HESI Pharmacology Exam Practice With
300 Question and Correct Answers
1. A nurse is caring for a client with hyperparathyroidism and notes that the client's
serum calcium level is 13 mg/dL. Which medication should the nurse prepare to
administer as prescribed to the client?
a. Calcium chloride
b. Calcium gluconate
c. Calcitonin (Miacalcin)
d. Large doses of vitamin D<correct answers>3. Calcitonin (Miacalcin)
2. Rationale:
3. The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is experiencing
hypercalcemia. Calcium gluconate and calcium chloride are medications used for
the treatment of tetany, which occurs as a result of acute hypocalcemia. In
hypercalcemia, large doses of vitamin D need to be avoided. Calcitonin, a thyroid
hormone, decreases the plasma calcium level by inhibiting bone resorption and
lowering the serum calcium concentration.
4. 2.) Oral iron supplements are prescribed for a 6-year-old child with iron deficiency
anemia. The nurse instructs the mother to administer the iron with which best food
item?
5. Milk
6. Water
7. Apple juice
8. Orange juice<correct answers>4. Orange juice
9. Rationale:
10. Vitamin C increases the absorption of iron by the body. The mother should be
instructed to administer the medication with a citrus fruit or a juice that is high in
vitamin C. Milk may affect absorption of the iron. Water will not assist in absorption.
Orange juice contains a greater amount of vitamin C than apple juice.
11. 3.) Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse
monitors the client, knowing that which of the following would indicate the presence
of systemic toxicity from this medication?
12. Tinnitus
13. Diarrhea
14. Constipation
15. Decreased respirations<correct answers>1. Tinnitus
16. Rationale:
,17. Salicylic acid is absorbed readily through the skin, and systemic toxicity (salicylism)
can result. Symptoms include tinnitus, dizziness, hyperpnea, and psychological
disturbances. Constipation and diarrhea are not associated with salicylism.
18. 4.) The camp nurse asks the children preparing to swim in the lake if they have
applied sunscreen. The nurse reminds the children that chemical sunscreens are
most effective when applied:
19. Immediately before swimming
20. 15 minutes before exposure to the sun
21. Immediately before exposure to the sun
22. At least 30 minutes before exposure to the sun<correct answers>4. At least 30
minutes before exposure to the sun
23. Rationale:
24. Sunscreens are most effective when applied at least 30 minutes before exposure to
the sun so that they can penetrate the skin. All sunscreens should be reapplied after
swimming or sweating.
25. 5.) Mafenide acetate (Sulfamylon) is prescribed for the client with a burn injury.
When applying the medication, the client complains of local discomfort and burning.
Which of the following is the most appropriate nursing action?
26. Notifying the registered nurse
27. Discontinuing the medication
28. Informing the client that this is normal
29. Applying a thinner film than prescribed to the burn site<correct answers>3.
Informing the client that this is normal
30. Rationale:
31. Mafenide acetate is bacteriostatic for gram-negative and gram-positive organisms
and is used to treat burns to reduce bacteria present in avascular tissues. The client
should be informed that the medication will cause local discomfort and burning and
that this is a normal reaction; therefore options 1, 2, and 4 are incorrect
32. 6.) The burn client is receiving treatments of topical mafenide acetate (Sulfamylon)
to the site of injury. The nurse monitors the client, knowing that which of the
following indicates that a systemic effect has occurred?
33. 1.Hyperventilation
34. 2.Elevated blood pressure
35. 3.Local pain at the burn site
36. 4.Local rash at the burn site<correct answers>1.Hyperventilation
37. Rationale:
38. Mafenide acetate is a carbonic anhydrase inhibitor and can suppress renal
excretion of acid, thereby causing acidosis. Clients receiving this treatment should
, be monitored for signs of an acid-base imbalance (hyperventilation). If this occurs,
the medication should be discontinued for 1 to 2 days. Options 3 and 4 describe
local rather than systemic effects. An elevated blood pressure may be expected
from the pain that occurs with a burn injury.
39. 7.) Isotretinoin is prescribed for a client with severe acne. Before the administration
of this medication, the nurse anticipates that which laboratory test will be
prescribed?
40. Platelet count
41. Triglyceride level
42. Complete blood count
43. White blood cell count<correct answers>2. Triglyceride level
44. Rationale:
45. Isotretinoin can elevate triglyceride levels. Blood triglyceride levels should be
measured before treatment and periodically thereafter until the effect on the
triglycerides has been evaluated. Options 1, 3, and 4 do not need to be monitored
specifically during this treatment.
46. 8.) A client with severe acne is seen in the clinic and the health care provider (HCP)
prescribes isotretinoin. The nurse reviews the client's medication record and would
contact the (HCP) if the client is taking which medication?
47. Vitamin A
48. Digoxin (Lanoxin)
49. Furosemide (Lasix)
50. Phenytoin (Dilantin)<correct answers>1. Vitamin A
51. Rationale:
52. Isotretinoin is a metabolite of vitamin A and can produce generalized intensification
of isotretinoin toxicity. Because of the potential for increased toxicity, vitamin A
supplements should be discontinued before isotretinoin therapy. Options 2, 3, and 4
are not contraindicated with the use of isotretinoin.
53. 9.) The nurse is applying a topical corticosteroid to a client with eczema. The nurse
would monitor for the potential for increased systemic absorption of the medication
if the medication were being applied to which of the following body areas?
54. Back
55. Axilla
56. Soles of the feet
57. Palms of the hands<correct answers>2. Axilla
58. Rationale:
59. Topical corticosteroids can be absorbed into the systemic circulation. Absorption is
higher from regions where the skin is especially permeable (scalp, axilla, face,
, eyelids, neck, perineum, genitalia), and lower from regions in which permeability is
poor (back, palms, soles).
60. 10.) The clinic nurse is performing an admission assessment on a client. The nurse
notes that the client is taking azelaic acid (Azelex). Because of the medication
prescription, the nurse would suspect that the client is being treated for:
61. Acne
62. Eczema
63. Hair loss
64. Herpes simplex<correct answers>1. Acne
65. Rationale:
66. Azelaic acid is a topical medication used to treat mild to moderate acne. The acid
appears to work by suppressing the growth of Propionibacterium acnes and
decreasing the proliferation of keratinocytes. Options 2, 3, and 4 are incorrect.
67. 11.) The health care provider has prescribed silver sulfadiazine (Silvadene) for the
client with a partial-thickness burn, which has cultured positive for gram-negative
bacteria. The nurse is reinforcing information to the client about the medication.
Which statement made by the client indicates a lack of understanding about the
treatments?
68. "The medication is an antibacterial."
69. "The medication will help heal the burn."
70. "The medication will permanently stain my skin."
71. "The medication should be applied directly to the wound."<correct answers>3. "The
medication will permanently stain my skin."
72. Rationale:
73. Silver sulfadiazine (Silvadene) is an antibacterial that has a broad spectrum of
activity against gram-negative bacteria, gram-positive bacteria, and yeast. It is
applied directly to the wound to assist in healing. It does not stain the skin.
74. 12.) A nurse is caring for a client who is receiving an intravenous (IV) infusion of an
antineoplastic medication. During the infusion, the client complains of pain at the
insertion site. During an inspection of the site, the nurse notes redness and swelling
and that the rate of infusion of the medication has slowed. The nurse should take
which appropriate action?
75. Notify the registered nurse.
76. Administer pain medication to reduce the discomfort.
77. Apply ice and maintain the infusion rate, as prescribed.
78. Elevate the extremity of the IV site, and slow the infusion.<correct answers>1.
Notify the registered nurse.
79. Rationale:
300 Question and Correct Answers
1. A nurse is caring for a client with hyperparathyroidism and notes that the client's
serum calcium level is 13 mg/dL. Which medication should the nurse prepare to
administer as prescribed to the client?
a. Calcium chloride
b. Calcium gluconate
c. Calcitonin (Miacalcin)
d. Large doses of vitamin D<correct answers>3. Calcitonin (Miacalcin)
2. Rationale:
3. The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is experiencing
hypercalcemia. Calcium gluconate and calcium chloride are medications used for
the treatment of tetany, which occurs as a result of acute hypocalcemia. In
hypercalcemia, large doses of vitamin D need to be avoided. Calcitonin, a thyroid
hormone, decreases the plasma calcium level by inhibiting bone resorption and
lowering the serum calcium concentration.
4. 2.) Oral iron supplements are prescribed for a 6-year-old child with iron deficiency
anemia. The nurse instructs the mother to administer the iron with which best food
item?
5. Milk
6. Water
7. Apple juice
8. Orange juice<correct answers>4. Orange juice
9. Rationale:
10. Vitamin C increases the absorption of iron by the body. The mother should be
instructed to administer the medication with a citrus fruit or a juice that is high in
vitamin C. Milk may affect absorption of the iron. Water will not assist in absorption.
Orange juice contains a greater amount of vitamin C than apple juice.
11. 3.) Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse
monitors the client, knowing that which of the following would indicate the presence
of systemic toxicity from this medication?
12. Tinnitus
13. Diarrhea
14. Constipation
15. Decreased respirations<correct answers>1. Tinnitus
16. Rationale:
,17. Salicylic acid is absorbed readily through the skin, and systemic toxicity (salicylism)
can result. Symptoms include tinnitus, dizziness, hyperpnea, and psychological
disturbances. Constipation and diarrhea are not associated with salicylism.
18. 4.) The camp nurse asks the children preparing to swim in the lake if they have
applied sunscreen. The nurse reminds the children that chemical sunscreens are
most effective when applied:
19. Immediately before swimming
20. 15 minutes before exposure to the sun
21. Immediately before exposure to the sun
22. At least 30 minutes before exposure to the sun<correct answers>4. At least 30
minutes before exposure to the sun
23. Rationale:
24. Sunscreens are most effective when applied at least 30 minutes before exposure to
the sun so that they can penetrate the skin. All sunscreens should be reapplied after
swimming or sweating.
25. 5.) Mafenide acetate (Sulfamylon) is prescribed for the client with a burn injury.
When applying the medication, the client complains of local discomfort and burning.
Which of the following is the most appropriate nursing action?
26. Notifying the registered nurse
27. Discontinuing the medication
28. Informing the client that this is normal
29. Applying a thinner film than prescribed to the burn site<correct answers>3.
Informing the client that this is normal
30. Rationale:
31. Mafenide acetate is bacteriostatic for gram-negative and gram-positive organisms
and is used to treat burns to reduce bacteria present in avascular tissues. The client
should be informed that the medication will cause local discomfort and burning and
that this is a normal reaction; therefore options 1, 2, and 4 are incorrect
32. 6.) The burn client is receiving treatments of topical mafenide acetate (Sulfamylon)
to the site of injury. The nurse monitors the client, knowing that which of the
following indicates that a systemic effect has occurred?
33. 1.Hyperventilation
34. 2.Elevated blood pressure
35. 3.Local pain at the burn site
36. 4.Local rash at the burn site<correct answers>1.Hyperventilation
37. Rationale:
38. Mafenide acetate is a carbonic anhydrase inhibitor and can suppress renal
excretion of acid, thereby causing acidosis. Clients receiving this treatment should
, be monitored for signs of an acid-base imbalance (hyperventilation). If this occurs,
the medication should be discontinued for 1 to 2 days. Options 3 and 4 describe
local rather than systemic effects. An elevated blood pressure may be expected
from the pain that occurs with a burn injury.
39. 7.) Isotretinoin is prescribed for a client with severe acne. Before the administration
of this medication, the nurse anticipates that which laboratory test will be
prescribed?
40. Platelet count
41. Triglyceride level
42. Complete blood count
43. White blood cell count<correct answers>2. Triglyceride level
44. Rationale:
45. Isotretinoin can elevate triglyceride levels. Blood triglyceride levels should be
measured before treatment and periodically thereafter until the effect on the
triglycerides has been evaluated. Options 1, 3, and 4 do not need to be monitored
specifically during this treatment.
46. 8.) A client with severe acne is seen in the clinic and the health care provider (HCP)
prescribes isotretinoin. The nurse reviews the client's medication record and would
contact the (HCP) if the client is taking which medication?
47. Vitamin A
48. Digoxin (Lanoxin)
49. Furosemide (Lasix)
50. Phenytoin (Dilantin)<correct answers>1. Vitamin A
51. Rationale:
52. Isotretinoin is a metabolite of vitamin A and can produce generalized intensification
of isotretinoin toxicity. Because of the potential for increased toxicity, vitamin A
supplements should be discontinued before isotretinoin therapy. Options 2, 3, and 4
are not contraindicated with the use of isotretinoin.
53. 9.) The nurse is applying a topical corticosteroid to a client with eczema. The nurse
would monitor for the potential for increased systemic absorption of the medication
if the medication were being applied to which of the following body areas?
54. Back
55. Axilla
56. Soles of the feet
57. Palms of the hands<correct answers>2. Axilla
58. Rationale:
59. Topical corticosteroids can be absorbed into the systemic circulation. Absorption is
higher from regions where the skin is especially permeable (scalp, axilla, face,
, eyelids, neck, perineum, genitalia), and lower from regions in which permeability is
poor (back, palms, soles).
60. 10.) The clinic nurse is performing an admission assessment on a client. The nurse
notes that the client is taking azelaic acid (Azelex). Because of the medication
prescription, the nurse would suspect that the client is being treated for:
61. Acne
62. Eczema
63. Hair loss
64. Herpes simplex<correct answers>1. Acne
65. Rationale:
66. Azelaic acid is a topical medication used to treat mild to moderate acne. The acid
appears to work by suppressing the growth of Propionibacterium acnes and
decreasing the proliferation of keratinocytes. Options 2, 3, and 4 are incorrect.
67. 11.) The health care provider has prescribed silver sulfadiazine (Silvadene) for the
client with a partial-thickness burn, which has cultured positive for gram-negative
bacteria. The nurse is reinforcing information to the client about the medication.
Which statement made by the client indicates a lack of understanding about the
treatments?
68. "The medication is an antibacterial."
69. "The medication will help heal the burn."
70. "The medication will permanently stain my skin."
71. "The medication should be applied directly to the wound."<correct answers>3. "The
medication will permanently stain my skin."
72. Rationale:
73. Silver sulfadiazine (Silvadene) is an antibacterial that has a broad spectrum of
activity against gram-negative bacteria, gram-positive bacteria, and yeast. It is
applied directly to the wound to assist in healing. It does not stain the skin.
74. 12.) A nurse is caring for a client who is receiving an intravenous (IV) infusion of an
antineoplastic medication. During the infusion, the client complains of pain at the
insertion site. During an inspection of the site, the nurse notes redness and swelling
and that the rate of infusion of the medication has slowed. The nurse should take
which appropriate action?
75. Notify the registered nurse.
76. Administer pain medication to reduce the discomfort.
77. Apply ice and maintain the infusion rate, as prescribed.
78. Elevate the extremity of the IV site, and slow the infusion.<correct answers>1.
Notify the registered nurse.
79. Rationale:
