RN HESI PHARMACOLOGY EXAM 2026
COMPREHENSIVE STUDY AND ANSWER GUIDE.
◉ 44.) A client is receiving acetylcysteine (Mucomyst), 20% solution
diluted in 0.9% normal saline by nebulizer. The nurse should have
which item available for possible use after giving this medication?
1. Ambu bag
2. Intubation tray
3. Nasogastric tube
4. Suction equipment. Answer: 4. Suction equipment
Rationale:
Acetylcysteine can be given orally or by nasogastric tube to treat
acetaminophen overdose, or it may be given by inhalation for use as
a mucolytic. The nurse administering this medication as a mucolytic
should have suction equipment available in case the client cannot
manage to clear the increased volume of liquefied secretions.
◉ 45.) A client has a prescription to take guaifenesin (Humibid)
every 4 hours, as needed. The nurse determines that the client
understands the most effective use of this medication if the client
states that he or she will:
1. Watch for irritability as a side effect.
2. Take the tablet with a full glass of water.
3. Take an extra dose if the cough is accompanied by fever.
,4. Crush the sustained-release tablet if immediate relief is needed..
Answer: 2. Take the tablet with a full glass of water.
Rationale:
Guaifenesin is an expectorant. It should be taken with a full glass of
water to decrease viscosity of secretions. Sustained-release
preparations should not be broken open, crushed, or chewed. The
medication may occasionally cause dizziness, headache, or
drowsiness as side effects. The client should contact the health care
provider if the cough lasts longer than 1 week or is accompanied by
fever, rash, sore throat, or persistent headache.
◉ 46.) A postoperative client has received a dose of naloxone
hydrochloride for respiratory depression shortly after transfer to the
nursing unit from the postanesthesia care unit. After administration
of the medication, the nurse checks the client for:
1. Pupillary changes
2. Scattered lung wheezes
3. Sudden increase in pain
4. Sudden episodes of diarrhea. Answer: 3. Sudden increase in pain
Rationale:
Naloxone hydrochloride is an antidote to opioids and may also be
given to the postoperative client to treat respiratory depression.
When given to the postoperative client for respiratory depression, it
may also reverse the effects of analgesics. Therefore, the nurse must
check the client for a sudden increase in the level of pain
,experienced. Options 1, 2, and 4 are not associated with this
medication.
◉ 47.) A client has been taking isoniazid (INH) for 2 months. The
client complains to a nurse about numbness, paresthesias, and
tingling in the extremities. The nurse interprets that the client is
experiencing:
1. Hypercalcemia
2. Peripheral neuritis
3. Small blood vessel spasm
4. Impaired peripheral circulation. Answer: 2. Peripheral neuritis
Rationale:
A common side effect of the TB drug INH is peripheral neuritis. This
is manifested by numbness, tingling, and paresthesias in the
extremities. This side effect can be minimized by pyridoxine
(vitamin B6) intake. Options 1, 3, and 4 are incorrect.
◉ 48.) A client is to begin a 6-month course of therapy with
isoniazid (INH). A nurse plans to teach the client to:
1. Drink alcohol in small amounts only.
2. Report yellow eyes or skin immediately.
3. Increase intake of Swiss or aged cheeses.
4. Avoid vitamin supplements during therapy.. Answer: 2. Report
yellow eyes or skin immediately.
, Rationale:
INH is hepatotoxic, and therefore the client is taught to report signs
and symptoms of hepatitis immediately (which include yellow skin
and sclera). For the same reason, alcohol should be avoided during
therapy. The client should avoid intake of Swiss cheese, fish such as
tuna, and foods containing tyramine because they may cause a
reaction characterized by redness and itching of the skin, flushing,
sweating, tachycardia, headache, or lightheadedness. The client can
avoid developing peripheral neuritis by increasing the intake of
pyridoxine (vitamin B6) during the course of INH therapy for TB.
◉ 49.) A client has been started on long-term therapy with rifampin
(Rifadin). A nurse teaches the client that the medication:
1. Should always be taken with food or antacids
2. Should be double-dosed if one dose is forgotten
3. Causes orange discoloration of sweat, tears, urine, and feces
4. May be discontinued independently if symptoms are gone in 3
months. Answer: 3. Causes orange discoloration of sweat, tears,
urine, and feces
Rationale:
Rifampin should be taken exactly as directed as part of TB therapy.
Doses should not be doubled or skipped. The client should not stop
therapy until directed to do so by a health care provider. The
medication should be administered on an empty stomach unless it
causes gastrointestinal upset, and then it may be taken with food.
Antacids, if prescribed, should be taken at least 1 hour before the
COMPREHENSIVE STUDY AND ANSWER GUIDE.
◉ 44.) A client is receiving acetylcysteine (Mucomyst), 20% solution
diluted in 0.9% normal saline by nebulizer. The nurse should have
which item available for possible use after giving this medication?
1. Ambu bag
2. Intubation tray
3. Nasogastric tube
4. Suction equipment. Answer: 4. Suction equipment
Rationale:
Acetylcysteine can be given orally or by nasogastric tube to treat
acetaminophen overdose, or it may be given by inhalation for use as
a mucolytic. The nurse administering this medication as a mucolytic
should have suction equipment available in case the client cannot
manage to clear the increased volume of liquefied secretions.
◉ 45.) A client has a prescription to take guaifenesin (Humibid)
every 4 hours, as needed. The nurse determines that the client
understands the most effective use of this medication if the client
states that he or she will:
1. Watch for irritability as a side effect.
2. Take the tablet with a full glass of water.
3. Take an extra dose if the cough is accompanied by fever.
,4. Crush the sustained-release tablet if immediate relief is needed..
Answer: 2. Take the tablet with a full glass of water.
Rationale:
Guaifenesin is an expectorant. It should be taken with a full glass of
water to decrease viscosity of secretions. Sustained-release
preparations should not be broken open, crushed, or chewed. The
medication may occasionally cause dizziness, headache, or
drowsiness as side effects. The client should contact the health care
provider if the cough lasts longer than 1 week or is accompanied by
fever, rash, sore throat, or persistent headache.
◉ 46.) A postoperative client has received a dose of naloxone
hydrochloride for respiratory depression shortly after transfer to the
nursing unit from the postanesthesia care unit. After administration
of the medication, the nurse checks the client for:
1. Pupillary changes
2. Scattered lung wheezes
3. Sudden increase in pain
4. Sudden episodes of diarrhea. Answer: 3. Sudden increase in pain
Rationale:
Naloxone hydrochloride is an antidote to opioids and may also be
given to the postoperative client to treat respiratory depression.
When given to the postoperative client for respiratory depression, it
may also reverse the effects of analgesics. Therefore, the nurse must
check the client for a sudden increase in the level of pain
,experienced. Options 1, 2, and 4 are not associated with this
medication.
◉ 47.) A client has been taking isoniazid (INH) for 2 months. The
client complains to a nurse about numbness, paresthesias, and
tingling in the extremities. The nurse interprets that the client is
experiencing:
1. Hypercalcemia
2. Peripheral neuritis
3. Small blood vessel spasm
4. Impaired peripheral circulation. Answer: 2. Peripheral neuritis
Rationale:
A common side effect of the TB drug INH is peripheral neuritis. This
is manifested by numbness, tingling, and paresthesias in the
extremities. This side effect can be minimized by pyridoxine
(vitamin B6) intake. Options 1, 3, and 4 are incorrect.
◉ 48.) A client is to begin a 6-month course of therapy with
isoniazid (INH). A nurse plans to teach the client to:
1. Drink alcohol in small amounts only.
2. Report yellow eyes or skin immediately.
3. Increase intake of Swiss or aged cheeses.
4. Avoid vitamin supplements during therapy.. Answer: 2. Report
yellow eyes or skin immediately.
, Rationale:
INH is hepatotoxic, and therefore the client is taught to report signs
and symptoms of hepatitis immediately (which include yellow skin
and sclera). For the same reason, alcohol should be avoided during
therapy. The client should avoid intake of Swiss cheese, fish such as
tuna, and foods containing tyramine because they may cause a
reaction characterized by redness and itching of the skin, flushing,
sweating, tachycardia, headache, or lightheadedness. The client can
avoid developing peripheral neuritis by increasing the intake of
pyridoxine (vitamin B6) during the course of INH therapy for TB.
◉ 49.) A client has been started on long-term therapy with rifampin
(Rifadin). A nurse teaches the client that the medication:
1. Should always be taken with food or antacids
2. Should be double-dosed if one dose is forgotten
3. Causes orange discoloration of sweat, tears, urine, and feces
4. May be discontinued independently if symptoms are gone in 3
months. Answer: 3. Causes orange discoloration of sweat, tears,
urine, and feces
Rationale:
Rifampin should be taken exactly as directed as part of TB therapy.
Doses should not be doubled or skipped. The client should not stop
therapy until directed to do so by a health care provider. The
medication should be administered on an empty stomach unless it
causes gastrointestinal upset, and then it may be taken with food.
Antacids, if prescribed, should be taken at least 1 hour before the
