2023-2024 HESI Pharmacology Practice Question With Answers (245 Solved Questions)

Name: 2023-2024 HESI Pharmacology Practice Question With Answers (245 Solved Questions)
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Take your revision to the next level with 2023-2024 HESI Pharmacology Practice Question With Answers, packed with past exams.

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HESI Pharmacology Exam Practice
Questions (245 Terms) with Detailed
Rationales 2023-2024
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?
1. Calcium chloride
2. Calcium gluconate
3. Calcitonin (Miacalcin)
4. Large doses of vitamin D - Exact Answer: 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?
1. Milk
2. Water

3. Apple juice
4. Orange juice - Exact Answer: 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?
1. Tinnitus
2. Diarrhea
3. Constipation
4. Decreased respirations - Exact Answer: 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:
1. Immediately before swimming
2. 15 minutes before exposure to the sun

3. Immediately before exposure to the sun
4. At least 30 minutes before exposure to the sun - Exact Answer: 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?
1. Notifying the registered nurse
2. Discontinuing the medication
3. Informing the client that this is normal
4. Applying a thinner film than prescribed to the burn site - Exact Answer: 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 - Exact Answer: 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 1 to 2 days. Options 3 and 4 describe
local rather than systemic effects. An elevated blood pressure may be expected
from the pain that occurs with a burn injury.
7.) Isotretinoin is prescribed for a client with severe acne. Before the
administration of this medication, the nurse anticipates that which laboratory test
will be prescribed?
1. Platelet count
2. Triglyceride level
3. Complete blood count
4. White blood cell count - Exact Answer: 2. Triglyceride level
Rationale:
Isotretinoin can elevate triglyceride levels. Blood triglyceride levels should be
measured before treatment and periodically thereafter until the effect on the

triglycerides has been evaluated. Options 1, 3, and 4 do not need to be monitored
specifically during this treatment.
8.) A client with severe acne is seen in the clinic and the health care provider
(HCP) prescribes isotretinoin. The nurse reviews the client's medication record and
would contact the (HCP) if the client is taking which medication?
1. Vitamin A
2. Digoxin (Lanoxin)
3. Furosemide (Lasix)
4. Phenytoin (Dilantin) - Exact Answer: 1. Vitamin A
Rationale:
Isotretinoin is a metabolite of vitamin A and can produce generalized
intensification of isotretinoin toxicity. Because of the potential for increased
toxicity, vitamin A supplements should be discontinued before isotretinoin
therapy. Options 2, 3, and 4 are not contraindicated with the use of isotretinoin.
9.) The nurse is applying a topical corticosteroid to a client with eczema. The nurse
would monitor for the potential for increased systemic absorption of the
medication if the medication were being applied to which of the following body
areas?
1. Back
2. Axilla
3. Soles of the feet
4. Palms of the hands - Exact Answer: 2. Axilla
Rationale:

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Topical corticosteroids can be absorbed into the systemic circulation. Absorption is
higher from regions where the skin is especially permeable (scalp, axilla, face,
eyelids, neck, perineum, genitalia), and lower from regions in which permeability
is poor (back, palms, soles).
10.) The clinic nurse is performing an admission assessment on a client. The nurse
notes that the client is taking azelaic acid (Azelex). Because of the medication
prescription, the nurse would suspect that the client is being treated for:
1. Acne
2. Eczema
3. Hair loss
4. Herpes simplex - Exact Answer: 1. Acne
Rationale:
Azelaic acid is a topical medication used to treat mild to moderate acne. The acid
appears to work by suppressing the growth of Propionibacterium acnes and
decreasing the proliferation of keratinocytes. Options 2, 3, and 4 are incorrect.
11.) The health care provider has prescribed silver sulfadiazine (Silvadene) for the
client with a partial-thickness burn, which has cultured positive for gram-negative
bacteria. The nurse is reinforcing information to the client about the medication.
Which statement made by the client indicates a lack of understanding about the
treatments?
1. "The medication is an antibacterial."
2. "The medication will help heal the burn."
3. "The medication will permanently stain my skin."

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4. "The medication should be applied directly to the wound." - Exact Answer: 3.
"The medication will permanently stain my skin."
Rationale:
Silver sulfadiazine (Silvadene) is an antibacterial that has a broad spectrum of
activity against gram-negative bacteria, gram-positive bacteria, and yeast. It is
applied directly to the wound to assist in healing. It does not stain the skin.
12.) A nurse is caring for a client who is receiving an intravenous (IV) infusion of an
antineoplastic medication. During the infusion, the client complains of pain at the
insertion site. During an inspection of the site, the nurse notes redness and
swelling and that the rate of infusion of the medication has slowed. The nurse
should take which appropriate action?
1. Notify the registered nurse.
2. Administer pain medication to reduce the discomfort.
3. Apply ice and maintain the infusion rate, as prescribed.
4. Elevate the extremity of the IV site, and slow the infusion. - Exact Answer: 1.
Notify the registered nurse.
Rationale:
When antineoplastic medications (Chemotheraputic Agents) are administered via
IV, great care must be taken to prevent the medication from escaping into the
tissues surrounding the injection site, because pain, tissue damage, and necrosis
can result. The nurse monitors for signs of extravasation, such as redness or
swelling at the insertion site and a decreased infusion rate. If extravasation occurs,
the registered nurse needs to be notified; he or she will then contact the health
care provider.

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13.) The client with squamous cell carcinoma of the larynx is receiving bleomycin
intravenously. The nurse caring for the client anticipates that which diagnostic
study will be prescribed?
1. Echocardiography
2. Electrocardiography
3. Cervical radiography
4. Pulmonary function studies - Exact Answer: 4. Pulmonary function studies
Rationale:
Bleomycin is an antineoplastic medication (Chemotheraputic Agents) that can
cause interstitial pneumonitis, which can progress to pulmonary fibrosis.
Pulmonary function studies along with hematological, hepatic, and renal function
tests need to be monitored. The nurse needs to monitor lung sounds for dyspnea
and crackles, which indicate pulmonary toxicity. The medication needs to be
discontinued immediately if pulmonary toxicity occurs. Options 1, 2, and 3 are
unrelated to the specific use of this medication.
14.) The client with acute myelocytic leukemia is being treated with busulfan
(Myleran). Which laboratory value would the nurse specifically monitor during
treatment with this medication?
1. Clotting time
2. Uric acid level
3. Potassium level
4. Blood glucose level - Exact Answer: 2. Uric acid level
Rationale:

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Busulfan (Myleran) can cause an increase in the uric acid level. Hyperuricemia can
produce uric acid nephropathy, renal stones, and acute renal failure. Options 1, 3,
and 4 are not specifically related to this medication.
15.) The client with small cell lung cancer is being treated with etoposide
(VePesid). The nurse who is assisting in caring for the client during its
administration understands that which side effect is specifically associated with
this medication?
1. Alopecia
2. Chest pain
3. Pulmonary fibrosis
4. Orthostatic hypotension - Exact Answer: 4. Orthostatic hypotension
Rationale:
A side effect specific to etoposide is orthostatic hypotension. The client's blood
pressure is monitored during the infusion. Hair loss occurs with nearly all the
antineoplastic medications. Chest pain and pulmonary fibrosis are unrelated to
this medication.
16.) The clinic nurse is reviewing a teaching plan for the client receiving an
antineoplastic medication. When implementing the plan, the nurse tells the client:
1. To take aspirin (acetylsalicylic acid) as needed for headache
2. Drink beverages containing alcohol in moderate amounts each evening
3. Consult with health care providers (HCPs) before receiving immunizations

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4. That it is not necessary to consult HCPs before receiving a flu vaccine at the
local health fair - Exact Answer: 3. Consult with health care providers (HCPs)
before receiving immunizations
Rationale:
Because antineoplastic medications lower the resistance of the body, clients must
be informed not to receive immunizations without a HCP's approval. Clients also
need to avoid contact with individuals who have recently received a live virus
vaccine. Clients need to avoid aspirin and aspirin-containing products to minimize
the risk of bleeding, and they need to avoid alcohol to minimize the risk of toxicity
and side effects.
17.) The client with ovarian cancer is being treated with vincristine (Oncovin). The
nurse monitors the client, knowing that which of the following indicates a side
effect specific to this medication?
1. Diarrhea
2. Hair loss
3. Chest pain
4. Numbness and tingling in the fingers and toes - Exact Answer: 4. Numbness
and tingling in the fingers and toes
Rationale:
A side effect specific to vincristine is peripheral neuropathy, which occurs in
almost every client. Peripheral neuropathy can be manifested as numbness and
tingling in the fingers and toes. Depression of the Achilles tendon reflex may be
the first clinical sign indicating peripheral neuropathy. Constipation rather than
diarrhea is most likely to occur with this medication, although diarrhea may occur

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occasionally. Hair loss occurs with nearly all the antineoplastic medications. Chest
pain is unrelated to this medication.
18.) The nurse is reviewing the history and physical examination of a client who
will be receiving asparaginase (Elspar), an antineoplastic agent. The nurse consults
with the registered nurse regarding the administration of the medication if which
of the following is documented in the client's history?
1. Pancreatitis
2. Diabetes mellitus
3. Myocardial infarction
4. Chronic obstructive pulmonary disease - Exact Answer: 1. Pancreatitis
Rationale:
Asparaginase (Elspar) is contraindicated if hypersensitivity exists, in pancreatitis,
or if the client has a history of pancreatitis. The medication impairs pancreatic
function and pancreatic function tests should be performed before therapy begins
and when a week or more has elapsed between administration of the doses. The
client needs to be monitored for signs of pancreatitis, which include nausea,
vomiting, and abdominal pain. The conditions noted in options 2, 3, and 4 are not
contraindicated with this medication.
19.) Tamoxifen is prescribed for the client with metastatic breast carcinoma. The
nurse understands that the primary action of this medication is to:
1. Increase DNA and RNA synthesis.
2. Promote the biosynthesis of nucleic acids.
3. Increase estrogen concentration and estrogen response.

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4. Compete with estradiol for binding to estrogen in tissues containing high
concentrations of receptors. - Exact Answer: 4. Compete with estradiol for binding
to estrogen in tissues containing high concentrations of receptors.
Rationale:
Tamoxifen is an antineoplastic medication that competes with estradiol for
binding to estrogen in tissues containing high concentrations of receptors.
Tamoxifen is used to treat metastatic breast carcinoma in women and men.
Tamoxifen is also effective in delaying the recurrence of cancer following
mastectomy. Tamoxifen reduces DNA synthesis and estrogen response.
20.) The client with metastatic breast cancer is receiving tamoxifen. The nurse
specifically monitors which laboratory value while the client is taking this
medication?
1. Glucose level
2. Calcium level
3. Potassium level
4. Prothrombin time - Exact Answer: 2. Calcium level
Rationale:
Tamoxifen may increase calcium, cholesterol, and triglyceride levels. Before the
initiation of therapy, a complete blood count, platelet count, and serum calcium
levels should be assessed. These blood levels, along with cholesterol and
triglyceride levels, should be monitored periodically during therapy. The nurse
should assess for hypercalcemia while the client is taking this medication. Signs of
hypercalcemia include increased urine volume, excessive thirst, nausea, vomiting,
constipation, hypotonicity of muscles, and deep bone and flank pain.

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21.) A nurse is assisting with caring for a client with cancer who is receiving
cisplatin. Select the adverse effects that the nurse monitors for that are associated
with this medication. Select all that apply.
1. Tinnitus
2. Ototoxicity
3. Hyperkalemia
4. Hypercalcemia
5. Nephrotoxicity
6. Hypomagnesemia - Exact Answer: 1. Tinnitus
2. Ototoxicity
5. Nephrotoxicity
6. Hypomagnesemia
Rationale:
Cisplatin is an alkylating medication. Alkylating medications are cell cycle phase-
nonspecific medications that affect the synthesis of DNA by causing the cross-
linking of DNA to inhibit cell reproduction. Cisplatin may cause ototoxicity,
tinnitus, hypokalemia, hypocalcemia, hypomagnesemia, and nephrotoxicity.
Amifostine (Ethyol) may be administered before cisplatin to reduce the potential
for renal toxicity.
22.) A nurse is caring for a client after thyroidectomy and notes that calcium
gluconate is prescribed for the client. The nurse determines that this medication
has been prescribed to:
1. Treat thyroid storm.

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2. Prevent cardiac irritability.
3. Treat hypocalcemic tetany.
4. Stimulate the release of parathyroid hormone. - Exact Answer: 3. Treat
hypocalcemic tetany.
Rationale:
Hypocalcemia can develop after thyroidectomy if the parathyroid glands are
accidentally removed or injured during surgery. Manifestations develop 1 to 7
days after surgery. If the client develops numbness and tingling around the mouth,
fingertips, or toes or muscle spasms or twitching, the health care provider is
notified immediately. Calcium gluconate should be kept at the bedside.
23.) A client who has been newly diagnosed with diabetes mellitus has been
stabilized with daily insulin injections. Which information should the nurse teach
when carrying out plans for discharge?
1. Keep insulin vials refrigerated at all times.
2. Rotate the insulin injection sites systematically.
3. Increase the amount of insulin before unusual exercise.
4. Monitor the urine acetone level to determine the insulin dosage. - Exact
Answer: 2. Rotate the insulin injection sites systematically.
Rationale:
Insulin dosages should not be adjusted or increased before unusual exercise. If
acetone is found in the urine, it may possibly indicate the need for additional
insulin. To minimize the discomfort associated with insulin injections, the insulin
should be administered at room temperature. Injection sites should be
systematically rotated from one area to another. The client should be instructed to

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give injections in one area, about 1 inch apart, until the whole area has been used
and then to change to another site. This prevents dramatic changes in daily insulin
absorption.
24.) A nurse is reinforcing teaching for a client regarding how to mix regular insulin
and NPH insulin in the same syringe. Which of the following actions, if performed
by the client, indicates the need for further teaching?
1. Withdraws the NPH insulin first
2. Withdraws the regular insulin first
3. Injects air into NPH insulin vial first
4. Injects an amount of air equal to the desired dose of insulin into the vial - Exact
Answer: 1. Withdraws the NPH insulin first
Rationale:
When preparing a mixture of regular insulin with another insulin preparation, the
regular insulin is drawn into the syringe first. This sequence will avoid
contaminating the vial of regular insulin with insulin of another type. Options 2, 3,
and 4 identify the correct actions for preparing NPH and regular insulin.
25.) A home care nurse visits a client recently diagnosed with diabetes mellitus
who is taking Humulin NPH insulin daily. The client asks the nurse how to store the
unopened vials of insulin. The nurse tells the client to:
1. Freeze the insulin.
2. Refrigerate the insulin.
3. Store the insulin in a dark, dry place.

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2023-2024 HESI Pharmacology Practice Question With Answers (245 Solved Questions)

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