Comprehensive Evolve Pharmacology
HESI Practice Examination: Questions
with Answers & Rationales
Section 1: Basic Principles & Calculations (Questions 1–30)
1. A nurse is preparing to administer 500 mg of an antibiotic. The
pharmacy supplies a vial with 1 g of powder and directs to reconstitute
with 2.5 mL of sterile water to yield 250 mg/mL. How many mL will the
nurse administer?
A) 0.5 mL
B) 1 mL
C) 2 mL
D) 2.5 mL
Answer: C) 2 mL
Rationale: The concentration is 250 mg per 1 mL. The order is for 500
mg. Set up the proportion: 250 mg / 1 mL = 500 mg / X mL. Cross-
multiply: 250X = 500. X = 2 mL.
2. The healthcare provider orders heparin 8,000 units subcutaneously.
The vial reads 10,000 units/mL. How many mL will the nurse
administer?
A) 0.8 mL
B) 1 mL
, C) 1.25 mL
D) 0.5 mL
Answer: A) 0.8 mL
Rationale: Desired over have: 8,000 units / 10,000 units/mL = 0.8 mL.
3. A patient is prescribed 40 mEq of potassium chloride. The
medication is available as 20 mEq per 15 mL. How many mL will the
nurse administer?
A) 15 mL
B) 20 mL
C) 30 mL
D) 45 mL
Answer: C) 30 mL
Rationale: 40 mEq / 20 mEq = 2. 2 x 15 mL = 30 mL.
4. Which patient statement indicates an understanding of the
therapeutic effect of albuterol?
A) "This medication will prevent my asthma attacks."
B) "This medication will thin out my lung secretions."
C) "This medication will open up my airways to help me breathe
easier."
D) "This medication will decrease the inflammation in my lungs."
Answer: C) "This medication will open up my airways to help me
breathe easier."
Rationale: Albuterol is a short-acting beta-2 agonist (SABA) that acts
as a bronchodilator. It does not prevent attacks (that is a controller
med), thin secretions (mucolytics), or primarily treat inflammation
(corticosteroids).
,5. A nurse is performing a medication reconciliation. What is the
primary purpose of this process?
A) To determine the patient's financial ability to pay for medications.
B) To create a complete list of all medications the patient is currently
taking to prevent errors.
C) To administer the first dose of all prescribed medications.
D) To evaluate the patient for side effects of a new drug.
Answer: B) To create a complete list of all medications the patient
is currently taking to prevent errors.
Rationale: Medication reconciliation is the process of creating the
most accurate list possible of all medications a patient is taking and
comparing it to the current orders to avoid omissions, duplications,
and interactions.
6. The prescriber orders digoxin 0.25 mg daily. The available tablet is
0.125 mg. How many tablets will the nurse give?
A) 0.5 tablet
B) 1 tablet
C) 2 tablets
D) 4 tablets
Answer: C) 2 tablets
Rationale: 0.25 mg / 0.125 mg per tablet = 2 tablets.
7. A patient is prescribed 1000 mL of D5W to run over 8 hours. The
drop factor is 15 gtt/mL. Calculate the drip rate in gtt/min.
A) 31 gtt/min
B) 21 gtt/min
C) 125 gtt/min
, D) 15 gtt/min
Answer: A) 31 gtt/min
Rationale: Formula: (Volume x Drop Factor) / Time (min). (1000 mL x
15 gtt/mL) / (8 hrs x 60 min) = = 31.25 gtt/min. Round
down to 31.
8. The nurse is teaching a patient about a new prescription for
nitroglycerin sublingual tablets. Which instruction is correct?
A) "Swallow the tablet with a full glass of water for faster absorption."
B) "Place the tablet between your cheek and gum."
C) "Chew the tablet thoroughly before swallowing."
D) "Place the tablet under your tongue and let it dissolve completely."
Answer: D) "Place the tablet under your tongue and let it dissolve
completely."
Rationale: Sublingual administration means placing the drug under
the tongue, where it dissolves and is absorbed directly into the
bloodstream through the mucosal tissue, bypassing first-pass
metabolism.
9. Which of the following is a toxic effect of acetaminophen?
A) Nephrotoxicity
B) Hepatotoxicity
C) Cardiotoxicity
D) Ototoxicity
Answer: B) Hepatotoxicity
Rationale: Acetaminophen is metabolized by the liver. In high doses,
the hepatic pathways become saturated, leading to the production of
a toxic metabolite (NAPQI) that causes severe liver damage. The
maximum daily dose for adults is generally 3,000–4,000 mg.
HESI Practice Examination: Questions
with Answers & Rationales
Section 1: Basic Principles & Calculations (Questions 1–30)
1. A nurse is preparing to administer 500 mg of an antibiotic. The
pharmacy supplies a vial with 1 g of powder and directs to reconstitute
with 2.5 mL of sterile water to yield 250 mg/mL. How many mL will the
nurse administer?
A) 0.5 mL
B) 1 mL
C) 2 mL
D) 2.5 mL
Answer: C) 2 mL
Rationale: The concentration is 250 mg per 1 mL. The order is for 500
mg. Set up the proportion: 250 mg / 1 mL = 500 mg / X mL. Cross-
multiply: 250X = 500. X = 2 mL.
2. The healthcare provider orders heparin 8,000 units subcutaneously.
The vial reads 10,000 units/mL. How many mL will the nurse
administer?
A) 0.8 mL
B) 1 mL
, C) 1.25 mL
D) 0.5 mL
Answer: A) 0.8 mL
Rationale: Desired over have: 8,000 units / 10,000 units/mL = 0.8 mL.
3. A patient is prescribed 40 mEq of potassium chloride. The
medication is available as 20 mEq per 15 mL. How many mL will the
nurse administer?
A) 15 mL
B) 20 mL
C) 30 mL
D) 45 mL
Answer: C) 30 mL
Rationale: 40 mEq / 20 mEq = 2. 2 x 15 mL = 30 mL.
4. Which patient statement indicates an understanding of the
therapeutic effect of albuterol?
A) "This medication will prevent my asthma attacks."
B) "This medication will thin out my lung secretions."
C) "This medication will open up my airways to help me breathe
easier."
D) "This medication will decrease the inflammation in my lungs."
Answer: C) "This medication will open up my airways to help me
breathe easier."
Rationale: Albuterol is a short-acting beta-2 agonist (SABA) that acts
as a bronchodilator. It does not prevent attacks (that is a controller
med), thin secretions (mucolytics), or primarily treat inflammation
(corticosteroids).
,5. A nurse is performing a medication reconciliation. What is the
primary purpose of this process?
A) To determine the patient's financial ability to pay for medications.
B) To create a complete list of all medications the patient is currently
taking to prevent errors.
C) To administer the first dose of all prescribed medications.
D) To evaluate the patient for side effects of a new drug.
Answer: B) To create a complete list of all medications the patient
is currently taking to prevent errors.
Rationale: Medication reconciliation is the process of creating the
most accurate list possible of all medications a patient is taking and
comparing it to the current orders to avoid omissions, duplications,
and interactions.
6. The prescriber orders digoxin 0.25 mg daily. The available tablet is
0.125 mg. How many tablets will the nurse give?
A) 0.5 tablet
B) 1 tablet
C) 2 tablets
D) 4 tablets
Answer: C) 2 tablets
Rationale: 0.25 mg / 0.125 mg per tablet = 2 tablets.
7. A patient is prescribed 1000 mL of D5W to run over 8 hours. The
drop factor is 15 gtt/mL. Calculate the drip rate in gtt/min.
A) 31 gtt/min
B) 21 gtt/min
C) 125 gtt/min
, D) 15 gtt/min
Answer: A) 31 gtt/min
Rationale: Formula: (Volume x Drop Factor) / Time (min). (1000 mL x
15 gtt/mL) / (8 hrs x 60 min) = = 31.25 gtt/min. Round
down to 31.
8. The nurse is teaching a patient about a new prescription for
nitroglycerin sublingual tablets. Which instruction is correct?
A) "Swallow the tablet with a full glass of water for faster absorption."
B) "Place the tablet between your cheek and gum."
C) "Chew the tablet thoroughly before swallowing."
D) "Place the tablet under your tongue and let it dissolve completely."
Answer: D) "Place the tablet under your tongue and let it dissolve
completely."
Rationale: Sublingual administration means placing the drug under
the tongue, where it dissolves and is absorbed directly into the
bloodstream through the mucosal tissue, bypassing first-pass
metabolism.
9. Which of the following is a toxic effect of acetaminophen?
A) Nephrotoxicity
B) Hepatotoxicity
C) Cardiotoxicity
D) Ototoxicity
Answer: B) Hepatotoxicity
Rationale: Acetaminophen is metabolized by the liver. In high doses,
the hepatic pathways become saturated, leading to the production of
a toxic metabolite (NAPQI) that causes severe liver damage. The
maximum daily dose for adults is generally 3,000–4,000 mg.
