Pharmacology HESI Exam Test Bank 2025/2026
Part 1: Questions 1–40
- A client with hypertension is prescribed lisinopril (Prinivil). Which adverse effect
should the nurse monitor for?A.Hypoglycemia B.Persistent dry cough C.Hypernatremia D.Increased heart rate
Answer:B
Rationale:Lisinopril, an ACE inhibitor, commonly causes a persistent dry cough due to increased bradykinin levels. Hypoglycemia is not associated with ACE inhibitors, as they do not affect blood glucose. Hypernatremia is unlikely; lisinopril may cause hyperkalemia. Increased heart rate is not typical, as ACE inhibitors may lower heart rate indirectly by reducing blood pressure.
- A client receiving vancomycin IV for MRSA needs monitoring for which adverse effect?
A.Ototoxicity B.Hypoglycemia C.Hypertension D.Hypernatremia
Answer:A
Rationale:Vancomycin, an antibiotic, can cause ototoxicity and nephrotoxicity, re- quiring monitoring for hearing loss or tinnitus. Hypoglycemia, hypertension, and hy- pernatremia are not associated with vancomycin.
- A client with type 2 diabetes is prescribed insulin glargine (Lantus). What is the best
patient teaching point?A.Administer at bedtime B.Mix with short-acting insulin C.Expect peak effects in 2–4 hours D.Inject in the arms only
Answer:A
Rationale:Insulin glargine, a long-acting insulin, is typically administered at bedtime for steady glucose control. It should not be mixed with other insulins, has no significant peak, and injection sites should rotate across the abdomen, thighs, and arms.
- A client on warfarin (Coumadin) for atrial fibrillation requires which laboratory mon-
itoring?A.Platelet count B.INR C.Serum creatinine D.Blood urea nitrogen
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Answer:B
Rationale:Warfarin’s anticoagulant effect is monitored using INR (therapeutic range 2–3 for atrial fibrillation). Platelet count is relevant for antiplatelet drugs, not warfarin.Creatinine and BUN assess renal function, not warfarin’s effects.
- A client receiving morphine sulfate reports constipation. What is the nurse’s priority
action?A.Administer a laxative as prescribed B.Decrease the morphine dose C.Encourage a low-fiber diet D.Monitor bowel sounds
Answer:A
Rationale:Morphine, an opioid, causes constipation. Administering a prescribed
laxative (e.g., docusate) is the priority. Decreasing the dose may compromise pain control, a low-fiber diet worsens constipation, and monitoring is secondary.
- A client with heart failure is prescribed furosemide (Lasix). Which electrolyte imbal-
ance is most likely?A.Hyperkalemia B.Hypokalemia C.Hypernatremia D.Hypermagnesemia
Answer:B
Rationale:Furosemide, a loop diuretic, increases potassium excretion, risking hy- pokalemia. Hyperkalemia, hypernatremia, and hypermagnesemia are less likely.
- A client with asthma is prescribed albuterol (Proventil). What is its mechanism of
action?A.Reduces airway inflammation B.Relaxes bronchial smooth muscles C.Decreases mucus production D.Inhibits histamine release
Answer:B
Rationale:Albuterol, a beta-2 agonist, relaxes bronchial smooth muscles for bron- chodilation. It does not primarily reduce inflammation (corticosteroids), decrease mu- cus, or inhibit histamine.
- A client with epilepsy is prescribed phenytoin (Dilantin). Which adverse effect should
the client report?A.Increased appetite B.Gingival hyperplasia C.Mild nausea D.Weight gain
Answer:B
Rationale:Phenytoin commonly causes gingival hyperplasia, requiring dental follow- up. Increased appetite, mild nausea, and weight gain are not typical.
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- A client on heparin has a PTT of 120 seconds. What is the nurse’s priority action?
A.Continue the infusion B.Stop the infusion and notify the provider C.Administer protamine sulfate D.Monitor for bleeding
Answer:B
Rationale:A PTT of 120 seconds is elevated (therapeutic range 60–80 seconds),
indicating bleeding risk. Stopping the infusion and notifying the provider is the priority.Protamine sulfate requires orders, and monitoring is secondary.
- A client with GERD is prescribed omeprazole (Prilosec). What is the priority teaching
point?A.Take 30–60 minutes before meals B.Avoid antacids C.Expect immediate relief D.Take at bedtime only
Answer:A
Rationale:Omeprazole, a PPI, is most effective taken 30–60 minutes before meals.It can be taken with antacids, does not provide immediate relief, and is not restricted to bedtime.
- A client is ordered 500 mg of amoxicillin every 8 hours. The pharmacy provides 250
mg capsules. How many capsules per dose?A.1 capsule B.2 capsules C.3 capsules D.4 capsules
Answer:B
Rationale:500 mg ÷ 250 mg/capsule = 2 capsules. One capsule provides 250 mg,
three capsules provide 750 mg, and four capsules provide 1000 mg, which are incorrect.
- A client with depression is prescribed fluoxetine (Prozac). What should the nurse
monitor initially?A.Increased suicidal ideation B.Hypotension C.Hyperglycemia D.Weight loss
Answer:A
Rationale:SSRIs like fluoxetine may increase suicidal ideation initially, requiring close monitoring. Hypotension, hyperglycemia, and weight loss are not primary con- cerns.
- A client with type 2 diabetes is prescribed metformin. Which condition is a contraindi-
cation?A.Hypertension B.Renal impairment
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C.Hyperlipidemia D.Asthma
Answer:B
Rationale:Metformin is contraindicated in renal impairment due to lactic acidosis risk. Hypertension, hyperlipidemia, and asthma are not contraindications.
- A client with a pulmonary embolism is prescribed enoxaparin (Lovenox). What is the
priority action?A.Monitor for bleeding B.Inject in the deltoid C.Check blood glucose D.Encourage ambulation
Answer:A
Rationale:Enoxaparin, a low-molecular-weight heparin, increases bleeding risk. Mon- itoring for bleeding (e.g., bruising, hematuria) is critical. Injections are given in the abdomen, not deltoid. Glucose and ambulation are not priorities.
- A client with bipolar disorder is prescribed lithium. Which laboratory value is critical?
A.Serum sodium B.Serum lithium levels C.Blood urea nitrogen D.Blood glucose
Answer:B
Rationale:Lithium has a narrow therapeutic range (0.6–1.2 mEq/L), requiring serum level monitoring to prevent toxicity. Sodium affects lithium excretion but is secondary.
- A client with rheumatoid arthritis is prescribed prednisone. What is the priority teach-
ing point?A.Taper the dose to avoid adrenal insufficiency B.Take on an empty stomach C.Avoid calcium-rich foods D.Expect weight loss
Answer:A
Rationale:Prednisone suppresses adrenal function, and abrupt discontinuation risks adrenal insufficiency. It should be taken with food, calcium-rich foods prevent osteo- porosis, and weight gain is common.
- A client is ordered 2 g of cefazolin IV every 6 hours. The vial contains 1 g reconstituted
with 10 mL sterile water (100 mg/mL). How many mL per dose?A.10 mL B.15 mL C.20 mL D.25 mL
Answer:C
Rationale:2 g = 2000 mg. At 100 mg/mL, 2000 mg ÷ 100 mg/mL = 20 mL. 10 mL
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