2026 HESI RN Pharmacology V1 Exit Exam
Questions | NCLEX Style Questions & Answers
2026 Exam · 200 Questions · With Rationales
ati. RN Pharmacology V1 Exit Exam Questions | NCLEX Style Questions & Answers (PDF), Exams of Pharmacology
2026 HESI
Question: 1 of 200
A patient receiving a continuous infusion of heparin develops a sudden drop in platelet count from 150,000 to
45,000/mm³. Which of the following pharmacologic interventions is most appropriate for managing this
A. Administer protamine sulfate intravenously
B. Discontinue heparin and initiate argatroban infusion
C. Increase the heparin infusion rate to achieve therapeutic aPTT
D. Administer vitamin K subcutaneously
PREVIOUS CONTINUE
A patient receiving a continuous infusion of heparin develops a sudden drop in platelet
count from 150,000 to 45,000/mm³. Which of the following pharmacologic interventions is
most appropriate for managing this complication?
A. Administer protamine sulfate intravenously
' B. Discontinue heparin and initiate argatroban infusion
C. Increase the heparin infusion rate to achieve therapeutic aPTT
D. Administer vitamin K subcutaneously
Correct Answer: B
The scenario describes heparin-induced thrombocytopenia (HIT), a immune-mediated reaction. Heparin must
be stopped immediately, and a direct thrombin inhibitor like argatroban is indicated. Protamine reverses heparin
but does not treat HIT; vitamin K reverses warfarin, not heparin.
Page 1 | 2026 HESI RN Pharmacology V1 Exit Exam Questions | NCLEX Style Questions & Answers (PDF), Exams of Pharmacology 2026
, 2026 HESI RN Pharmacology V1 Exit Exam
Questions | NCLEX Style Questions & Answers
2026 Exam · 200 Questions · With Rationales
ati. RN Pharmacology V1 Exit Exam Questions | NCLEX Style Questions & Answers (PDF), Exams of Pharmacology
2026 HESI
Question: 2 of 200
A patient with heart failure is receiving furosemide 40 mg IV twice daily and digoxin 0.125 mg orally daily.
Which laboratory value most warrants immediate nursing intervention?
A. Serum potassium 3.1 mEq/L
B. Serum digoxin level 0.8 ng/mL
C. Serum magnesium 2.0 mEq/L
D. Serum creatinine 1.0 mg/dL
PREVIOUS CONTINUE
A patient with heart failure is receiving furosemide 40 mg IV twice daily and digoxin 0.125
mg orally daily. Which laboratory value most warrants immediate nursing intervention?
' A. Serum potassium 3.1 mEq/L
B. Serum digoxin level 0.8 ng/mL
C. Serum magnesium 2.0 mEq/L
D. Serum creatinine 1.0 mg/dL
Correct Answer: A
Furosemide causes hypokalemia, which increases the risk of digoxin toxicity even at therapeutic digoxin levels.
A potassium of 3.1 mEq/L is hypokalemic and requires repletion. Digoxin level 0.8 ng/mL is subtherapeutic;
magnesium and creatinine are normal.
Page 2 | 2026 HESI RN Pharmacology V1 Exit Exam Questions | NCLEX Style Questions & Answers (PDF), Exams of Pharmacology 2026
, 2026 HESI RN Pharmacology V1 Exit Exam
Questions | NCLEX Style Questions & Answers
2026 Exam · 200 Questions · With Rationales
ati. RN Pharmacology V1 Exit Exam Questions | NCLEX Style Questions & Answers (PDF), Exams of Pharmacology
2026 HESI
Question: 3 of 200
A patient is prescribed a medication that undergoes extensive first-pass metabolism. Which route of
administration would achieve the highest systemic bioavailability?
A. Oral
B. Sublingual
C. Rectal
D. Transdermal
PREVIOUS CONTINUE
A patient is prescribed a medication that undergoes extensive first-pass metabolism.
Which route of administration would achieve the highest systemic bioavailability?
A. Oral
' B. Sublingual
C. Rectal
D. Transdermal
Correct Answer: B
Sublingual administration bypasses the portal circulation, avoiding first-pass metabolism in the liver. Oral drugs
undergo significant first-pass; rectal and transdermal routes partially avoid it but not as completely as
sublingual.
Page 3 | 2026 HESI RN Pharmacology V1 Exit Exam Questions | NCLEX Style Questions & Answers (PDF), Exams of Pharmacology 2026
, 2026 HESI RN Pharmacology V1 Exit Exam
Questions | NCLEX Style Questions & Answers
2026 Exam · 200 Questions · With Rationales
ati. RN Pharmacology V1 Exit Exam Questions | NCLEX Style Questions & Answers (PDF), Exams of Pharmacology
2026 HESI
Question: 4 of 200
A nurse is administering IV vancomycin to a patient. The patient reports sudden onset of flushing, pruritus, and
hypotension. Which action should the nurse take first?
A. Slow the infusion rate and notify the provider
B. Administer diphenhydramine intramuscularly
C. Stop the infusion immediately and assess vital signs
D. Increase the IV fluid rate and monitor for resolution
PREVIOUS CONTINUE
A nurse is administering IV vancomycin to a patient. The patient reports sudden onset of
flushing, pruritus, and hypotension. Which action should the nurse take first?
A. Slow the infusion rate and notify the provider
B. Administer diphenhydramine intramuscularly
' C. Stop the infusion immediately and assess vital signs
D. Increase the IV fluid rate and monitor for resolution
Correct Answer: C
These symptoms suggest Red Man Syndrome, a histamine-mediated infusion reaction to vancomycin. The
priority is to stop the infusion to prevent progression. Slowing the rate may be done after the reaction is
controlled, but immediate cessation is critical.
Page 4 | 2026 HESI RN Pharmacology V1 Exit Exam Questions | NCLEX Style Questions & Answers (PDF), Exams of Pharmacology 2026
Questions | NCLEX Style Questions & Answers
2026 Exam · 200 Questions · With Rationales
ati. RN Pharmacology V1 Exit Exam Questions | NCLEX Style Questions & Answers (PDF), Exams of Pharmacology
2026 HESI
Question: 1 of 200
A patient receiving a continuous infusion of heparin develops a sudden drop in platelet count from 150,000 to
45,000/mm³. Which of the following pharmacologic interventions is most appropriate for managing this
A. Administer protamine sulfate intravenously
B. Discontinue heparin and initiate argatroban infusion
C. Increase the heparin infusion rate to achieve therapeutic aPTT
D. Administer vitamin K subcutaneously
PREVIOUS CONTINUE
A patient receiving a continuous infusion of heparin develops a sudden drop in platelet
count from 150,000 to 45,000/mm³. Which of the following pharmacologic interventions is
most appropriate for managing this complication?
A. Administer protamine sulfate intravenously
' B. Discontinue heparin and initiate argatroban infusion
C. Increase the heparin infusion rate to achieve therapeutic aPTT
D. Administer vitamin K subcutaneously
Correct Answer: B
The scenario describes heparin-induced thrombocytopenia (HIT), a immune-mediated reaction. Heparin must
be stopped immediately, and a direct thrombin inhibitor like argatroban is indicated. Protamine reverses heparin
but does not treat HIT; vitamin K reverses warfarin, not heparin.
Page 1 | 2026 HESI RN Pharmacology V1 Exit Exam Questions | NCLEX Style Questions & Answers (PDF), Exams of Pharmacology 2026
, 2026 HESI RN Pharmacology V1 Exit Exam
Questions | NCLEX Style Questions & Answers
2026 Exam · 200 Questions · With Rationales
ati. RN Pharmacology V1 Exit Exam Questions | NCLEX Style Questions & Answers (PDF), Exams of Pharmacology
2026 HESI
Question: 2 of 200
A patient with heart failure is receiving furosemide 40 mg IV twice daily and digoxin 0.125 mg orally daily.
Which laboratory value most warrants immediate nursing intervention?
A. Serum potassium 3.1 mEq/L
B. Serum digoxin level 0.8 ng/mL
C. Serum magnesium 2.0 mEq/L
D. Serum creatinine 1.0 mg/dL
PREVIOUS CONTINUE
A patient with heart failure is receiving furosemide 40 mg IV twice daily and digoxin 0.125
mg orally daily. Which laboratory value most warrants immediate nursing intervention?
' A. Serum potassium 3.1 mEq/L
B. Serum digoxin level 0.8 ng/mL
C. Serum magnesium 2.0 mEq/L
D. Serum creatinine 1.0 mg/dL
Correct Answer: A
Furosemide causes hypokalemia, which increases the risk of digoxin toxicity even at therapeutic digoxin levels.
A potassium of 3.1 mEq/L is hypokalemic and requires repletion. Digoxin level 0.8 ng/mL is subtherapeutic;
magnesium and creatinine are normal.
Page 2 | 2026 HESI RN Pharmacology V1 Exit Exam Questions | NCLEX Style Questions & Answers (PDF), Exams of Pharmacology 2026
, 2026 HESI RN Pharmacology V1 Exit Exam
Questions | NCLEX Style Questions & Answers
2026 Exam · 200 Questions · With Rationales
ati. RN Pharmacology V1 Exit Exam Questions | NCLEX Style Questions & Answers (PDF), Exams of Pharmacology
2026 HESI
Question: 3 of 200
A patient is prescribed a medication that undergoes extensive first-pass metabolism. Which route of
administration would achieve the highest systemic bioavailability?
A. Oral
B. Sublingual
C. Rectal
D. Transdermal
PREVIOUS CONTINUE
A patient is prescribed a medication that undergoes extensive first-pass metabolism.
Which route of administration would achieve the highest systemic bioavailability?
A. Oral
' B. Sublingual
C. Rectal
D. Transdermal
Correct Answer: B
Sublingual administration bypasses the portal circulation, avoiding first-pass metabolism in the liver. Oral drugs
undergo significant first-pass; rectal and transdermal routes partially avoid it but not as completely as
sublingual.
Page 3 | 2026 HESI RN Pharmacology V1 Exit Exam Questions | NCLEX Style Questions & Answers (PDF), Exams of Pharmacology 2026
, 2026 HESI RN Pharmacology V1 Exit Exam
Questions | NCLEX Style Questions & Answers
2026 Exam · 200 Questions · With Rationales
ati. RN Pharmacology V1 Exit Exam Questions | NCLEX Style Questions & Answers (PDF), Exams of Pharmacology
2026 HESI
Question: 4 of 200
A nurse is administering IV vancomycin to a patient. The patient reports sudden onset of flushing, pruritus, and
hypotension. Which action should the nurse take first?
A. Slow the infusion rate and notify the provider
B. Administer diphenhydramine intramuscularly
C. Stop the infusion immediately and assess vital signs
D. Increase the IV fluid rate and monitor for resolution
PREVIOUS CONTINUE
A nurse is administering IV vancomycin to a patient. The patient reports sudden onset of
flushing, pruritus, and hypotension. Which action should the nurse take first?
A. Slow the infusion rate and notify the provider
B. Administer diphenhydramine intramuscularly
' C. Stop the infusion immediately and assess vital signs
D. Increase the IV fluid rate and monitor for resolution
Correct Answer: C
These symptoms suggest Red Man Syndrome, a histamine-mediated infusion reaction to vancomycin. The
priority is to stop the infusion to prevent progression. Slowing the rate may be done after the reaction is
controlled, but immediate cessation is critical.
Page 4 | 2026 HESI RN Pharmacology V1 Exit Exam Questions | NCLEX Style Questions & Answers (PDF), Exams of Pharmacology 2026
