HESI Pharmacology V1 | 2026 Q&A with
Rationale
1. A nurse is preparing to administer digoxin to a client with heart failure. Which of the
following findings should lead the nurse to withhold the medication and notify the provider?
A. Blood pressure of 130/80 mmHg
B. Serum potassium level of 4.5 mEq/L
C. Digoxin level of 0.8 ng/mL
D. Apical heart rate of 52 beats per minute
Correct Answer: D
Rationale: Digoxin is a cardiac glycoside that increases myocardial contractility but slows
the heart rate. Before administration, the nurse must assess the apical pulse for a full
minute, and the dose is typically held if the heart rate is less than 60 beats per minute in an
adult. A heart rate of 52 is too low and could indicate digoxin toxicity or bradycardia risk.
2. A client is prescribed intravenous heparin for the treatment of a pulmonary embolism.
Which laboratory value is the priority for the nurse to monitor while the client is receiving
this therapy?
A. Prothrombin time (PT)
B. International Normalized Ratio (INR)
C. Activated partial thromboplastin time (aPTT)
,D. Platelet count
Correct Answer: C
Rationale: The aPTT is the standard laboratory test used to monitor the effectiveness and
safety of unfractionated heparin therapy. The goal is typically to maintain the aPTT at 1.5 to
2.5 times the normal baseline value. While platelet counts are monitored for heparin-
induced thrombocytopenia, the aPTT is the primary indicator for titration of the dose.
3. A nurse is providing discharge teaching for a client who will be taking warfarin at home.
Which of the following dietary instructions should the nurse include?
A. Avoid all green leafy vegetables to prevent bleeding.
B. Drink at least 3 liters of fluid daily to prevent toxicity.
C. Increase intake of foods high in Vitamin K to improve clotting.
D. Maintain a consistent intake of foods high in Vitamin K.
Correct Answer: D
Rationale: Vitamin K is the antagonist for warfarin, and fluctuations in its intake can
significantly affect the medication’s efficacy. Clients do not need to avoid Vitamin K entirely
but must maintain a steady, consistent daily intake of green leafy vegetables. Large changes
in Vitamin K intake can cause the INR to become unstable, leading to either clotting or
bleeding risks.
,4. A client with hypertension is prescribed lisinopril. The nurse should instruct the client to
report which of the following common side effects to the provider?
A. Gingival hyperplasia
B. Orange-colored urine
C. Persistent dry cough
D. Tinnitus
Correct Answer: C
Rationale: Lisinopril is an ACE inhibitor, and a common side effect of this class is a
persistent, non-productive dry cough caused by the accumulation of bradykinin. If the
cough becomes intolerable, the healthcare provider may switch the client to an Angiotensin
II Receptor Blocker (ARB). This side effect is specific to ACE inhibitors and does not
indicate an infection.
5. A nurse is caring for a client who is receiving furosemide for the treatment of peripheral
edema. Which of the following electrolyte imbalances should the nurse monitor for most
closely?
A. Hyperkalemia
B. Hypernatremia
C. Hypokalemia
D. Hypercalcemia
, Correct Answer: C
Rationale: Furosemide is a loop diuretic that promotes the excretion of water, sodium, and
potassium. Hypokalemia is a significant and common adverse effect that can lead to cardiac
dysrhythmias. The nurse must monitor serum potassium levels and encourage the intake of
potassium-rich foods or administer supplements as prescribed.
6. A nurse is preparing to administer the first dose of albuterol via a metered-dose inhaler
(MDI) to a client with asthma. The nurse should explain that this medication works by which
of the following mechanisms?
A. Reducing airway inflammation
B. Thinning respiratory secretions
C. Suppressing the cough reflex
D. Dilating the bronchioles
Correct Answer: D
Rationale: Albuterol is a short-acting beta-2 agonist (SABA) that acts as a rescue
medication by causing rapid bronchodilation. It stimulates beta-2 receptors in the lungs to
relax smooth muscle, thereby opening the airways. It is used for acute asthma attacks
rather than long-term inflammatory control.
7. A client is prescribed spironolactone for the management of heart failure. Which of the
following instructions should the nurse provide to the client?
A. Avoid foods high in potassium, such as bananas and spinach.
Rationale
1. A nurse is preparing to administer digoxin to a client with heart failure. Which of the
following findings should lead the nurse to withhold the medication and notify the provider?
A. Blood pressure of 130/80 mmHg
B. Serum potassium level of 4.5 mEq/L
C. Digoxin level of 0.8 ng/mL
D. Apical heart rate of 52 beats per minute
Correct Answer: D
Rationale: Digoxin is a cardiac glycoside that increases myocardial contractility but slows
the heart rate. Before administration, the nurse must assess the apical pulse for a full
minute, and the dose is typically held if the heart rate is less than 60 beats per minute in an
adult. A heart rate of 52 is too low and could indicate digoxin toxicity or bradycardia risk.
2. A client is prescribed intravenous heparin for the treatment of a pulmonary embolism.
Which laboratory value is the priority for the nurse to monitor while the client is receiving
this therapy?
A. Prothrombin time (PT)
B. International Normalized Ratio (INR)
C. Activated partial thromboplastin time (aPTT)
,D. Platelet count
Correct Answer: C
Rationale: The aPTT is the standard laboratory test used to monitor the effectiveness and
safety of unfractionated heparin therapy. The goal is typically to maintain the aPTT at 1.5 to
2.5 times the normal baseline value. While platelet counts are monitored for heparin-
induced thrombocytopenia, the aPTT is the primary indicator for titration of the dose.
3. A nurse is providing discharge teaching for a client who will be taking warfarin at home.
Which of the following dietary instructions should the nurse include?
A. Avoid all green leafy vegetables to prevent bleeding.
B. Drink at least 3 liters of fluid daily to prevent toxicity.
C. Increase intake of foods high in Vitamin K to improve clotting.
D. Maintain a consistent intake of foods high in Vitamin K.
Correct Answer: D
Rationale: Vitamin K is the antagonist for warfarin, and fluctuations in its intake can
significantly affect the medication’s efficacy. Clients do not need to avoid Vitamin K entirely
but must maintain a steady, consistent daily intake of green leafy vegetables. Large changes
in Vitamin K intake can cause the INR to become unstable, leading to either clotting or
bleeding risks.
,4. A client with hypertension is prescribed lisinopril. The nurse should instruct the client to
report which of the following common side effects to the provider?
A. Gingival hyperplasia
B. Orange-colored urine
C. Persistent dry cough
D. Tinnitus
Correct Answer: C
Rationale: Lisinopril is an ACE inhibitor, and a common side effect of this class is a
persistent, non-productive dry cough caused by the accumulation of bradykinin. If the
cough becomes intolerable, the healthcare provider may switch the client to an Angiotensin
II Receptor Blocker (ARB). This side effect is specific to ACE inhibitors and does not
indicate an infection.
5. A nurse is caring for a client who is receiving furosemide for the treatment of peripheral
edema. Which of the following electrolyte imbalances should the nurse monitor for most
closely?
A. Hyperkalemia
B. Hypernatremia
C. Hypokalemia
D. Hypercalcemia
, Correct Answer: C
Rationale: Furosemide is a loop diuretic that promotes the excretion of water, sodium, and
potassium. Hypokalemia is a significant and common adverse effect that can lead to cardiac
dysrhythmias. The nurse must monitor serum potassium levels and encourage the intake of
potassium-rich foods or administer supplements as prescribed.
6. A nurse is preparing to administer the first dose of albuterol via a metered-dose inhaler
(MDI) to a client with asthma. The nurse should explain that this medication works by which
of the following mechanisms?
A. Reducing airway inflammation
B. Thinning respiratory secretions
C. Suppressing the cough reflex
D. Dilating the bronchioles
Correct Answer: D
Rationale: Albuterol is a short-acting beta-2 agonist (SABA) that acts as a rescue
medication by causing rapid bronchodilation. It stimulates beta-2 receptors in the lungs to
relax smooth muscle, thereby opening the airways. It is used for acute asthma attacks
rather than long-term inflammatory control.
7. A client is prescribed spironolactone for the management of heart failure. Which of the
following instructions should the nurse provide to the client?
A. Avoid foods high in potassium, such as bananas and spinach.
