HESI Pharmacology Practice Exam
2025-2026 Edition: Updated Questions
& Verified Answers to Guarantee a
Pass
The client has begun medication therapy with pancrelipase (Pancrease MT). The nurse evaluates that
the medication is having the optimal intended benefit if which effect is observed?
1. Weight loss
2. Relief of heartburn
3. Reduction of steatorrhea
4. Absence of abdominal pain
3. Reduction of steatorrhea
Rationale:
Pancrelipase (Pancrease MT) is a pancreatic enzyme used in clients with pancreatitis as a digestive aid.
The medication should reduce the amount of fatty stools (steatorrhea). Another intended effect could
be improved nutritional status. It is not used to treat abdominal pain or heartburn. Its use could result in
weight gain but should not result in weight loss if it is aiding in digestion.
An older client recently has been taking cimetidine (Tagamet). The nurse monitors the client for which
most frequent central nervous system side effect of this medication?
1. Tremors
2. Dizziness
3. Confusion
4. Hallucinations
3.Confusion
Rationale:
Cimetidine is a histamine 2 (H2)-receptor antagonist. Older clients are especially susceptible to central
nervous system side effects of cimetidine. The most frequent of these is confusion. Less common central
nervous system side effects include headache, dizziness, drowsiness, and hallucinations.
Page 1 of 37
,The client with a gastric ulcer has a prescription for sucralfate (Carafate), 1 g by mouth four times
daily. The nurse schedules the medication for which times?
1. With meals and at bedtime
2. Every 6 hours around the clock
3. One hour after meals and at bedtime
4. One hour before meals and at bedtime
4. One hour before meals and at bedtime
Rationale:
Sucralfate is a gastric protectant. The medication should be scheduled for administration 1 hour before
meals and at bedtime. The medication is timed to allow it to form a protective coating over the ulcer
before food intake stimulates gastric acid production and mechanical irritation. The other options are
incorrect.
The client who chronically uses nonsteroidal anti-inflammatory drugs has been taking misoprostol
(Cytotec). The nurse determines that the medication is having the intended therapeutic effect if which
of the following is noted?
1. Resolved diarrhea
2. Relief of epigastric pain
3. Decreased platelet count
4. Decreased white blood cell count
2. Relief of epigastric pain
Rationale:
The client who chronically uses nonsteroidal anti-inflammatory drugs (NSAIDs) is prone to gastric
mucosal injury. Misoprostol is a gastric protectant and is given specifically to prevent this occurrence.
Diarrhea can be a side effect of the medication, but is not an intended effect. Options 3 and 4 are
incorrect
The client has been taking omeprazole (Prilosec) for 4 weeks. The ambulatory care nurse evaluates
that the client is receiving optimal intended effect of the medication if the client reports the absence
of which symptom?
1. Diarrhea
2. Heartburn
3. Flatulence
4. Constipation
2.Heartburn
Rationale:
Omeprazole is a proton pump inhibitor classified as an antiulcer agent. The intended effect of the
Page 2 of 37
,medication is relief of pain from gastric irritation, often called heartburn by clients. Omeprazole is not
used to treat the conditions identified in options 1, 3, and 4.
42.) A client with a peptic ulcer is diagnosed with a Helicobacter pylori infection. The nurse is
reinforcing teaching for the client about the medications prescribed, including clarithromycin (Biaxin),
esomeprazole (Nexium), and amoxicillin (Amoxil). Which statement by the client indicates the best
understanding of the medication regimen?
1. "My ulcer will heal because these medications will kill the bacteria."
2. "These medications are only taken when I have pain from my ulcer."
3. "The medications will kill the bacteria and stop the acid production."
4. "These medications will coat the ulcer and decrease the acid production in my stomach."
3. "The medications will kill the bacteria and stop the acid production."
Rationale:
Triple therapy for Helicobacter pylori infection usually includes two antibacterial drugs and a proton
pump inhibitor. Clarithromycin and amoxicillin are antibacterials. Esomeprazole is a proton pump
inhibitor. These medications will kill the bacteria and decrease acid production.
A histamine (H2)-receptor antagonist will be prescribed for a client. The nurse understands that which
medications are H2-receptor antagonists? Select all that apply.
1. Nizatidine (Axid)
2. Ranitidine (Zantac)
3. Famotidine (Pepcid)
4. Cimetidine (Tagamet)
5. Esomeprazole (Nexium)
6. Lansoprazole (Prevacid)
1. Nizatidine (Axid)
2. Ranitidine (Zantac)
3. Famotidine (Pepcid)
4. Cimetidine (Tagamet)
Rationale:
H2-receptor antagonists suppress secretion of gastric acid, alleviate symptoms of heartburn, and assist
in preventing complications of peptic ulcer disease. These medications also suppress gastric acid
secretions and are used in active ulcer disease, erosive esophagitis, and pathological hypersecretory
conditions. The other medications listed are proton pump inhibitors.H2-receptor antagonists medication
names end with -dine.Proton pump inhibitors medication names end with -zole.
A client is receiving acetylcysteine (Mucomyst), 20% solution diluted in 0.9% normal saline by
nebulizer. The nurse should have which item available for possible use after giving this medication?
1. Ambu bag
Page 3 of 37
, 2. Intubation tray
3. Nasogastric tube
4. Suction equipment
4. Suction equipment
Rationale:
Acetylcysteine can be given orally or by nasogastric tube to treat acetaminophen overdose, or it may be
given by inhalation for use as a mucolytic. The nurse administering this medication as a mucolytic should
have suction equipment available in case the client cannot manage to clear the increased volume of
liquefied secretions.
A client has a prescription to take guaifenesin (Humibid) every 4 hours, as needed. The nurse
determines that the client understands the most effective use of this medication if the client states
that he or she will:
1. Watch for irritability as a side effect.
2. Take the tablet with a full glass of water.
3. Take an extra dose if the cough is accompanied by fever.
4. Crush the sustained-release tablet if immediate relief is needed.
2. Take the tablet with a full glass of water.
Rationale:
Guaifenesin is an expectorant. It should be taken with a full glass of water to decrease viscosity of
secretions. Sustained-release preparations should not be broken open, crushed, or chewed. The
medication may occasionally cause dizziness, headache, or drowsiness as side effects. The client should
contact the health care provider if the cough lasts longer than 1 week or is accompanied by fever, rash,
sore throat, or persistent headache.
A postoperative client has received a dose of naloxone hydrochloride for respiratory depression
shortly after transfer to the nursing unit from the postanesthesia care unit. After administration of the
medication, the nurse checks the client for:
1. Pupillary changes
2. Scattered lung wheezes
3. Sudden increase in pain
4. Sudden episodes of diarrhea
3. Sudden increase in pain
Rationale:
Naloxone hydrochloride is an antidote to opioids and may also be given to the postoperative client to
treat respiratory depression. When given to the postoperative client for respiratory depression, it may
Page 4 of 37
2025-2026 Edition: Updated Questions
& Verified Answers to Guarantee a
Pass
The client has begun medication therapy with pancrelipase (Pancrease MT). The nurse evaluates that
the medication is having the optimal intended benefit if which effect is observed?
1. Weight loss
2. Relief of heartburn
3. Reduction of steatorrhea
4. Absence of abdominal pain
3. Reduction of steatorrhea
Rationale:
Pancrelipase (Pancrease MT) is a pancreatic enzyme used in clients with pancreatitis as a digestive aid.
The medication should reduce the amount of fatty stools (steatorrhea). Another intended effect could
be improved nutritional status. It is not used to treat abdominal pain or heartburn. Its use could result in
weight gain but should not result in weight loss if it is aiding in digestion.
An older client recently has been taking cimetidine (Tagamet). The nurse monitors the client for which
most frequent central nervous system side effect of this medication?
1. Tremors
2. Dizziness
3. Confusion
4. Hallucinations
3.Confusion
Rationale:
Cimetidine is a histamine 2 (H2)-receptor antagonist. Older clients are especially susceptible to central
nervous system side effects of cimetidine. The most frequent of these is confusion. Less common central
nervous system side effects include headache, dizziness, drowsiness, and hallucinations.
Page 1 of 37
,The client with a gastric ulcer has a prescription for sucralfate (Carafate), 1 g by mouth four times
daily. The nurse schedules the medication for which times?
1. With meals and at bedtime
2. Every 6 hours around the clock
3. One hour after meals and at bedtime
4. One hour before meals and at bedtime
4. One hour before meals and at bedtime
Rationale:
Sucralfate is a gastric protectant. The medication should be scheduled for administration 1 hour before
meals and at bedtime. The medication is timed to allow it to form a protective coating over the ulcer
before food intake stimulates gastric acid production and mechanical irritation. The other options are
incorrect.
The client who chronically uses nonsteroidal anti-inflammatory drugs has been taking misoprostol
(Cytotec). The nurse determines that the medication is having the intended therapeutic effect if which
of the following is noted?
1. Resolved diarrhea
2. Relief of epigastric pain
3. Decreased platelet count
4. Decreased white blood cell count
2. Relief of epigastric pain
Rationale:
The client who chronically uses nonsteroidal anti-inflammatory drugs (NSAIDs) is prone to gastric
mucosal injury. Misoprostol is a gastric protectant and is given specifically to prevent this occurrence.
Diarrhea can be a side effect of the medication, but is not an intended effect. Options 3 and 4 are
incorrect
The client has been taking omeprazole (Prilosec) for 4 weeks. The ambulatory care nurse evaluates
that the client is receiving optimal intended effect of the medication if the client reports the absence
of which symptom?
1. Diarrhea
2. Heartburn
3. Flatulence
4. Constipation
2.Heartburn
Rationale:
Omeprazole is a proton pump inhibitor classified as an antiulcer agent. The intended effect of the
Page 2 of 37
,medication is relief of pain from gastric irritation, often called heartburn by clients. Omeprazole is not
used to treat the conditions identified in options 1, 3, and 4.
42.) A client with a peptic ulcer is diagnosed with a Helicobacter pylori infection. The nurse is
reinforcing teaching for the client about the medications prescribed, including clarithromycin (Biaxin),
esomeprazole (Nexium), and amoxicillin (Amoxil). Which statement by the client indicates the best
understanding of the medication regimen?
1. "My ulcer will heal because these medications will kill the bacteria."
2. "These medications are only taken when I have pain from my ulcer."
3. "The medications will kill the bacteria and stop the acid production."
4. "These medications will coat the ulcer and decrease the acid production in my stomach."
3. "The medications will kill the bacteria and stop the acid production."
Rationale:
Triple therapy for Helicobacter pylori infection usually includes two antibacterial drugs and a proton
pump inhibitor. Clarithromycin and amoxicillin are antibacterials. Esomeprazole is a proton pump
inhibitor. These medications will kill the bacteria and decrease acid production.
A histamine (H2)-receptor antagonist will be prescribed for a client. The nurse understands that which
medications are H2-receptor antagonists? Select all that apply.
1. Nizatidine (Axid)
2. Ranitidine (Zantac)
3. Famotidine (Pepcid)
4. Cimetidine (Tagamet)
5. Esomeprazole (Nexium)
6. Lansoprazole (Prevacid)
1. Nizatidine (Axid)
2. Ranitidine (Zantac)
3. Famotidine (Pepcid)
4. Cimetidine (Tagamet)
Rationale:
H2-receptor antagonists suppress secretion of gastric acid, alleviate symptoms of heartburn, and assist
in preventing complications of peptic ulcer disease. These medications also suppress gastric acid
secretions and are used in active ulcer disease, erosive esophagitis, and pathological hypersecretory
conditions. The other medications listed are proton pump inhibitors.H2-receptor antagonists medication
names end with -dine.Proton pump inhibitors medication names end with -zole.
A client is receiving acetylcysteine (Mucomyst), 20% solution diluted in 0.9% normal saline by
nebulizer. The nurse should have which item available for possible use after giving this medication?
1. Ambu bag
Page 3 of 37
, 2. Intubation tray
3. Nasogastric tube
4. Suction equipment
4. Suction equipment
Rationale:
Acetylcysteine can be given orally or by nasogastric tube to treat acetaminophen overdose, or it may be
given by inhalation for use as a mucolytic. The nurse administering this medication as a mucolytic should
have suction equipment available in case the client cannot manage to clear the increased volume of
liquefied secretions.
A client has a prescription to take guaifenesin (Humibid) every 4 hours, as needed. The nurse
determines that the client understands the most effective use of this medication if the client states
that he or she will:
1. Watch for irritability as a side effect.
2. Take the tablet with a full glass of water.
3. Take an extra dose if the cough is accompanied by fever.
4. Crush the sustained-release tablet if immediate relief is needed.
2. Take the tablet with a full glass of water.
Rationale:
Guaifenesin is an expectorant. It should be taken with a full glass of water to decrease viscosity of
secretions. Sustained-release preparations should not be broken open, crushed, or chewed. The
medication may occasionally cause dizziness, headache, or drowsiness as side effects. The client should
contact the health care provider if the cough lasts longer than 1 week or is accompanied by fever, rash,
sore throat, or persistent headache.
A postoperative client has received a dose of naloxone hydrochloride for respiratory depression
shortly after transfer to the nursing unit from the postanesthesia care unit. After administration of the
medication, the nurse checks the client for:
1. Pupillary changes
2. Scattered lung wheezes
3. Sudden increase in pain
4. Sudden episodes of diarrhea
3. Sudden increase in pain
Rationale:
Naloxone hydrochloride is an antidote to opioids and may also be given to the postoperative client to
treat respiratory depression. When given to the postoperative client for respiratory depression, it may
Page 4 of 37
