HESI RN Pharmacology Exam 2026 Practice
Questions & Verified Answers | Complete
Study Guide & Test Bank Review PDF
HESI RN PHARMACOLOGY EXAM 2026 PRACTICE QUESTIONS & VERIFIED
ANSWERS | COMPLETE STUDY GUIDE & TEST BANK REVIEW
DOCUMENT OVERVIEW
• This comprehensive exam contains verified practice questions designed to
strengthen pharmacology knowledge and prepare for the HESI RN examination
with emphasis on drug classifications, mechanisms of action, side effects,
contraindications, and clinical applications.
• Study this material by reviewing each question thoroughly, understanding the
EXPERT RATIONALE behind correct answers, and identifying knowledge gaps
across all major pharmacological categories including cardiovascular, respiratory,
gastrointestinal, neurological, endocrine, and antimicrobial agents.
QUESTIONS
QUESTION 1
A nurse is preparing to administer digoxin to a client with heart failure. Which
of the following is the primary mechanism of action for digoxin?
A) Blocks calcium channels to reduce heart rate
B) Inhibits the sodium-potassium pump
C) Increases myocardial contractility and decreases conduction velocity
D) Dilates coronary arteries to improve perfusion
E) Reduces preload by promoting diuresis
CORRECT ANSWER: C) Increases myocardial contractility and decreases
conduction velocity
,EXPERT RATIONALE: Digoxin is a cardiac glycoside that works by inhibiting the
Na+/K+-ATPase pump, which indirectly increases intracellular calcium. This
increased calcium strengthens myocardial contractility, making the heart pump
more effectively. Additionally, digoxin decreases conduction velocity through the
atrioventricular (AV) node, which helps control ventricular rate in atrial fibrillation.
While digoxin does have some diuretic effects and effects on the AV node, its
primary therapeutic benefit comes from increased contractility and reduced
conduction velocity.
QUESTION 2
A client taking metoprolol for hypertension reports experiencing fatigue and
decreased exercise tolerance. What is the most appropriate nursing action?
A) Advise the client to discontinue the medication immediately
B) Reassure the client that these are temporary effects and will resolve within one
week
C) Assess vital signs and report findings to the healthcare provider for possible dose
adjustment
D) Recommend the client increase sodium intake to counteract the medication
effects
E) Suggest the client take the medication with food to reduce side effects
CORRECT ANSWER: C) Assess vital signs and report findings to the
healthcare provider for possible dose adjustment
EXPERT RATIONALE: Fatigue and decreased exercise tolerance are common side
effects of beta-blockers like metoprolol due to decreased heart rate and cardiac
output. However, these symptoms should be reported to the healthcare provider
rather than ignored. The provider may adjust the dose to find a therapeutic level
that effectively treats hypertension while minimizing side effects. Discontinuing the
medication abruptly is dangerous and can cause rebound hypertension. The
symptoms may take weeks to resolve, and dietary modifications do not address the
underlying medication effect.
,QUESTION 3
A nurse is reviewing medications for a client with atrial fibrillation who is
starting warfarin therapy. Which of the following statements by the client
indicates a need for further teaching?
A) "I will have regular blood tests to monitor my INR levels"
B) "I will avoid eating large amounts of leafy green vegetables"
C) "I should report any signs of bleeding immediately to my doctor"
D) "I can take aspirin whenever I have a headache"
E) "I must avoid NSAIDs unless specifically prescribed by my doctor"
CORRECT ANSWER: D) "I can take aspirin whenever I have a headache"
EXPERT RATIONALE: Warfarin is a vitamin K antagonist used for anticoagulation.
Clients taking warfarin should NOT take aspirin or NSAIDs without specific
healthcare provider approval because these medications increase bleeding risk
when combined with warfarin. All other statements are correct: regular INR
monitoring is essential, consistency with vitamin K intake is important (not
complete avoidance), bleeding signs should be reported, and NSAIDs should be
avoided unless prescribed. This response indicates the client needs additional
education about drug interactions.
QUESTION 4
A 65-year-old client with hypertension is prescribed lisinopril, an ACE
inhibitor. Which side effect should the nurse specifically monitor for?
A) Hypokalemia and muscle weakness
B) Persistent dry cough and angioedema
C) Tachycardia and palpitations
D) Hyperglycemia and increased thirst
, E) Constipation and abdominal distention
CORRECT ANSWER: B) Persistent dry cough and angioedema
EXPERT RATIONALE: ACE inhibitors like lisinopril inhibit the conversion of
angiotensin I to angiotensin II. This also prevents the breakdown of bradykinin,
which accumulates in the lungs and causes a persistent dry cough in approximately
10-20% of patients. Angioedema (swelling of deeper skin and mucous membrane
layers) is a rare but serious side effect that requires immediate discontinuation.
While ACE inhibitors can cause hyperkalemia (not hypokalemia), the most
characteristic and commonly reported side effect is the dry cough. This is an
expected adverse effect rather than a sign of serious pathology, though clients
should be counseled about it.
QUESTION 5
A client is prescribed theophylline for COPD. The nurse should monitor for
which sign of theophylline toxicity?
A) Bradycardia and hypotension
B) Nausea, vomiting, tachycardia, and tremors
C) Facial flushing and headache
D) Muscle weakness and fatigue
E) Constipation and urinary retention
CORRECT ANSWER: B) Nausea, vomiting, tachycardia, and tremors
EXPERT RATIONALE: Theophylline is a methylxanthine bronchodilator with a
narrow therapeutic window (10-20 mcg/mL). Early signs of toxicity include nausea,
vomiting, and tremors, followed by more serious manifestations like tachycardia,
arrhythmias, and seizures if toxicity progresses. The therapeutic index is narrow,
meaning the difference between therapeutic and toxic levels is small. Serum levels
should be monitored regularly. Common side effects include gastric upset and
tremors, but when these occur in conjunction with tachycardia, toxicity should be
Questions & Verified Answers | Complete
Study Guide & Test Bank Review PDF
HESI RN PHARMACOLOGY EXAM 2026 PRACTICE QUESTIONS & VERIFIED
ANSWERS | COMPLETE STUDY GUIDE & TEST BANK REVIEW
DOCUMENT OVERVIEW
• This comprehensive exam contains verified practice questions designed to
strengthen pharmacology knowledge and prepare for the HESI RN examination
with emphasis on drug classifications, mechanisms of action, side effects,
contraindications, and clinical applications.
• Study this material by reviewing each question thoroughly, understanding the
EXPERT RATIONALE behind correct answers, and identifying knowledge gaps
across all major pharmacological categories including cardiovascular, respiratory,
gastrointestinal, neurological, endocrine, and antimicrobial agents.
QUESTIONS
QUESTION 1
A nurse is preparing to administer digoxin to a client with heart failure. Which
of the following is the primary mechanism of action for digoxin?
A) Blocks calcium channels to reduce heart rate
B) Inhibits the sodium-potassium pump
C) Increases myocardial contractility and decreases conduction velocity
D) Dilates coronary arteries to improve perfusion
E) Reduces preload by promoting diuresis
CORRECT ANSWER: C) Increases myocardial contractility and decreases
conduction velocity
,EXPERT RATIONALE: Digoxin is a cardiac glycoside that works by inhibiting the
Na+/K+-ATPase pump, which indirectly increases intracellular calcium. This
increased calcium strengthens myocardial contractility, making the heart pump
more effectively. Additionally, digoxin decreases conduction velocity through the
atrioventricular (AV) node, which helps control ventricular rate in atrial fibrillation.
While digoxin does have some diuretic effects and effects on the AV node, its
primary therapeutic benefit comes from increased contractility and reduced
conduction velocity.
QUESTION 2
A client taking metoprolol for hypertension reports experiencing fatigue and
decreased exercise tolerance. What is the most appropriate nursing action?
A) Advise the client to discontinue the medication immediately
B) Reassure the client that these are temporary effects and will resolve within one
week
C) Assess vital signs and report findings to the healthcare provider for possible dose
adjustment
D) Recommend the client increase sodium intake to counteract the medication
effects
E) Suggest the client take the medication with food to reduce side effects
CORRECT ANSWER: C) Assess vital signs and report findings to the
healthcare provider for possible dose adjustment
EXPERT RATIONALE: Fatigue and decreased exercise tolerance are common side
effects of beta-blockers like metoprolol due to decreased heart rate and cardiac
output. However, these symptoms should be reported to the healthcare provider
rather than ignored. The provider may adjust the dose to find a therapeutic level
that effectively treats hypertension while minimizing side effects. Discontinuing the
medication abruptly is dangerous and can cause rebound hypertension. The
symptoms may take weeks to resolve, and dietary modifications do not address the
underlying medication effect.
,QUESTION 3
A nurse is reviewing medications for a client with atrial fibrillation who is
starting warfarin therapy. Which of the following statements by the client
indicates a need for further teaching?
A) "I will have regular blood tests to monitor my INR levels"
B) "I will avoid eating large amounts of leafy green vegetables"
C) "I should report any signs of bleeding immediately to my doctor"
D) "I can take aspirin whenever I have a headache"
E) "I must avoid NSAIDs unless specifically prescribed by my doctor"
CORRECT ANSWER: D) "I can take aspirin whenever I have a headache"
EXPERT RATIONALE: Warfarin is a vitamin K antagonist used for anticoagulation.
Clients taking warfarin should NOT take aspirin or NSAIDs without specific
healthcare provider approval because these medications increase bleeding risk
when combined with warfarin. All other statements are correct: regular INR
monitoring is essential, consistency with vitamin K intake is important (not
complete avoidance), bleeding signs should be reported, and NSAIDs should be
avoided unless prescribed. This response indicates the client needs additional
education about drug interactions.
QUESTION 4
A 65-year-old client with hypertension is prescribed lisinopril, an ACE
inhibitor. Which side effect should the nurse specifically monitor for?
A) Hypokalemia and muscle weakness
B) Persistent dry cough and angioedema
C) Tachycardia and palpitations
D) Hyperglycemia and increased thirst
, E) Constipation and abdominal distention
CORRECT ANSWER: B) Persistent dry cough and angioedema
EXPERT RATIONALE: ACE inhibitors like lisinopril inhibit the conversion of
angiotensin I to angiotensin II. This also prevents the breakdown of bradykinin,
which accumulates in the lungs and causes a persistent dry cough in approximately
10-20% of patients. Angioedema (swelling of deeper skin and mucous membrane
layers) is a rare but serious side effect that requires immediate discontinuation.
While ACE inhibitors can cause hyperkalemia (not hypokalemia), the most
characteristic and commonly reported side effect is the dry cough. This is an
expected adverse effect rather than a sign of serious pathology, though clients
should be counseled about it.
QUESTION 5
A client is prescribed theophylline for COPD. The nurse should monitor for
which sign of theophylline toxicity?
A) Bradycardia and hypotension
B) Nausea, vomiting, tachycardia, and tremors
C) Facial flushing and headache
D) Muscle weakness and fatigue
E) Constipation and urinary retention
CORRECT ANSWER: B) Nausea, vomiting, tachycardia, and tremors
EXPERT RATIONALE: Theophylline is a methylxanthine bronchodilator with a
narrow therapeutic window (10-20 mcg/mL). Early signs of toxicity include nausea,
vomiting, and tremors, followed by more serious manifestations like tachycardia,
arrhythmias, and seizures if toxicity progresses. The therapeutic index is narrow,
meaning the difference between therapeutic and toxic levels is small. Serum levels
should be monitored regularly. Common side effects include gastric upset and
tremors, but when these occur in conjunction with tachycardia, toxicity should be
