HESI PHARMACOLOGY EXAM
PRACTICE WITH CORRECT
ANSWERS 2025
149.) A client taking fexofenadine (Allegra) is scheduled for allergy skin
testing and tells the nurse in the health care provider's office that a dose was
taken this morning. The nurse determines that:
1. The client should reschedule the appointment.
2. A lower dose of allergen will need to be injected.
3. A higher dose of allergen will need to be injected.
4. The client should have the skin test read a day later than usual.
( correct answers ) 1. The client should reschedule the appointment.
Rationale:
Fexofenadine is an antihistamine, which provides relief of symptoms caused
by allergy. Antihistamines should be discontinued for at least 3 days (72
hours) before allergy skin testing to avoid false-negative readings. This client
should have the appointment rescheduled for 3 days after discontinuing the
medication.
150.) A client complaining of not feeling well is seen in a clinic. The client is
taking several medications for the control of heart disease and hypertension.
These medications include a β-blocker, digoxin (Lanoxin), and a diuretic. A
tentative diagnosis of digoxin toxicity is made. Which of the following
assessment data would support this diagnosis?
1. Dyspnea, edema, and palpitations
2. Chest pain, hypotension, and paresthesia
GRADED A+
,3. Double vision, loss of appetite, and nausea
4. Constipation, dry mouth, and sleep disorder ( correct answers ) 3.
Double vision, loss of appetite, and nausea
Rationale:
Double vision, loss of appetite, and nausea are signs of digoxin toxicity.
Additional signs of digoxin toxicity include bradycardia, difficulty reading,
visual alterations such as green and yellow vision or seeing spots or halos,
confusion, vomiting, diarrhea, decreased libido, and impotence.
**gastrointestinal (GI) and visual disturbances occur with digoxin toxicity**
151.) A client is being treated for acute congestive heart failure with
intravenously administered bumetanide. The vital signs are as follows: blood
pressure, 100/60 mm Hg; pulse, 96 beats/min; and respirations, 24
breaths/min. After the initial dose, which of the following is the priority
assessment?
1. Monitoring weight loss
2. Monitoring temperature
3. Monitoring blood pressure
4. Monitoring potassium level ( correct answers ) 3. Monitoring blood
pressure
Rationale:
Bumetanide is a loop diuretic. Hypotension is a common side effect
associated with the use of this medication. The other options also require
assessment but are not the priority.
**priority ABCs—airway, breathing, and circulation**
152.) Intravenous heparin therapy is prescribed for a client. While
implementing this prescription, a nurse ensures that which of the following
medications is available on the nursing unit?
1. Protamine sulfate
2. Potassium chloride
3. Phytonadione (vitamin K )
GRADED A+
,4. Aminocaproic acid (Amicar) ( correct answers ) 1. Protamine sulfate
Rationale:
The antidote to heparin is protamine sulfate; it should be readily available for
use if excessive bleeding or hemorrhage occurs. Potassium chloride is
administered for a potassium deficit. Vitamin K is an antidote for warfarin
sodium. Aminocaproic acid is the antidote for thrombolytic therapy.
153.) A client is diagnosed with pulmonary embolism and is to be treated
with streptokinase (Streptase). A nurse would report which priority data
collection finding to the registered nurse before initiating this therapy?
1. Adventitious breath sounds
2. Temperature of 99.4° F orally
3. Blood pressure of 198/110 mm Hg
4. Respiratory rate of 28 breaths/min ( correct answers ) 3. Blood
pressure of 198/110 mm Hg
Rationale:
Thrombolytic therapy is contraindicated in a number of preexisting
conditions in which there is a risk of uncontrolled bleeding, similar to the
case in anticoagulant therapy. Thrombolytic therapy also is contraindicated
in severe uncontrolled hypertension because of the risk of cerebral
hemorrhage. Therefore the nurse would report the results of the blood
pressure to the registered nurse before initiating therapy. The findings in
options 1, 2, and 4 may be present in the client with pulmonary embolism.
154.) A nurse is reinforcing dietary instructions to a client who has been
prescribed cyclosporine (Sandimmune). Which food item would the nurse
instruct the client to avoid?
1. Red meats
2. Orange juice
3. Grapefruit juice
4. Green, leafy vegetables ( correct answers ) 3. Grapefruit juice
Rationale:
GRADED A+
, A compound present in grapefruit juice inhibits metabolism of cyclosporine.
As a result, the consumption of grapefruit juice can raise cyclosporine levels
by 50% to 100%, thereby greatly increasing the risk of toxicity. Grapefruit
juice needs to be avoided. Red meats, orange juice, and green leafy
vegetables are acceptable to consume.
155.) Mycophenolate mofetil (CellCept) is prescribed for a client as
prophylaxis for organ rejection following an allogeneic renal transplant.
Which of the following instructions does the nurse reinforce regarding
administration of this medication?
1. Administer following meals.
2. Take the medication with a magnesium-type antacid.
3. Open the capsule and mix with food for administration.
4. Contact the health care provider (HCP) if a sore throat occurs. ( correct
answers ) 4. Contact the health care provider (HCP) if a sore throat occurs.
Rationale:
Mycophenolate mofetil should be administered on an empty stomach. The
capsules should not be opened or crushed. The client should contact the HCP
if unusual bleeding or bruising, sore throat, mouth sores, abdominal pain, or
fever occurs because these are adverse effects of the medication. Antacids
containing magnesium and aluminum may decrease the absorption of the
medication and therefore should not be taken with the medication. The
medication may be given in combination with corticosteroids and
cyclosporine.
**neutropenia can occur with this medication**
156.) A nurse is reviewing the laboratory results for a client receiving
tacrolimus (Prograf). Which laboratory result would indicate to the nurse that
the client is experiencing an adverse effect of the medication?
1. Blood glucose of 200 mg/dL
2. Potassium level of 3.8 mEq/L
3. Platelet count of 300,000 cells/mm3
4. White blood cell count of 6000 cells/mm3 ( correct answers ) 1. Blood
glucose of 200 mg/dL
GRADED A+
PRACTICE WITH CORRECT
ANSWERS 2025
149.) A client taking fexofenadine (Allegra) is scheduled for allergy skin
testing and tells the nurse in the health care provider's office that a dose was
taken this morning. The nurse determines that:
1. The client should reschedule the appointment.
2. A lower dose of allergen will need to be injected.
3. A higher dose of allergen will need to be injected.
4. The client should have the skin test read a day later than usual.
( correct answers ) 1. The client should reschedule the appointment.
Rationale:
Fexofenadine is an antihistamine, which provides relief of symptoms caused
by allergy. Antihistamines should be discontinued for at least 3 days (72
hours) before allergy skin testing to avoid false-negative readings. This client
should have the appointment rescheduled for 3 days after discontinuing the
medication.
150.) A client complaining of not feeling well is seen in a clinic. The client is
taking several medications for the control of heart disease and hypertension.
These medications include a β-blocker, digoxin (Lanoxin), and a diuretic. A
tentative diagnosis of digoxin toxicity is made. Which of the following
assessment data would support this diagnosis?
1. Dyspnea, edema, and palpitations
2. Chest pain, hypotension, and paresthesia
GRADED A+
,3. Double vision, loss of appetite, and nausea
4. Constipation, dry mouth, and sleep disorder ( correct answers ) 3.
Double vision, loss of appetite, and nausea
Rationale:
Double vision, loss of appetite, and nausea are signs of digoxin toxicity.
Additional signs of digoxin toxicity include bradycardia, difficulty reading,
visual alterations such as green and yellow vision or seeing spots or halos,
confusion, vomiting, diarrhea, decreased libido, and impotence.
**gastrointestinal (GI) and visual disturbances occur with digoxin toxicity**
151.) A client is being treated for acute congestive heart failure with
intravenously administered bumetanide. The vital signs are as follows: blood
pressure, 100/60 mm Hg; pulse, 96 beats/min; and respirations, 24
breaths/min. After the initial dose, which of the following is the priority
assessment?
1. Monitoring weight loss
2. Monitoring temperature
3. Monitoring blood pressure
4. Monitoring potassium level ( correct answers ) 3. Monitoring blood
pressure
Rationale:
Bumetanide is a loop diuretic. Hypotension is a common side effect
associated with the use of this medication. The other options also require
assessment but are not the priority.
**priority ABCs—airway, breathing, and circulation**
152.) Intravenous heparin therapy is prescribed for a client. While
implementing this prescription, a nurse ensures that which of the following
medications is available on the nursing unit?
1. Protamine sulfate
2. Potassium chloride
3. Phytonadione (vitamin K )
GRADED A+
,4. Aminocaproic acid (Amicar) ( correct answers ) 1. Protamine sulfate
Rationale:
The antidote to heparin is protamine sulfate; it should be readily available for
use if excessive bleeding or hemorrhage occurs. Potassium chloride is
administered for a potassium deficit. Vitamin K is an antidote for warfarin
sodium. Aminocaproic acid is the antidote for thrombolytic therapy.
153.) A client is diagnosed with pulmonary embolism and is to be treated
with streptokinase (Streptase). A nurse would report which priority data
collection finding to the registered nurse before initiating this therapy?
1. Adventitious breath sounds
2. Temperature of 99.4° F orally
3. Blood pressure of 198/110 mm Hg
4. Respiratory rate of 28 breaths/min ( correct answers ) 3. Blood
pressure of 198/110 mm Hg
Rationale:
Thrombolytic therapy is contraindicated in a number of preexisting
conditions in which there is a risk of uncontrolled bleeding, similar to the
case in anticoagulant therapy. Thrombolytic therapy also is contraindicated
in severe uncontrolled hypertension because of the risk of cerebral
hemorrhage. Therefore the nurse would report the results of the blood
pressure to the registered nurse before initiating therapy. The findings in
options 1, 2, and 4 may be present in the client with pulmonary embolism.
154.) A nurse is reinforcing dietary instructions to a client who has been
prescribed cyclosporine (Sandimmune). Which food item would the nurse
instruct the client to avoid?
1. Red meats
2. Orange juice
3. Grapefruit juice
4. Green, leafy vegetables ( correct answers ) 3. Grapefruit juice
Rationale:
GRADED A+
, A compound present in grapefruit juice inhibits metabolism of cyclosporine.
As a result, the consumption of grapefruit juice can raise cyclosporine levels
by 50% to 100%, thereby greatly increasing the risk of toxicity. Grapefruit
juice needs to be avoided. Red meats, orange juice, and green leafy
vegetables are acceptable to consume.
155.) Mycophenolate mofetil (CellCept) is prescribed for a client as
prophylaxis for organ rejection following an allogeneic renal transplant.
Which of the following instructions does the nurse reinforce regarding
administration of this medication?
1. Administer following meals.
2. Take the medication with a magnesium-type antacid.
3. Open the capsule and mix with food for administration.
4. Contact the health care provider (HCP) if a sore throat occurs. ( correct
answers ) 4. Contact the health care provider (HCP) if a sore throat occurs.
Rationale:
Mycophenolate mofetil should be administered on an empty stomach. The
capsules should not be opened or crushed. The client should contact the HCP
if unusual bleeding or bruising, sore throat, mouth sores, abdominal pain, or
fever occurs because these are adverse effects of the medication. Antacids
containing magnesium and aluminum may decrease the absorption of the
medication and therefore should not be taken with the medication. The
medication may be given in combination with corticosteroids and
cyclosporine.
**neutropenia can occur with this medication**
156.) A nurse is reviewing the laboratory results for a client receiving
tacrolimus (Prograf). Which laboratory result would indicate to the nurse that
the client is experiencing an adverse effect of the medication?
1. Blood glucose of 200 mg/dL
2. Potassium level of 3.8 mEq/L
3. Platelet count of 300,000 cells/mm3
4. White blood cell count of 6000 cells/mm3 ( correct answers ) 1. Blood
glucose of 200 mg/dL
GRADED A+
