HESI PHARMACOLOGY EXAMINATION TEST
2026 FULL SOLVED QUESTIONS AND
SOLUTIONS
◉ 60.) A nurse is planning to administer hydrochlorothiazide
(HydroDIURIL) to a client. The nurse understands that which of the
following are concerns related to the administration of this
medication?
1. Hypouricemia, hyperkalemia
2. Increased risk of osteoporosis
3. Hypokalemia, hyperglycemia, sulfa allergy
4. Hyperkalemia, hypoglycemia, penicillin allergy. Answer: 3.
Hypokalemia, hyperglycemia, sulfa allergy
Rationale:
Thiazide diuretics such as hydrochlorothiazide are sulfa-based
medications, and a client with a sulfa allergy is at risk for an allergic
reaction. Also, clients are at risk for hypokalemia, hyperglycemia,
hypercalcemia, hyperlipidemia, and hyperuricemia.
◉ 61.) A home health care nurse is visiting a client with elevated
triglyceride levels and a serum cholesterol level of 398 mg/dL. The
client is taking cholestyramine (Questran). Which of the following
statements, if made by the client, indicates the need for further
education?
,1. "Constipation and bloating might be a problem."
2. "I'll continue to watch my diet and reduce my fats."
3. "Walking a mile each day will help the whole process."
4. "I'll continue my nicotinic acid from the health food store.".
Answer: 4. "I'll continue my nicotinic acid from the health food
store."
Rationale:
Nicotinic acid, even an over-the-counter form, should be avoided
because it may lead to liver abnormalities. All lipid-lowering
medications also can cause liver abnormalities, so a combination of
nicotinic acid and cholestyramine resin is to be avoided.
Constipation and bloating are the two most common side effects.
Walking and the reduction of fats in the diet are therapeutic
measures to reduce cholesterol and triglyceride levels.
◉ 62.) A client is on nicotinic acid (niacin) for hyperlipidemia and
the nurse provides instructions to the client about the medication.
Which statement by the client would indicate an understanding of
the instructions?
1. "It is not necessary to avoid the use of alcohol."
2. "The medication should be taken with meals to decrease
flushing."
3. "Clay-colored stools are a common side effect and should not be
of concern."
, 4. "Ibuprofen (Motrin) taken 30 minutes before the nicotinic acid
should decrease the flushing.". Answer: 4. "Ibuprofen (Motrin) taken
30 minutes before the nicotinic acid should decrease the flushing."
Rationale:
Flushing is a side effect of this medication. Aspirin or a nonsteroidal
anti-inflammatory drug can be taken 30 minutes before taking the
medication to decrease flushing. Alcohol consumption needs to be
avoided because it will enhance this side effect. The medication
should be taken with meals, this will decrease gastrointestinal upset.
Taking the medication with meals has no effect on the flushing. Clay-
colored stools are a sign of hepatic dysfunction and should be
immediately reported to the health care provider (HCP).
◉ 63.) A client with coronary artery disease complains of substernal
chest pain. After checking the client's heart rate and blood pressure,
a nurse administers nitroglycerin, 0.4 mg, sublingually. After 5
minutes, the client states, "My chest still hurts." Select the
appropriate actions that the nurse should take. Select all that apply.
1. Call a code blue.
2. Contact the registered nurse.
3. Contact the client's family.
4. Assess the client's pain level.
5. Check the client's blood pressure.
6. Administer a second nitroglycerin, 0.4 mg, sublingually.. Answer:
2. Contact the registered nurse.
, 4. Assess the client's pain level.
5. Check the client's blood pressure.
6. Administer a second nitroglycerin, 0.4 mg, sublingually.
Rationale:
The usual guideline for administering nitroglycerin tablets for a
hospitalized client with chest pain is to administer one tablet every
5 minutes PRN for chest pain, for a total dose of three tablets. The
registered nurse should be notified of the client's condition, who will
then notify the health care provider as appropriate. Because the
client is still complaining of chest pain, the nurse would administer a
second nitroglycerin tablet. The nurse would assess the client's pain
level and check the client's blood pressure before administering
each nitroglycerin dose. There are no data in the question that
indicate the need to call a code blue. In addition, it is not necessary
to contact the client's family unless the client has requested this.
◉ 64.) Nalidixic acid (NegGram) is prescribed for a client with a
urinary tract infection. On review of the client's record, the nurse
notes that the client is taking warfarin sodium (Coumadin) daily.
Which prescription should the nurse anticipate for this client?
1. Discontinuation of warfarin sodium (Coumadin)
2. A decrease in the warfarin sodium (Coumadin) dosage
3. An increase in the warfarin sodium (Coumadin) dosage
4. A decrease in the usual dose of nalidixic acid (NegGram). Answer:
2. A decrease in the warfarin sodium (Coumadin) dosage
2026 FULL SOLVED QUESTIONS AND
SOLUTIONS
◉ 60.) A nurse is planning to administer hydrochlorothiazide
(HydroDIURIL) to a client. The nurse understands that which of the
following are concerns related to the administration of this
medication?
1. Hypouricemia, hyperkalemia
2. Increased risk of osteoporosis
3. Hypokalemia, hyperglycemia, sulfa allergy
4. Hyperkalemia, hypoglycemia, penicillin allergy. Answer: 3.
Hypokalemia, hyperglycemia, sulfa allergy
Rationale:
Thiazide diuretics such as hydrochlorothiazide are sulfa-based
medications, and a client with a sulfa allergy is at risk for an allergic
reaction. Also, clients are at risk for hypokalemia, hyperglycemia,
hypercalcemia, hyperlipidemia, and hyperuricemia.
◉ 61.) A home health care nurse is visiting a client with elevated
triglyceride levels and a serum cholesterol level of 398 mg/dL. The
client is taking cholestyramine (Questran). Which of the following
statements, if made by the client, indicates the need for further
education?
,1. "Constipation and bloating might be a problem."
2. "I'll continue to watch my diet and reduce my fats."
3. "Walking a mile each day will help the whole process."
4. "I'll continue my nicotinic acid from the health food store.".
Answer: 4. "I'll continue my nicotinic acid from the health food
store."
Rationale:
Nicotinic acid, even an over-the-counter form, should be avoided
because it may lead to liver abnormalities. All lipid-lowering
medications also can cause liver abnormalities, so a combination of
nicotinic acid and cholestyramine resin is to be avoided.
Constipation and bloating are the two most common side effects.
Walking and the reduction of fats in the diet are therapeutic
measures to reduce cholesterol and triglyceride levels.
◉ 62.) A client is on nicotinic acid (niacin) for hyperlipidemia and
the nurse provides instructions to the client about the medication.
Which statement by the client would indicate an understanding of
the instructions?
1. "It is not necessary to avoid the use of alcohol."
2. "The medication should be taken with meals to decrease
flushing."
3. "Clay-colored stools are a common side effect and should not be
of concern."
, 4. "Ibuprofen (Motrin) taken 30 minutes before the nicotinic acid
should decrease the flushing.". Answer: 4. "Ibuprofen (Motrin) taken
30 minutes before the nicotinic acid should decrease the flushing."
Rationale:
Flushing is a side effect of this medication. Aspirin or a nonsteroidal
anti-inflammatory drug can be taken 30 minutes before taking the
medication to decrease flushing. Alcohol consumption needs to be
avoided because it will enhance this side effect. The medication
should be taken with meals, this will decrease gastrointestinal upset.
Taking the medication with meals has no effect on the flushing. Clay-
colored stools are a sign of hepatic dysfunction and should be
immediately reported to the health care provider (HCP).
◉ 63.) A client with coronary artery disease complains of substernal
chest pain. After checking the client's heart rate and blood pressure,
a nurse administers nitroglycerin, 0.4 mg, sublingually. After 5
minutes, the client states, "My chest still hurts." Select the
appropriate actions that the nurse should take. Select all that apply.
1. Call a code blue.
2. Contact the registered nurse.
3. Contact the client's family.
4. Assess the client's pain level.
5. Check the client's blood pressure.
6. Administer a second nitroglycerin, 0.4 mg, sublingually.. Answer:
2. Contact the registered nurse.
, 4. Assess the client's pain level.
5. Check the client's blood pressure.
6. Administer a second nitroglycerin, 0.4 mg, sublingually.
Rationale:
The usual guideline for administering nitroglycerin tablets for a
hospitalized client with chest pain is to administer one tablet every
5 minutes PRN for chest pain, for a total dose of three tablets. The
registered nurse should be notified of the client's condition, who will
then notify the health care provider as appropriate. Because the
client is still complaining of chest pain, the nurse would administer a
second nitroglycerin tablet. The nurse would assess the client's pain
level and check the client's blood pressure before administering
each nitroglycerin dose. There are no data in the question that
indicate the need to call a code blue. In addition, it is not necessary
to contact the client's family unless the client has requested this.
◉ 64.) Nalidixic acid (NegGram) is prescribed for a client with a
urinary tract infection. On review of the client's record, the nurse
notes that the client is taking warfarin sodium (Coumadin) daily.
Which prescription should the nurse anticipate for this client?
1. Discontinuation of warfarin sodium (Coumadin)
2. A decrease in the warfarin sodium (Coumadin) dosage
3. An increase in the warfarin sodium (Coumadin) dosage
4. A decrease in the usual dose of nalidixic acid (NegGram). Answer:
2. A decrease in the warfarin sodium (Coumadin) dosage
