COURSE CODE: PHARMACOLOGY HESI EXAM TIME
COURSE TITLE: HESI Pharmacology Practice Test — Comprehensive DATE ALLOWED
Examination —/—/ 120
INSTRUCTOR: — —— Minutes
HESI Pharmacology Practice Test
Comprehensive Assessment — Medication Administration, Therapeutic Effects, Adverse Reactions & Client
Education
ALL QUESTIONS ARE COMPULSORY
A MULTIPLE CHOICE QUESTIONS (65 Marks)
Choose the single best answer for each question. Write the correct letter (A, B, C, or D) in the space provided.
1. The nurse reviews the new prescription, phenelzine (Nardil), a monoamine oxidase
inhibitor (MAOI), for a client with depression on the psychiatric unit. Which
information is most important for the nurse to assess?
A. Consumption of any alcohol or tyramine-rich foods.
B. Reports of nausea or vomiting.
C. Therapeutic serum drug levels.
D. Blood pressure and pulse prior to taking each dose.
✦ CORRECT ANSWER: A — Consumption of any alcohol or tyramine-rich foods.
Phenelzine (Nardil) is an MAOI requiring strict avoidance of tyramine-rich foods (aged cheeses, cured meats,
red wine, tap beer) and alcohol to prevent potentially fatal hypertensive crisis. This is the most critical
assessment because dietary non-compliance can be life-threatening. The interaction between MAOIs and
tyramine causes massive catecholamine release.
,2. The nurse is administering haloperidol 0.5 mg IM PRN to a client for the first time.
What side effects should the nurse assess the client for during the initial dose?
A. Bradykinesia.
B. Dystonia.
C. Somatization.
D. Akathisia.
✦ CORRECT ANSWER: B — Dystonia.
Acute dystonic reactions (muscle spasms of the neck, face, tongue, and back) are most likely to occur with the
first dose of a first-generation antipsychotic like haloperidol. This is an early-onset extrapyramidal symptom
(EPS). Bradykinesia and akathisia typically develop later. Dystonic reactions are treated with anticholinergic
agents like benztropine or diphenhydramine.
3. The nurse assesses a client at risk for a possible interaction with an over-the-counter
(OTC) decongestant. Which client health history should the nurse report to the
healthcare provider? (Select all that apply.)
A. Type 1 diabetes mellitus (DM).
B. Closed angle glaucoma.
C. Chronic hypertension.
D. Rheumatoid arthritis.
E. Crohn's disease.
✦ CORRECT ANSWER: B and C — Closed angle glaucoma and Chronic hypertension.
OTC decongestants (pseudoephedrine, phenylephrine) are sympathomimetics that cause vasoconstriction and
can dangerously elevate intraocular pressure in closed-angle glaucoma and blood pressure in hypertensive
clients. These are absolute contraindications for decongestant use. Type 1 DM, rheumatoid arthritis, and
Crohn's disease are not directly worsened by decongestants.
,4. A client prescribed ipratropium reports nausea, blurred vision, headaches, and
insomnia after using the inhaler. Which action should the nurse implement first?
A. Withhold the medication and report symptoms and vital signs to the healthcare provider.
B. Give PRN medication for nausea and vomiting and evaluate client in 30 minutes.
C. Reassure client that the ipratropium given will alleviate the symptoms.
D. Delay administration of ipratropium until the next maintenance medication is scheduled.
✦ CORRECT ANSWER: A — Withhold the medication and report symptoms and vital signs to the
healthcare provider.
Nausea, blurred vision, headaches, and insomnia are anticholinergic side effects indicating possible
ipratropium toxicity or intolerance. The medication should be withheld and the provider notified with
complete vital signs. Anticholinergic effects include: urinary retention, dry mouth, blurred vision, constipation,
tachycardia, and confusion (especially in older adults).
5. A client diagnosed with multiple sclerosis is experiencing profound weakness, blurry
vision, and shooting pains in both legs. Which medication is considered the best
course of treatment for the nurse to administer?
A. High dose methylprednisolone intravenously.
B. Baclofen three times a day.
C. Broad spectrum antibiotic coverage orally.
D. Immunomodulatory drug therapy periodically.
✦ CORRECT ANSWER: A — High dose methylprednisolone intravenously.
High-dose IV methylprednisolone is the standard treatment for acute MS exacerbations. It reduces
inflammation and shortens the duration of the relapse by suppressing the immune-mediated inflammatory
attack on myelin. Baclofen treats spasticity but not acute attacks. Antibiotics are ineffective.
Immunomodulatory drugs (interferons, glatiramer) are for long-term prevention, not acute exacerbations.
, 6. The nurse administers 30 mL of lactulose for a client with stage 2 hepatic
encephalopathy. Which assessment finding would indicate the medication is being
therapeutic?
A. A decrease in blood ammonia levels.
B. A softening in the stools.
C. An increase in glucose absorption.
D. A suppression of gut acidification.
✦ CORRECT ANSWER: A — A decrease in blood ammonia levels.
Lactulose treats hepatic encephalopathy by trapping ammonia in the gut (through acidification of colon
contents) and promoting its excretion in stool, thereby reducing blood ammonia levels. Decreased serum
ammonia correlates with improved mental status. Stool softening is a side effect, not the therapeutic goal.
7. The nurse is teaching a client newly diagnosed with type 1 diabetes about neutral
protamine Hagedorn (NPH) insulin. Which statement by the client indicates an
understanding of how the medication works?
A. "It facilitates the transport of glucose into the cells."
B. "It stimulates the function of beta cells in the pancreas."
C. "It increases the intracellular receptor site sensitivity."
D. "It delays the carbohydrate digestion and absorption."
✦ CORRECT ANSWER: A — "It facilitates the transport of glucose into the cells."
Insulin's mechanism of action is to bind to cell surface receptors and facilitate glucose transport across cell
membranes into cells, lowering blood glucose. It does not stimulate beta cells (that's sulfonylureas), increase
receptor sensitivity (that's metformin), or delay carbohydrate absorption (that's acarbose). NPH is
intermediate-acting insulin.
COURSE TITLE: HESI Pharmacology Practice Test — Comprehensive DATE ALLOWED
Examination —/—/ 120
INSTRUCTOR: — —— Minutes
HESI Pharmacology Practice Test
Comprehensive Assessment — Medication Administration, Therapeutic Effects, Adverse Reactions & Client
Education
ALL QUESTIONS ARE COMPULSORY
A MULTIPLE CHOICE QUESTIONS (65 Marks)
Choose the single best answer for each question. Write the correct letter (A, B, C, or D) in the space provided.
1. The nurse reviews the new prescription, phenelzine (Nardil), a monoamine oxidase
inhibitor (MAOI), for a client with depression on the psychiatric unit. Which
information is most important for the nurse to assess?
A. Consumption of any alcohol or tyramine-rich foods.
B. Reports of nausea or vomiting.
C. Therapeutic serum drug levels.
D. Blood pressure and pulse prior to taking each dose.
✦ CORRECT ANSWER: A — Consumption of any alcohol or tyramine-rich foods.
Phenelzine (Nardil) is an MAOI requiring strict avoidance of tyramine-rich foods (aged cheeses, cured meats,
red wine, tap beer) and alcohol to prevent potentially fatal hypertensive crisis. This is the most critical
assessment because dietary non-compliance can be life-threatening. The interaction between MAOIs and
tyramine causes massive catecholamine release.
,2. The nurse is administering haloperidol 0.5 mg IM PRN to a client for the first time.
What side effects should the nurse assess the client for during the initial dose?
A. Bradykinesia.
B. Dystonia.
C. Somatization.
D. Akathisia.
✦ CORRECT ANSWER: B — Dystonia.
Acute dystonic reactions (muscle spasms of the neck, face, tongue, and back) are most likely to occur with the
first dose of a first-generation antipsychotic like haloperidol. This is an early-onset extrapyramidal symptom
(EPS). Bradykinesia and akathisia typically develop later. Dystonic reactions are treated with anticholinergic
agents like benztropine or diphenhydramine.
3. The nurse assesses a client at risk for a possible interaction with an over-the-counter
(OTC) decongestant. Which client health history should the nurse report to the
healthcare provider? (Select all that apply.)
A. Type 1 diabetes mellitus (DM).
B. Closed angle glaucoma.
C. Chronic hypertension.
D. Rheumatoid arthritis.
E. Crohn's disease.
✦ CORRECT ANSWER: B and C — Closed angle glaucoma and Chronic hypertension.
OTC decongestants (pseudoephedrine, phenylephrine) are sympathomimetics that cause vasoconstriction and
can dangerously elevate intraocular pressure in closed-angle glaucoma and blood pressure in hypertensive
clients. These are absolute contraindications for decongestant use. Type 1 DM, rheumatoid arthritis, and
Crohn's disease are not directly worsened by decongestants.
,4. A client prescribed ipratropium reports nausea, blurred vision, headaches, and
insomnia after using the inhaler. Which action should the nurse implement first?
A. Withhold the medication and report symptoms and vital signs to the healthcare provider.
B. Give PRN medication for nausea and vomiting and evaluate client in 30 minutes.
C. Reassure client that the ipratropium given will alleviate the symptoms.
D. Delay administration of ipratropium until the next maintenance medication is scheduled.
✦ CORRECT ANSWER: A — Withhold the medication and report symptoms and vital signs to the
healthcare provider.
Nausea, blurred vision, headaches, and insomnia are anticholinergic side effects indicating possible
ipratropium toxicity or intolerance. The medication should be withheld and the provider notified with
complete vital signs. Anticholinergic effects include: urinary retention, dry mouth, blurred vision, constipation,
tachycardia, and confusion (especially in older adults).
5. A client diagnosed with multiple sclerosis is experiencing profound weakness, blurry
vision, and shooting pains in both legs. Which medication is considered the best
course of treatment for the nurse to administer?
A. High dose methylprednisolone intravenously.
B. Baclofen three times a day.
C. Broad spectrum antibiotic coverage orally.
D. Immunomodulatory drug therapy periodically.
✦ CORRECT ANSWER: A — High dose methylprednisolone intravenously.
High-dose IV methylprednisolone is the standard treatment for acute MS exacerbations. It reduces
inflammation and shortens the duration of the relapse by suppressing the immune-mediated inflammatory
attack on myelin. Baclofen treats spasticity but not acute attacks. Antibiotics are ineffective.
Immunomodulatory drugs (interferons, glatiramer) are for long-term prevention, not acute exacerbations.
, 6. The nurse administers 30 mL of lactulose for a client with stage 2 hepatic
encephalopathy. Which assessment finding would indicate the medication is being
therapeutic?
A. A decrease in blood ammonia levels.
B. A softening in the stools.
C. An increase in glucose absorption.
D. A suppression of gut acidification.
✦ CORRECT ANSWER: A — A decrease in blood ammonia levels.
Lactulose treats hepatic encephalopathy by trapping ammonia in the gut (through acidification of colon
contents) and promoting its excretion in stool, thereby reducing blood ammonia levels. Decreased serum
ammonia correlates with improved mental status. Stool softening is a side effect, not the therapeutic goal.
7. The nurse is teaching a client newly diagnosed with type 1 diabetes about neutral
protamine Hagedorn (NPH) insulin. Which statement by the client indicates an
understanding of how the medication works?
A. "It facilitates the transport of glucose into the cells."
B. "It stimulates the function of beta cells in the pancreas."
C. "It increases the intracellular receptor site sensitivity."
D. "It delays the carbohydrate digestion and absorption."
✦ CORRECT ANSWER: A — "It facilitates the transport of glucose into the cells."
Insulin's mechanism of action is to bind to cell surface receptors and facilitate glucose transport across cell
membranes into cells, lowering blood glucose. It does not stimulate beta cells (that's sulfonylureas), increase
receptor sensitivity (that's metformin), or delay carbohydrate absorption (that's acarbose). NPH is
intermediate-acting insulin.
