse <60. Hypokalemia (3.2) increases toxicity risk but the visual change is an active toxicity symptom
requiring immediate action.



2. A client is started on furosemide (Lasix) 40 mg daily. Which laboratory value should the nurse
monitor most closely?

 A) Serum sodium

 B) Serum calcium

 C) Serum potassium

 D) Serum magnesium

Correct Answer: C
Rationale: Furosemide is a loop diuretic that causes significant potassium wasting. Hypokalemia can

,lead to cardiac dysrhythmias, especially if the client is also on digoxin. All electrolytes should be
monitored, but potassium is the highest priority.



3. The nurse administers lisinopril (Zestril) to a client. Which adverse effect requires the client to stop
the medication and seek immediate care?

 A) Dry cough

 B) Angioedema

 C) Dizziness

 D) Headache

Correct Answer: B
Rationale: Angioedema (swelling of the face, lips, tongue, or airway) is a rare but life-threatening
adverse effect of ACE inhibitors like lisinopril. Dry cough is common but not immediately dangerous.
Dizziness and headache are common initial side effects.



4. A client on metoprolol (Lopressor) has a blood pressure of 88/52 mmHg and reports dizziness. What
is the nurse's priority action?

 A) Administer the medication as scheduled

 B) Hold the medication and notify the healthcare provider

 C) Increase fluid intake to raise blood pressure

 D) Place the client in Trendelenburg position

Correct Answer: B
Rationale: Metoprolol is a beta-blocker that lowers heart rate and blood pressure. With hypotension
(88/52) and symptomatic dizziness, the medication should be held and the provider notified.
Administration could worsen hypotension.



5. A client is prescribed amiodarone (Cordarone) for atrial fibrillation. Which baseline test is essential
before starting this medication?

 A) Thyroid function tests

 B) Liver function tests

,  C) Pulmonary function tests

 D) Chest x-ray

Correct Answer: A
Rationale: Amiodarone contains iodine and can cause hyperthyroidism or hypothyroidism. Baseline and
periodic thyroid function tests are essential. While it also affects lungs, liver, and eyes, thyroid
monitoring is the standard baseline requirement.



6. The nurse is administering clopidogrel (Plavix) to a client with a history of stroke. Which finding
indicates the medication is effective?

 A) Prothrombin time (PT) of 12 seconds

 B) Absence of new thrombotic events

 C) International normalized ratio (INR) of 2.5

 D) Platelet count of 150,000/mm³

Correct Answer: B
Rationale: Clopidogrel is an antiplatelet medication; therapeutic effectiveness is demonstrated by
prevention of thrombotic events (stroke, MI). PT/INR is monitored for warfarin, not clopidogrel. Platelet
count indicates safety, not efficacy.



7. A client is receiving a heparin infusion. Which laboratory value indicates the therapy is within
therapeutic range?

 A) aPTT of 60 seconds

 B) INR of 2.5

 C) Platelet count of 50,000/mm³

 D) PT of 15 seconds

Correct Answer: A
Rationale: For heparin therapy, the therapeutic goal is an aPTT 1.5–2.5 times the normal control
(typically 60–80 seconds). INR is used for warfarin monitoring. Low platelets may indicate HIT (heparin-
induced thrombocytopenia), a complication.

, 8. The nurse is teaching a client newly prescribed warfarin (Coumadin). Which statement by the client
indicates understanding?

 A) "I will take ibuprofen if I have a headache."

 B) "I will eat the same amount of green vegetables each week."

 C) "I will stop this medication if I notice bruising."

 D) "I will take my medication in the morning with breakfast."

Correct Answer: B
Rationale: Consistency in vitamin K intake (green leafy vegetables) is essential to maintain stable INR
levels. NSAIDs like ibuprofen increase bleeding risk and should be avoided. Warfarin should not be
stopped without provider guidance.



9. A client reports chest pain and is prescribed nitroglycerin sublingual. How should the nurse instruct
the client to take this medication?

 A) Swallow the tablet with a full glass of water

 B) Place one tablet under the tongue and allow to dissolve

 C) Chew the tablet for faster absorption

 D) Take with food to prevent stomach upset

Correct Answer: B
Rationale: Sublingual nitroglycerin is absorbed through the oral mucosa. It should be placed under the
tongue and allowed to dissolve. Swallowing or chewing reduces effectiveness due to first-pass
metabolism.



10. A client on atorvastatin (Lipitor) reports severe muscle pain and dark urine. What is the nurse's
priority action?

 A) Encourage increased fluid intake

 B) Administer prescribed acetaminophen

 C) Hold the medication and notify the provider

 D) Apply heat to painful muscles