HESI ADVANCED
PHARMACOLOGY FINAL EXAM
2026 QUESTIONS AND ANSWERS
WITH RATIONALES/GRADED
A+/2026 UPDATE/100% CORRECT
/INSTANT DOWNLOAD
Section 1: Cardiovascular Pharmacology (Questions 1-15)
1. A patient with heart failure with reduced ejection fraction (HFrEF) is prescribed
sacubitril/valsartan. Which laboratory value requires immediate notification of the
provider?
• A) Serum potassium 4.2 mEq/L
• B) BNP 150 pg/mL
• C) Serum creatinine 2.5 mg/dL (increase from baseline 1.0 mg/dL) –
(Correct Answer)
• D) Hemoglobin 12 g/dL
2. A nurse is administering IV amiodarone for refractory ventricular tachycardia.
Which adverse effect requires the most immediate action?
• A) Blue-gray skin discoloration
• B) Corneal microdeposits
• C) Acute respiratory distress with hypoxemia – (Correct Answer)
• D) Asymptomatic bradycardia (HR 55 bpm)
,3. A patient on warfarin has an INR of 4.5 with minor gingival bleeding. The next
dose of warfarin is due. What should the nurse do?
• A) Administer the warfarin as ordered
• B) Hold the warfarin and notify the provider – (Correct Answer)
• C) Administer vitamin K 10 mg PO immediately
• D) Give the warfarin and apply pressure to gums
4. Which medication is most appropriate for acute rate control in a patient with atrial
fibrillation and rapid ventricular response (heart rate 140 bpm) who has severe left
ventricular dysfunction (EF 20%)?
• A) Metoprolol IV
• B) Diltiazem IV
• C) Digoxin IV – (Correct Answer)
• D) Amiodarone IV
5. A patient taking atorvastatin reports new-onset muscle pain and dark urine. Which
laboratory test is most critical?
• A) Liver function tests
• B) Creatine kinase (CK) – (Correct Answer)
• C) Renal panel
• D) Complete blood count
6. For a patient receiving a heparin infusion for PE, which PTT value indicates
therapeutic range (assuming the laboratory control is 30 seconds)?
• A) 45 seconds
• B) 90 seconds – (Correct Answer)
• C) 120 seconds
• D) 150 seconds
7. Which drug-food interaction is most concerning for a patient taking verapamil?
• A) Grapefruit juice – (Correct Answer)
• B) Green leafy vegetables
• C) Dairy products
• D) High-protein meals
8. A patient with hypertension and benign prostatic hyperplasia (BPH) would benefit
most from which antihypertensive?
• A) Lisinopril
• B) Hydrochlorothiazide
, • C) Doxazosin – (Correct Answer)
• D) Amlodipine
9. After administering alteplase (tPA) for ischemic stroke, the nurse observes the
patient’s gums bleeding and a decrease in blood pressure. The priority action is:
• A) Apply pressure to the gums
• B) Discontinue the tPA infusion and call the provider – (Correct Answer)
• C) Administer protamine sulfate
• D) Increase the infusion rate to complete quickly
10. A patient on clopidogrel is scheduled for elective hernia repair surgery. The nurse
advises the patient to stop clopidogrel how many days before surgery?
• A) 2 days
• B) 5 days – (Correct Answer)
• C) 10 days
• D) 14 days
11. Which new oral anticoagulant (DOAC) has a specific reversal agent (andexanet
alfa) indicated for life-threatening bleeding?
• A) Rivaroxaban
• B) Dabigatran
• C) Apixaban – (Correct Answer)
• D) Edoxaban
12. A patient receiving furosemide 80 mg IV push reports tinnitus and hearing loss.
This is most likely due to:
• A) Allergic reaction
• B) Ototoxicity from rapid administration – (Correct Answer)
• C) Electrolyte imbalance
• D) Underlying inner ear infection
13. Which beta-blocker is considered cardioselective (beta-1 selective)?
• A) Propranolol
• B) Carvedilol
• C) Metoprolol succinate – (Correct Answer)
• D) Labetalol
14. A patient with stable angina is prescribed ranolazine. The nurse should monitor
which ECG change specifically associated with this drug?
PHARMACOLOGY FINAL EXAM
2026 QUESTIONS AND ANSWERS
WITH RATIONALES/GRADED
A+/2026 UPDATE/100% CORRECT
/INSTANT DOWNLOAD
Section 1: Cardiovascular Pharmacology (Questions 1-15)
1. A patient with heart failure with reduced ejection fraction (HFrEF) is prescribed
sacubitril/valsartan. Which laboratory value requires immediate notification of the
provider?
• A) Serum potassium 4.2 mEq/L
• B) BNP 150 pg/mL
• C) Serum creatinine 2.5 mg/dL (increase from baseline 1.0 mg/dL) –
(Correct Answer)
• D) Hemoglobin 12 g/dL
2. A nurse is administering IV amiodarone for refractory ventricular tachycardia.
Which adverse effect requires the most immediate action?
• A) Blue-gray skin discoloration
• B) Corneal microdeposits
• C) Acute respiratory distress with hypoxemia – (Correct Answer)
• D) Asymptomatic bradycardia (HR 55 bpm)
,3. A patient on warfarin has an INR of 4.5 with minor gingival bleeding. The next
dose of warfarin is due. What should the nurse do?
• A) Administer the warfarin as ordered
• B) Hold the warfarin and notify the provider – (Correct Answer)
• C) Administer vitamin K 10 mg PO immediately
• D) Give the warfarin and apply pressure to gums
4. Which medication is most appropriate for acute rate control in a patient with atrial
fibrillation and rapid ventricular response (heart rate 140 bpm) who has severe left
ventricular dysfunction (EF 20%)?
• A) Metoprolol IV
• B) Diltiazem IV
• C) Digoxin IV – (Correct Answer)
• D) Amiodarone IV
5. A patient taking atorvastatin reports new-onset muscle pain and dark urine. Which
laboratory test is most critical?
• A) Liver function tests
• B) Creatine kinase (CK) – (Correct Answer)
• C) Renal panel
• D) Complete blood count
6. For a patient receiving a heparin infusion for PE, which PTT value indicates
therapeutic range (assuming the laboratory control is 30 seconds)?
• A) 45 seconds
• B) 90 seconds – (Correct Answer)
• C) 120 seconds
• D) 150 seconds
7. Which drug-food interaction is most concerning for a patient taking verapamil?
• A) Grapefruit juice – (Correct Answer)
• B) Green leafy vegetables
• C) Dairy products
• D) High-protein meals
8. A patient with hypertension and benign prostatic hyperplasia (BPH) would benefit
most from which antihypertensive?
• A) Lisinopril
• B) Hydrochlorothiazide
, • C) Doxazosin – (Correct Answer)
• D) Amlodipine
9. After administering alteplase (tPA) for ischemic stroke, the nurse observes the
patient’s gums bleeding and a decrease in blood pressure. The priority action is:
• A) Apply pressure to the gums
• B) Discontinue the tPA infusion and call the provider – (Correct Answer)
• C) Administer protamine sulfate
• D) Increase the infusion rate to complete quickly
10. A patient on clopidogrel is scheduled for elective hernia repair surgery. The nurse
advises the patient to stop clopidogrel how many days before surgery?
• A) 2 days
• B) 5 days – (Correct Answer)
• C) 10 days
• D) 14 days
11. Which new oral anticoagulant (DOAC) has a specific reversal agent (andexanet
alfa) indicated for life-threatening bleeding?
• A) Rivaroxaban
• B) Dabigatran
• C) Apixaban – (Correct Answer)
• D) Edoxaban
12. A patient receiving furosemide 80 mg IV push reports tinnitus and hearing loss.
This is most likely due to:
• A) Allergic reaction
• B) Ototoxicity from rapid administration – (Correct Answer)
• C) Electrolyte imbalance
• D) Underlying inner ear infection
13. Which beta-blocker is considered cardioselective (beta-1 selective)?
• A) Propranolol
• B) Carvedilol
• C) Metoprolol succinate – (Correct Answer)
• D) Labetalol
14. A patient with stable angina is prescribed ranolazine. The nurse should monitor
which ECG change specifically associated with this drug?
