1|Page
HESI BSN 315 PHARMACOLOGY COMPREHENSIVE
EXAM BANK 2026–2027 EDITION 220 PRACTICE
QUESTIONS + ANSWERS & RATIONALES HIGH-
YIELD CONTENT • FIRST-TIME PASS • GRADED A+
# SECTION 1: CARDIOVASCULAR PHARMACOLOGY (Questions
1–35)
**1. A patient with heart failure is prescribed digoxin. Which finding
requires immediate intervention?**
A) Heart rate of 58 bpm
B) Serum digoxin level of 1.2 ng/mL
C) Anorexia and nausea
D) Yellow-tinted vision
**Answer: D**
*Rationale:* Yellow-tinted vision (xanthopsia) is a classic sign of
digoxin toxicity. HR 58 is acceptable for HF if asymptomatic.
Therapeutic level is 0.8–2.0 ng/mL. Anorexia/nausea can occur in HF or
toxicity but vision change is more specific.
**2. A patient on warfarin has an INR of 4.5. Which action is
priority?**
,2|Page
A) Administer vitamin K
B) Hold next dose and notify provider
C) Give fresh frozen plasma
D) Increase warfarin dose
**Answer: B**
*Rationale:* INR target 2–3 for most indications. 4.5 is elevated but not
critical unless bleeding. Holding dose and notifying provider is first step.
Vitamin K used if bleeding or very high INR (>10 or with bleeding).
**3. Which medication is most likely to cause gingival hyperplasia?**
A) Amlodipine
B) Lisinopril
C) Phenytoin
D) Metoprolol
**Answer: C**
*Rationale:* Phenytoin (anticonvulsant) is a classic cause. Among CV
drugs, nifedipine can cause it, but amlodipine less so. Phenytoin is high-
yield cross-test.
**4. A patient taking amiodarone develops pulmonary fibrosis. What is
the priority action?**
,3|Page
A) Increase oxygen
B) Discontinue amiodarone
C) Start prednisone
D) Obtain chest X-ray
**Answer: B**
*Rationale:* Amiodarone-induced pulmonary toxicity requires drug
discontinuation first. Corticosteroids may be used but removal of cause
is priority.
**5. Which medication is a direct thrombin inhibitor used for HIT?**
A) Heparin
B) Enoxaparin
C) Argatroban
D) Warfarin
**Answer: C**
*Rationale:* Argatroban and lepirudin are direct thrombin inhibitors for
heparin-induced thrombocytopenia (HIT).
**6. A patient on furosemide reports muscle cramps and weakness.
Which lab abnormality is most likely?**
A) Hypernatremia
, 4|Page
B) Hypokalemia
C) Hypercalcemia
D) Hypomagnesemia
**Answer: B**
*Rationale:* Loop diuretics cause potassium and magnesium wasting.
Hypokalemia causes muscle weakness and cramps.
**7. Which antihypertensive is contraindicated in pregnancy?**
A) Methyldopa
B) Labetalol
C) Nifedipine
D) Lisinopril (ACE inhibitor)
**Answer: D**
*Rationale:* ACE inhibitors and ARBs cause fetal renal agenesis and
oligohydramnios. Methyldopa and labetalol are pregnancy-safe.
**8. A patient on clopidogrel is scheduled for surgery. When should it be
stopped electively?**
A) 1 day before
B) 5–7 days before
C) 12 hours before
HESI BSN 315 PHARMACOLOGY COMPREHENSIVE
EXAM BANK 2026–2027 EDITION 220 PRACTICE
QUESTIONS + ANSWERS & RATIONALES HIGH-
YIELD CONTENT • FIRST-TIME PASS • GRADED A+
# SECTION 1: CARDIOVASCULAR PHARMACOLOGY (Questions
1–35)
**1. A patient with heart failure is prescribed digoxin. Which finding
requires immediate intervention?**
A) Heart rate of 58 bpm
B) Serum digoxin level of 1.2 ng/mL
C) Anorexia and nausea
D) Yellow-tinted vision
**Answer: D**
*Rationale:* Yellow-tinted vision (xanthopsia) is a classic sign of
digoxin toxicity. HR 58 is acceptable for HF if asymptomatic.
Therapeutic level is 0.8–2.0 ng/mL. Anorexia/nausea can occur in HF or
toxicity but vision change is more specific.
**2. A patient on warfarin has an INR of 4.5. Which action is
priority?**
,2|Page
A) Administer vitamin K
B) Hold next dose and notify provider
C) Give fresh frozen plasma
D) Increase warfarin dose
**Answer: B**
*Rationale:* INR target 2–3 for most indications. 4.5 is elevated but not
critical unless bleeding. Holding dose and notifying provider is first step.
Vitamin K used if bleeding or very high INR (>10 or with bleeding).
**3. Which medication is most likely to cause gingival hyperplasia?**
A) Amlodipine
B) Lisinopril
C) Phenytoin
D) Metoprolol
**Answer: C**
*Rationale:* Phenytoin (anticonvulsant) is a classic cause. Among CV
drugs, nifedipine can cause it, but amlodipine less so. Phenytoin is high-
yield cross-test.
**4. A patient taking amiodarone develops pulmonary fibrosis. What is
the priority action?**
,3|Page
A) Increase oxygen
B) Discontinue amiodarone
C) Start prednisone
D) Obtain chest X-ray
**Answer: B**
*Rationale:* Amiodarone-induced pulmonary toxicity requires drug
discontinuation first. Corticosteroids may be used but removal of cause
is priority.
**5. Which medication is a direct thrombin inhibitor used for HIT?**
A) Heparin
B) Enoxaparin
C) Argatroban
D) Warfarin
**Answer: C**
*Rationale:* Argatroban and lepirudin are direct thrombin inhibitors for
heparin-induced thrombocytopenia (HIT).
**6. A patient on furosemide reports muscle cramps and weakness.
Which lab abnormality is most likely?**
A) Hypernatremia
, 4|Page
B) Hypokalemia
C) Hypercalcemia
D) Hypomagnesemia
**Answer: B**
*Rationale:* Loop diuretics cause potassium and magnesium wasting.
Hypokalemia causes muscle weakness and cramps.
**7. Which antihypertensive is contraindicated in pregnancy?**
A) Methyldopa
B) Labetalol
C) Nifedipine
D) Lisinopril (ACE inhibitor)
**Answer: D**
*Rationale:* ACE inhibitors and ARBs cause fetal renal agenesis and
oligohydramnios. Methyldopa and labetalol are pregnancy-safe.
**8. A patient on clopidogrel is scheduled for surgery. When should it be
stopped electively?**
A) 1 day before
B) 5–7 days before
C) 12 hours before
