STUDY NOTES & REFERENCE GUIDE
PHARMACOLOGY PRACTICE HESI ···
EXAM
ADULT HEALTH 1 ··
ACTUAL QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES
2026 \2027 UPDATED
Fundamentals of Nursing
LecClara Stuvia | Page 1 of 113
, STUDY NOTES & REFERENCE GUIDE
A 43-year-old female client is prescribed thyroid replacement hormone following a
·
thyroidectomy. Which adverse effects should the nurse instruct the client to report
·
immediately to the healthcare provider? - Correct Answer✅-Tinnitus and dizziness.
···
Tachycardia and chest pain. Correct ···
Dry skin and intolerance to cold.
·
Weight gain and increased appetite.
·
Thyroid replacement hormone increases the metabolic rate of all tissues. Common signs
·
and symptoms of toxicity include tachycardia and chest pain and should be reported to
·
the healthcare provider immediately.
·
A Category X drug is prescribed for a young adult female client. Which instruction is
···
most important for the nurse to teach this client? - Correct Answer✅-Use a reliable
form of birth control. Correct
Avoid exposure to ultra violet light.
Refuse this medication if planning pregnancy.
Abstain from intercourse while on this drug.
Drugs classified in the Category X place a client who is in the first trimester of
pregnancy at risk for teratogenesis, so women in the childbearing years should be
counseled to use a reliable form of birth control during drug therapy. If the client is
planning to become pregnant, she should be encouraged to discuss plans for pregnancy
with the healthcare provider, so a safer alternative prescription can be provided if
pregnancy occurs.
A client asks the nurse if glipizide (Glucotrol) is an oral insulin. Which response should
the nurse provide? - Correct Answer✅-"Yes, it is an oral insulin and has the same
actions and properties as intermediate insulin."
"Yes, it is an oral insulin and is distributed, metabolized, and excreted in the same
manner as insulin."
"No, it is not an oral insulin and can be used only when some beta cell function is
present." Correct
"No, it is not an oral insulin, but it is effective for those who are resistant to injectable
insulins."
An effective oral form of insulin has not yet been developed because when insulin is
taken orally, it is destroyed by digestive enzymes. Glipizide (Glucotrol) is an oral
hypoglycemic agent that enhances pancreatic production of insulin.
LecClara Stuvia | Page 2 of 113
, STUDY NOTES & REFERENCE GUIDE
A client being discharged home is prescribed an antibiotic with a dosage three times
higher than it was administered when the client was in the hospital. Which route of
administration should the nurse anticipate will be prescribed for the greatest first-pass
effect? - Correct Answer✅-Oral. Correct
Sublingual.
Intravenous.
Subcutaneous.
The first-pass effect is a pharmacokinetic phenomenon that is related to the drug's
metabolism in the liver. After oral medications are absorbed from the gastrointestinal
tract, the drug is carried directly to the liver via the hepatic portal circulation, where
hepatic inactivation occurs and reduces the bioavailability (strength/concentration) of
the drug.
A client being discharged is prescribed warfarin for the treatment following a
pulmonary embolism. Which diagnostic test should the nurse instruct the client to
receive once a month? - Correct Answer✅-Perfusion scan.
Prothrombin Time (PT). Correct
Activated partial thromboplastin (aPTT).
Serum Coumadin level (SCL).
When used for a client with pulmonary embolus, the therapeutic goal for warfarin
therapy is a PT 1 to 2 times greater than the control, or an INR of 2 to 3. A client
prescribed warfarin should have the PT or INR levels checked at a minimum once a
month.
A client being treated for hyperthyroidism with propylthiouracil (PTU) asks the nurse
how the medication works. Which is the best response to give the client? - Correct
Answer✅-It decreases the amount of thyroid-stimulating hormone circulating in the
blood.
It increases the amount of thyroid-stimulating hormone circulating in the blood.
It enhances the amount of T4 and diminishes the amount of T3 produced by the thyroid.
It inhibits the synthesis of T3 and T4 by the thyroid gland. Correct
Propylthiouracil (PTU) is an adjunct therapy used to control hyperthyroidism by
inhibiting the production of thyroid hormones. It is often prescribed in preparation for
thyroidectomy or radioactive iodine therapy.
A client has a continuous IV infusion of dopamine (Intropin) and an IV of normal saline
at 50 mL/hour. The nurse notes that the client's urinary output has been 20 mL/hour
LecClara Stuvia | Page 3 of 113
, STUDY NOTES & REFERENCE GUIDE
for the last 2 hours. Which intervention should the nurse initiate? - Correct Answer✅-
Stop the infusion of dopamine.
Change the normal saline to a keep open rate.
Replace the urinary catheter.
Notify the healthcare provider of the urinary output. Correct
The main effect of dopamine is adrenergic stimulation used to increase cardiac output,
which should also result in increased urinary output. A urinary output of less than 20
mL/hour is oliguria and should be reported to the healthcare provider, so the dose of
dopamine can be adjusted. Depending on the current rate of administration, the dose
may need to be increased or decreased.
A client is admitted to the hospital for a new onset of supraventricular tachycardia
(SVT) and is prescribed digoxin. For which laboratory finding should the nurse notify
the healthcare provider immediately? - Correct Answer✅-Potassium level of 3.1
mEq/L. Correct
Sodium level of 132 mEq/L.
Calcium level of 8.6 mg/dL.
Magnesium level of 1.2 mEq/L.
Hypokalemia affects myocardial contractility and places this client at greatest risk for
dysrhythmias that may be unresponsive to drug therapy. Although an imbalance of
serum sodium, calcium, and magnesium can effect cardiac rhythm, the greatest risk for a
client receiving digoxin is low potassium.
A client is admitted to the hospital for diagnostic testing for possible myasthenia gravis.
The nurse prepares for intravenous administration of edrophonium chloride (Tensilon).
What is the expected outcome for this client following administration of this
pharmacologic agent? - Correct Answer✅-Progressive difficulty with swallowing.
Decreased respiratory effort.
Improvement in generalized fatigue.
Decreased muscle weakness. Correct
Administration of edrophonium chloride (Tensilon), a cholinergic agent, will
temporarily reduce muscle weakness, the most common complaint of newly-diagnosed
clients with myasthenia gravis. This medication is used to diagnose myasthenia gravis
due to its short duration of action. This drug would temporarily reverse difficulty in
swallowing and respiratory effort.
LecClara Stuvia | Page 4 of 113
PHARMACOLOGY PRACTICE HESI ···
EXAM
ADULT HEALTH 1 ··
ACTUAL QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES
2026 \2027 UPDATED
Fundamentals of Nursing
LecClara Stuvia | Page 1 of 113
, STUDY NOTES & REFERENCE GUIDE
A 43-year-old female client is prescribed thyroid replacement hormone following a
·
thyroidectomy. Which adverse effects should the nurse instruct the client to report
·
immediately to the healthcare provider? - Correct Answer✅-Tinnitus and dizziness.
···
Tachycardia and chest pain. Correct ···
Dry skin and intolerance to cold.
·
Weight gain and increased appetite.
·
Thyroid replacement hormone increases the metabolic rate of all tissues. Common signs
·
and symptoms of toxicity include tachycardia and chest pain and should be reported to
·
the healthcare provider immediately.
·
A Category X drug is prescribed for a young adult female client. Which instruction is
···
most important for the nurse to teach this client? - Correct Answer✅-Use a reliable
form of birth control. Correct
Avoid exposure to ultra violet light.
Refuse this medication if planning pregnancy.
Abstain from intercourse while on this drug.
Drugs classified in the Category X place a client who is in the first trimester of
pregnancy at risk for teratogenesis, so women in the childbearing years should be
counseled to use a reliable form of birth control during drug therapy. If the client is
planning to become pregnant, she should be encouraged to discuss plans for pregnancy
with the healthcare provider, so a safer alternative prescription can be provided if
pregnancy occurs.
A client asks the nurse if glipizide (Glucotrol) is an oral insulin. Which response should
the nurse provide? - Correct Answer✅-"Yes, it is an oral insulin and has the same
actions and properties as intermediate insulin."
"Yes, it is an oral insulin and is distributed, metabolized, and excreted in the same
manner as insulin."
"No, it is not an oral insulin and can be used only when some beta cell function is
present." Correct
"No, it is not an oral insulin, but it is effective for those who are resistant to injectable
insulins."
An effective oral form of insulin has not yet been developed because when insulin is
taken orally, it is destroyed by digestive enzymes. Glipizide (Glucotrol) is an oral
hypoglycemic agent that enhances pancreatic production of insulin.
LecClara Stuvia | Page 2 of 113
, STUDY NOTES & REFERENCE GUIDE
A client being discharged home is prescribed an antibiotic with a dosage three times
higher than it was administered when the client was in the hospital. Which route of
administration should the nurse anticipate will be prescribed for the greatest first-pass
effect? - Correct Answer✅-Oral. Correct
Sublingual.
Intravenous.
Subcutaneous.
The first-pass effect is a pharmacokinetic phenomenon that is related to the drug's
metabolism in the liver. After oral medications are absorbed from the gastrointestinal
tract, the drug is carried directly to the liver via the hepatic portal circulation, where
hepatic inactivation occurs and reduces the bioavailability (strength/concentration) of
the drug.
A client being discharged is prescribed warfarin for the treatment following a
pulmonary embolism. Which diagnostic test should the nurse instruct the client to
receive once a month? - Correct Answer✅-Perfusion scan.
Prothrombin Time (PT). Correct
Activated partial thromboplastin (aPTT).
Serum Coumadin level (SCL).
When used for a client with pulmonary embolus, the therapeutic goal for warfarin
therapy is a PT 1 to 2 times greater than the control, or an INR of 2 to 3. A client
prescribed warfarin should have the PT or INR levels checked at a minimum once a
month.
A client being treated for hyperthyroidism with propylthiouracil (PTU) asks the nurse
how the medication works. Which is the best response to give the client? - Correct
Answer✅-It decreases the amount of thyroid-stimulating hormone circulating in the
blood.
It increases the amount of thyroid-stimulating hormone circulating in the blood.
It enhances the amount of T4 and diminishes the amount of T3 produced by the thyroid.
It inhibits the synthesis of T3 and T4 by the thyroid gland. Correct
Propylthiouracil (PTU) is an adjunct therapy used to control hyperthyroidism by
inhibiting the production of thyroid hormones. It is often prescribed in preparation for
thyroidectomy or radioactive iodine therapy.
A client has a continuous IV infusion of dopamine (Intropin) and an IV of normal saline
at 50 mL/hour. The nurse notes that the client's urinary output has been 20 mL/hour
LecClara Stuvia | Page 3 of 113
, STUDY NOTES & REFERENCE GUIDE
for the last 2 hours. Which intervention should the nurse initiate? - Correct Answer✅-
Stop the infusion of dopamine.
Change the normal saline to a keep open rate.
Replace the urinary catheter.
Notify the healthcare provider of the urinary output. Correct
The main effect of dopamine is adrenergic stimulation used to increase cardiac output,
which should also result in increased urinary output. A urinary output of less than 20
mL/hour is oliguria and should be reported to the healthcare provider, so the dose of
dopamine can be adjusted. Depending on the current rate of administration, the dose
may need to be increased or decreased.
A client is admitted to the hospital for a new onset of supraventricular tachycardia
(SVT) and is prescribed digoxin. For which laboratory finding should the nurse notify
the healthcare provider immediately? - Correct Answer✅-Potassium level of 3.1
mEq/L. Correct
Sodium level of 132 mEq/L.
Calcium level of 8.6 mg/dL.
Magnesium level of 1.2 mEq/L.
Hypokalemia affects myocardial contractility and places this client at greatest risk for
dysrhythmias that may be unresponsive to drug therapy. Although an imbalance of
serum sodium, calcium, and magnesium can effect cardiac rhythm, the greatest risk for a
client receiving digoxin is low potassium.
A client is admitted to the hospital for diagnostic testing for possible myasthenia gravis.
The nurse prepares for intravenous administration of edrophonium chloride (Tensilon).
What is the expected outcome for this client following administration of this
pharmacologic agent? - Correct Answer✅-Progressive difficulty with swallowing.
Decreased respiratory effort.
Improvement in generalized fatigue.
Decreased muscle weakness. Correct
Administration of edrophonium chloride (Tensilon), a cholinergic agent, will
temporarily reduce muscle weakness, the most common complaint of newly-diagnosed
clients with myasthenia gravis. This medication is used to diagnose myasthenia gravis
due to its short duration of action. This drug would temporarily reverse difficulty in
swallowing and respiratory effort.
LecClara Stuvia | Page 4 of 113
