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HESI Pharmacology Test Bank 2025/2026 – 180 NCLEX-
Style Questions with Answers & Rationales (Drug Classes &
Side Effects)
1. A nurse is administering furosemide (Lasix). Which electrolyte imbalance is most concerning?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
Answer: B. Hypokalemia
Rationale: Loop diuretics like furosemide cause potassium loss, increasing the risk for
dysrhythmias.
2. A client taking warfarin is taught to avoid foods high in vitamin K. Which food should the
nurse instruct the client to limit?
A. Bananas
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B. Spinach
C. Apples
D. Rice
Answer: B. Spinach
Rationale: Vitamin K decreases the effectiveness of warfarin by promoting clotting factor
synthesis.
3. A nurse is administering morphine IV. Which side effect is most critical to monitor?
A. Constipation
B. Respiratory depression
C. Sedation
D. Nausea
Answer: B. Respiratory depression
Rationale: Opioid analgesics can cause respiratory depression, the most life-threatening adverse
effect.
4. A client taking gentamicin develops tinnitus and hearing loss. Which complication is
suspected?
A. Nephrotoxicity
B. Ototoxicity
C. Hepatotoxicity
D. Neurotoxicity
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Answer: B. Ototoxicity
Rationale: Aminoglycosides (gentamicin) can damage the inner ear, leading to permanent
hearing loss.
5. Which statement indicates correct use of sublingual nitroglycerin?
A. “I can swallow the tablet with water.”
B. “I should expect a headache after taking it.”
C. “I can take up to 5 tablets in 30 minutes.”
D. “I should store tablets in a weekly pill organizer.”
Answer: B. I should expect a headache after taking it.
Rationale: Headaches are a common side effect due to vasodilation. Max dose is 3 tablets within
15 minutes.
6. A client with asthma is prescribed montelukast. The nurse should teach the client:
A. “Use this medication to stop sudden attacks.”
B. “Take this medication once daily in the evening.”
C. “Shake the inhaler well before each dose.”
D. “Take this only when symptoms appear.”
Answer: B. Take this medication once daily in the evening.
Rationale: Montelukast is a leukotriene receptor antagonist used for long-term prevention, not
acute attacks.
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7. Which medication requires monitoring for lithium toxicity?
A. Hydrochlorothiazide
B. Acetaminophen
C. Ferrous sulfate
D. Furosemide
Answer: A. Hydrochlorothiazide
Rationale: Thiazide diuretics can cause sodium loss, increasing lithium reabsorption and
toxicity.
8. A client with tuberculosis is prescribed rifampin. Which teaching is essential?
A. “Your urine and tears may turn orange.”
B. “Avoid dairy products with this drug.”
C. “Take this medication with antacids.”
D. “Limit fluids to prevent renal damage.”
Answer: A. Your urine and tears may turn orange.
Rationale: Rifampin causes harmless orange discoloration of body fluids.
9. Which adverse effect is associated with ACE inhibitors (e.g., lisinopril)?
A. Bradycardia
B. Dry cough
HESI Pharmacology Test Bank 2025/2026 – 180 NCLEX-
Style Questions with Answers & Rationales (Drug Classes &
Side Effects)
1. A nurse is administering furosemide (Lasix). Which electrolyte imbalance is most concerning?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
Answer: B. Hypokalemia
Rationale: Loop diuretics like furosemide cause potassium loss, increasing the risk for
dysrhythmias.
2. A client taking warfarin is taught to avoid foods high in vitamin K. Which food should the
nurse instruct the client to limit?
A. Bananas
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B. Spinach
C. Apples
D. Rice
Answer: B. Spinach
Rationale: Vitamin K decreases the effectiveness of warfarin by promoting clotting factor
synthesis.
3. A nurse is administering morphine IV. Which side effect is most critical to monitor?
A. Constipation
B. Respiratory depression
C. Sedation
D. Nausea
Answer: B. Respiratory depression
Rationale: Opioid analgesics can cause respiratory depression, the most life-threatening adverse
effect.
4. A client taking gentamicin develops tinnitus and hearing loss. Which complication is
suspected?
A. Nephrotoxicity
B. Ototoxicity
C. Hepatotoxicity
D. Neurotoxicity
,3 | Page
Answer: B. Ototoxicity
Rationale: Aminoglycosides (gentamicin) can damage the inner ear, leading to permanent
hearing loss.
5. Which statement indicates correct use of sublingual nitroglycerin?
A. “I can swallow the tablet with water.”
B. “I should expect a headache after taking it.”
C. “I can take up to 5 tablets in 30 minutes.”
D. “I should store tablets in a weekly pill organizer.”
Answer: B. I should expect a headache after taking it.
Rationale: Headaches are a common side effect due to vasodilation. Max dose is 3 tablets within
15 minutes.
6. A client with asthma is prescribed montelukast. The nurse should teach the client:
A. “Use this medication to stop sudden attacks.”
B. “Take this medication once daily in the evening.”
C. “Shake the inhaler well before each dose.”
D. “Take this only when symptoms appear.”
Answer: B. Take this medication once daily in the evening.
Rationale: Montelukast is a leukotriene receptor antagonist used for long-term prevention, not
acute attacks.
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7. Which medication requires monitoring for lithium toxicity?
A. Hydrochlorothiazide
B. Acetaminophen
C. Ferrous sulfate
D. Furosemide
Answer: A. Hydrochlorothiazide
Rationale: Thiazide diuretics can cause sodium loss, increasing lithium reabsorption and
toxicity.
8. A client with tuberculosis is prescribed rifampin. Which teaching is essential?
A. “Your urine and tears may turn orange.”
B. “Avoid dairy products with this drug.”
C. “Take this medication with antacids.”
D. “Limit fluids to prevent renal damage.”
Answer: A. Your urine and tears may turn orange.
Rationale: Rifampin causes harmless orange discoloration of body fluids.
9. Which adverse effect is associated with ACE inhibitors (e.g., lisinopril)?
A. Bradycardia
B. Dry cough
