HESI Pharmacology V1-V5 (2026/2027)
Exam | Updated Version | Verified
Answers & Detailed Rationales |
Complete Study Guide| Brand new!!
HESI Pharmacology V1
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
CORRECT ANS: 3
EXPERT RATIONALE
The normal serum calcium range is 8.6 to 10.0 mg/dL. A level of 13 mg/dL indicates significant
hypercalcemia, which can result from hyperparathyroidism due to excessive parathyroid
,hormone (PTH) secretion, leading to increased bone resorption and calcium release. Calcitonin,
a hormone produced by the thyroid gland, lowers serum calcium levels by inhibiting osteoclastic
bone resorption and promoting renal excretion of calcium. It is the appropriate medication for
treating hypercalcemia. Calcium chloride (1) and calcium gluconate (2) are used to treat acute
hypocalcemia and tetany, which would be contraindicated here. Large doses of vitamin D (4)
would increase intestinal calcium absorption and worsen hypercalcemia, so they must be
avoided.
DIF: Cognitive Level: Apply (Application)
REF: Endocrine Disorders / Hyperparathyroidism
OBJ: Identify treatment for hypercalcemia
TOP: Implementation / Pharmacology
MSC: NCLEX: Physiological Integrity – Pharmacological and Parenteral Therapies
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
CORRECT ANS: 4
EXPERT RATIONALE
Vitamin C (ascorbic acid) significantly enhances the absorption of non-heme iron from the
gastrointestinal tract by reducing ferric iron (Fe³⁺) to the more absorbable ferrous form (Fe²⁺)
and forming a soluble complex. Orange juice is rich in vitamin C and is therefore the best choice
to administer with oral iron supplements. Milk (1) contains calcium and casein, which can inhibit
iron absorption. Water (2) will not facilitate absorption. While apple juice (3) contains some
vitamin C, orange juice contains a substantially higher concentration, making it the superior
choice.
DIF: Cognitive Level: Apply (Application)
REF: Pediatric / Nutritional Deficiencies
OBJ: Identify foods that enhance iron absorption
TOP: Teaching / Nutrition
MSC: NCLEX: Health Promotion and Maintenance – Nutrition
,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
CORRECT ANS: 1
EXPERT RATIONALE
Salicylic acid is a topical keratolytic agent used to treat psoriasis and other hyperkeratotic skin
conditions. It is absorbed readily through the skin, particularly when applied to large surface
areas or under occlusive dressings. Systemic toxicity, known as salicylism, can occur. Early signs
and symptoms of salicylism include tinnitus (ringing in the ears), dizziness, hyperpnea (rapid,
deep breathing), and psychological disturbances such as confusion or agitation. Diarrhea (2) and
constipation (3) are not classic signs of salicylism. Decreased respirations (4) are not a feature;
instead, respiratory stimulation (hyperpnea) is more characteristic.
DIF: Cognitive Level: Analyze (Application)
REF: Integumentary Pharmacology / Salicylates
OBJ: Identify signs of systemic toxicity
TOP: Assessment
MSC: NCLEX: Physiological Integrity – Pharmacological and Parenteral Therapies
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
CORRECT ANS: 4
EXPERT RATIONALE
Chemical sunscreens work by absorbing ultraviolet (UV) radiation and converting it to heat,
, which is then released from the skin. For optimal effectiveness, they require time to penetrate
the stratum corneum and bind to the skin. Therefore, they should be applied at least 30
minutes before sun exposure to allow for adequate absorption and distribution. All sunscreens
should be reapplied after swimming, sweating, or towel drying, as water resistance is not
absolute. Application immediately before swimming or sun exposure (1, 3) would not allow
sufficient time for absorption. Fifteen minutes (2) is also insufficient time for maximum efficacy.
DIF: Cognitive Level: Understand (Comprehension)
REF: Health Promotion / Sun Protection
OBJ: Teach proper sunscreen application
TOP: Teaching
MSC: NCLEX: Health Promotion and Maintenance – Self-Care
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
CORRECT ANS: 3
EXPERT RATIONALE
Mafenide acetate is a topical sulfonamide antibacterial agent used in the treatment of burn
wounds to reduce bacterial colonization, particularly against gram-negative organisms. It is
known to cause significant local discomfort, burning, and pain upon application, especially to
partial-thickness wounds. This is a normal and expected reaction due to the medication's
penetration into the wound and its effect on nerve endings. The client should be informed of
this to alleviate anxiety and promote cooperation with treatment. Notifying the registered nurse
(1) is not necessary for a known expected effect. Discontinuing the medication (2) or applying a
thinner film (4) would compromise the therapeutic efficacy and is not indicated.
DIF: Cognitive Level: Apply (Application)
REF: Burn Care / Topical Antimicrobials
OBJ: Identify expected side effects of mafenide acetate
TOP: Implementation
MSC: NCLEX: Physiological Integrity – Pharmacological and Parenteral Therapies
Exam | Updated Version | Verified
Answers & Detailed Rationales |
Complete Study Guide| Brand new!!
HESI Pharmacology V1
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
CORRECT ANS: 3
EXPERT RATIONALE
The normal serum calcium range is 8.6 to 10.0 mg/dL. A level of 13 mg/dL indicates significant
hypercalcemia, which can result from hyperparathyroidism due to excessive parathyroid
,hormone (PTH) secretion, leading to increased bone resorption and calcium release. Calcitonin,
a hormone produced by the thyroid gland, lowers serum calcium levels by inhibiting osteoclastic
bone resorption and promoting renal excretion of calcium. It is the appropriate medication for
treating hypercalcemia. Calcium chloride (1) and calcium gluconate (2) are used to treat acute
hypocalcemia and tetany, which would be contraindicated here. Large doses of vitamin D (4)
would increase intestinal calcium absorption and worsen hypercalcemia, so they must be
avoided.
DIF: Cognitive Level: Apply (Application)
REF: Endocrine Disorders / Hyperparathyroidism
OBJ: Identify treatment for hypercalcemia
TOP: Implementation / Pharmacology
MSC: NCLEX: Physiological Integrity – Pharmacological and Parenteral Therapies
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
CORRECT ANS: 4
EXPERT RATIONALE
Vitamin C (ascorbic acid) significantly enhances the absorption of non-heme iron from the
gastrointestinal tract by reducing ferric iron (Fe³⁺) to the more absorbable ferrous form (Fe²⁺)
and forming a soluble complex. Orange juice is rich in vitamin C and is therefore the best choice
to administer with oral iron supplements. Milk (1) contains calcium and casein, which can inhibit
iron absorption. Water (2) will not facilitate absorption. While apple juice (3) contains some
vitamin C, orange juice contains a substantially higher concentration, making it the superior
choice.
DIF: Cognitive Level: Apply (Application)
REF: Pediatric / Nutritional Deficiencies
OBJ: Identify foods that enhance iron absorption
TOP: Teaching / Nutrition
MSC: NCLEX: Health Promotion and Maintenance – Nutrition
,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
CORRECT ANS: 1
EXPERT RATIONALE
Salicylic acid is a topical keratolytic agent used to treat psoriasis and other hyperkeratotic skin
conditions. It is absorbed readily through the skin, particularly when applied to large surface
areas or under occlusive dressings. Systemic toxicity, known as salicylism, can occur. Early signs
and symptoms of salicylism include tinnitus (ringing in the ears), dizziness, hyperpnea (rapid,
deep breathing), and psychological disturbances such as confusion or agitation. Diarrhea (2) and
constipation (3) are not classic signs of salicylism. Decreased respirations (4) are not a feature;
instead, respiratory stimulation (hyperpnea) is more characteristic.
DIF: Cognitive Level: Analyze (Application)
REF: Integumentary Pharmacology / Salicylates
OBJ: Identify signs of systemic toxicity
TOP: Assessment
MSC: NCLEX: Physiological Integrity – Pharmacological and Parenteral Therapies
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
CORRECT ANS: 4
EXPERT RATIONALE
Chemical sunscreens work by absorbing ultraviolet (UV) radiation and converting it to heat,
, which is then released from the skin. For optimal effectiveness, they require time to penetrate
the stratum corneum and bind to the skin. Therefore, they should be applied at least 30
minutes before sun exposure to allow for adequate absorption and distribution. All sunscreens
should be reapplied after swimming, sweating, or towel drying, as water resistance is not
absolute. Application immediately before swimming or sun exposure (1, 3) would not allow
sufficient time for absorption. Fifteen minutes (2) is also insufficient time for maximum efficacy.
DIF: Cognitive Level: Understand (Comprehension)
REF: Health Promotion / Sun Protection
OBJ: Teach proper sunscreen application
TOP: Teaching
MSC: NCLEX: Health Promotion and Maintenance – Self-Care
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
CORRECT ANS: 3
EXPERT RATIONALE
Mafenide acetate is a topical sulfonamide antibacterial agent used in the treatment of burn
wounds to reduce bacterial colonization, particularly against gram-negative organisms. It is
known to cause significant local discomfort, burning, and pain upon application, especially to
partial-thickness wounds. This is a normal and expected reaction due to the medication's
penetration into the wound and its effect on nerve endings. The client should be informed of
this to alleviate anxiety and promote cooperation with treatment. Notifying the registered nurse
(1) is not necessary for a known expected effect. Discontinuing the medication (2) or applying a
thinner film (4) would compromise the therapeutic efficacy and is not indicated.
DIF: Cognitive Level: Apply (Application)
REF: Burn Care / Topical Antimicrobials
OBJ: Identify expected side effects of mafenide acetate
TOP: Implementation
MSC: NCLEX: Physiological Integrity – Pharmacological and Parenteral Therapies
