HESI PHARMACOLOGY EXAM PRACTICE QUESTIONS
AND ANSWERS GRADED A+ 2026
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 -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 -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 -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 -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 -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 -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 -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) -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 -ANSWER-2. Axilla
Rationale:
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:
AND ANSWERS GRADED A+ 2026
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 -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 -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 -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 -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 -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 -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 -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) -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 -ANSWER-2. Axilla
Rationale:
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:
