1
RN HESI Pharmacology V1 Actual Exam
2026/2027 – Complete Exam-Style Questions
with Detailed Rationales | 100% Verified |
Pass Guaranteed – A+ Graded
[SECTION 1: Cardiovascular & Renal Pharmacology — Questions 1-18]
Q1: A patient taking Lisinopril reports a persistent, dry, hacking cough. The nurse identifies this
as a common side effect of which class of medications?
A. Calcium Channel Blockers (CCBs)
B. Beta-Blockers
C. Angiotensin-Converting Enzyme (ACE) Inhibitors [CORRECT]
D. Angiotensin II Receptor Blockers (ARBs)
Correct Answer: C
Rationale: The dry, non-productive cough is a hallmark side effect of ACE inhibitors, affecting
up to 20% of patients. It is caused by the accumulation of bradykinin. ARBs (Option D) are often
prescribed as an alternative because they do not inhibit bradykinin breakdown and therefore do
not cause this cough.
Q2: A patient prescribed Amlodipine reports swelling in their ankles and feet. What is the most
likely cause?
A. Hyperkalemia
B. Constipation
C. Peripheral edema [CORRECT]
D. Bronchospasm
Correct Answer: C
,2
Rationale: Peripheral edema (swelling) is a common, dose-dependent side effect of
dihydropyridine calcium channel blockers like amlodipine. It is caused by vasodilation of
precapillary arterioles. Dihydropyridines like verapamil and diltiazem are more likely to cause
constipation.
Q3: Which statement is true regarding the monitoring of a patient taking Warfarin (Coumadin)?
A. The International Normalized Ratio (INR) goal is 1.0 to 1.5.
C. The INR goal is typically 2.0 to 3.0 for most indications.
D. Vitamin E increases the INR effect.
Correct Answer: C
Rationale: For most conditions like atrial fibrillation or DVT treatment, the therapeutic INR
range is 2.0 to 3.0. An INR of 1.0 to 1.5 indicates subtherapeutic levels. Vitamin K (not Vitamin
E) is the antidote and reduces the INR effect.
Q4: A patient with heart failure is prescribed Digoxin. Which finding indicates potential toxicity?
A. Heart rate of 70 bpm
B. Blood pressure of 120/80 mmHg
C. Yellow-green halos around visual fields (halos)
D. Respiratory rate of 16 breaths/minute
Correct Answer: C
Rationale: Visual disturbances, specifically yellow-green halos or blurred vision (halos), are
classic early signs of digoxin toxicity. Other signs include nausea, vomiting, and cardiac
arrhythmias (bradycardia). A heart rate of 70 is normal for a patient on digoxin.
Q5: The nurse is teaching a patient about Hydrochlorothiazide (HCTZ). Which adverse effect
should be included in the teaching?
A. Hypokalemia
B. Hypoglycemia
,3
C. Ototoxicity
D. Tendon rupture
Correct Answer: A
Rationale: Thiazide diuretics cause potassium loss (hypokalemia) and sodium retention.
Hypoglycemia (hyperglycemia) is a risk, not an immediate side effect of the dose itself.
Ototoxicity is associated with loop diuretics and aminoglycosides.
Q6: A patient is prescribed Furosemide. The nurse should advise the patient to report which
adverse effect immediately?
A. Weight gain
B. Ringing in the ears (tinnitus) or hearing loss
C. Dry cough
D. Muscle cramps
Correct Answer: B
Rationale: Furosemide (a loop diuretic) is associated with ototoxicity, which can manifest as
tinnitus (ringing in ears), hearing loss, or a sense of fullness. This is often reversible if caught
early but requires immediate medical attention. Dry cough is associated with ACE inhibitors.
Q7: Which medication class is the antidote for Heparin overdose?
A. Vitamin K
B. Atropine
C. Protamine sulfate
D. Flumazenil
Correct Answer: C
, 4
Rationale: Protamine sulfate is the specific antidote for heparin. It works by binding to heparin,
forming a stable complex that inactivates it. Vitamin K is the antidote for warfarin, and
flumazenil is for benzodiazeine overdose.
Q8: A patient with asthma is being treated for hypertension. Which antihypertensive should be
used with caution?
A. Non-selective beta-blockers (e.g., Propranolol)
B. Angiotensin II Receptor Blockers (ARBs)
C. Calcium Channel Blockers (CCBs)
D. Diuretics
Correct Answer: A
Rationale: Non-selective beta-blockers can block beta-2 receptors in the lungs, leading to
bronchoconstriction. Patients with asthma or reactive airway disease should generally be
prescribed selective beta-blockers (like metoprolol) or alternative classes like ARBs or CCBs.
Q9: The nurse is administering an Anticoagulant. Which medication requires monitoring of the
Partial Thromboplastin Time (PTT) to ensure it remains 1.5 to 2.5 times the control?
A. Warfarin
B. Heparin
C. Apixaban
D. Rivaroxaban
Correct Answer: B
Rationale: Heparin (Unfractionated and Low Molecular Weight Heparin like Enoxaparin) affects
the intrinsic pathway and requires monitoring of PTT. Direct Oral Anticoagulants (DOACs) like
Apixaban and Rivaroxaban do not require routine INR or PTT monitoring. Warfarin is monitored
by INR.
RN HESI Pharmacology V1 Actual Exam
2026/2027 – Complete Exam-Style Questions
with Detailed Rationales | 100% Verified |
Pass Guaranteed – A+ Graded
[SECTION 1: Cardiovascular & Renal Pharmacology — Questions 1-18]
Q1: A patient taking Lisinopril reports a persistent, dry, hacking cough. The nurse identifies this
as a common side effect of which class of medications?
A. Calcium Channel Blockers (CCBs)
B. Beta-Blockers
C. Angiotensin-Converting Enzyme (ACE) Inhibitors [CORRECT]
D. Angiotensin II Receptor Blockers (ARBs)
Correct Answer: C
Rationale: The dry, non-productive cough is a hallmark side effect of ACE inhibitors, affecting
up to 20% of patients. It is caused by the accumulation of bradykinin. ARBs (Option D) are often
prescribed as an alternative because they do not inhibit bradykinin breakdown and therefore do
not cause this cough.
Q2: A patient prescribed Amlodipine reports swelling in their ankles and feet. What is the most
likely cause?
A. Hyperkalemia
B. Constipation
C. Peripheral edema [CORRECT]
D. Bronchospasm
Correct Answer: C
,2
Rationale: Peripheral edema (swelling) is a common, dose-dependent side effect of
dihydropyridine calcium channel blockers like amlodipine. It is caused by vasodilation of
precapillary arterioles. Dihydropyridines like verapamil and diltiazem are more likely to cause
constipation.
Q3: Which statement is true regarding the monitoring of a patient taking Warfarin (Coumadin)?
A. The International Normalized Ratio (INR) goal is 1.0 to 1.5.
C. The INR goal is typically 2.0 to 3.0 for most indications.
D. Vitamin E increases the INR effect.
Correct Answer: C
Rationale: For most conditions like atrial fibrillation or DVT treatment, the therapeutic INR
range is 2.0 to 3.0. An INR of 1.0 to 1.5 indicates subtherapeutic levels. Vitamin K (not Vitamin
E) is the antidote and reduces the INR effect.
Q4: A patient with heart failure is prescribed Digoxin. Which finding indicates potential toxicity?
A. Heart rate of 70 bpm
B. Blood pressure of 120/80 mmHg
C. Yellow-green halos around visual fields (halos)
D. Respiratory rate of 16 breaths/minute
Correct Answer: C
Rationale: Visual disturbances, specifically yellow-green halos or blurred vision (halos), are
classic early signs of digoxin toxicity. Other signs include nausea, vomiting, and cardiac
arrhythmias (bradycardia). A heart rate of 70 is normal for a patient on digoxin.
Q5: The nurse is teaching a patient about Hydrochlorothiazide (HCTZ). Which adverse effect
should be included in the teaching?
A. Hypokalemia
B. Hypoglycemia
,3
C. Ototoxicity
D. Tendon rupture
Correct Answer: A
Rationale: Thiazide diuretics cause potassium loss (hypokalemia) and sodium retention.
Hypoglycemia (hyperglycemia) is a risk, not an immediate side effect of the dose itself.
Ototoxicity is associated with loop diuretics and aminoglycosides.
Q6: A patient is prescribed Furosemide. The nurse should advise the patient to report which
adverse effect immediately?
A. Weight gain
B. Ringing in the ears (tinnitus) or hearing loss
C. Dry cough
D. Muscle cramps
Correct Answer: B
Rationale: Furosemide (a loop diuretic) is associated with ototoxicity, which can manifest as
tinnitus (ringing in ears), hearing loss, or a sense of fullness. This is often reversible if caught
early but requires immediate medical attention. Dry cough is associated with ACE inhibitors.
Q7: Which medication class is the antidote for Heparin overdose?
A. Vitamin K
B. Atropine
C. Protamine sulfate
D. Flumazenil
Correct Answer: C
, 4
Rationale: Protamine sulfate is the specific antidote for heparin. It works by binding to heparin,
forming a stable complex that inactivates it. Vitamin K is the antidote for warfarin, and
flumazenil is for benzodiazeine overdose.
Q8: A patient with asthma is being treated for hypertension. Which antihypertensive should be
used with caution?
A. Non-selective beta-blockers (e.g., Propranolol)
B. Angiotensin II Receptor Blockers (ARBs)
C. Calcium Channel Blockers (CCBs)
D. Diuretics
Correct Answer: A
Rationale: Non-selective beta-blockers can block beta-2 receptors in the lungs, leading to
bronchoconstriction. Patients with asthma or reactive airway disease should generally be
prescribed selective beta-blockers (like metoprolol) or alternative classes like ARBs or CCBs.
Q9: The nurse is administering an Anticoagulant. Which medication requires monitoring of the
Partial Thromboplastin Time (PTT) to ensure it remains 1.5 to 2.5 times the control?
A. Warfarin
B. Heparin
C. Apixaban
D. Rivaroxaban
Correct Answer: B
Rationale: Heparin (Unfractionated and Low Molecular Weight Heparin like Enoxaparin) affects
the intrinsic pathway and requires monitoring of PTT. Direct Oral Anticoagulants (DOACs) like
Apixaban and Rivaroxaban do not require routine INR or PTT monitoring. Warfarin is monitored
by INR.
