2026 HESI PHARMACOLOGY REVIEW EXAMS
QUESTIONS AND ANSWERS SURE A+
✔✔The nurse is preparing to apply a surface anesthetic agent for a client. Which action
should the nurse implement to reduce the risk of systemic absorption?
A. Apply the anesthetic to mucous membranes.
B. Limit the area of application to inflamed areas.
C. Avoid abraded skin areas when applying the anesthetic.
D. Spread the topical agent over a large surface area. - ✔✔C. Avoid abraded skin areas
when applying the anesthetic.
To minimize systemic absorption of topical anesthetics, the anesthetic agent should be
applied to the smallest surface area of intact skin. Application to the mucous
membranes poses the greatest risk of systemic absorption because absorption occurs
more readily through mucous membranes than through the skin. Inflamed areas
generally have an increased blood supply, which increases the risk of systemic
absorption, so option B should be avoided. A large surface area increases the amount
of topical drug that is available for transdermal absorption, so the smallest area should
be covered, not option D.
✔✔A client experiencing dysrhythmias is given quinidine, 300 mg PO every 6 hours.
The nurse plans to observe this client for which common side effect associated with the
use of this medication?
A. Diarrhea
B. Hypothermia
C. Seizures
D. Dysphagia - ✔✔A. Diarrhea
The most common side effects associated with quinidine therapy are gastrointestinal
complaints, such as diarrhea. Options B, C, and D are not usually associated with
quinidine therapy.
,✔✔The health care provider prescribes the H2 antagonist famotidine, 20 mg PO in the
morning and at bedtime. Which statement regarding the action of H2 antagonists offers
the correct rationale for administering the medication at bedtime?
A. Gastric acid secreted at night is buffered, preventing pepsin formation.
B. Hydrochloric acid secreted during the night is blocked.
C. The drug relaxes stomach muscles at night to reduce acid.
D. Ingestion of the medication at night offers a sedative effect, promoting sleep. - ✔✔B.
Hydrochloric acid secreted during the night is blocked.
H2 antagonists act on the parietal cells to inhibit gastric secretion. Some gastric
secretion occurs all the time, even when the stomach is empty, unless medications are
taken to inhibit this action. Options C and D are not actions of famotidine. Option A is
the action of antacids. Antacids do not affect healing or prevent the recurrence of ulcers;
they merely provide symptomatic relief. Knowing the difference between H2 antagonists
and antacids is important when teaching clients.
✔✔The nurse is preparing to administer the disease-modifying antirheumatic drug
(DMARD) methotrexate to a client diagnosed with rheumatoid arthritis. Which
intervention is most important to implement prior to administering this medication?
A. Assess the client's liver function test results.
B. Monitor the client's intake and output.
C. Have another nurse check the prescription.
D. Assess the client's oral mucosa. - ✔✔C. Have another nurse check the prescription.
Double-checking the prescription is an important intervention because death can occur
from an overdose. This medication is administered weekly and in low doses for
rheumatoid arthritis and should not be confused with administration of the drug as a
chemotherapeutic agent. Options A and B are appropriate interventions for those who
are receiving this drug, but they are not the most important interventions. Stomatitis is
an expected side effect of this medication.
✔✔A female client with myasthenia gravis is taking a cholinesterase inhibitor and asks
the nurse what can be done to remedy her fatigue and difficulty swallowing. What action
should the nurse implement?
A. Explore a plan for development of coping strategies for the symptoms with the client.
B. Explain to the client that the dosage is too high, so she should skip every other dose
of medication.
C. Advise the client to contact her health care provider because of the development of
tolerance to the medication.
D. Develop a teaching plan for the client to self-adjust the dose of medication in
response to symptoms. - ✔✔D. Develop a teaching plan for the client to self-adjust the
dose of medication in response to symptoms.
,Maintaining optimal dosage for cholinesterase inhibitors can be challenging for clients
with myasthenia gravis. Clients should be taught to recognize signs of overmedication
and undermedication so that they can modify the dosage themselves based on a
prescribed sliding scale. Options A, B, and C do not adequately address the client's
concerns.
✔✔A female client is receiving tetracycline for acne. Which client teaching should the
nurse include?
A. Oral contraceptives may not be effective.
B. Drinking cranberry juice will promote healing.
C. Breast tenderness may occur as a side effect.
D. The urine will turn a red-orange color. - ✔✔A. Oral contraceptives may not be
effective.
Certain antibiotics, such as tetracycline, decrease the effectiveness of oral
contraceptives. Options B, C, and D do not convey accurate information related to client
teaching about this medication.
✔✔A client who is experiencing an acute attack of gouty arthritis is prescribed
colchicine USP, 1 mg PO daily. Which information is most important for the nurse to
provide the client?
A. Take the medication with meals.
B. Limit fluid intake until the attack subsides.
C. Stop the medication when the pain resolves.
D. Report any vomiting to the clinic. - ✔✔D. Report any vomiting to the clinic.
The client should be instructed to report signs of colchicine toxicity, such as nausea,
diarrhea, vomiting, and/or abdominal pain, to the health care provider. Food inhibits the
absorption of colchicine when ingested concurrently. Limited fluid intake decreases the
excretion of the uric acid crystals, which contributes to painful attacks. Typically, a client
should remain on a daily dose of colchicine to decrease the number and severity of
acute attacks, so stopping the medication after the pain resolves is not indicated.
✔✔Amoxicillin, 500 mg PO every 8 hours, is prescribed for a client with an infection.
The drug is available in a suspension of 125 mg/5 mL. How many milliliters should the
nurse administer with each dose?
A. 10
B. 15
C. 20
D. 25 - ✔✔C. 20
500 mg/x mL = 125 mg/5 mL
, 125x = 2500
x = 20 mL
✔✔Methenamine mandelate is prescribed for a client with a urinary tract infection and
renal calculi. Which finding indicates to the nurse that the medication is effective?
A. The frequency of urinary tract infections decreases.
B. The urine changes color and pain is diminished.
C. The dipstick test changes from +1 to trace.
D. The daily urinary output increases by 10%. - ✔✔A. The frequency of urinary tract
infections decreases.
Mandelamine is prescribed to acidify the urine, decreasing the incidence of calcium
phosphate calculi and urinary tract infections. Option B is related to the administration of
pyridine. Mandelamine has no effect on option C or D.
✔✔Two hours after taking the first dose of penicillin, a client arrives at the emergency
department complaining of feeling ill, exhibiting hives, having difficulty breathing, and
experiencing hypotension. These findings are consistent with which client response that
requires immediate action?
A. Severe acute anaphylactic response
B. Side reaction that should resolve
C. Idiosyncratic reaction
D. Cumulative drug response - ✔✔A. Severe acute anaphylactic response
Anaphylaxis related to penicillin can cause a life-threatening allergic response
characterized by bronchospasm, laryngeal edema, and a precipitous drop in blood
pressure. This client's ingestion of penicillin and presenting clinical picture indicate the
client is having an acute reaction with respiratory difficulty. Options B, C, and D are
other physiologic responses to medications, but immediate action is required for a
potential loss of airway, breathing, and circulation.
✔✔Which class of antineoplastic chemotherapy agents resembles the essential
elements required for DNA and RNA synthesis and inhibits enzymes necessary for
cellular function and replication?
A. Alkylating agents
B. Antimetabolites
C. Antitumor antibiotics
D. Plant alkaloids - ✔✔B. Antimetabolites
Antimetabolites exert their action by inhibiting the enzymes necessary for cellular
function and replication. Options A, C, and D have a different mechanism of action.
QUESTIONS AND ANSWERS SURE A+
✔✔The nurse is preparing to apply a surface anesthetic agent for a client. Which action
should the nurse implement to reduce the risk of systemic absorption?
A. Apply the anesthetic to mucous membranes.
B. Limit the area of application to inflamed areas.
C. Avoid abraded skin areas when applying the anesthetic.
D. Spread the topical agent over a large surface area. - ✔✔C. Avoid abraded skin areas
when applying the anesthetic.
To minimize systemic absorption of topical anesthetics, the anesthetic agent should be
applied to the smallest surface area of intact skin. Application to the mucous
membranes poses the greatest risk of systemic absorption because absorption occurs
more readily through mucous membranes than through the skin. Inflamed areas
generally have an increased blood supply, which increases the risk of systemic
absorption, so option B should be avoided. A large surface area increases the amount
of topical drug that is available for transdermal absorption, so the smallest area should
be covered, not option D.
✔✔A client experiencing dysrhythmias is given quinidine, 300 mg PO every 6 hours.
The nurse plans to observe this client for which common side effect associated with the
use of this medication?
A. Diarrhea
B. Hypothermia
C. Seizures
D. Dysphagia - ✔✔A. Diarrhea
The most common side effects associated with quinidine therapy are gastrointestinal
complaints, such as diarrhea. Options B, C, and D are not usually associated with
quinidine therapy.
,✔✔The health care provider prescribes the H2 antagonist famotidine, 20 mg PO in the
morning and at bedtime. Which statement regarding the action of H2 antagonists offers
the correct rationale for administering the medication at bedtime?
A. Gastric acid secreted at night is buffered, preventing pepsin formation.
B. Hydrochloric acid secreted during the night is blocked.
C. The drug relaxes stomach muscles at night to reduce acid.
D. Ingestion of the medication at night offers a sedative effect, promoting sleep. - ✔✔B.
Hydrochloric acid secreted during the night is blocked.
H2 antagonists act on the parietal cells to inhibit gastric secretion. Some gastric
secretion occurs all the time, even when the stomach is empty, unless medications are
taken to inhibit this action. Options C and D are not actions of famotidine. Option A is
the action of antacids. Antacids do not affect healing or prevent the recurrence of ulcers;
they merely provide symptomatic relief. Knowing the difference between H2 antagonists
and antacids is important when teaching clients.
✔✔The nurse is preparing to administer the disease-modifying antirheumatic drug
(DMARD) methotrexate to a client diagnosed with rheumatoid arthritis. Which
intervention is most important to implement prior to administering this medication?
A. Assess the client's liver function test results.
B. Monitor the client's intake and output.
C. Have another nurse check the prescription.
D. Assess the client's oral mucosa. - ✔✔C. Have another nurse check the prescription.
Double-checking the prescription is an important intervention because death can occur
from an overdose. This medication is administered weekly and in low doses for
rheumatoid arthritis and should not be confused with administration of the drug as a
chemotherapeutic agent. Options A and B are appropriate interventions for those who
are receiving this drug, but they are not the most important interventions. Stomatitis is
an expected side effect of this medication.
✔✔A female client with myasthenia gravis is taking a cholinesterase inhibitor and asks
the nurse what can be done to remedy her fatigue and difficulty swallowing. What action
should the nurse implement?
A. Explore a plan for development of coping strategies for the symptoms with the client.
B. Explain to the client that the dosage is too high, so she should skip every other dose
of medication.
C. Advise the client to contact her health care provider because of the development of
tolerance to the medication.
D. Develop a teaching plan for the client to self-adjust the dose of medication in
response to symptoms. - ✔✔D. Develop a teaching plan for the client to self-adjust the
dose of medication in response to symptoms.
,Maintaining optimal dosage for cholinesterase inhibitors can be challenging for clients
with myasthenia gravis. Clients should be taught to recognize signs of overmedication
and undermedication so that they can modify the dosage themselves based on a
prescribed sliding scale. Options A, B, and C do not adequately address the client's
concerns.
✔✔A female client is receiving tetracycline for acne. Which client teaching should the
nurse include?
A. Oral contraceptives may not be effective.
B. Drinking cranberry juice will promote healing.
C. Breast tenderness may occur as a side effect.
D. The urine will turn a red-orange color. - ✔✔A. Oral contraceptives may not be
effective.
Certain antibiotics, such as tetracycline, decrease the effectiveness of oral
contraceptives. Options B, C, and D do not convey accurate information related to client
teaching about this medication.
✔✔A client who is experiencing an acute attack of gouty arthritis is prescribed
colchicine USP, 1 mg PO daily. Which information is most important for the nurse to
provide the client?
A. Take the medication with meals.
B. Limit fluid intake until the attack subsides.
C. Stop the medication when the pain resolves.
D. Report any vomiting to the clinic. - ✔✔D. Report any vomiting to the clinic.
The client should be instructed to report signs of colchicine toxicity, such as nausea,
diarrhea, vomiting, and/or abdominal pain, to the health care provider. Food inhibits the
absorption of colchicine when ingested concurrently. Limited fluid intake decreases the
excretion of the uric acid crystals, which contributes to painful attacks. Typically, a client
should remain on a daily dose of colchicine to decrease the number and severity of
acute attacks, so stopping the medication after the pain resolves is not indicated.
✔✔Amoxicillin, 500 mg PO every 8 hours, is prescribed for a client with an infection.
The drug is available in a suspension of 125 mg/5 mL. How many milliliters should the
nurse administer with each dose?
A. 10
B. 15
C. 20
D. 25 - ✔✔C. 20
500 mg/x mL = 125 mg/5 mL
, 125x = 2500
x = 20 mL
✔✔Methenamine mandelate is prescribed for a client with a urinary tract infection and
renal calculi. Which finding indicates to the nurse that the medication is effective?
A. The frequency of urinary tract infections decreases.
B. The urine changes color and pain is diminished.
C. The dipstick test changes from +1 to trace.
D. The daily urinary output increases by 10%. - ✔✔A. The frequency of urinary tract
infections decreases.
Mandelamine is prescribed to acidify the urine, decreasing the incidence of calcium
phosphate calculi and urinary tract infections. Option B is related to the administration of
pyridine. Mandelamine has no effect on option C or D.
✔✔Two hours after taking the first dose of penicillin, a client arrives at the emergency
department complaining of feeling ill, exhibiting hives, having difficulty breathing, and
experiencing hypotension. These findings are consistent with which client response that
requires immediate action?
A. Severe acute anaphylactic response
B. Side reaction that should resolve
C. Idiosyncratic reaction
D. Cumulative drug response - ✔✔A. Severe acute anaphylactic response
Anaphylaxis related to penicillin can cause a life-threatening allergic response
characterized by bronchospasm, laryngeal edema, and a precipitous drop in blood
pressure. This client's ingestion of penicillin and presenting clinical picture indicate the
client is having an acute reaction with respiratory difficulty. Options B, C, and D are
other physiologic responses to medications, but immediate action is required for a
potential loss of airway, breathing, and circulation.
✔✔Which class of antineoplastic chemotherapy agents resembles the essential
elements required for DNA and RNA synthesis and inhibits enzymes necessary for
cellular function and replication?
A. Alkylating agents
B. Antimetabolites
C. Antitumor antibiotics
D. Plant alkaloids - ✔✔B. Antimetabolites
Antimetabolites exert their action by inhibiting the enzymes necessary for cellular
function and replication. Options A, C, and D have a different mechanism of action.
