NSG 520 HESI ACTUAL Exam 2026
Pathophysiology and Pharmacology TEST
BANK QUESTIONS WITH VERIFIED
CORRECT ANSWERS
The nurse is assessing a client admitted for the treatment of hypertensive urgency.
Which finding should be reported to the health care provider immediately?
A. An acute change in mental status
B. Blood pressure of 180/90
C. A history of MI
D. Clear, yellow urine - ANSWER-A. An acute change in mental status
Correct
This ANSWER is correct because an acute mental status change indicates that a
neurologic insult has occurred due to critically elevated blood pressure and should be
immediately reported to the provider.
Incorrect
This ANSWER choice is not correct because this is an expected finding for a client with
a diagnosis of hypertnsive urgency. There is no need to report an expected finding to
the provider.
Incorrect
This ANSWER choice is not correct because a history of myocardial infarction is not a
priority finding over an acute mental status change. An acute change in mental status
indicates a neurologic deficit and should be immediately assessed and addressed.
Incorrect
This ANSWER choice is not correct because clear, yellow urine is an indicator of
kidneys that are functioning properly.
The nurse is caring for a client who goes into cardiac arrest. Rhythm analysis reveals
that the client is experiencing pulseless electrical activity (PEA). Which medication is
considered the first line of therapy for this situation? - ANSWER-Epinephrine
This ANSWER is correct because for clients in cardiac arrest, epinephrine is the primary
drug given to clients experiencing pulseless electrical activity (PEA). Epinephrine is
administered in 1 mg intravenous or intraosseous doses. Each dose must be given 3-5
minutes apart.
The nurse is caring for multiple clients who each receive an angiotensin-converting
enzyme (ACE) inhibitor to manage hypertension. For which client should the nurse
suggest discussing a medication change with the health care provider? - ANSWER-A
female that is planning to become pregnant
,This ANSWER is correct because ACE inhibitors have teratogenic properties, which
means that this medication may cause severe birth defects. The client who is newly
married and using natural family planning may become pregnant, so a different
medication would be a better choice for managing this client's hypertension.
Methyldopa, labetalol, and nifedipine are all examples of antihypertensives that may be
safe to use during pregnancy.
When presenting a comparison of diphenhydramine and loratadine, what primary
advantage will the registered nurse (RN) provide for choosing loratadine over
diphenhydramine for the treatment of seasonal allergies? - ANSWER-loratadine has
less side effects than diphenhydramine is the primary advantage. This drug does not
cause sedation or drowsiness. The drug also has a longer duration than
diphenhydramine.
The parent expresses frustration to the nurse that the montelukast just isn't working
though she has been giving it to her child nightly for the past 3 nights. The nurse
correctly educates the mother with which correct statement? - ANSWER-Leukotriene
inhibitors are long-term therapy. It takes 1-2 weeks to see a therapeutic response of the
medication.
Which medication does the nursing instructor teach that, when taken with nitroglycerin,
can cause profound hypotension? - ANSWER-phosphodiesterase-5 enzyme inhibitors,
such as the brand-name medications of Viagra and Cilias, treat erectile dysfunction
through vasodilation. This added affection with another vasodilator, nitroglycerin, can
cause an unsafe drop in blood pressure.
A client with acute kidney injury is at highest risk for which electrolyte imbalance? -
ANSWER-hyperkalemia - due to acidosis and decreased ability to filter potassium.
Which educational point will the registered nurse (RN) provide to the client prescribed
codeine as an antitussive? Select all that apply. - ANSWER-Increase fluid to at least
64oz per day
Take the prescribed drug with food each time
Stand slowly to prevent dizziness
Which sign/symptom would be expected in a client diagnosed with hypercalcemia?
Select all that apply. - ANSWER-kidney stones
bone pain
muscle weakness
lethargy
Which best describes the pathophysiology of wheezes during an acute asthma attack? -
ANSWER-Airway inflammation and bronchoconstriction
, Which client displays the greatest risk for developing stress incontinence? - ANSWER-
Pt in 3rd trimester of pregnancy
The nurse is calculating intake and output from 0700-1700. The client has an IV infusing
at 75 mL/hr. For breakfast the client has: an 8 oz. cup of coffee, 3 tsp. of gelatin, a 30
oz. cup of ice, and 240 mL of orange juice. At lunch the client has 8 oz. tea, an 8 oz.
chicken patty and 6 oz cola. How many mL will the nurse record as intake?
The family reports emptying 12 oz., 18 oz. and 5 oz. from the urinal. The client also
vomits 800 mL of emesis. How many mL will the nurse record as output? - ANSWER-IV
fluids, 75 mL x 10 hours = 750
8 oz of coffee: 8 x 30 mL= 240 mL
3 tsp of gelatin: 3 x 3 mL= 15 mL
30 oz of ice: ½ x 30 oz *ice counts as ½ = 15 oz x 30 mL = 450 mL
240 mL of orange juice= 240 mL
8 oz of tea= 8 x 30 = 240 mL
6 oz of cola= 6 x 30 mL = 180 mL
*Note that the chicken patty is not liquid and will not be calculated in I&O calculation.
The correct ANSWER for output is 1850 mL
12 oz x 30 mL = 360 mL
18 oz x 30 mL = 540 mL
5 oz x 30 mL = 150 mL
800 mL of vomitus= 800 mL
The charge nurse is evaluating infection control practices on the unit. Which action by a
unlicensed assistive personnel (UAP) indicates a need to provide additional education?
- ANSWER-additional education is needed for a unlicensed assistive personnel (UAP)
who completes oral care of a client positive for influenza with just a face shield. If
contact with body fluids are a possibility, a gown, gloves, and goggles or eye protection
should be donned before entering the room.
Which client should be placed in airborne and contact precautions? - ANSWER-This
ANSWER is correct because a client diagnosed with varicella (chicken pox) should be
placed in airborne and contact precautions. Diseases needing airborne precautions
include tuberculosis, measles, chickenpox (Varicella), and SARS. Varicella has open
sores and is transmitted, not only by air, but by touching the vesicles' fluid. Therefore, a
client with varicella (chicken pox) should be placed in airborne and contact precautions.
A client with a deep vein thrombosis in the right leg is receiving heparin subcutaneously
every 12 hours. How should heparin be administered? - ANSWER-25G 5/8'' needle at
90 degrees
The nurse is preparing to administer a dose of digoxin to multiple clients. For which
client should the nurse withhold the medication and contact the health care provider? -
ANSWER-Client w/ a hx of atrial flutter and a hr of 52bpm
Pathophysiology and Pharmacology TEST
BANK QUESTIONS WITH VERIFIED
CORRECT ANSWERS
The nurse is assessing a client admitted for the treatment of hypertensive urgency.
Which finding should be reported to the health care provider immediately?
A. An acute change in mental status
B. Blood pressure of 180/90
C. A history of MI
D. Clear, yellow urine - ANSWER-A. An acute change in mental status
Correct
This ANSWER is correct because an acute mental status change indicates that a
neurologic insult has occurred due to critically elevated blood pressure and should be
immediately reported to the provider.
Incorrect
This ANSWER choice is not correct because this is an expected finding for a client with
a diagnosis of hypertnsive urgency. There is no need to report an expected finding to
the provider.
Incorrect
This ANSWER choice is not correct because a history of myocardial infarction is not a
priority finding over an acute mental status change. An acute change in mental status
indicates a neurologic deficit and should be immediately assessed and addressed.
Incorrect
This ANSWER choice is not correct because clear, yellow urine is an indicator of
kidneys that are functioning properly.
The nurse is caring for a client who goes into cardiac arrest. Rhythm analysis reveals
that the client is experiencing pulseless electrical activity (PEA). Which medication is
considered the first line of therapy for this situation? - ANSWER-Epinephrine
This ANSWER is correct because for clients in cardiac arrest, epinephrine is the primary
drug given to clients experiencing pulseless electrical activity (PEA). Epinephrine is
administered in 1 mg intravenous or intraosseous doses. Each dose must be given 3-5
minutes apart.
The nurse is caring for multiple clients who each receive an angiotensin-converting
enzyme (ACE) inhibitor to manage hypertension. For which client should the nurse
suggest discussing a medication change with the health care provider? - ANSWER-A
female that is planning to become pregnant
,This ANSWER is correct because ACE inhibitors have teratogenic properties, which
means that this medication may cause severe birth defects. The client who is newly
married and using natural family planning may become pregnant, so a different
medication would be a better choice for managing this client's hypertension.
Methyldopa, labetalol, and nifedipine are all examples of antihypertensives that may be
safe to use during pregnancy.
When presenting a comparison of diphenhydramine and loratadine, what primary
advantage will the registered nurse (RN) provide for choosing loratadine over
diphenhydramine for the treatment of seasonal allergies? - ANSWER-loratadine has
less side effects than diphenhydramine is the primary advantage. This drug does not
cause sedation or drowsiness. The drug also has a longer duration than
diphenhydramine.
The parent expresses frustration to the nurse that the montelukast just isn't working
though she has been giving it to her child nightly for the past 3 nights. The nurse
correctly educates the mother with which correct statement? - ANSWER-Leukotriene
inhibitors are long-term therapy. It takes 1-2 weeks to see a therapeutic response of the
medication.
Which medication does the nursing instructor teach that, when taken with nitroglycerin,
can cause profound hypotension? - ANSWER-phosphodiesterase-5 enzyme inhibitors,
such as the brand-name medications of Viagra and Cilias, treat erectile dysfunction
through vasodilation. This added affection with another vasodilator, nitroglycerin, can
cause an unsafe drop in blood pressure.
A client with acute kidney injury is at highest risk for which electrolyte imbalance? -
ANSWER-hyperkalemia - due to acidosis and decreased ability to filter potassium.
Which educational point will the registered nurse (RN) provide to the client prescribed
codeine as an antitussive? Select all that apply. - ANSWER-Increase fluid to at least
64oz per day
Take the prescribed drug with food each time
Stand slowly to prevent dizziness
Which sign/symptom would be expected in a client diagnosed with hypercalcemia?
Select all that apply. - ANSWER-kidney stones
bone pain
muscle weakness
lethargy
Which best describes the pathophysiology of wheezes during an acute asthma attack? -
ANSWER-Airway inflammation and bronchoconstriction
, Which client displays the greatest risk for developing stress incontinence? - ANSWER-
Pt in 3rd trimester of pregnancy
The nurse is calculating intake and output from 0700-1700. The client has an IV infusing
at 75 mL/hr. For breakfast the client has: an 8 oz. cup of coffee, 3 tsp. of gelatin, a 30
oz. cup of ice, and 240 mL of orange juice. At lunch the client has 8 oz. tea, an 8 oz.
chicken patty and 6 oz cola. How many mL will the nurse record as intake?
The family reports emptying 12 oz., 18 oz. and 5 oz. from the urinal. The client also
vomits 800 mL of emesis. How many mL will the nurse record as output? - ANSWER-IV
fluids, 75 mL x 10 hours = 750
8 oz of coffee: 8 x 30 mL= 240 mL
3 tsp of gelatin: 3 x 3 mL= 15 mL
30 oz of ice: ½ x 30 oz *ice counts as ½ = 15 oz x 30 mL = 450 mL
240 mL of orange juice= 240 mL
8 oz of tea= 8 x 30 = 240 mL
6 oz of cola= 6 x 30 mL = 180 mL
*Note that the chicken patty is not liquid and will not be calculated in I&O calculation.
The correct ANSWER for output is 1850 mL
12 oz x 30 mL = 360 mL
18 oz x 30 mL = 540 mL
5 oz x 30 mL = 150 mL
800 mL of vomitus= 800 mL
The charge nurse is evaluating infection control practices on the unit. Which action by a
unlicensed assistive personnel (UAP) indicates a need to provide additional education?
- ANSWER-additional education is needed for a unlicensed assistive personnel (UAP)
who completes oral care of a client positive for influenza with just a face shield. If
contact with body fluids are a possibility, a gown, gloves, and goggles or eye protection
should be donned before entering the room.
Which client should be placed in airborne and contact precautions? - ANSWER-This
ANSWER is correct because a client diagnosed with varicella (chicken pox) should be
placed in airborne and contact precautions. Diseases needing airborne precautions
include tuberculosis, measles, chickenpox (Varicella), and SARS. Varicella has open
sores and is transmitted, not only by air, but by touching the vesicles' fluid. Therefore, a
client with varicella (chicken pox) should be placed in airborne and contact precautions.
A client with a deep vein thrombosis in the right leg is receiving heparin subcutaneously
every 12 hours. How should heparin be administered? - ANSWER-25G 5/8'' needle at
90 degrees
The nurse is preparing to administer a dose of digoxin to multiple clients. For which
client should the nurse withhold the medication and contact the health care provider? -
ANSWER-Client w/ a hx of atrial flutter and a hr of 52bpm
