HESI Pharmacology Exam Practice
Questions and Answers Already Passed
1) A nurse is caring for a client with hyperparathyroidism and notes that the client’s serum
calcium level is 13 mg/dL. Which medication should the nurse prepare to administer as
prescribed to the client?
- Calcium chloride
- Calcium gluconate
- Calcitonin (Miacalcin)
- Large doses of vitamin D ✔✔3. Calcitonin (Miacalcin)
Rationale:
The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is experiencing hypercalcemia.
Calcium gluconate and calcium chloride are medications used for the treatment of tetany, which
occurs as a result of acute hypocalcemia. In hypercalcemia, large doses of vitamin D need to be
avoided. Calcitonin, a thyroid hormone, decreases the plasma calcium level by inhibiting bone
resorption and lowering the serum calcium concentration.
2.) Oral iron supplements are prescribed for a 6-year-old child with iron deficiency anemia. The
nurse instructs the mother to administer the iron with which best food item? - Milk
- Water
- Apple juice
- Orange juice ✔✔4. Orange juice
Rationale:
Vitamin C increases the absorption of iron by the body. The mother should be instructed to
administer the medication with a citrus fruit or a juice that is high in vitamin C. Milk may affect
absorption of the iron. Water will not assist in absorption. Orange juice contains a greater
amount of vitamin C than apple juice.
3.) Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse monitors the
client, knowing that which of the following would indicate the presence of systemic toxicity
from this medication? - Tinnitus
- Diarrhea
- Constipation
- Decreased respirations ✔✔1. Tinnitus
Rationale:
Salicylic acid is absorbed readily through the skin, and systemic toxicity (salicylism) can result.
Symptoms include tinnitus, dizziness, hyperpnea, and psychological disturbances. Constipation
and diarrhea are not associated with salicylism.
4.) The camp nurse asks the children preparing to swim in the lake if they have applied
sunscreen. The nurse reminds the children that chemical sunscreens are most effective when
applied:
- Immediately before swimming
- 15 minutes before exposure to the sun
- Immediately before exposure to the sun
- At least 30 minutes before exposure to the sun ✔✔4. At least 30 minutes before exposure to
the sun
Rationale:
Sunscreens are most effective when applied at least 30 minutes before exposure to the sun so that
they can penetrate the skin. All sunscreens should be reapplied after swimming or sweating.
5.) Mafenide acetate (Sulfamylon) is prescribed for the client with a burn injury. When applying
the medication, the client complains of local discomfort and burning. Which of the following is
the most appropriate nursing action? - Notifying the registered nurse
- Discontinuing the medication
- Informing the client that this is normal
- Applying a thinner film than prescribed to the burn site ✔✔3. Informing the client that this is
normal
Rationale:
Mafenide acetate is bacteriostatic for gram-negative and gram-positive organisms and is used to
treat burns to reduce bacteria present in avascular tissues. The client should be informed that the
medication will cause local discomfort and burning and that this is a normal reaction; therefore
options 1, 2, and 4 are incorrect
6.) The burn client is receiving treatments of topical mafenide acetate (Sulfamylon) to the site of
injury. The nurse monitors the client, knowing that which of the following indicates that a
systemic effect has occurred?
1.Hyperventilation
2.Elevated blood pressure
3.Local pain at the burn site
4.Local rash at the burn site ✔✔1.Hyperventilation
Rationale:
Mafenide acetate is a carbonic anhydrase inhibitor and can suppress renal excretion of acid,
thereby causing acidosis. Clients receiving this treatment should be monitored for signs of an
acid-base imbalance (hyperventilation). If this occurs, the medication should be discontinued for
HESI Pharmacology Practice Exam
Already Graded A
Following the administration of sublingual nitroglycerin to a client experiencing an acute anginal
attack, which assessment finding indicates to the nurse that the desired effect has been achieved?
A. Client states chest pain is relieved
B. Client’s pulse decreases from 120 to 90
C. Client’s systolic blood pressure decreases from 180 to 90
D. Clients SaO2 level increases from 92% to 96% ✔✔A. nitroglycerin reduces mycocardial
oxygen consumption which decreases ischemia and reduces chest pain
A client with hyperlipidemia recieves a prescription for niacin (niaspan). which client teaching is
most important for the nurse to provide
a. expected duration of flushing
b. symptoms of hyperglycemia
c. diets that minimize gi irritation
d. comfort measure for pruritis ✔✔A. flushing of the face and neck, lasting up to an hour, is a
frequent reason for discontinuing niacin. inclusion of this effect in clietn teaching may promote
compliance in taking the med.
When assessing an adolescent who recently overdosed on acetaminophen (tylonel), it is most
important for the nurse to assess for pain in which area of the body
a. flank
b. abdomen
c. chest
d. head ✔✔B. acetaminophen toxicisty an result in liver damage; therefore, it is especially
important for the nurse to assess for pain in the right upper quadrant of the abdomen (which
might indicated liver damage)
A client is admitted to the coronary care unit with a medical diagnosis of acute myocardial
infarction. which medication prescription decreases both preload and afterload
a. nitroglycerin
b. propranolol
c. propranolol
d. captopril ✔✔A. nitroglycerin is a nitrate that causes peripheral vasodilation and decreases
contractility, thereby decreasing both preload and afterload
A client is being treated for hyperthyroidism with propylthiouracil (PTU). The nurse knows that
the action of this drug is to
A. decrease the amount of the thyroid-stimulating hormone circulating in the blood
B. increase the amount of thyroid-stimulating hormone circulating in the blood
C. increase the amount of T4 and decrease the amount of T3 produced by the thyroid
D. inhibit synthesis of T3 and T4 by the thyroid gland ✔✔D. PTU is an adjunct therapy used to
control hyperthyroidism by inhibiting production of thyroid hormones. It is often prescribed in
prep for thyroidectomy or radioactive iodine therapy
Which change in data indicates to the nurse the desired effect of the angiotensin II receptor
antagonist has been achieved
A. Dependent edema reduced form +3 to +1
B. Serum HDL increased from 35 to 55mg/dl
C. PUlse rate reduced from 150 to 90 beats/min
D. Blood pressure reducedf rom 160/90 to 130.80 ✔✔D. angiotensin II receptor antagonist
(blocker), prescribed from treatment of HTN. The desired effect is a decrease in blood pressure.
Which instructions should the nurse give to a female client who just recieved a prescription for
oral metronidazole (flagyl) for treatment of trichomonas vaginalis (select all that apply)
A. increase fluid intake, especially cranberry juice
B. Do not abruptly discontinue the medication; taper use
C. Check blood pressure daily to detect hypertension
D. Avoid drinking alcohol while taking this medication
E. Use condoms until treatment is completed
F. Ensure that all sexual partners are treated at the same time ✔✔ADEF
The nurse is transcribing a new prescription for spironolactone (aldactone) for a client who
receives an angiotensin-converting enzyme inhibitor. Which action should the nurse implement
A. verify both prescriptions with the HCP
B. report the med interactions to the nurse manager
C. hold the ACE inhibitor and give the new prescription
D. Transcribe and send the prescription to the pharmacy ✔✔A. the concomitant use of an ACE
inhibitor and a potassium-sparing diuretic sucha s spironolactone, should be given with caution
b/c the two drugs may interact to cause an elevation in serum potassium levels.
A client has myxedema, which results from a deficiency of thyroid hormone synthesis in adults.
The nurse knows that which medication should be contraindicated for this client?
A. liothyronine (cytomel) to replace iodine
B. Furosemide (Lasix) for relief of fluid retention
C. Pentobarbital sodium for sleep
Hesi Pharmacology (ACTUAL)
Questions and Answers with Complete
Solutions
Before administering a laxative to a bedfast client, it is most important for the nurse to perform
what assessment?
a-Observe the skin integrity of the client’s rectal and sacral areas
b-assess the client strength in moving and turning in the bed
c-evaluate the client’s ability to recognize the urge to defecate
d-determine the frequency and consistency of bowel movements ✔✔D
rationale
the nurse should ensure that the client is not experiencing diarrhea (answer choice D) before
administering a laxative, which will increase the frequency of bowel movements. answer choices
A,B,C R4 and assessments for the provision of care when the client experience is a valve, but are
of less priority then answer choice D which provides data about the possible need to hold
medication
A female client with multiple sclerosis reports having less fatigue and improved memory since
she began using the herbal supplement, ginkgo biloba. Which information is most important for
the nurse to include in the teaching plans for this client?
HESI Pharmacology 2021 Questions and
Answers Already Passed
A client with giardiasis is taking metronidazole (Flagyl) 2 grams PO. Which information should
the nurse include in the client’s instruction? ✔✔Take the medication with food.
A client is receiving metoprolol (Lopressor SR). What assessment is most important for the
nurse to obtain? ✔✔Blood pressure.
A client with a dysrhythmia is to receive procainamide (Pronestyl) in 4 divided doses over the
next 24 hours. What dosing schedule is best for the nurse to implement? ✔✔q6h.
Which instruction(s) should the nurse give to a female client who just received a prescription for
oral metronidazole (Flagyl) for treatment of trichomonas vaginalis? (Select all that apply.)
✔✔Increase fluid intake, especially cranberry juice.
Avoid drinking alcohol while taking this medication.
Use condoms until treatment is completed. Ensure that all sexual partners are treated at the same
time.
An adult client is given a prescription for a scopolamine patch (Transderm Scop) to prevent
motion sickness while on a cruise. Which information should the nurse provide to the client?
✔✔Apply the patch at least 4 hours prior to departure.
Which client should the nurse identify as being at highest risk for complications during the use of
an opioid analgesic? ✔✔A young adult with inflammatory bowel disease.
A client who has been prescribed atorvastatin (Lipitor) one month ago calls the triage nurse at
the clinic complaining of muscle pain and weakness in his legs. Which statement reflects the
correct drug-specific teaching the nurse should provide to this client? ✔✔Make an appointment
to see the healthcare provider because muscle pain may be an indication of a serious side effect
A client is being treated for hyperthyroidism with propylthiouracil (PTU). The nurse knows that
the action of this drug is to ✔✔inhibit synthesis of T3 and T4 by the thyroid gland.
Which change in data indicates to the nurse that the desired effect of the angiotensin II receptor
antagonist valsartan (Diovan) has been achieved? ✔✔Blood pressure reduced from 160/90 to
130/80.
HESI Pharmacology Practice Test
Questions and Answers Graded A
The nurse reviews the new prescription, phenelzine (Nardil), a monoamine oxidase inhibitor
(MAOI), for a client with depression on the psychiatric unit. Which information is most
important for the nurse to assess?
A. Consumption of any alcohol or tyramine rich foods
B. Reports of nausea or vomiting
C. Therapeutic serum drug levels
D. Blood pressure and pulse prior to taking each dose ✔✔A
The nurse is administering haloperidol 0.5 mg IM PRN to a client for the first time. What side
effects should the nurse assess thr client during the initial dose?
A. Bradykinesia
B. Dystonia
C. Somatization
D. Akathisia ✔✔B
While reviewing the client’s electronic medical record (EMR), the nurse assesses a client who is
at risk for a possible interaction with an over-the-counter (OTC) decongestant. Which client
health history should the nurse report to the health care provider concerning the OTC
medication? (Select all that apply)
A. Type 1 diabetes mellitus (DM)
B. Closed angle glaucome
C. Chronic hypertension
D. Rheumatoid arthritis
E. Crohn’s disease ✔✔B,C
A client prescribed ipratropium reports nausea, blurred vision, headaches, and insomnia after
using the inhaler. Which action should the nurse implement first?
A. Withhold the medication and report symptoms and vital signs to the healthcare provider
B. Give PRN medication for nausea and vomiting and evaluate client in 30 minutes
C. reassure client that the ipratropium given will alleviate the symptoms
D. Delay administration of ipratropium until the next maintenance medication is scheduled ✔✔A
A client diagnosed with multiple sclerosis is experiencing profound weakness, blurry vision, and
shooting pains in both legs. Which medication is considered the best course of treatment for the
nurse to administer?
A. High dose methylprednisolone intravenously
B. Baclofen three times a day
C. Broad spectrum antibiotic coverage orally
D. Immunomodulatory drug therapy periodically ✔✔A
The nurse administers 30 mL of lactulose for a client with stage 2 hepatic encephalopathy.
Which assessment finding would indicate the medication is being therapeutic?
A. A decrease in blood ammonia levels
B. A softening in the stools
C. An increase in glucose absorption
D. A suppression of gut acidification ✔✔A
The nurse is teaching a client who is newly diagnosed with type 1 diabetes about neutral
protamine Hagedor (NPH) insulin. Which statement by the client indicates an understanding of
how the medication works?
A. It facilitates the transport of glucose into the cells
B. It stimulates the function of beta cells in the pancreas
C. It increases the intracellular receptor site sensitivity
D. It delays the carbohydrate digestion and absorption ✔✔A
The nurse should withhold which medication if a client reports nausea, vomiting, and diarrhea?
A. Colchicine (Mitigare, Colcrys)
B. Erythromycin (E-mycin)
C. Naproxen (Aleve, Naprosyn)
D. Labetolol (Normodyne) ✔✔A
A client newly prescribed esomeprazole for gastroesophageal reflux disease (GERD) asks the
nurse how the medication will help. Which is the best explanation to provide the client?
Pharmacology HESI Questions and
Answers 100% Pass
A client who is taking an oral dose of tetracycline reports gastrointestinal upset. Which snack
should the nurse instruct the client to take with the tetracycline?
a. Fruit-flavored yogurt
b. Toasted wheat bread and jelly
c. Cold cereal with skim milk
d. Cheese and crackers ✔✔B.
The nurse is assessing the eyes of a client who just received mydriatic eye drops. Which
physiological function of the eye will not respond during the therapeutic period after
administration of eye drops?
a. Refraction
b. Eye convergence
c. Pupillary constriction
d. Accommodation ✔✔C.
A older male client is being discharged after a myocardial infacrtion (MI) and receives a new
prescription for atenolol. Which instruction is most important for the nurse to include in her
clients teaching plan?
a. Avoid intake of alcoholic beverages.
b. Avoid driving or operating machinery.
c. Take a missed dose as soon as possible.
d. Standing slowly when getting up from bed ✔✔D.
The healthcare provider prescribes vancomycin 500 mg IV every 12 hours for a client with
methicillin-resistant staphylococcus aureus (MRSA). Review of the client’s laboratory values
shows that serum peak and trough levels are within the desired therapeutic range and the serum
creatinine level is 4.5 mg/dL. Which action should the nurse implement?
a. Withhold the next scheduled dose and contact the healthcare provider. b. Monitor the
laboratory values until all prescribed doses have been given. c. Administer the next dose and flag
the results for the healthcare provider. d. Insert a second IV catheter for the administration of
emergency IV fluids. ✔✔A.
After taking orlistat for one week, a female client tells the home health nurse that she is
experiencing increasingly frequent oily stools and flatus. Which action should the nurse take? a.
Instruct the client to increase her intake of saturated fats over the next week. b. Obtain a stool
specimen to evaluate for occult blood and fat content.
c. Ask the client to describe her dietary intake history for the last several days. d. Advise the
client to stop taking the drug and contact her healthcare provider. ✔✔C.
- A client receiving a heparin sodium infusion develops hemoptysis. The nurse reviews the
client’s
laboratory values to include hemoglobin 8 g/dL and platelet count of 50,000/mm3. Vital signs
are: oxygen saturation 92% on 50% venturi mask, heart rate 130 beats/minute, respiration 32
breaths/minute, and blood pressure 76/50mmHg. Which intervention should the nurse implement
first?
a. Obtain consent for a blood transfusion.
b. Stop the heparin sodium infusion.
c. Titrate Venturi mask oxygen to 60%.
d. Administer protamine sulfate. ✔✔B.
The nurse is teaching a client with coronary artery disease about a newly prescribed medication,
atorvastatin. The client plans to take the medication in the morning with breakfast. Which food
choices are best for the nurse to recommend that the client should include with the meal? (select
all that apply)
a. Whole milk.
b. Low fat yogurt.
HESI PHARMACOLOGY PRACTICE
QUESTIONS FOR FINAL
A client is receiving clonidine (Catapres) 0.1 mg/24hr via transdermal patch. Which assessment
finding indicates that the desired effect of the medication has been achieved?
A. Client denies recent episodes of angina.
B. Change in peripheral edema from +3 to +1.
C. Client denies recent nausea or vomiting.
D. Blood pressure has changed from 180/120 to 140/70. Correct ✔✔Catapres acts as a centrallyacting analgesic and antihypertensive agent. (D) indicates a reduction in hypertension. Catapres
does not affect (A, B, or C), so these findings do not indicate desired outcomes of Catapres
After abdominal surgery, a male client is prescribed low molecular weight heparin (LMWH).
During administration of the medication, the client asks the nurse why he is receiving this
medication. Which is the best response for the nurse to provide?
A. This medication is a blood thinner given to prevent blood clot formation. Correct
B. This medication enhances antibiotics to prevent infection.
C. This medication dissolves any clots that develop in the legs. Incorrect
D. This abdominal injection assists in the healing of the abdominal wound. ✔✔Unfractionated
heparin or low molecular weight heparin (LMWH) is an anticoagulant that inhibits thrombin-
mediated conversion of fibrinogen to fibrin and is given prophylactically to prevent
postoperative venous thrombosis (A) or to treat pulmonary embolism or deep vein thrombosis
following knee and abdominal surgeries. Heparin does not dissolve clots but prevents clot
extension or further clot formation (C). The anticoagulant heparin does not prevent infection (B)
or influence operative wound healing (D).
A client with coronary artery disease who is taking digoxin (Lanoxin) receives a new
prescription for atorvastatin (Lipitor). Two weeks after initiation of the Lipitor prescription, the
nurse assesses the client. Which finding requires the most immediate intervention?
A. Heartburn.
B. Headache.
C. Constipation.
D. Vomiting. Correct ✔✔Vomiting, anorexia and abdominal pain are early indications of
digitalis toxicity. Since Lipitor increases the risk for digitalis toxicity, this finding requires the
most immediate intervention by the nurse (D). (A, B and C) are expected side effects of Lipitor
A client with heart failure is prescribed spironolactone (Aldactone). Which information is most
important for the nurse to provide to the client about diet modifications?
Do not add salt to foods during preparation.
Refrain for eating foods high in potassium. Correct
Restrict fluid intake to 1000 ml per day.
Increase intake of milk and milk products. ✔✔Spironolactone (Aldactone), an aldosterone
antagonist, is a potassium-sparing diuretic, so a diet high in potassium should be avoided (B),
including potassium salt substitutes, which can lead to hyperkalemia. Although (A) is a common
diet modification in heart failure, the risk of hyperkalemia is more important with Aldactone.
Restriction of fluids (C) or increasing milk and milk products (D) are not indicated with this
prescription.
A client with a dysrhythmia is to receive procainamide (Pronestyl) in 4 divided doses over the
next 24 hours. What dosing schedule is best for the nurse to implement?
q6h. Correct
QID.
AC and bedtime.
PC and bedtime. ✔✔Pronestyl is a class 1A antidysrhythmic. It should be taken around-theclock (A) so that a stable blood level of the drug can be maintained, thereby decreasing the
possibility of hypotension (an adverse effect) occurring because of too much of the drug
circulating systemically at any particular time of day. (B, C, and D) do not provide an aroundthe-clock dosing schedule. Pronestyl may be given with food if GI distress is a problem, but an
around-the-clock schedule should still be maintained.
A client who was prescribed atorvastatin (Lipitor) one month ago calls the triage nurse at the
clinic complaining of muscle pain and weakness in his legs. Which statement reflects the correct
drug-specific teaching the nurse should provide to this client?
A. Increase consumption of potassium-rich foods since low potassium levels can cause muscle
spasms.
B. Have serum electrolytes checked at the next scheduled appointment to assess hyponatremia, a
cause of cramping.
C. Make an appointment to see the healthcare provider, because muscle pain may be an
indication of a serious side effect. Correct
D. Be sure to consume a low-cholesterol diet while taking the drug to enhance the effectiveness
of the drug. ✔✔Myopathy, suggested by the leg pain and weakness, is a serious, and potentially
life-threatening, complication of Lipitor, and should be evaluated immediately by the healthcare
Pharm HESI Practice Exam Questions
and Answers Graded A
The nurse is caring for a client who has taken atenolol for 2 years. The healthcare provider
recently changed the medication to enalapril to manage the client’s blood pressure. Which
instruction should the nurse provide the client regarding the new medication?
A. Take the medication at bedtime.
B. Report presence of increased bruising.
C. Check pulse before taking medication.
D. Rise slowly when getting out of bed or chair. ✔✔D. Rise slowly when getting out of bed or
chair.
A female client calls the clinic and talks with the nurse to inquire about a possible reaction after
taking amoxicillin for 5 days. She reports having vaginal discomfort, itching, and a white
discharge. The nurse should discuss which action with the client?
A. Discontinue the antibiotic because original symptoms have subsided.
B. Continue taking medication until finished until the symptoms subside.
C. Consult with healthcare provider about another treatment for this effect.
D. Use an over-the-counter (OTC) vaginal wash to flush out the secretions. ✔✔C. Consult with
healthcare provider about another treatment for this effect.
The nurse is making early morning rounds on a group of clients when a client begins exhibiting
symptoms of an acute asthma attack. The nurse administers a PRN prescription for a Beta 2
receptor agonist agent. Which client response should the nurse expect?
A. Tachycardia.
B. Increased blood pressure.
C. Rapid resolution of wheezing.
D. Improved pulse oximetry values.
E. Reduce fever airway inflammation. ✔✔C, D
A client prescribed atenolol has a blood pressure of 120/68 mmHg, displaying a sinus
bradycardia with a rate of 58 beats/minute, and a P-R interval of 0.24. Which action should the
nurse take?
A. Lower the head of the bed and assess the client for orthostatic vital sign changes.
B. Give the medication as prescribed and continue to monitor the client.
C. Prepare to administer atropine sulfate IV push.
D. Hold the prescribed dose and contact the healthcare provider. ✔✔B. Give the medication as
prescribed and continue to monitor the client.
The nurse is preparing the 0900 dose of losartan (Cozaar), an angiotensin II receptor blocker
(ARB), for a client with hypertension and heart failure. The nurse reviews the client’s laboratory
results and notes that the client’s serum potassium level is 5.9 mEq/L. Which action should the
nurse take first?
A. Withhold the scheduled dose.
B. Check the client’s apical pulse.
C. Notify the healthcare provider.
D. Repeat the serum potassium level. ✔✔A. Withhold the scheduled dose.
Upon admission to the emergency center, an adult client with acute status asthmaticus is
prescribed this series of medications. In which order should the nurse administer the prescribed
medications? (Arrange from first to last.) ✔✔1. Albuterol (Proventil) puffs.
- Salmeterol (Serevent Diskus).
- Prednisone (Deltasone) orally.
- Gentamicin (Garamycin) IM.
An adult client is given a prescription for a scopolamine patch (Transderm Scop) to prevent
motion sickness while on a cruise. Which information should the nurse provide to the client?
A. Apply the patch at least 4 hours prior to departure.
B. Change the patch every other day while on the cruise.
C. Place the patch on a hairless area at the base of the skull.
D. Drink no more than 2 alcoholic drinks during the cruise. ✔✔A. Apply the patch at least 4
hours prior to departure.
A client with giardiasis is taking metronidazole (Flagyl) 2 grams PO. Which information should
the nurse include in the client’s instruction?
A. Notify the clinic of any changes in the color of urine.
B. Avoid overexposure to the sun.
C. Stop the medication after the diarrhea resolves.
D. Take the medication with food. ✔✔D. Take the medication with food.
Pharmacology Hesi Questions and
Answers 100% Pass
A wife is caring for her husband who has Parkinson’s disease. The wife calls the clinic and report
the husband has involuntary movement… ✔✔Determine what other medications the patient has
taken
What are some common side effects of antidepressants? ✔✔Blurred vision, dry ,mouth,
constipation
A client is discharged with a prescription for warfarin. What discharge instructions should the
nurse emphasize? ✔✔Avoid going barefoot especially outside
A client who is taking an oral dose of tetracycline complains of GI upset. What snack should the
nurse instruct the client to take with this medication? ✔✔Toasted wheat bread and jelly
A patient was given a dose of Trimethobenzamide is sedated but easily aroused. What should the
nurse do? ✔✔Allow the patient to rest
A client is having an acute asthma attack. What medication to administer? ✔✔Pirbuterol
The nurse is assessing the client’s INR which is 20. What is the nurse’s priority? ✔✔Give
Vitamin K, STOP THE INFUSSSION
A client is being educated on Benadryl. What is the most important teaching? ✔✔Avoid driving,
restlessness, drowsiness
A client complaints about upset stomach when taking Resedronate. ✔✔R. What will the nurse
ask the client?
How does the nurse know that Kayexalate is effective? ✔✔K+ 3.8, 3.5, 5.0
Prevent asthma attack when inhaled ✔✔mucomyst (acetylcysteine)
The nurse is administering IV fluconazole (Diflucan) to a client who has systemic candidiasis.
After reviewing the diagnostic studies, the nurse identifies a rising trend in the liver enzyme for
aspartate aminotransferase (AST). What action should the nurse implement? ✔✔Hold the dose
and notify the healthcare provider of the changes in laboratory studies
Pharm II HESI Questions and Answers
Graded A
Which of the following is a rapid acting insulin and should be administered immediately before a
meal?
A. Glargine
B. Aspart (Lispro)
C. NPH
D. Regular ✔✔B. Aspart
rationale: onset is 5 minutes
Glargine=Lantus (long lasting)
A PT has an anaphylactic allergy to sulfa drugs. She receives sulfamethoxazole. She becomes
flushed and SOB. Her HR is normal but her BP is dropping. You first administer
A. Epinephrine
B. Diphenhydramine
C. Albuterol
D. Atropine ✔✔A. Epi
rationale: raises BP
Which of the following would be an adverse effect of methimazole (Tapazole)
A. Tachycardia
B. Bradycardia
C. SOB
D. Arrhythmias ✔✔This is an anti-thyroid medication
B. Bradycardia
One of your PTs is started on verapamil (Calan). Before administering the dose you check
A. HR
B. urine output
C. weight
D. temp ✔✔this is a calcium channel blocker–worried about HR
A. HR
One of your PTs is to be started on iron sulfate therapy. You instruct him to:
A. take with meals
B. take on empty stomach
C. remain upright for at least 60 min following administration
D. take with vitamin A to increase absorption ✔✔B. take on empty stomach
rationale: taking with food lessens absorption, but it can cause upset stomach so most like to take
with food
take iron with vitamin C to increase absorption
liquid iron-drink through straw bc it can stain teeth black
which of the following should be considered when administering IV potassium?
A. Max rate infused through central line is 20 meq/h
B. Max rate infused through peripheral line is 10 meq/h
C. Max concentration through a central line is 20 meq/50ml
D. Max concentration through peripheral line is 10 meq/100ml
E. all of the above ✔✔E. all of the above
will usually be infused peripherally
which is the following agents is used to treat MG
A. Atropine (anticholinergic)
B. Pyridostigmine (Mestinon-acetylcholinesterase inhibitor)
Pharm HESI Practice Questions and
Answers Rated A
- DM peripheral neuropathy prescribed pregabalin x 2 weeks; reports diminished foot pain.
Nurse notes no improvement in healing of several toe ulcers
A. Review plan for strategies used to manage foot ulcers
B. Reassure patient ulcers take several months to heal
C. Explain that dose will need to increase
D. Withhold next dose until HCP is notified ✔✔ANS: A - DM Type 2 managed with glimepiride prescribed with additional injectable exenatide. Nurse
should teach:
A. Notify HCP of anorexia
B. Eat foods high in potassium
C. Administer subQ after meals
D. Watch for jitteriness and diaphoresis ✔✔ANS: D - Epi injection using auto-injection pen; requires intervention from nurse if client:
A. Administers into fleshy outer thigh
B. Holds pen in place after injection
C. Cleanse pen for reuse
D. Insert pen through clothing ✔✔ANS: C
- IV piperacillin-tazobactam; stop infusion if:
A. Hypertension
B. Pupillary constriction
C. Scratchy throat
D. Bradycardia ✔✔ANS: C - Client with influenza and having symptoms asks about oseltamivir.
A. Once symptoms occur, it is too late to receive influenza vaccine
B. Antibiotics are not helpful in viral infection
C. OTC meds are sufficient to manage influenza symptoms
D. Refer to HCP to get Rx ✔✔ANS: D - Order: Streptomycin 200 mg IM Q12 hour. 1 g in 2.5 mL available. How many mL is
administered?
200 mg x 1g x 2.5 mL = 0.5 mL
1000 mg g ✔✔ANS: 0.5 mL
- Client is on warfarn. Best communication from nurse:
A. Monitor signs of bleeding
B. Client repeats back information ✔✔ANS: B - Azithromycin; need to report A/E:
A. Yellow sclera
B. Flatulence and nausea
C. Urinary frequency
D. Headache ✔✔ANS: A - 1 L infused in 9 hours. What is mL/hour?
1000 mL/ 9 hr ✔✔ANS: 111 mL/hr
HESI PHARMACOLOGY REVIEW
LATEST 2023 ALREADY PASSED
ELDERLY HAVE DECREASED RENAL FUNCTION ✔✔EXCRETE DUGS AT A SLOWER
RATE THAN YOUNGER ADULTS.
RISK OF TOXICITY FOR MEDS SCHEDULED CLOSE TOGETHER EXAMPLE Q 4HRS FOR NARCOTICS
SUCCINYLCHOLINE (ANECTINE) DEPOLARIZING NEUROMUSCULAR BLOCKER
USED DURING SURGERY ✔✔MAY CAUSE VENTRICULAR TACHYCARDIA/DYSRHYTHMIAS.
***ADDED NEUROMUSCULAR BLOCKER(NMB) ACTION WHEN VANCOMYCIN IS
GIVEN WITH NMBs
FORMULA IV DRIP RATES ✔✔VOLUME (mL) X DRIP RATE (20GTT/mL)/TIME
250mL x 20GTTS/MIN DIVIDED BY 60MIN
NEUPOGEN ADMINISTERED TO INCREASE THE WBC COUNT IN NEUTROPENIC
PATIENTS ✔✔WBC INCREASE FROM 2,500/MM3 TO 5,500/MM3 – MEANS DESIRED
EFFECT IS REACHED.
HYDROMORPHONE (DILAUDID) IS A POTENT OPIOID USED TO TREAT POSTOP
PAIN ✔✔SLOWS PERISTALSIS
CAUSES CONSTIPATION
ALWAYS AUSCULTATE FORBOWEL SOUNDS
LEVALBUTEROL IS A SHORT-ACTING BETA 2 AGONIST (SABA) ✔✔SHOULD BE
USED DURING ACUTE ASTHMATIC EPISODES NOT LONG TERM USE.
FLUTICASONE IS GLUCOCORTICOID FOR PREVENTION OF ACUTE ASTHMA
✔✔NOT FOR ACUTE EPISODES
GIVEN BID
KETOROLAC (TORADOL) AN NSAID, CAUSES GASTRIC IRRITATION AND SHOULD
BE GIVEN WITH MEALS ✔✔HAS PAIN RELIEF COMPARABLE TO MORPHINE BUT IS
NOT AN OPIOID
NOT TO BE USED FOR CHRONIC PAIN
DO NOT GIVE FOR MORE THAN 5 DAYS
ENDROPHONIUM (TENSILON) AN ANTICHOLINESTERASE ✔✔IT ENHANCES THE
EFFECTS OF ACETYLCHOLINE AT THE SKELETAL MUSCLE RECEPTORS.
USED IN PATIENTS WITH MYASTHENIA GRAVIS
EFFECTIVE IF IMPROVEMENT IN PATIENTS MUSCLE STRENGTH.
MIOTICS CONSTRICT THE PUPIL ✔✔REDUCING NIGHT VISION
RISK FOR INJURY
MYDRIASIS DILATE THE PUPIL ✔✔BY BLOCKING MUSCARINIC RECEPTORS THAT
CONTRACT THE EYE.
MALE PARTNER SHOULD BE TREATED ALSO ✔✔IF THEIR PARTNER HAS
TRICHOMONAS (ANY STD), EVEN IF ASYMPTOMATIC
ARICEPT ✔✔MAY SLOW THE PROGRESSION FOR ALZHEIMER’S DISEASE OVER
THE NEXT YEAR (12 MONTHS)
PATIENT RECEIVING LINEZOLID (ZYVOX) FOR NOSOCOMIAL PNEUMONIA
✔✔REPORT WATERY DIARRHEA STOOLS ASAP AS IT COULD BE C-DIFF.
ORAL CONTRACEPTIVE PILLS (OCPs) HAVE DECREASES EFFICACY WHILE ON ABT
✔✔USE 2ND METHOD OF BIRTH CONTROL
FEOSOL (FERROUS SULFATE, FeSO4) IN LIQUID FORM ✔✔DRINK WITH A STRAW
TO PREVENT STAINING TEETH AND MUCOUS MEMBRANES.
Z TRACT IF GIVEN IM
HYDROCHLOROTHIAZIDE (HCTZ) ✔✔CAN BE SAFELY ADMINISTERED WITH A
HIGHER THAN AVERAGE POTASSIUM LEVEL OF 6.2 BECAUSE IT WILL PROMOTE
POTASSIUM LOSS.
ANTIHISTAMINES (DIPHENHYDRAMINE-BENADRYL) ✔✔DECREASE
NASOPHARYNGEAL SECRETIONS BY BLOCKING HISTAMINE RECEPTORS
WHEN MEDICATIONS WITH SIMILAR ACTION ARE ADMINISTERED TOGETHER
✔✔ADDITIVE EFFECTS OCCUR THAT IS THE SUM OF THE EFFECTS.
ANITHYPERTENSIVES TOGETHER WILL CAUSE LOW BLOOD PRESSURE.