HESI PRACTICE EXAM-PHARM 315 | [LATEST 2026/2027 UPDATE] QUESTIONS & ANSWERS | GRADE A | 100% CORRECT
Which client should the nurse identify as being at highest risk for complications during the use of an opioid analgesic? ✔️A young adult with
inflammatory bowel disease.
Rationale:
The principal indication for opioid use is acute pain, and a client with inflammatory bowel disease is at risk for toxic megacolon or paralytic ileus
related to slowed peristalsis, a side effect of morphine. Adverse effects of morphine do not pose as great a risk for clients with diabetes or a
fracture as for the client with bowel disease.
The healthcare provider prescribes digitalis (Digoxin) for a client diagnosed with heart failure. Which intervention should the nurse implement
prior to administering the digoxin? ✔️Assess the serum potassium level.
Rationale:
Hypokalemia (decreased serum potassium) will precipitate digitalis toxicity in persons receiving digoxin. The nurse should monitor the client's
serum potassium levels. Blood pressure and respiratory rate will not inform the nurse about potential safety issues with digitalis.
A client with hyperlipidemia receives a prescription for niacin (Niaspan). Which client teaching is most important for the nurse to provide?
✔️Expected duration of flushing.
Rationale:
Flushing of the face and neck, lasting up to an hour, is a frequent reason for discontinuing niacin. Inclusion of this effect in client teaching may
promote compliance in taking the medication. While nutrition tips and managing pruritis are worthwhile instructions to help clients minimize or
cope with normal side effects associated with niacin (Niaspan), flushing is intense and causes the most concern for the client.
A client who was prescribed atorvastatin (Lipitor) one month ago calls the triage nurse at the clinic complaining of muscle pain and weakness in
his legs. Which statement reflects the correct drug-specific teaching the nurse should provide to this client? ✔️Make an appointment to see the
healthcare provider, because muscle pain may be an indication of a serious side effect.
Rationale:
Myopathy, suggested by the leg pain and weakness, is a serious, and potentially life-threatening, complication of Lipitor, and should be
evaluated immediately by the healthcare provider.
An antacid (Maalox) is prescribed for a client with peptic ulcer disease. The nurse knows that the purpose of this medication is to ✔️maintain a
gastric pH of 3.5 or above.
Rationale:
The objective of antacids is to neutralize gastric acids and keep pH of 3.5 or above which is necessary for pepsinogen inactivity.
Which dosing schedule should the nurse teach the client to observe for a controlled-release oxycodone prescription? ✔️Every 12 hours.
Rationale:
A controlled-release oxycodone provides long-acting analgesia to relieve moderate to severe pain, so a dosing schedule of every 12 hours
provides the best around-the-clock pain management. Controlled-release oxycodone is not prescribed for breakthrough pain on a PRN or as
needed schedule. Using a schedule of every 4 to 6 hours may jeopardize patient safety due to cumulative effects.
, A client with osteoarthritis receives a new prescription for celecoxib (Celebrex) orally for symptom management. The nurse notes the client is
allergic to sulfa. Which action is most important for the nurse to implement prior to administering the first dose? ✔️Notify the healthcare
provider.
Rationale:
Celebrex contains a sulfur molecule, which can lead to an allergic reaction in individuals who are sensitive to sulfonamides, so the healthcare
provider should be notified of the client's allergies.
The nurse is assessing a client who is experiencing anaphylaxis from an insect sting. Which prescription should the nurse prepare to administer
this client? ✔️Epinephrine.
Rationale:
Epinephrine is an adrenergic agent that stimulates beta receptors to increase cardiac automaticity in cardiac arrest and relax bronchospasms in
anaphylaxis. On the ither hand, dopamine is a vasopressor used to treat clients with shock. Ephedrine causes peripheral vasoconstriction and is
used in the treatment of nasal congestion. Diphenhydramine is an antihistamine decongestant used in the treatment of mild allergic reactions
and motion sickness. Epinephrine is the medication of choice in treating anaphylaxis.
A client is being treated for osteoporosis with alendronate (Fosamax), and the nurse has completed discharge teaching regarding medication
administration. Which morning schedule would indicate to the nurse that the client teaching has been effective? ✔️Take medication, go for a 30
minute morning walk, then eat breakfast.
Rationale:
Alendronate (Fosamax) is best absorbed when taken thirty minutes before eating in the morning. The client should also be advised to remain in
an upright position for at least thirty minutes after taking the medication to reduce the risk of esophageal reflux and irritation.
After abdominal surgery, a male client is prescribed low molecular weight heparin (LMWH). During administration of the medication, the client
asks the nurse why he is receiving this medication. Which is the best response for the nurse to provide? ✔️This medication is a blood thinner
given to prevent blood clot formation.
Rationale:
Unfractionated heparin or low molecular weight heparin (LMWH) is an anticoagulant that inhibits thrombin-mediated conversion of fibrinogen
to fibrin and is given prophylactically to prevent postoperative venous thrombosis in order to prevent pulmonary embolism or deep vein
thrombosis following knee and abdominal surgeries.
Which symptoms are serious adverse effects of beta-adrenergic blockers such as propranolol (Inderal)? ✔️Wheezing, hypotension, and AV block.
Rationale:
Wheezing, hypotension, and AV block represents the most serious adverse effects of beta-blocking agents. AV block is generally associated with
bradycardia and results in potentially life-threatening decreases in cardiac output. Additionally, wheezing secondary to bronchospasm and
hypotension represent life-threatening respiratory and cardiac disorders.
Following the administration of sublingual nitroglycerin to a client experiencing an acute anginal attack, which assessment finding indicates to
the nurse that the desired effect has been achieved? ✔️Client states chest pain is relieved.
Rationale:
Nitroglycerin reduces myocardial oxygen consumption which decreases ischemia and reduces chest pain.
Which client should the nurse identify as being at highest risk for complications during the use of an opioid analgesic? ✔️A young adult with
inflammatory bowel disease.
Rationale:
The principal indication for opioid use is acute pain, and a client with inflammatory bowel disease is at risk for toxic megacolon or paralytic ileus
related to slowed peristalsis, a side effect of morphine. Adverse effects of morphine do not pose as great a risk for clients with diabetes or a
fracture as for the client with bowel disease.
The healthcare provider prescribes digitalis (Digoxin) for a client diagnosed with heart failure. Which intervention should the nurse implement
prior to administering the digoxin? ✔️Assess the serum potassium level.
Rationale:
Hypokalemia (decreased serum potassium) will precipitate digitalis toxicity in persons receiving digoxin. The nurse should monitor the client's
serum potassium levels. Blood pressure and respiratory rate will not inform the nurse about potential safety issues with digitalis.
A client with hyperlipidemia receives a prescription for niacin (Niaspan). Which client teaching is most important for the nurse to provide?
✔️Expected duration of flushing.
Rationale:
Flushing of the face and neck, lasting up to an hour, is a frequent reason for discontinuing niacin. Inclusion of this effect in client teaching may
promote compliance in taking the medication. While nutrition tips and managing pruritis are worthwhile instructions to help clients minimize or
cope with normal side effects associated with niacin (Niaspan), flushing is intense and causes the most concern for the client.
A client who was prescribed atorvastatin (Lipitor) one month ago calls the triage nurse at the clinic complaining of muscle pain and weakness in
his legs. Which statement reflects the correct drug-specific teaching the nurse should provide to this client? ✔️Make an appointment to see the
healthcare provider, because muscle pain may be an indication of a serious side effect.
Rationale:
Myopathy, suggested by the leg pain and weakness, is a serious, and potentially life-threatening, complication of Lipitor, and should be
evaluated immediately by the healthcare provider.
An antacid (Maalox) is prescribed for a client with peptic ulcer disease. The nurse knows that the purpose of this medication is to ✔️maintain a
gastric pH of 3.5 or above.
Rationale:
The objective of antacids is to neutralize gastric acids and keep pH of 3.5 or above which is necessary for pepsinogen inactivity.
Which dosing schedule should the nurse teach the client to observe for a controlled-release oxycodone prescription? ✔️Every 12 hours.
Rationale:
A controlled-release oxycodone provides long-acting analgesia to relieve moderate to severe pain, so a dosing schedule of every 12 hours
provides the best around-the-clock pain management. Controlled-release oxycodone is not prescribed for breakthrough pain on a PRN or as
needed schedule. Using a schedule of every 4 to 6 hours may jeopardize patient safety due to cumulative effects.
, A client with osteoarthritis receives a new prescription for celecoxib (Celebrex) orally for symptom management. The nurse notes the client is
allergic to sulfa. Which action is most important for the nurse to implement prior to administering the first dose? ✔️Notify the healthcare
provider.
Rationale:
Celebrex contains a sulfur molecule, which can lead to an allergic reaction in individuals who are sensitive to sulfonamides, so the healthcare
provider should be notified of the client's allergies.
The nurse is assessing a client who is experiencing anaphylaxis from an insect sting. Which prescription should the nurse prepare to administer
this client? ✔️Epinephrine.
Rationale:
Epinephrine is an adrenergic agent that stimulates beta receptors to increase cardiac automaticity in cardiac arrest and relax bronchospasms in
anaphylaxis. On the ither hand, dopamine is a vasopressor used to treat clients with shock. Ephedrine causes peripheral vasoconstriction and is
used in the treatment of nasal congestion. Diphenhydramine is an antihistamine decongestant used in the treatment of mild allergic reactions
and motion sickness. Epinephrine is the medication of choice in treating anaphylaxis.
A client is being treated for osteoporosis with alendronate (Fosamax), and the nurse has completed discharge teaching regarding medication
administration. Which morning schedule would indicate to the nurse that the client teaching has been effective? ✔️Take medication, go for a 30
minute morning walk, then eat breakfast.
Rationale:
Alendronate (Fosamax) is best absorbed when taken thirty minutes before eating in the morning. The client should also be advised to remain in
an upright position for at least thirty minutes after taking the medication to reduce the risk of esophageal reflux and irritation.
After abdominal surgery, a male client is prescribed low molecular weight heparin (LMWH). During administration of the medication, the client
asks the nurse why he is receiving this medication. Which is the best response for the nurse to provide? ✔️This medication is a blood thinner
given to prevent blood clot formation.
Rationale:
Unfractionated heparin or low molecular weight heparin (LMWH) is an anticoagulant that inhibits thrombin-mediated conversion of fibrinogen
to fibrin and is given prophylactically to prevent postoperative venous thrombosis in order to prevent pulmonary embolism or deep vein
thrombosis following knee and abdominal surgeries.
Which symptoms are serious adverse effects of beta-adrenergic blockers such as propranolol (Inderal)? ✔️Wheezing, hypotension, and AV block.
Rationale:
Wheezing, hypotension, and AV block represents the most serious adverse effects of beta-blocking agents. AV block is generally associated with
bradycardia and results in potentially life-threatening decreases in cardiac output. Additionally, wheezing secondary to bronchospasm and
hypotension represent life-threatening respiratory and cardiac disorders.
Following the administration of sublingual nitroglycerin to a client experiencing an acute anginal attack, which assessment finding indicates to
the nurse that the desired effect has been achieved? ✔️Client states chest pain is relieved.
Rationale:
Nitroglycerin reduces myocardial oxygen consumption which decreases ischemia and reduces chest pain.
