HESI RN PHARMACOLOGY
V1 EXAM (3 Set Exams)
(NGN style Qs & Case studies)
Actual Qs & Ans to Pass the Exam
This hesi test contains:
passing score Guarantee
Each Exam has 55 Ques and Ans
Format Set of Multiple-choice
questions with incorporating Next Generation
NCLEX (NGN) and Case studies questions
Expert-Verified Explanations & Solutions
,────────────────────────────────────────────────────────
Contents
HESI RN PHARMACOLOGY V1 EXAM ......................................... 2
SET 1 ........................................................................................... 2
HESI RN PHARMACOLOGY V1 EXAM ....................................... 30
SET 2 ......................................................................................... 30
HESI RN PHARMACOLOGY V1 EXAM ....................................... 55
SET 3 ......................................................................................... 55
HESI RN PHARMACOLOGY V1 EXAM
SET 1
────────────────────────────────────────────────────────
────────────────────────────────────────────────────────
1) A client taking atorvasta n develops an increased serum crea ne
phosphokinase (CK) level. The nurse should assess the client for the onset of
which problem?
A. Muscle tenderness
B. Nausea and vomi ng
C. Excessive bruising
D. Peripheral edema
,Correct Answer: A. Muscle tenderness
Expert-Verified Explana/on:
• Sta ns (e.g., atorvasta n) can cause myopathy, which may progress to
rhabdomyolysis in severe cases. An elevated CK level o1en signifies muscle injury.
Muscle tenderness, especially in large muscle groups, is one of the earliest clinical
signs of myopathy. If untreated, severe myopathy can become life-threatening.
────────────────────────────────────────────────────────
2) An increase in which serum laboratory value indicates to the nurse that a
prescrip on for atorvasta n is having the desired effect for a client at risk for
coronary artery disease?
A. LDL (Low-density lipoprotein)
B. Triglycerides
C. HDL (High-density lipoprotein)
D. VLDL (Very low-density lipoprotein)
Correct Answer: C. HDL (High-density lipoprotein)
Expert-Verified Explana/on:
• Atorvasta n lowers LDL primarily but can also modestly raise HDL (“good
cholesterol”). An increase in HDL is protec ve and a sign that therapy is working.
Therapeu c success can also include a decrease in LDL.
────────────────────────────────────────────────────────
3) [NGN - Case Study]
Pa ent Data — History & Physical:
• 36-year-old female with moderate persistent asthma on flu casone/salmeterol
twice daily, albuterol as needed
• Reports more severe symptoms, frequent albuterol use, FEV₁ of 60–65%
• Complaints: dizziness, palpita ons, no wheezes, O₂ sat 99%
,Tasks:
1) Iden fy the likely condi on.
2) State two ac ons to take.
3) State two parameters to monitor.
Likely Condi on: Methemoglobinemia
Ac ons to Take (two examples):
• Draw blood for a CBC
• Administer methylene blue
Parameters to Monitor (two examples):
• Methemoglobin level
• Heart rate and rhythm
Expert-Verified Explana/on:
• Methemoglobin forms when hemoglobin is oxidized and cannot carry O₂
effec vely. Pa ents can present with dizziness, palpita ons, and normal pulse
oximetry readings despite feeling unwell. Methylene blue is the an dote. Heart
rate/rhythm should be monitored because hypoxia can affect cardiac status.
────────────────────────────────────────────────────────
4) A client prescribed gabapen n 300 mg by mouth three mes a day for
postherpe c neuralgia is being discharged. Which symptoms should the nurse tell
the client to report immediately to the healthcare provider?
A. Sexual dysfunc on
B. Gastric irrita on
C. Rapid weight gain
D. Photosensi vity
Correct Answer: B. Gastric irrita on
,Expert-Verified Explana/on:
• Gabapen n commonly causes gastrointes nal upset (e.g., nausea, dyspepsia).
Significant or prolonged GI irrita on warrants provider no fica on. Adjustments
in dosage or medica on administra on me may be needed to ensure compliance
and comfort.
────────────────────────────────────────────────────────
5) A client with chronic lower back pain has been taking the NSAID ibuprofen
twice daily for several months. Which assessment is most important for the nurse
to complete?
A. Assess back pain using a numeric scale
B. Palpate the volume of pedal pulses
C. Determine presence of abdominal pain
D. Evaluate ongoing sleep paQerns
Correct Answer: C. Determine presence of abdominal pain
Expert-Verified Explana/on:
• Chronic NSAID therapy (like ibuprofen) increases the risk of pep c ulcer disease
and GI bleeding. Abdominal pain can be an early indicator. Teaching the client
about recognizing signs such as black, tarry stools or discomfort in the epigastric
region is essen al.
────────────────────────────────────────────────────────
6) The nurse administers risedronate at 0700 to a client with osteoporosis. The
client requests milk to drink with the medica on. Which ac on should the nurse
take?
A. Instruct the client that only water is permiQed with the medica on
B. Assign a UAP to bring a glass of low-fat milk
C. Withhold the medica on un l the client’s breakfast arrives
,D. Consult with the pharmacist about scheduling the dose one hour a1er the
client eats
Correct Answer: A. Instruct the client that only water is permiQed with the
medica on
Expert-Verified Explana/on:
• Risedronate and other bisphosphonates must be taken with plain water on an
empty stomach. Food or other beverages, including milk, interfere with
absorp on and increase the risk of esophageal irrita on. The client should remain
upright for at least 30 minutes a1er taking the drug.
────────────────────────────────────────────────────────
7) Which ac on should the nurse implement to assess the effec veness of the
calcium channel blocker amlodipine?
A. Note the client’s serum calcium levels
B. Monitor the client’s serum electrolytes
C. Review the client’s intake and output
D. Measure the client’s blood pressure
Correct Answer: D. Measure the client’s blood pressure
Expert-Verified Explana/on:
• Amlodipine is primarily prescribed for hypertension. Its direct effect is to lower
blood pressure via vasodila on. Checking BP is the best way to measure its clinical
effec veness.
────────────────────────────────────────────────────────
8) A client is receiving tamsulosin for benign prosta c hyperplasia (BPH). Which
instruc on is most important for the nurse to provide?
A. Use a twice-a-week dosing schedule
,B. Stand and sit up slowly
C. Take the medica on early in the day
D. Reduce daily fluid intake
Correct Answer: B. Stand and sit up slowly
Expert-Verified Explana/on:
• Tamsulosin can cause alpha-1 blockade leading to orthosta c hypotension and
dizziness when changing posi ons. Teaching the client to rise slowly can prevent
falls. Adequate fluid intake remains an important aspect of overall health unless
otherwise contraindicated.
────────────────────────────────────────────────────────
9) A client with chemotherapy-induced nausea has been prescribed
metoclopramide. Which adverse effect is most important to report?
A. Nausea
B. Involuntary movements
C. Diarrhea
D. Unusual irritability
Correct Answer: B. Involuntary movements
Expert-Verified Explana/on:
• Metoclopramide can cause extrapyramidal side effects, such as tardive
dyskinesia (lip-smacking, facial grimacing, tongue protrusion) or acute dystonia.
These signs should be reported immediately, as they can become permanent if
not addressed.
────────────────────────────────────────────────────────
10) A client is receiving orlistat for weight management. Which ongoing
assessment should be used to determine the medica on’s effec veness?
,A. Body mass index
B. Depression screening
C. Daily calorie count
D. Serum protein levels
Correct Answer: A. Body mass index (BMI)
Expert-Verified Explana/on:
• Orlistat reduces fat absorp on, aiding in weight loss. Monitoring weight or
calcula ng BMI is the most direct and objec ve measure of therapeu c
effec veness.
────────────────────────────────────────────────────────
11) Before administering the ini al dose of sumatriptan succinate to a client with
migraine headaches, it is most important to confirm that the client does not have
a history of:
A. Type 2 diabetes mellitus
B. Seasonal allergic rhini s
C. Irritable bowel syndrome
D. Coronary artery disease
Correct Answer: D. Coronary artery disease
Expert-Verified Explana/on:
• Sumatriptan’s mechanism involves constric on of cranial blood vessels. In
clients with coronary artery disease, this vasoconstric ve ac on could precipitate
serious cardiac ischemia or coronary spasm.
────────────────────────────────────────────────────────
12) A client receives a prescrip on for ciprofloxacin 400 mg IV every 12 hours to
be infused over 1 hour. The IV bag has ciprofloxacin 400 mg in 200 mL of D5W.
How many mL/hr should the nurse program the pump to deliver?
,Correct Answer: 200 mL/hr
Expert-Verified Explana/on:
• 200 mL infused over 60 minutes → 200 mL/hr. This ensures appropriate
therapeu c levels and minimizes complica ons.
────────────────────────────────────────────────────────
13) Before administering a laxa ve to a bedfast client, the nurse should first:
A. Determine the frequency and consistency of bowel movements
B. Observe the skin integrity of the rectal and sacral areas
C. Assess the client’s strength in moving and turning
D. Evaluate the client’s ability to recognize the urge to defecate
Correct Answer: A. Determine the frequency and consistency of bowel
movements
Expert-Verified Explana/on:
• Administering laxa ves should be done carefully to avoid diarrhea, dehydra on,
or electrolyte imbalances. Assessing the client’s baseline bowel paQern ensures it
is truly needed.
────────────────────────────────────────────────────────
14) A client who takes methotrexate for rheumatoid arthri s is prescribed
adalimumab. Which instruc ons are necessary?
A. Have a chest x-ray before your first dose
B. Avoid crowds and sick contacts
C. Obtain rou ne vaccina ons on schedule
D. Schedule annual eye exams
Correct Answer: A. Have a chest x-ray before your first dose
, Expert-Verified Explana/on:
• Adalimumab (a TNF inhibitor) increases the risk of reac va ng latent
tuberculosis. Guidelines typically require TB screening (chest x-ray, TB skin test or
IGRA) before ini a ng biologic therapy.
────────────────────────────────────────────────────────
15) Prior to giving asparaginase (Elspar), an an neoplas c agent, which condi on
in the client’s history should prompt the nurse to consult with the provider?
A. Pancrea s
B. Diabetes mellitus
C. Myocardial infarc on
D. Chronic obstruc ve pulmonary disease
Correct Answer: A. Pancrea s
Expert-Verified Explana/on:
• Asparaginase can severely exacerbate or cause pancrea s. It is contraindicated
in clients who have a history of or ac ve pancrea c inflamma on.
────────────────────────────────────────────────────────
16) A client with hypothyroidism is prescribed levothyroxine sodium. The nurse
should instruct the client to report which symptom that suggests overdose?
A. Intolerance to cold
B. Cons pa on
C. Restlessness
D. Decreased appe te
Correct Answer: C. Restlessness
Expert-Verified Explana/on:
V1 EXAM (3 Set Exams)
(NGN style Qs & Case studies)
Actual Qs & Ans to Pass the Exam
This hesi test contains:
passing score Guarantee
Each Exam has 55 Ques and Ans
Format Set of Multiple-choice
questions with incorporating Next Generation
NCLEX (NGN) and Case studies questions
Expert-Verified Explanations & Solutions
,────────────────────────────────────────────────────────
Contents
HESI RN PHARMACOLOGY V1 EXAM ......................................... 2
SET 1 ........................................................................................... 2
HESI RN PHARMACOLOGY V1 EXAM ....................................... 30
SET 2 ......................................................................................... 30
HESI RN PHARMACOLOGY V1 EXAM ....................................... 55
SET 3 ......................................................................................... 55
HESI RN PHARMACOLOGY V1 EXAM
SET 1
────────────────────────────────────────────────────────
────────────────────────────────────────────────────────
1) A client taking atorvasta n develops an increased serum crea ne
phosphokinase (CK) level. The nurse should assess the client for the onset of
which problem?
A. Muscle tenderness
B. Nausea and vomi ng
C. Excessive bruising
D. Peripheral edema
,Correct Answer: A. Muscle tenderness
Expert-Verified Explana/on:
• Sta ns (e.g., atorvasta n) can cause myopathy, which may progress to
rhabdomyolysis in severe cases. An elevated CK level o1en signifies muscle injury.
Muscle tenderness, especially in large muscle groups, is one of the earliest clinical
signs of myopathy. If untreated, severe myopathy can become life-threatening.
────────────────────────────────────────────────────────
2) An increase in which serum laboratory value indicates to the nurse that a
prescrip on for atorvasta n is having the desired effect for a client at risk for
coronary artery disease?
A. LDL (Low-density lipoprotein)
B. Triglycerides
C. HDL (High-density lipoprotein)
D. VLDL (Very low-density lipoprotein)
Correct Answer: C. HDL (High-density lipoprotein)
Expert-Verified Explana/on:
• Atorvasta n lowers LDL primarily but can also modestly raise HDL (“good
cholesterol”). An increase in HDL is protec ve and a sign that therapy is working.
Therapeu c success can also include a decrease in LDL.
────────────────────────────────────────────────────────
3) [NGN - Case Study]
Pa ent Data — History & Physical:
• 36-year-old female with moderate persistent asthma on flu casone/salmeterol
twice daily, albuterol as needed
• Reports more severe symptoms, frequent albuterol use, FEV₁ of 60–65%
• Complaints: dizziness, palpita ons, no wheezes, O₂ sat 99%
,Tasks:
1) Iden fy the likely condi on.
2) State two ac ons to take.
3) State two parameters to monitor.
Likely Condi on: Methemoglobinemia
Ac ons to Take (two examples):
• Draw blood for a CBC
• Administer methylene blue
Parameters to Monitor (two examples):
• Methemoglobin level
• Heart rate and rhythm
Expert-Verified Explana/on:
• Methemoglobin forms when hemoglobin is oxidized and cannot carry O₂
effec vely. Pa ents can present with dizziness, palpita ons, and normal pulse
oximetry readings despite feeling unwell. Methylene blue is the an dote. Heart
rate/rhythm should be monitored because hypoxia can affect cardiac status.
────────────────────────────────────────────────────────
4) A client prescribed gabapen n 300 mg by mouth three mes a day for
postherpe c neuralgia is being discharged. Which symptoms should the nurse tell
the client to report immediately to the healthcare provider?
A. Sexual dysfunc on
B. Gastric irrita on
C. Rapid weight gain
D. Photosensi vity
Correct Answer: B. Gastric irrita on
,Expert-Verified Explana/on:
• Gabapen n commonly causes gastrointes nal upset (e.g., nausea, dyspepsia).
Significant or prolonged GI irrita on warrants provider no fica on. Adjustments
in dosage or medica on administra on me may be needed to ensure compliance
and comfort.
────────────────────────────────────────────────────────
5) A client with chronic lower back pain has been taking the NSAID ibuprofen
twice daily for several months. Which assessment is most important for the nurse
to complete?
A. Assess back pain using a numeric scale
B. Palpate the volume of pedal pulses
C. Determine presence of abdominal pain
D. Evaluate ongoing sleep paQerns
Correct Answer: C. Determine presence of abdominal pain
Expert-Verified Explana/on:
• Chronic NSAID therapy (like ibuprofen) increases the risk of pep c ulcer disease
and GI bleeding. Abdominal pain can be an early indicator. Teaching the client
about recognizing signs such as black, tarry stools or discomfort in the epigastric
region is essen al.
────────────────────────────────────────────────────────
6) The nurse administers risedronate at 0700 to a client with osteoporosis. The
client requests milk to drink with the medica on. Which ac on should the nurse
take?
A. Instruct the client that only water is permiQed with the medica on
B. Assign a UAP to bring a glass of low-fat milk
C. Withhold the medica on un l the client’s breakfast arrives
,D. Consult with the pharmacist about scheduling the dose one hour a1er the
client eats
Correct Answer: A. Instruct the client that only water is permiQed with the
medica on
Expert-Verified Explana/on:
• Risedronate and other bisphosphonates must be taken with plain water on an
empty stomach. Food or other beverages, including milk, interfere with
absorp on and increase the risk of esophageal irrita on. The client should remain
upright for at least 30 minutes a1er taking the drug.
────────────────────────────────────────────────────────
7) Which ac on should the nurse implement to assess the effec veness of the
calcium channel blocker amlodipine?
A. Note the client’s serum calcium levels
B. Monitor the client’s serum electrolytes
C. Review the client’s intake and output
D. Measure the client’s blood pressure
Correct Answer: D. Measure the client’s blood pressure
Expert-Verified Explana/on:
• Amlodipine is primarily prescribed for hypertension. Its direct effect is to lower
blood pressure via vasodila on. Checking BP is the best way to measure its clinical
effec veness.
────────────────────────────────────────────────────────
8) A client is receiving tamsulosin for benign prosta c hyperplasia (BPH). Which
instruc on is most important for the nurse to provide?
A. Use a twice-a-week dosing schedule
,B. Stand and sit up slowly
C. Take the medica on early in the day
D. Reduce daily fluid intake
Correct Answer: B. Stand and sit up slowly
Expert-Verified Explana/on:
• Tamsulosin can cause alpha-1 blockade leading to orthosta c hypotension and
dizziness when changing posi ons. Teaching the client to rise slowly can prevent
falls. Adequate fluid intake remains an important aspect of overall health unless
otherwise contraindicated.
────────────────────────────────────────────────────────
9) A client with chemotherapy-induced nausea has been prescribed
metoclopramide. Which adverse effect is most important to report?
A. Nausea
B. Involuntary movements
C. Diarrhea
D. Unusual irritability
Correct Answer: B. Involuntary movements
Expert-Verified Explana/on:
• Metoclopramide can cause extrapyramidal side effects, such as tardive
dyskinesia (lip-smacking, facial grimacing, tongue protrusion) or acute dystonia.
These signs should be reported immediately, as they can become permanent if
not addressed.
────────────────────────────────────────────────────────
10) A client is receiving orlistat for weight management. Which ongoing
assessment should be used to determine the medica on’s effec veness?
,A. Body mass index
B. Depression screening
C. Daily calorie count
D. Serum protein levels
Correct Answer: A. Body mass index (BMI)
Expert-Verified Explana/on:
• Orlistat reduces fat absorp on, aiding in weight loss. Monitoring weight or
calcula ng BMI is the most direct and objec ve measure of therapeu c
effec veness.
────────────────────────────────────────────────────────
11) Before administering the ini al dose of sumatriptan succinate to a client with
migraine headaches, it is most important to confirm that the client does not have
a history of:
A. Type 2 diabetes mellitus
B. Seasonal allergic rhini s
C. Irritable bowel syndrome
D. Coronary artery disease
Correct Answer: D. Coronary artery disease
Expert-Verified Explana/on:
• Sumatriptan’s mechanism involves constric on of cranial blood vessels. In
clients with coronary artery disease, this vasoconstric ve ac on could precipitate
serious cardiac ischemia or coronary spasm.
────────────────────────────────────────────────────────
12) A client receives a prescrip on for ciprofloxacin 400 mg IV every 12 hours to
be infused over 1 hour. The IV bag has ciprofloxacin 400 mg in 200 mL of D5W.
How many mL/hr should the nurse program the pump to deliver?
,Correct Answer: 200 mL/hr
Expert-Verified Explana/on:
• 200 mL infused over 60 minutes → 200 mL/hr. This ensures appropriate
therapeu c levels and minimizes complica ons.
────────────────────────────────────────────────────────
13) Before administering a laxa ve to a bedfast client, the nurse should first:
A. Determine the frequency and consistency of bowel movements
B. Observe the skin integrity of the rectal and sacral areas
C. Assess the client’s strength in moving and turning
D. Evaluate the client’s ability to recognize the urge to defecate
Correct Answer: A. Determine the frequency and consistency of bowel
movements
Expert-Verified Explana/on:
• Administering laxa ves should be done carefully to avoid diarrhea, dehydra on,
or electrolyte imbalances. Assessing the client’s baseline bowel paQern ensures it
is truly needed.
────────────────────────────────────────────────────────
14) A client who takes methotrexate for rheumatoid arthri s is prescribed
adalimumab. Which instruc ons are necessary?
A. Have a chest x-ray before your first dose
B. Avoid crowds and sick contacts
C. Obtain rou ne vaccina ons on schedule
D. Schedule annual eye exams
Correct Answer: A. Have a chest x-ray before your first dose
, Expert-Verified Explana/on:
• Adalimumab (a TNF inhibitor) increases the risk of reac va ng latent
tuberculosis. Guidelines typically require TB screening (chest x-ray, TB skin test or
IGRA) before ini a ng biologic therapy.
────────────────────────────────────────────────────────
15) Prior to giving asparaginase (Elspar), an an neoplas c agent, which condi on
in the client’s history should prompt the nurse to consult with the provider?
A. Pancrea s
B. Diabetes mellitus
C. Myocardial infarc on
D. Chronic obstruc ve pulmonary disease
Correct Answer: A. Pancrea s
Expert-Verified Explana/on:
• Asparaginase can severely exacerbate or cause pancrea s. It is contraindicated
in clients who have a history of or ac ve pancrea c inflamma on.
────────────────────────────────────────────────────────
16) A client with hypothyroidism is prescribed levothyroxine sodium. The nurse
should instruct the client to report which symptom that suggests overdose?
A. Intolerance to cold
B. Cons pa on
C. Restlessness
D. Decreased appe te
Correct Answer: C. Restlessness
Expert-Verified Explana/on:
