HESI PHARMACOLOGY EXIT 2026 TEST
PAPER QUESTIONS AND SOLUTIONS
EXAMPREP
⩥ Which nursing intervention is most important when caring for a client
receiving the antimetabolite cytosine arabinoside (Arc-C) for
chemotherapy?
A) Hydrate the client with IV fluids before and after infusion.
B) Assess the client for numbness and tingling of extremities.
C) Inspect the client's oral mucosa for ulcerations.
D) Monitor the client's urine pH for increased acidity. Answer: C)
Inspect the client's oral mucosa for ulcerations.
Cytosine arabinoside (Arc-C) affects the rapidly growing cells of the
body, therefore stomatitis and mucosal ulcerations are key signs of
antimetabolite toxicity (C). (A, B, and D) are not typical interventions
associated with the administration of antimetabolites.
⩥ When assessing an adolescent who recently overdosed on
acetaminophen (Tylenol), it is most important for the nurse to assess for
pain in which area of the body?
A) Flank.
B) Abdomen.
C) Chest.
,D) Head. Answer: B) Abdomen.
Acetaminophen toxicity can result in liver damage; therefore, it is
especially important for the nurse to assess for pain in the right upper
quadrant of the abdomen (B), which might indicate liver damage. (A, C,
and D) are not areas where pain would be anticipated.
⩥ An adult client is given a prescription for a scopolamine patch
(Transderm Scop) to prevent motion sickness while on a cruise. Which
information should the nurse provide to the client?
A) Apply the patch at least 4 hours prior to departure.
B) Change the patch every other day while on the cruise.
C) Place the patch on a hairless area at the base of the skull.
D) Drink no more than 2 alcoholic drinks during the cruise. Answer: A)
Apply the patch at least 4 hours prior to departure.
Scopolamine, an anticholinergic agent, is used to prevent motion
sickness and has a peak onset in 6 hours, so the client should be
instructed to apply the patch at least 4 hours before departure (A) on the
cruise ship. The duration of the transdermal patch is 72 hours, so (B) is
not needed. Scolopamine blocks muscarinic receptors in the inner ear
and to the vomiting center, so the best application site of the patch is
behind the ear, not at the base of the skull (C). Anticholinergic
medications are CNS depressants, so the client should be instructed to
avoid alcohol (D) while using the patch.
,⩥ The nurse is reviewing the use of the patient-controlled analgesia
(PCA) pump with a client in the immediate postoperative period. The
client will receive morphine 1 mg IV per hour basal rate with 1 mg IV
every 15 minutes per PCA to total 5 mg IV maximally per hour. What
assessment has the highest priority before initiating the PCA pump?
A) The expiration date on the morphine syringe in the pump.
B) The rate and depth of the client's respirations.
C) The type of anesthesia used during the surgical procedure.
D) The client's subjective and objective signs of pain. Answer: B) The
rate and depth of the client's respirations.
A life-threatening side effect of intravenous administration of morphine
sulfate, an opiate narcotic, is respiratory depression (B). The PCA pump
should be stopped and the healthcare provider notified if the client's
respiratory rate falls below 12 breaths per minute, and the nurse should
anticipate adjustments in the client's dosage before the PCA pump is
restarted. (A, C, and D) provide helpful information, but are not as high
a priority as the assessment described in (B).
⩥ A medication that is classified as a beta-1 agonist is most commonly
prescribed for a client with which condition?
A) Glaucoma.
B) Hypertension.
C) Heart failure.
D) Asthma. Answer: C) Heart failure.
, Beta-1 agonists improve cardiac output by increasing the heart rate and
blood pressure and are indicated in heart failure (C), shock,
atrioventricular block dysrhythmias, and cardiac arrest. Glaucoma (A) is
managed using adrenergic agents and beta-adrenergic blocking agents.
Beta-1 blocking agents are used in the management of hypertension (B).
Medications that stimulate beta-2 receptors in the bronchi are effective
for bronchoconstriction in respiratory disorders, such as asthma (D).
⩥ A female client with rheumatoid arthritis take ibuprofen (Motrin) 600
mg PO 4 times a day. To prevent gastrointestinal bleeding, misoprostol
(Cytotec) 100 mcg PO is prescribed. Which information is most
important for the nurse to include in client teaching?
A) Use contraception during intercourse.
B) Ensure the Cytotec is taken on an empty stomach.
C) Encourage oral fluid intake to prevent constipation.
D) Take Cytotec 30 minutes prior to Motrin. Answer: A) Use
contraception during intercourse.
Cytotec, a synthetic form of a prostaglandin, is classified as pregnancy
Category X and can act as an abortifacient, so the client should be
instructed to use contraception during intercourse (A) to prevent loss of
an early pregnancy. (B) is not necessary. A common side effect of
Cytotec is diarrhea, so constipation prevention strategies are usually not
needed (C). Cytotec and Motrin should be taken together (D) to provide
protective properties against gastrointestinal bleeding.
PAPER QUESTIONS AND SOLUTIONS
EXAMPREP
⩥ Which nursing intervention is most important when caring for a client
receiving the antimetabolite cytosine arabinoside (Arc-C) for
chemotherapy?
A) Hydrate the client with IV fluids before and after infusion.
B) Assess the client for numbness and tingling of extremities.
C) Inspect the client's oral mucosa for ulcerations.
D) Monitor the client's urine pH for increased acidity. Answer: C)
Inspect the client's oral mucosa for ulcerations.
Cytosine arabinoside (Arc-C) affects the rapidly growing cells of the
body, therefore stomatitis and mucosal ulcerations are key signs of
antimetabolite toxicity (C). (A, B, and D) are not typical interventions
associated with the administration of antimetabolites.
⩥ When assessing an adolescent who recently overdosed on
acetaminophen (Tylenol), it is most important for the nurse to assess for
pain in which area of the body?
A) Flank.
B) Abdomen.
C) Chest.
,D) Head. Answer: B) Abdomen.
Acetaminophen toxicity can result in liver damage; therefore, it is
especially important for the nurse to assess for pain in the right upper
quadrant of the abdomen (B), which might indicate liver damage. (A, C,
and D) are not areas where pain would be anticipated.
⩥ An adult client is given a prescription for a scopolamine patch
(Transderm Scop) to prevent motion sickness while on a cruise. Which
information should the nurse provide to the client?
A) Apply the patch at least 4 hours prior to departure.
B) Change the patch every other day while on the cruise.
C) Place the patch on a hairless area at the base of the skull.
D) Drink no more than 2 alcoholic drinks during the cruise. Answer: A)
Apply the patch at least 4 hours prior to departure.
Scopolamine, an anticholinergic agent, is used to prevent motion
sickness and has a peak onset in 6 hours, so the client should be
instructed to apply the patch at least 4 hours before departure (A) on the
cruise ship. The duration of the transdermal patch is 72 hours, so (B) is
not needed. Scolopamine blocks muscarinic receptors in the inner ear
and to the vomiting center, so the best application site of the patch is
behind the ear, not at the base of the skull (C). Anticholinergic
medications are CNS depressants, so the client should be instructed to
avoid alcohol (D) while using the patch.
,⩥ The nurse is reviewing the use of the patient-controlled analgesia
(PCA) pump with a client in the immediate postoperative period. The
client will receive morphine 1 mg IV per hour basal rate with 1 mg IV
every 15 minutes per PCA to total 5 mg IV maximally per hour. What
assessment has the highest priority before initiating the PCA pump?
A) The expiration date on the morphine syringe in the pump.
B) The rate and depth of the client's respirations.
C) The type of anesthesia used during the surgical procedure.
D) The client's subjective and objective signs of pain. Answer: B) The
rate and depth of the client's respirations.
A life-threatening side effect of intravenous administration of morphine
sulfate, an opiate narcotic, is respiratory depression (B). The PCA pump
should be stopped and the healthcare provider notified if the client's
respiratory rate falls below 12 breaths per minute, and the nurse should
anticipate adjustments in the client's dosage before the PCA pump is
restarted. (A, C, and D) provide helpful information, but are not as high
a priority as the assessment described in (B).
⩥ A medication that is classified as a beta-1 agonist is most commonly
prescribed for a client with which condition?
A) Glaucoma.
B) Hypertension.
C) Heart failure.
D) Asthma. Answer: C) Heart failure.
, Beta-1 agonists improve cardiac output by increasing the heart rate and
blood pressure and are indicated in heart failure (C), shock,
atrioventricular block dysrhythmias, and cardiac arrest. Glaucoma (A) is
managed using adrenergic agents and beta-adrenergic blocking agents.
Beta-1 blocking agents are used in the management of hypertension (B).
Medications that stimulate beta-2 receptors in the bronchi are effective
for bronchoconstriction in respiratory disorders, such as asthma (D).
⩥ A female client with rheumatoid arthritis take ibuprofen (Motrin) 600
mg PO 4 times a day. To prevent gastrointestinal bleeding, misoprostol
(Cytotec) 100 mcg PO is prescribed. Which information is most
important for the nurse to include in client teaching?
A) Use contraception during intercourse.
B) Ensure the Cytotec is taken on an empty stomach.
C) Encourage oral fluid intake to prevent constipation.
D) Take Cytotec 30 minutes prior to Motrin. Answer: A) Use
contraception during intercourse.
Cytotec, a synthetic form of a prostaglandin, is classified as pregnancy
Category X and can act as an abortifacient, so the client should be
instructed to use contraception during intercourse (A) to prevent loss of
an early pregnancy. (B) is not necessary. A common side effect of
Cytotec is diarrhea, so constipation prevention strategies are usually not
needed (C). Cytotec and Motrin should be taken together (D) to provide
protective properties against gastrointestinal bleeding.
