2025-2026 HESI Pharmacology Exit RN
Exam Study Guide by HESI Elsevier: 200
Questions & Answers to Pass on Your
First Attempt and Avoid Resits
1.
1.A healthcare provider prescribes cephalexin
monohydrate (Keflex) for a client with a postoperative
infection. It is most important for the nurse to assess for
what additional drug allergy before administering this
prescription?
A) Penicillins.
B) Aminoglycosides.
C) Erythromycins.
D) Sulfonamides.
Answer: A) Penicillins.
Rationale: Cross-allergies exist between penicillins and
cephalosporins, such as cephalexin monohydrate (Keflex), so
checking for a penicillin allergy is a wise precaution before
administering this drug.
2. Which nursing intervention is most important when
caring for a client receiving the antimetabolite cytosine
arabinoside (Arc-C) for chemotherapy?
A) Hydrate the client with IV fluids before and after infusion.
B) Assess the client for numbness and tingling of extremities.
C) Inspect the client's oral mucosa for ulcerations.
D) Monitor the client's urine pH for increased acidity.
, Answer: C) Inspect the client's oral mucosa for ulcerations.
Rationale: Cytosine arabinoside (Arc-C) affects rapidly growing
cells; therefore, stomatitis and mucosal ulcerations are key
signs of antimetabolite toxicity.
3. When assessing an adolescent who recently overdosed on
acetaminophen (Tylenol), it is most important for the
nurse to assess for pain in which area of the body?
A) Flank.
B) Abdomen.
C) Chest.
D) Head.
Answer: B) Abdomen.
Rationale: Acetaminophen toxicity can result in liver damage;
therefore, it is especially important for the nurse to assess for
abdominal pain.
4. 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.
Answer: C) Calcitonin (Miacalcin).
*Rationale: The normal serum calcium level is 8.6 to 10.0
mg/dL. This client is experiencing hypercalcemia. Calcitonin, a
thyroid hormone, decreases the plasma calcium level by
inhibiting bone resorption.*
5. 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?
A) Milk.
B) Water.
C) Apple juice.
D) Orange juice.
Answer: D) Orange juice.
Rationale: Vitamin C increases the absorption of iron by the
body. Orange juice contains a greater amount of vitamin C
than apple juice. Milk may affect absorption of the iron, and
water will not assist in absorption.
6. 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?
A) Tinnitus.
B) Diarrhea.
C) Constipation.
D) Decreased respirations.
Answer: A) Tinnitus.
Rationale: Tinnitus is a known adverse effect and sign of
systemic toxicity from salicylates, indicating a need to assess
for further toxicity.
7. A client with heart failure is prescribed digoxin. Which
finding requires immediate nursing intervention?
A) Heart rate of 62 beats per minute.
B) Serum potassium level of 3.2 mEq/L.
C) Blood pressure 118/76 mmHg.
D) Respiratory rate 18 breaths per minute.
*Answer: B) Serum potassium level of 3.2 mEq/L.*
*Rationale: Hypokalemia (K+ <3.5) increases the risk of
, digoxin toxicity. Normal HR is 60-100, and BP and RR are
normal.*
8. A client taking amiodarone reports shortness of breath
and a nonproductive cough. What is the nurse's priority
action?
A) Administer oxygen as needed.
B) Notify the healthcare provider immediately.
C) Give the client an antitussive medication.
D) Reassure the client this is a common side effect.
Answer: B) Notify the healthcare provider immediately.
Rationale: Amiodarone can cause pulmonary toxicity
(interstitial lung disease). Cough and dyspnea require
immediate HCP notification for chest X-ray and possible drug
discontinuation.
9. Select all that apply: A client is starting warfarin. Which
instructions should the nurse include?
A) Take the medication at the same time each day.
B) Avoid eating large amounts of leafy green vegetables.
C) Use a soft-bristled toothbrush.
D) Take ibuprofen for headaches.
E) Get INR levels checked regularly.
Answer: A, B, C, E.
Rationale: Consistent timing and monitoring are key for safety.
Leafy greens are high in Vitamin K which can interfere with
warfarin. A soft toothbrush reduces bleeding risk. Ibuprofen
increases bleeding risk and should be avoided.
10.A client receiving heparin IV continuous infusion has an
aPTT of 110 seconds (normal 25-35). The nurse should
anticipate which order?
A) Increase the heparin infusion rate.
Exam Study Guide by HESI Elsevier: 200
Questions & Answers to Pass on Your
First Attempt and Avoid Resits
1.
1.A healthcare provider prescribes cephalexin
monohydrate (Keflex) for a client with a postoperative
infection. It is most important for the nurse to assess for
what additional drug allergy before administering this
prescription?
A) Penicillins.
B) Aminoglycosides.
C) Erythromycins.
D) Sulfonamides.
Answer: A) Penicillins.
Rationale: Cross-allergies exist between penicillins and
cephalosporins, such as cephalexin monohydrate (Keflex), so
checking for a penicillin allergy is a wise precaution before
administering this drug.
2. Which nursing intervention is most important when
caring for a client receiving the antimetabolite cytosine
arabinoside (Arc-C) for chemotherapy?
A) Hydrate the client with IV fluids before and after infusion.
B) Assess the client for numbness and tingling of extremities.
C) Inspect the client's oral mucosa for ulcerations.
D) Monitor the client's urine pH for increased acidity.
, Answer: C) Inspect the client's oral mucosa for ulcerations.
Rationale: Cytosine arabinoside (Arc-C) affects rapidly growing
cells; therefore, stomatitis and mucosal ulcerations are key
signs of antimetabolite toxicity.
3. When assessing an adolescent who recently overdosed on
acetaminophen (Tylenol), it is most important for the
nurse to assess for pain in which area of the body?
A) Flank.
B) Abdomen.
C) Chest.
D) Head.
Answer: B) Abdomen.
Rationale: Acetaminophen toxicity can result in liver damage;
therefore, it is especially important for the nurse to assess for
abdominal pain.
4. 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.
Answer: C) Calcitonin (Miacalcin).
*Rationale: The normal serum calcium level is 8.6 to 10.0
mg/dL. This client is experiencing hypercalcemia. Calcitonin, a
thyroid hormone, decreases the plasma calcium level by
inhibiting bone resorption.*
5. 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?
A) Milk.
B) Water.
C) Apple juice.
D) Orange juice.
Answer: D) Orange juice.
Rationale: Vitamin C increases the absorption of iron by the
body. Orange juice contains a greater amount of vitamin C
than apple juice. Milk may affect absorption of the iron, and
water will not assist in absorption.
6. 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?
A) Tinnitus.
B) Diarrhea.
C) Constipation.
D) Decreased respirations.
Answer: A) Tinnitus.
Rationale: Tinnitus is a known adverse effect and sign of
systemic toxicity from salicylates, indicating a need to assess
for further toxicity.
7. A client with heart failure is prescribed digoxin. Which
finding requires immediate nursing intervention?
A) Heart rate of 62 beats per minute.
B) Serum potassium level of 3.2 mEq/L.
C) Blood pressure 118/76 mmHg.
D) Respiratory rate 18 breaths per minute.
*Answer: B) Serum potassium level of 3.2 mEq/L.*
*Rationale: Hypokalemia (K+ <3.5) increases the risk of
, digoxin toxicity. Normal HR is 60-100, and BP and RR are
normal.*
8. A client taking amiodarone reports shortness of breath
and a nonproductive cough. What is the nurse's priority
action?
A) Administer oxygen as needed.
B) Notify the healthcare provider immediately.
C) Give the client an antitussive medication.
D) Reassure the client this is a common side effect.
Answer: B) Notify the healthcare provider immediately.
Rationale: Amiodarone can cause pulmonary toxicity
(interstitial lung disease). Cough and dyspnea require
immediate HCP notification for chest X-ray and possible drug
discontinuation.
9. Select all that apply: A client is starting warfarin. Which
instructions should the nurse include?
A) Take the medication at the same time each day.
B) Avoid eating large amounts of leafy green vegetables.
C) Use a soft-bristled toothbrush.
D) Take ibuprofen for headaches.
E) Get INR levels checked regularly.
Answer: A, B, C, E.
Rationale: Consistent timing and monitoring are key for safety.
Leafy greens are high in Vitamin K which can interfere with
warfarin. A soft toothbrush reduces bleeding risk. Ibuprofen
increases bleeding risk and should be avoided.
10.A client receiving heparin IV continuous infusion has an
aPTT of 110 seconds (normal 25-35). The nurse should
anticipate which order?
A) Increase the heparin infusion rate.
