1
HESI Fundamentals & Pharmacology 2025 | 300
Verified Questions + A+ Rationales | NCLEX & Nursing
School Exam Prep
1. A nurse prepares to administer digoxin 0.25 mg to a client with heart failure. The apical pulse
is 52 bpm. What is the nurse’s priority action?
A. Administer the medication
B. Notify the provider
C. Recheck the heart rate in 1 hour
D. Document the finding and continue care
Answer: B. Notify the provider
Rationale: Digoxin slows AV conduction and can cause bradycardia. If the apical heart rate is
below 60 bpm, the dose is withheld and the provider is notified to prevent digoxin toxicity
and cardiac compromise.
, 2
2. A nurse teaches a client prescribed warfarin about dietary restrictions. Which food selection
indicates correct understanding?
A. Spinach and broccoli daily
B. Cranberry juice every morning
C. Chicken with rice and green beans
D. Kale salad with multivitamins
Answer: C. Chicken with rice and green beans
Rationale: Warfarin interacts with vitamin K-rich foods like spinach, broccoli, and kale,
which can reduce its anticoagulant effect. Consistent, moderate vitamin K intake is
important to maintain therapeutic INR.
3. A nurse is caring for a client with COPD receiving 2 L/min nasal cannula oxygen. The
client becomes confused and drowsy. Which is the priority nursing action?
A. Increase oxygen to 6 L/min
B. Obtain ABG results
C. Notify the respiratory therapist
D. Turn the client to a prone position
Answer: B. Obtain ABG results
Rationale: COPD clients rely on hypoxic drive for breathing. Increasing oxygen too high
may lead to CO2 retention and hypercapnia, causing confusion and somnolence. ABGs
confirm CO2 retention and guide oxygen adjustment.
, 3
4. A client with hypertension is prescribed lisinopril. Which lab finding requires immediate
intervention?
A. Sodium 140 mEq/L
B. Potassium 6.0 mEq/L
C. Hemoglobin 13 g/dL
D. BUN 15 mg/dL
Answer: B. Potassium 6.0 mEq/L
Rationale: ACE inhibitors like lisinopril can cause hyperkalemia due to aldosterone
suppression. Potassium >5.5 mEq/L increases risk of cardiac dysrhythmias, requiring urgent
evaluation and treatment.
5. A nurse prepares to insert a urinary catheter in a female client. Which action maintains
sterile technique?
A. Place the catheter kit on the bed
B. Clean the perineal area from back to front
C. Open the sterile catheter kit at the bedside table
D. Wear clean gloves for the entire procedure
Answer: C. Open the sterile catheter kit at the bedside table
, 4
Rationale: Sterile technique requires using a clean surface to maintain the sterility of
equipment. Perineal cleaning must be front to back, and sterile gloves are used for catheter
insertion.
6. A postoperative client has an NG tube to low suction. Which lab result is the priority to
monitor?
A. Sodium
B. Potassium
C. Hemoglobin
D. Glucose
Answer: B. Potassium
Rationale: NG suction removes gastric contents rich in potassium, leading to hypokalemia,
which can cause cardiac arrhythmias and muscle weakness. Electrolyte monitoring is
critical.
7. A client with type 2 diabetes reports blurred vision, fatigue, and frequent urination. Which
lab value would the nurse expect to find?
A. Blood glucose 65 mg/dL
B. Blood glucose 250 mg/dL
C. HbA1c 5.5%
D. Sodium 135 mEq/L
HESI Fundamentals & Pharmacology 2025 | 300
Verified Questions + A+ Rationales | NCLEX & Nursing
School Exam Prep
1. A nurse prepares to administer digoxin 0.25 mg to a client with heart failure. The apical pulse
is 52 bpm. What is the nurse’s priority action?
A. Administer the medication
B. Notify the provider
C. Recheck the heart rate in 1 hour
D. Document the finding and continue care
Answer: B. Notify the provider
Rationale: Digoxin slows AV conduction and can cause bradycardia. If the apical heart rate is
below 60 bpm, the dose is withheld and the provider is notified to prevent digoxin toxicity
and cardiac compromise.
, 2
2. A nurse teaches a client prescribed warfarin about dietary restrictions. Which food selection
indicates correct understanding?
A. Spinach and broccoli daily
B. Cranberry juice every morning
C. Chicken with rice and green beans
D. Kale salad with multivitamins
Answer: C. Chicken with rice and green beans
Rationale: Warfarin interacts with vitamin K-rich foods like spinach, broccoli, and kale,
which can reduce its anticoagulant effect. Consistent, moderate vitamin K intake is
important to maintain therapeutic INR.
3. A nurse is caring for a client with COPD receiving 2 L/min nasal cannula oxygen. The
client becomes confused and drowsy. Which is the priority nursing action?
A. Increase oxygen to 6 L/min
B. Obtain ABG results
C. Notify the respiratory therapist
D. Turn the client to a prone position
Answer: B. Obtain ABG results
Rationale: COPD clients rely on hypoxic drive for breathing. Increasing oxygen too high
may lead to CO2 retention and hypercapnia, causing confusion and somnolence. ABGs
confirm CO2 retention and guide oxygen adjustment.
, 3
4. A client with hypertension is prescribed lisinopril. Which lab finding requires immediate
intervention?
A. Sodium 140 mEq/L
B. Potassium 6.0 mEq/L
C. Hemoglobin 13 g/dL
D. BUN 15 mg/dL
Answer: B. Potassium 6.0 mEq/L
Rationale: ACE inhibitors like lisinopril can cause hyperkalemia due to aldosterone
suppression. Potassium >5.5 mEq/L increases risk of cardiac dysrhythmias, requiring urgent
evaluation and treatment.
5. A nurse prepares to insert a urinary catheter in a female client. Which action maintains
sterile technique?
A. Place the catheter kit on the bed
B. Clean the perineal area from back to front
C. Open the sterile catheter kit at the bedside table
D. Wear clean gloves for the entire procedure
Answer: C. Open the sterile catheter kit at the bedside table
, 4
Rationale: Sterile technique requires using a clean surface to maintain the sterility of
equipment. Perineal cleaning must be front to back, and sterile gloves are used for catheter
insertion.
6. A postoperative client has an NG tube to low suction. Which lab result is the priority to
monitor?
A. Sodium
B. Potassium
C. Hemoglobin
D. Glucose
Answer: B. Potassium
Rationale: NG suction removes gastric contents rich in potassium, leading to hypokalemia,
which can cause cardiac arrhythmias and muscle weakness. Electrolyte monitoring is
critical.
7. A client with type 2 diabetes reports blurred vision, fatigue, and frequent urination. Which
lab value would the nurse expect to find?
A. Blood glucose 65 mg/dL
B. Blood glucose 250 mg/dL
C. HbA1c 5.5%
D. Sodium 135 mEq/L
