HESI Pharmacology Exam 2025 – 100% Verified Q&A with
Clinical Rationales and Updated Review Content
80 Unique Questions with Answers and Rationales
Medication Classes
Question 1: A patient is prescribed lisinopril for hypertension. This medication belongs
to which class?
A. Beta-blockers
B. ACE inhibitors
C. Calcium channel blockers
D. Diuretics
Correct Answer: B. ACE inhibitors
Rationale: Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor that reduces
blood pressure by inhibiting angiotensin II formation, leading to vasodilation. It is not a
beta-blocker, calcium channel blocker, or diuretic.
Reference: Web:5
Question 2: A nurse is administering metformin to a patient with type 2 diabetes. This
drug is classified as:
A. Sulfonylurea
B. Biguanide
C. Thiazolidinedione
D. DPP-4 inhibitor
Correct Answer: B. Biguanide
Rationale: Metformin is a biguanide that decreases hepatic glucose production and im-
proves insulin sensitivity. Sulfonylureas stimulate insulin release, thiazolidinediones en-
hance insulin sensitivity differently, and DPP-4 inhibitors prevent glucagon release.
Reference: Web:8
Question 3: A patient with a seizure disorder is prescribed levetiracetam. This medica-
tion is:
A. A barbiturate
B. A benzodiazepine
C. An anticonvulsant
D. A tricyclic antidepressant
Correct Answer: C. An anticonvulsant
Rationale: Levetiracetam is an anticonvulsant used to control seizures by modulating
neurotransmitter release. It is not a barbiturate, benzodiazepine, or antidepressant.
Reference: Web:9
1
,Question 4: A patient receiving chemotherapy is prescribed ondansetron. This drug be-
longs to which class?
A. Antihistamine
B. Serotonin receptor antagonist
C. Dopamine antagonist
D. Corticosteroid
Correct Answer: B. Serotonin receptor antagonist
Rationale: Ondansetron is a 5-HT3 serotonin receptor antagonist used to prevent chemotherapy-
induced nausea and vomiting. It is not an antihistamine, dopamine antagonist, or corti-
costeroid.
Reference: Web:15
Question 5: A patient with atrial fibrillation is prescribed dabigatran. This medication
is:
A. A direct thrombin inhibitor
B. A vitamin K antagonist
C. An antiplatelet agent
D. A beta-blocker
Correct Answer: A. A direct thrombin inhibitor
Rationale: Dabigatran directly inhibits thrombin, preventing clot formation in atrial
fibrillation. It is not a vitamin K antagonist (like warfarin), antiplatelet agent, or beta-
blocker.
Reference: Web:17
Adverse Effects
Question 6: A patient on fluoxetine reports nausea and insomnia. The nurse recognizes
these as:
A. Expected side effects
B. Signs of serotonin syndrome
C. Allergic reactions
D. Overdose symptoms
Correct Answer: A. Expected side effects
Rationale: Fluoxetine, an SSRI, commonly causes nausea and insomnia as initial side
effects. Serotonin syndrome involves agitation, tremors, and hyperthermia, while allergic
reactions or overdose present differently.
Reference: Web:19
Question 7: A patient receiving gentamicin is monitored for:
A. Hepatotoxicity
B. Nephrotoxicity
C. Hyperglycemia
2
, D. Hypertension
Correct Answer: B. Nephrotoxicity
Rationale: Gentamicin, an aminoglycoside, is associated with nephrotoxicity and ototox-
icity, requiring renal function monitoring. Hepatotoxicity, hyperglycemia, and hyperten-
sion are not primary concerns.
Reference: Web:5
Question 8: A patient on prednisone reports weight gain and facial swelling. The nurse
identifies this as:
A. Cushingoid features
B. Anaphylaxis
C. Hypoglycemia
D. Bone marrow suppression
Correct Answer: A. Cushingoid features
Rationale: Long-term prednisone use causes Cushingoid features like weight gain, moon
face, and fat redistribution. Anaphylaxis, hypoglycemia, and bone marrow suppression
are not typical.
Reference: Web:9
Question 9: A patient on levothyroxine reports palpitations and sweating. This suggests:
A. Hypothyroidism
B. Hyperthyroidism
C. Hypokalemia
D. Hyperglycemia
Correct Answer: B. Hyperthyroidism
Rationale: Excessive levothyroxine can cause hyperthyroidism symptoms, including pal-
pitations and sweating, due to increased metabolic rate. Hypothyroidism presents oppo-
sitely, and hypokalemia or hyperglycemia are unrelated.
Reference: Web:8
Question 10: A patient on warfarin develops dark stools. The nurse suspects:
A. Gastrointestinal bleeding
B. Hematuria
C. Vitamin K toxicity
D. Thrombocytopenia
Correct Answer: A. Gastrointestinal bleeding
Rationale: Warfarin, an anticoagulant, increases bleeding risk, and dark stools sug-
gest gastrointestinal bleeding. Hematuria presents differently, and vitamin K toxicity
or thrombocytopenia are not directly related.
Reference: Web:17
3
Clinical Rationales and Updated Review Content
80 Unique Questions with Answers and Rationales
Medication Classes
Question 1: A patient is prescribed lisinopril for hypertension. This medication belongs
to which class?
A. Beta-blockers
B. ACE inhibitors
C. Calcium channel blockers
D. Diuretics
Correct Answer: B. ACE inhibitors
Rationale: Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor that reduces
blood pressure by inhibiting angiotensin II formation, leading to vasodilation. It is not a
beta-blocker, calcium channel blocker, or diuretic.
Reference: Web:5
Question 2: A nurse is administering metformin to a patient with type 2 diabetes. This
drug is classified as:
A. Sulfonylurea
B. Biguanide
C. Thiazolidinedione
D. DPP-4 inhibitor
Correct Answer: B. Biguanide
Rationale: Metformin is a biguanide that decreases hepatic glucose production and im-
proves insulin sensitivity. Sulfonylureas stimulate insulin release, thiazolidinediones en-
hance insulin sensitivity differently, and DPP-4 inhibitors prevent glucagon release.
Reference: Web:8
Question 3: A patient with a seizure disorder is prescribed levetiracetam. This medica-
tion is:
A. A barbiturate
B. A benzodiazepine
C. An anticonvulsant
D. A tricyclic antidepressant
Correct Answer: C. An anticonvulsant
Rationale: Levetiracetam is an anticonvulsant used to control seizures by modulating
neurotransmitter release. It is not a barbiturate, benzodiazepine, or antidepressant.
Reference: Web:9
1
,Question 4: A patient receiving chemotherapy is prescribed ondansetron. This drug be-
longs to which class?
A. Antihistamine
B. Serotonin receptor antagonist
C. Dopamine antagonist
D. Corticosteroid
Correct Answer: B. Serotonin receptor antagonist
Rationale: Ondansetron is a 5-HT3 serotonin receptor antagonist used to prevent chemotherapy-
induced nausea and vomiting. It is not an antihistamine, dopamine antagonist, or corti-
costeroid.
Reference: Web:15
Question 5: A patient with atrial fibrillation is prescribed dabigatran. This medication
is:
A. A direct thrombin inhibitor
B. A vitamin K antagonist
C. An antiplatelet agent
D. A beta-blocker
Correct Answer: A. A direct thrombin inhibitor
Rationale: Dabigatran directly inhibits thrombin, preventing clot formation in atrial
fibrillation. It is not a vitamin K antagonist (like warfarin), antiplatelet agent, or beta-
blocker.
Reference: Web:17
Adverse Effects
Question 6: A patient on fluoxetine reports nausea and insomnia. The nurse recognizes
these as:
A. Expected side effects
B. Signs of serotonin syndrome
C. Allergic reactions
D. Overdose symptoms
Correct Answer: A. Expected side effects
Rationale: Fluoxetine, an SSRI, commonly causes nausea and insomnia as initial side
effects. Serotonin syndrome involves agitation, tremors, and hyperthermia, while allergic
reactions or overdose present differently.
Reference: Web:19
Question 7: A patient receiving gentamicin is monitored for:
A. Hepatotoxicity
B. Nephrotoxicity
C. Hyperglycemia
2
, D. Hypertension
Correct Answer: B. Nephrotoxicity
Rationale: Gentamicin, an aminoglycoside, is associated with nephrotoxicity and ototox-
icity, requiring renal function monitoring. Hepatotoxicity, hyperglycemia, and hyperten-
sion are not primary concerns.
Reference: Web:5
Question 8: A patient on prednisone reports weight gain and facial swelling. The nurse
identifies this as:
A. Cushingoid features
B. Anaphylaxis
C. Hypoglycemia
D. Bone marrow suppression
Correct Answer: A. Cushingoid features
Rationale: Long-term prednisone use causes Cushingoid features like weight gain, moon
face, and fat redistribution. Anaphylaxis, hypoglycemia, and bone marrow suppression
are not typical.
Reference: Web:9
Question 9: A patient on levothyroxine reports palpitations and sweating. This suggests:
A. Hypothyroidism
B. Hyperthyroidism
C. Hypokalemia
D. Hyperglycemia
Correct Answer: B. Hyperthyroidism
Rationale: Excessive levothyroxine can cause hyperthyroidism symptoms, including pal-
pitations and sweating, due to increased metabolic rate. Hypothyroidism presents oppo-
sitely, and hypokalemia or hyperglycemia are unrelated.
Reference: Web:8
Question 10: A patient on warfarin develops dark stools. The nurse suspects:
A. Gastrointestinal bleeding
B. Hematuria
C. Vitamin K toxicity
D. Thrombocytopenia
Correct Answer: A. Gastrointestinal bleeding
Rationale: Warfarin, an anticoagulant, increases bleeding risk, and dark stools sug-
gest gastrointestinal bleeding. Hematuria presents differently, and vitamin K toxicity
or thrombocytopenia are not directly related.
Reference: Web:17
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