COURSE CODE: HESI-PN-PHARM
EXAM DATE TIME ALLOWED
COURSE TITLE: HESI Pharmacology NCLEX-PN — 2026/2027
— / — / —— 240 Minutes
INSTRUCTOR: —
◇
HESI Pharmacology NCLEX-PN — 2026/2027
300 Questions with Verified Answers & Rationales (Graded A+)
ALL QUESTIONS ARE COMPULSORY
A MULTIPLE CHOICE QUESTIONS (1–122) (244 Marks)
Choose the single best answer for each question. Write the correct letter in the space provided.
1. A client with hyperparathyroidism has a serum calcium of 13 mg/dL. Which medication should the
nurse prepare to administer?
A. Calcium chloride
B. Calcium gluconate
C. Calcitonin (Miacalcin)
D. Large doses of vitamin D
◆
✦ CORRECT ANSWER: C. Calcitonin (Miacalcin)
Rationale: Normal calcium is 8.6-10.0 mg/dL. Calcitonin decreases plasma calcium by inhibiting bone resorption. Calcium
gluconate and chloride treat hypocalcemic tetany. Vitamin D would worsen hypercalcemia.
, 2. Oral iron is prescribed for a 6-year-old with iron deficiency anemia. The nurse should instruct the
mother to administer the iron with which food?
A. Milk
B. Water
C. Apple juice
D. Orange juice
◆
✦ CORRECT ANSWER: D. Orange juice
Rationale: Vitamin C increases iron absorption. Orange juice contains more vitamin C than apple juice. Milk may impair iron
absorption.
3. Salicylic acid is prescribed for psoriasis. Which symptom indicates systemic toxicity (salicylism)?
A. Tinnitus
B. Diarrhea
C. Constipation
D. Decreased respirations
◆
✦ CORRECT ANSWER: A. Tinnitus
Rationale: Salicylic acid is absorbed through skin. Systemic toxicity (salicylism) manifests as tinnitus, dizziness, hyperpnea, and
psychological disturbances.
4. Chemical sunscreens are most effective when applied at what time?
A. Immediately before swimming
B. 15 minutes before sun exposure
C. Immediately before sun exposure
D. At least 30 minutes before sun exposure
◆
✦ CORRECT ANSWER: D. At least 30 minutes before sun exposure
Rationale: Sunscreens require 30 minutes to penetrate the skin for maximum effectiveness. Reapply after swimming or sweating.
, 5. A client receiving topical mafenide acetate (Sulfamylon) complains of local burning. What is the most
appropriate nursing action?
A. Notify the registered nurse
B. Discontinue the medication
C. Inform the client that this is normal
D. Apply a thinner film
◆
✦ CORRECT ANSWER: C. Inform the client that this is normal
Rationale: Local discomfort and burning are normal reactions to mafenide acetate application. The client should be informed of
this expected effect.
6. Which finding indicates a systemic effect of topical mafenide acetate (Sulfamylon)?
A. Hyperventilation
B. Elevated blood pressure
C. Local pain at the burn site
D. Local rash at the burn site
◆
✦ CORRECT ANSWER: A. Hyperventilation
Rationale: Mafenide is a carbonic anhydrase inhibitor that can cause metabolic acidosis. Hyperventilation is a compensatory
response indicating systemic acid-base imbalance.
7. Before administering isotretinoin for severe acne, which laboratory test should the nurse anticipate?
A. Platelet count
B. Triglyceride level
C. Complete blood count
D. White blood cell count
◆
✦ CORRECT ANSWER: B. Triglyceride level
Rationale: Isotretinoin can significantly elevate triglyceride levels. Baseline and periodic monitoring is required throughout
therapy.
, 8. The nurse would contact the HCP if a client prescribed isotretinoin is taking which medication?
A. Vitamin A
B. Digoxin (Lanoxin)
C. Furosemide (Lasix)
D. Phenytoin (Dilantin)
◆
✦ CORRECT ANSWER: A. Vitamin A
Rationale: Isotretinoin is a vitamin A metabolite. Concurrent vitamin A supplements intensify toxicity risk and must be
discontinued.
9. Topical corticosteroid application to which body area has the highest risk of systemic absorption?
A. Back
B. Axilla
C. Soles of the feet
D. Palms of the hands
◆
✦ CORRECT ANSWER: B. Axilla
Rationale: Systemic absorption is highest in areas with permeable skin: scalp, axilla, face, eyelids, neck, perineum, and genitalia.
The back, palms, and soles have lower permeability.
10. A client taking azelaic acid (Azelex) is most likely being treated for which condition?
A. Acne
B. Eczema
C. Hair loss
D. Herpes simplex
◆
✦ CORRECT ANSWER: A. Acne
Rationale: Azelaic acid is a topical medication for mild to moderate acne. It suppresses Propionibacterium acnes growth and
decreases keratinocyte proliferation.
EXAM DATE TIME ALLOWED
COURSE TITLE: HESI Pharmacology NCLEX-PN — 2026/2027
— / — / —— 240 Minutes
INSTRUCTOR: —
◇
HESI Pharmacology NCLEX-PN — 2026/2027
300 Questions with Verified Answers & Rationales (Graded A+)
ALL QUESTIONS ARE COMPULSORY
A MULTIPLE CHOICE QUESTIONS (1–122) (244 Marks)
Choose the single best answer for each question. Write the correct letter in the space provided.
1. A client with hyperparathyroidism has a serum calcium of 13 mg/dL. Which medication should the
nurse prepare to administer?
A. Calcium chloride
B. Calcium gluconate
C. Calcitonin (Miacalcin)
D. Large doses of vitamin D
◆
✦ CORRECT ANSWER: C. Calcitonin (Miacalcin)
Rationale: Normal calcium is 8.6-10.0 mg/dL. Calcitonin decreases plasma calcium by inhibiting bone resorption. Calcium
gluconate and chloride treat hypocalcemic tetany. Vitamin D would worsen hypercalcemia.
, 2. Oral iron is prescribed for a 6-year-old with iron deficiency anemia. The nurse should instruct the
mother to administer the iron with which food?
A. Milk
B. Water
C. Apple juice
D. Orange juice
◆
✦ CORRECT ANSWER: D. Orange juice
Rationale: Vitamin C increases iron absorption. Orange juice contains more vitamin C than apple juice. Milk may impair iron
absorption.
3. Salicylic acid is prescribed for psoriasis. Which symptom indicates systemic toxicity (salicylism)?
A. Tinnitus
B. Diarrhea
C. Constipation
D. Decreased respirations
◆
✦ CORRECT ANSWER: A. Tinnitus
Rationale: Salicylic acid is absorbed through skin. Systemic toxicity (salicylism) manifests as tinnitus, dizziness, hyperpnea, and
psychological disturbances.
4. Chemical sunscreens are most effective when applied at what time?
A. Immediately before swimming
B. 15 minutes before sun exposure
C. Immediately before sun exposure
D. At least 30 minutes before sun exposure
◆
✦ CORRECT ANSWER: D. At least 30 minutes before sun exposure
Rationale: Sunscreens require 30 minutes to penetrate the skin for maximum effectiveness. Reapply after swimming or sweating.
, 5. A client receiving topical mafenide acetate (Sulfamylon) complains of local burning. What is the most
appropriate nursing action?
A. Notify the registered nurse
B. Discontinue the medication
C. Inform the client that this is normal
D. Apply a thinner film
◆
✦ CORRECT ANSWER: C. Inform the client that this is normal
Rationale: Local discomfort and burning are normal reactions to mafenide acetate application. The client should be informed of
this expected effect.
6. Which finding indicates a systemic effect of topical mafenide acetate (Sulfamylon)?
A. Hyperventilation
B. Elevated blood pressure
C. Local pain at the burn site
D. Local rash at the burn site
◆
✦ CORRECT ANSWER: A. Hyperventilation
Rationale: Mafenide is a carbonic anhydrase inhibitor that can cause metabolic acidosis. Hyperventilation is a compensatory
response indicating systemic acid-base imbalance.
7. Before administering isotretinoin for severe acne, which laboratory test should the nurse anticipate?
A. Platelet count
B. Triglyceride level
C. Complete blood count
D. White blood cell count
◆
✦ CORRECT ANSWER: B. Triglyceride level
Rationale: Isotretinoin can significantly elevate triglyceride levels. Baseline and periodic monitoring is required throughout
therapy.
, 8. The nurse would contact the HCP if a client prescribed isotretinoin is taking which medication?
A. Vitamin A
B. Digoxin (Lanoxin)
C. Furosemide (Lasix)
D. Phenytoin (Dilantin)
◆
✦ CORRECT ANSWER: A. Vitamin A
Rationale: Isotretinoin is a vitamin A metabolite. Concurrent vitamin A supplements intensify toxicity risk and must be
discontinued.
9. Topical corticosteroid application to which body area has the highest risk of systemic absorption?
A. Back
B. Axilla
C. Soles of the feet
D. Palms of the hands
◆
✦ CORRECT ANSWER: B. Axilla
Rationale: Systemic absorption is highest in areas with permeable skin: scalp, axilla, face, eyelids, neck, perineum, and genitalia.
The back, palms, and soles have lower permeability.
10. A client taking azelaic acid (Azelex) is most likely being treated for which condition?
A. Acne
B. Eczema
C. Hair loss
D. Herpes simplex
◆
✦ CORRECT ANSWER: A. Acne
Rationale: Azelaic acid is a topical medication for mild to moderate acne. It suppresses Propionibacterium acnes growth and
decreases keratinocyte proliferation.
