HESI Pharmacology Nightingale College Fall
2025 (Nightingale BSN 315 course)
Questions With Complete Solutions
Course
HESI
1. The nurse is preparing to administer digoxin to a patient. Which lab value
must be reviewed before giving the medication?
A. Serum potassium
B. Serum calcium
C. Hemoglobin
D. Platelet count
Answer: A. Serum potassium
Rationale: Hypokalemia increases the risk of digoxin toxicity. It's critical to check potassium
levels before administering digoxin.
2. A client taking warfarin (Coumadin) has an INR of 4.5. What is the most
appropriate nursing intervention?
A. Administer the next dose as scheduled.
B. Hold the dose and notify the healthcare provider.
C. Increase the dosage.
D. Administer vitamin D.
Answer: B. Hold the dose and notify the healthcare provider.
Rationale: The therapeutic INR range is typically 2–3. An INR of 4.5 indicates increased
bleeding risk, so the dose should be held and the provider notified.
3. A client is prescribed furosemide (Lasix). What adverse effect should the nurse
monitor for?
A. Hyperkalemia
B. Hypocalcemia
C. Hypokalemia
D. Hypernatremia
,Answer: C. Hypokalemia
Rationale: Furosemide is a loop diuretic that causes potassium loss, so hypokalemia is a
common side effect.
4. The nurse is teaching a client prescribed tetracycline. Which instruction is
most important?
A. Take with milk to reduce stomach upset.
B. Avoid sunlight while taking this medication.
C. Take at bedtime to minimize nausea.
D. Use antacids if stomach upset occurs.
Answer: B. Avoid sunlight while taking this medication.
Rationale: Tetracycline can cause photosensitivity. Patients should avoid direct sunlight or use
sun protection.
5. A patient with type 1 diabetes is prescribed regular insulin. When should the
nurse expect the insulin to begin working?
A. 5–10 minutes
B. 15–30 minutes
C. 1–2 hours
D. 3–4 hours
Answer: B. 15–30 minutes
Rationale: Regular insulin (short-acting) begins to work in about 15–30 minutes.
6. A client taking lithium reports nausea and tremors. What is the nurse's
priority action?
A. Reassure the patient that this is expected.
B. Administer antiemetic.
C. Hold the dose and check lithium levels.
D. Encourage fluids and rest.
Answer: C. Hold the dose and check lithium levels.
,Rationale: Nausea and tremors may indicate lithium toxicity. The medication should be held and
serum levels checked.
7. Which of the following medications requires peak and trough monitoring?
A. Acetaminophen
B. Vancomycin
C. Amoxicillin
D. Loratadine
Answer: B. Vancomycin
Rationale: Vancomycin has a narrow therapeutic index, requiring peak and trough levels to
avoid toxicity.
8. A nurse is administering nitroglycerin for chest pain. Which instruction is
most appropriate?
A. Swallow the tablet with water.
B. Take one tablet every hour until relieved.
C. Place the tablet under the tongue and do not swallow.
D. Chew the tablet for faster absorption.
Answer: C. Place the tablet under the tongue and do not swallow.
Rationale: Sublingual nitroglycerin works quickly to relieve chest pain by direct absorption into
the bloodstream.
9. Which client finding indicates that the patient is experiencing a common side
effect of opioid therapy?
A. Hypertension
B. Diarrhea
C. Urinary retention
D. Hypoglycemia
Answer: C. Urinary retention
Rationale: Opioids commonly cause urinary retention due to decreased bladder tone.
, 10. The nurse is preparing to administer heparin subcutaneously. What is the
best site for administration?
A. Deltoid muscle
B. Dorsogluteal site
C. Abdomen at least 2 inches from the umbilicus
D. Vastus lateralis
Answer: C. Abdomen at least 2 inches from the umbilicus
Rationale: Subcutaneous heparin is typically given in the abdomen to reduce risk of hematoma
and improve absorption.
11. A client is prescribed prednisone. What should the nurse teach the client about stopping
this medication?
A. Stop immediately if symptoms resolve
B. Taper off gradually under medical supervision
C. Double the dose every other day
D. Take only when symptoms are severe
Answer: B. Taper off gradually under medical supervision
Rationale: Sudden withdrawal of corticosteroids can cause adrenal insufficiency. Tapering is
essential.
12. A patient is receiving gentamicin. What finding should be reported immediately?
A. Muscle weakness
B. Ringing in the ears
C. Increased appetite
D. Drowsiness
Answer: B. Ringing in the ears
Rationale: Tinnitus can indicate ototoxicity, a known adverse effect of aminoglycosides like
gentamicin.
13. A client receiving morphine IV reports nausea and itching. What is the nurse’s priority
action?
2025 (Nightingale BSN 315 course)
Questions With Complete Solutions
Course
HESI
1. The nurse is preparing to administer digoxin to a patient. Which lab value
must be reviewed before giving the medication?
A. Serum potassium
B. Serum calcium
C. Hemoglobin
D. Platelet count
Answer: A. Serum potassium
Rationale: Hypokalemia increases the risk of digoxin toxicity. It's critical to check potassium
levels before administering digoxin.
2. A client taking warfarin (Coumadin) has an INR of 4.5. What is the most
appropriate nursing intervention?
A. Administer the next dose as scheduled.
B. Hold the dose and notify the healthcare provider.
C. Increase the dosage.
D. Administer vitamin D.
Answer: B. Hold the dose and notify the healthcare provider.
Rationale: The therapeutic INR range is typically 2–3. An INR of 4.5 indicates increased
bleeding risk, so the dose should be held and the provider notified.
3. A client is prescribed furosemide (Lasix). What adverse effect should the nurse
monitor for?
A. Hyperkalemia
B. Hypocalcemia
C. Hypokalemia
D. Hypernatremia
,Answer: C. Hypokalemia
Rationale: Furosemide is a loop diuretic that causes potassium loss, so hypokalemia is a
common side effect.
4. The nurse is teaching a client prescribed tetracycline. Which instruction is
most important?
A. Take with milk to reduce stomach upset.
B. Avoid sunlight while taking this medication.
C. Take at bedtime to minimize nausea.
D. Use antacids if stomach upset occurs.
Answer: B. Avoid sunlight while taking this medication.
Rationale: Tetracycline can cause photosensitivity. Patients should avoid direct sunlight or use
sun protection.
5. A patient with type 1 diabetes is prescribed regular insulin. When should the
nurse expect the insulin to begin working?
A. 5–10 minutes
B. 15–30 minutes
C. 1–2 hours
D. 3–4 hours
Answer: B. 15–30 minutes
Rationale: Regular insulin (short-acting) begins to work in about 15–30 minutes.
6. A client taking lithium reports nausea and tremors. What is the nurse's
priority action?
A. Reassure the patient that this is expected.
B. Administer antiemetic.
C. Hold the dose and check lithium levels.
D. Encourage fluids and rest.
Answer: C. Hold the dose and check lithium levels.
,Rationale: Nausea and tremors may indicate lithium toxicity. The medication should be held and
serum levels checked.
7. Which of the following medications requires peak and trough monitoring?
A. Acetaminophen
B. Vancomycin
C. Amoxicillin
D. Loratadine
Answer: B. Vancomycin
Rationale: Vancomycin has a narrow therapeutic index, requiring peak and trough levels to
avoid toxicity.
8. A nurse is administering nitroglycerin for chest pain. Which instruction is
most appropriate?
A. Swallow the tablet with water.
B. Take one tablet every hour until relieved.
C. Place the tablet under the tongue and do not swallow.
D. Chew the tablet for faster absorption.
Answer: C. Place the tablet under the tongue and do not swallow.
Rationale: Sublingual nitroglycerin works quickly to relieve chest pain by direct absorption into
the bloodstream.
9. Which client finding indicates that the patient is experiencing a common side
effect of opioid therapy?
A. Hypertension
B. Diarrhea
C. Urinary retention
D. Hypoglycemia
Answer: C. Urinary retention
Rationale: Opioids commonly cause urinary retention due to decreased bladder tone.
, 10. The nurse is preparing to administer heparin subcutaneously. What is the
best site for administration?
A. Deltoid muscle
B. Dorsogluteal site
C. Abdomen at least 2 inches from the umbilicus
D. Vastus lateralis
Answer: C. Abdomen at least 2 inches from the umbilicus
Rationale: Subcutaneous heparin is typically given in the abdomen to reduce risk of hematoma
and improve absorption.
11. A client is prescribed prednisone. What should the nurse teach the client about stopping
this medication?
A. Stop immediately if symptoms resolve
B. Taper off gradually under medical supervision
C. Double the dose every other day
D. Take only when symptoms are severe
Answer: B. Taper off gradually under medical supervision
Rationale: Sudden withdrawal of corticosteroids can cause adrenal insufficiency. Tapering is
essential.
12. A patient is receiving gentamicin. What finding should be reported immediately?
A. Muscle weakness
B. Ringing in the ears
C. Increased appetite
D. Drowsiness
Answer: B. Ringing in the ears
Rationale: Tinnitus can indicate ototoxicity, a known adverse effect of aminoglycosides like
gentamicin.
13. A client receiving morphine IV reports nausea and itching. What is the nurse’s priority
action?
