HESI Pharmacology Test Bank 2026 –
Cardiovascular Pharmacology Questions 1-45
WITH CORRECT ANSWERS.
Question 1.
A nurse is caring for a client who has been prescribed digoxin 0.125 mg orally daily for
heart failure. Before administering the medication, the nurse assesses the client. Which
finding requires the nurse to hold the medication and notify the healthcare provider
immediately?
☐ A. Blood pressure of 138/88 mmHg
☐ B. Apical pulse rate of 54 beats per minute
☑ C. Apical pulse rate of 48 beats per minute
☐ D. Respiratory rate of 18 breaths per minute
ANSWER: C. Apical pulse rate of 48 beats per minute
RATIONALE: Digoxin is a cardiac glycoside used in the treatment of heart failure and
atrial fibrillation. Before administering digoxin, the nurse must assess the apical pulse
for a full 60 seconds. The medication should be held and the healthcare provider
notified if the pulse rate is below 60 beats per minute in adults, as digoxin slows
conduction through the atrioventricular node and can cause life-threatening bradycardia.
An apical pulse of 48 beats per minute is below the safe threshold. A blood pressure of
138/88 mmHg and a respiratory rate of 18 breaths per minute are within acceptable
ranges and would not require holding the medication. Option B at 54 beats per minute is
also below 60 and would also require holding, but 48 beats per minute represents a
more critically low value and is the most clinically significant finding presented.
Question 2.
,A client with chronic heart failure is taking furosemide 40 mg orally daily. The nurse
evaluates the client and identifies which laboratory value as the most concerning
complication associated with this medication?
☐ A. Serum sodium of 138 mEq/L
☑ B. Serum potassium of 3.0 mEq/L
☐ C. Serum creatinine of 1.0 mg/dL
☐ D. Blood glucose of 98 mg/dL
ANSWER: B. Serum potassium of 3.0 mEq/L
RATIONALE: Furosemide is a loop diuretic that works by inhibiting sodium and chloride
reabsorption in the ascending loop of Henle. A major adverse effect of furosemide is
hypokalemia due to enhanced potassium excretion. A serum potassium of 3.0 mEq/L is
below the normal range of 3.5 to 5.0 mEq/L and represents hypokalemia. This is
particularly dangerous in clients with heart failure who may also be taking digoxin, as
hypokalemia increases the risk of digoxin toxicity and life-threatening cardiac
dysrhythmias. The nurse should notify the healthcare provider and anticipate potassium
supplementation. The other laboratory values listed are within normal ranges and do not
represent immediate concern.
Question 3.
A nurse is educating a client newly prescribed lisinopril 10 mg daily for hypertension.
Which statement by the client indicates a need for further teaching?
☐ A. "I will report any swelling of my lips or throat immediately."
☐ B. "I should avoid salt substitutes while taking this medication."
☑ C. "I can take ibuprofen for my headaches while on this medication."
☐ D. "I may develop a dry cough that does not go away."
ANSWER: C. "I can take ibuprofen for my headaches while on this medication."
RATIONALE: Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor used for
hypertension, heart failure, and renal protection in diabetic patients. Nonsteroidal anti-
inflammatory drugs (NSAIDs) such as ibuprofen can reduce the antihypertensive effect
of lisinopril and increase the risk of renal impairment when used concurrently. Therefore,
the client should avoid NSAIDs and use acetaminophen for pain relief instead.
, Angioedema (swelling of lips, throat) is a serious adverse effect of ACE inhibitors and
must be reported immediately. Salt substitutes contain potassium chloride and can
cause hyperkalemia when combined with ACE inhibitors. A persistent dry cough is a
well-known side effect of ACE inhibitors due to increased bradykinin levels.
Question 4.
A nurse is preparing to administer metoprolol succinate 50 mg orally to a client with
hypertension. The client's current vital signs are: blood pressure 118/72 mmHg, heart
rate 52 beats per minute, and respiratory rate 14 breaths per minute. What is the most
appropriate nursing action?
☐ A. Administer the medication as prescribed
☐ B. Crush the tablet and mix with applesauce before administering
☑ C. Hold the medication and notify the healthcare provider
☐ D. Administer half the prescribed dose
ANSWER: C. Hold the medication and notify the healthcare provider
RATIONALE: Metoprolol succinate is a cardioselective beta-1 adrenergic blocker used
for hypertension, angina, and heart failure. Beta-blockers slow the heart rate and reduce
blood pressure by blocking catecholamine effects on the heart. Before administering
metoprolol, the nurse should assess the client's heart rate and blood pressure. A heart
rate of 52 beats per minute is below the safe threshold of 60 beats per minute, and
administering the medication could further lower the heart rate and cause symptomatic
bradycardia or hemodynamic instability. The nurse should hold the medication and
contact the healthcare provider for further orders. Metoprolol succinate is an extended-
release tablet and must never be crushed. Administering half the dose is not within the
nurse's scope of practice without a provider order.
Question 5.
A client with atrial fibrillation is prescribed warfarin therapy. The nurse reviews the
client's current INR result of 4.8. What is the priority nursing action?
☐ A. Administer the next scheduled dose of warfarin as ordered
☐ B. Document the finding and reassess in four hours
☑ C. Hold the warfarin dose and notify the healthcare provider
Cardiovascular Pharmacology Questions 1-45
WITH CORRECT ANSWERS.
Question 1.
A nurse is caring for a client who has been prescribed digoxin 0.125 mg orally daily for
heart failure. Before administering the medication, the nurse assesses the client. Which
finding requires the nurse to hold the medication and notify the healthcare provider
immediately?
☐ A. Blood pressure of 138/88 mmHg
☐ B. Apical pulse rate of 54 beats per minute
☑ C. Apical pulse rate of 48 beats per minute
☐ D. Respiratory rate of 18 breaths per minute
ANSWER: C. Apical pulse rate of 48 beats per minute
RATIONALE: Digoxin is a cardiac glycoside used in the treatment of heart failure and
atrial fibrillation. Before administering digoxin, the nurse must assess the apical pulse
for a full 60 seconds. The medication should be held and the healthcare provider
notified if the pulse rate is below 60 beats per minute in adults, as digoxin slows
conduction through the atrioventricular node and can cause life-threatening bradycardia.
An apical pulse of 48 beats per minute is below the safe threshold. A blood pressure of
138/88 mmHg and a respiratory rate of 18 breaths per minute are within acceptable
ranges and would not require holding the medication. Option B at 54 beats per minute is
also below 60 and would also require holding, but 48 beats per minute represents a
more critically low value and is the most clinically significant finding presented.
Question 2.
,A client with chronic heart failure is taking furosemide 40 mg orally daily. The nurse
evaluates the client and identifies which laboratory value as the most concerning
complication associated with this medication?
☐ A. Serum sodium of 138 mEq/L
☑ B. Serum potassium of 3.0 mEq/L
☐ C. Serum creatinine of 1.0 mg/dL
☐ D. Blood glucose of 98 mg/dL
ANSWER: B. Serum potassium of 3.0 mEq/L
RATIONALE: Furosemide is a loop diuretic that works by inhibiting sodium and chloride
reabsorption in the ascending loop of Henle. A major adverse effect of furosemide is
hypokalemia due to enhanced potassium excretion. A serum potassium of 3.0 mEq/L is
below the normal range of 3.5 to 5.0 mEq/L and represents hypokalemia. This is
particularly dangerous in clients with heart failure who may also be taking digoxin, as
hypokalemia increases the risk of digoxin toxicity and life-threatening cardiac
dysrhythmias. The nurse should notify the healthcare provider and anticipate potassium
supplementation. The other laboratory values listed are within normal ranges and do not
represent immediate concern.
Question 3.
A nurse is educating a client newly prescribed lisinopril 10 mg daily for hypertension.
Which statement by the client indicates a need for further teaching?
☐ A. "I will report any swelling of my lips or throat immediately."
☐ B. "I should avoid salt substitutes while taking this medication."
☑ C. "I can take ibuprofen for my headaches while on this medication."
☐ D. "I may develop a dry cough that does not go away."
ANSWER: C. "I can take ibuprofen for my headaches while on this medication."
RATIONALE: Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor used for
hypertension, heart failure, and renal protection in diabetic patients. Nonsteroidal anti-
inflammatory drugs (NSAIDs) such as ibuprofen can reduce the antihypertensive effect
of lisinopril and increase the risk of renal impairment when used concurrently. Therefore,
the client should avoid NSAIDs and use acetaminophen for pain relief instead.
, Angioedema (swelling of lips, throat) is a serious adverse effect of ACE inhibitors and
must be reported immediately. Salt substitutes contain potassium chloride and can
cause hyperkalemia when combined with ACE inhibitors. A persistent dry cough is a
well-known side effect of ACE inhibitors due to increased bradykinin levels.
Question 4.
A nurse is preparing to administer metoprolol succinate 50 mg orally to a client with
hypertension. The client's current vital signs are: blood pressure 118/72 mmHg, heart
rate 52 beats per minute, and respiratory rate 14 breaths per minute. What is the most
appropriate nursing action?
☐ A. Administer the medication as prescribed
☐ B. Crush the tablet and mix with applesauce before administering
☑ C. Hold the medication and notify the healthcare provider
☐ D. Administer half the prescribed dose
ANSWER: C. Hold the medication and notify the healthcare provider
RATIONALE: Metoprolol succinate is a cardioselective beta-1 adrenergic blocker used
for hypertension, angina, and heart failure. Beta-blockers slow the heart rate and reduce
blood pressure by blocking catecholamine effects on the heart. Before administering
metoprolol, the nurse should assess the client's heart rate and blood pressure. A heart
rate of 52 beats per minute is below the safe threshold of 60 beats per minute, and
administering the medication could further lower the heart rate and cause symptomatic
bradycardia or hemodynamic instability. The nurse should hold the medication and
contact the healthcare provider for further orders. Metoprolol succinate is an extended-
release tablet and must never be crushed. Administering half the dose is not within the
nurse's scope of practice without a provider order.
Question 5.
A client with atrial fibrillation is prescribed warfarin therapy. The nurse reviews the
client's current INR result of 4.8. What is the priority nursing action?
☐ A. Administer the next scheduled dose of warfarin as ordered
☐ B. Document the finding and reassess in four hours
☑ C. Hold the warfarin dose and notify the healthcare provider
