PHARM HESI PRACTICE EXAM WITH
QUESTIONS AND ANSWERS
Question 1
A client with diabetes mellitus visits a health care clinic. The client's diabetes mellitus
previously had been well controlled with glyburide (DiaBeta) daily, but recently the
fasting blood glucose level has been 180 to 200 mg/dL. Which medication, if added
to the client's regimen, may have contributed to the hyperglycemia?
1. Prednisone
2. Phenelzine (Nardil)
3. Atenolol (Tenormin)
4. Allopurinol (Zyloprim)
Correct Answer
1. Prednisone
Rationale:
Prednisone may decrease the effect of oral hypoglycemics, insulin, diuretics, and
potassium supplements. Option 2, a monoamine oxidase inhibitor, and option 3, a
β-blocker, have their own intrinsic hypoglycemic activity. Option 4 decreases urinary
excretion of sulfonylurea agents, causing increased levels of the oral agents, which
can lead to hypoglycemia.
Question 2
Long-term corticosteroids should be taken at what time of the day?
Correct Answer
Morning since the drug should be given around the time of the natural release of
cortisol--day time.
Page 1 of 337
,Question 3
) A client with a history of simple partial seizures is taking clorazepate (Tranxene), and
asks the nurse if there is a risk of addiction. The nurse's response is based on the
understanding that clorazepate:
1. Is not habit forming, either physically or psychologically
2. Leads to physical tolerance, but only after 10 or more years of therapy
3. Leads to physical and psychological dependence with prolonged high-dose therapy
4. Can result in psychological dependence only, because of the nature of the
medication
Correct Answer
3. Leads to physical and psychological dependence with prolonged high-dose
therapy
Rationale:
Clorazepate is classified as an anticonvulsant, antianxiety agent, and sedative-
hypnotic (benzodiazepine). One of the concerns with clorazepate therapy is that the
medication can lead to physical or psychological dependence with prolonged
therapy at high doses. For this reason, the amount of medication that is readily
available to the client at any one time is restricted.
*Eliminate options 2 and 4 first because of the closed-ended word "only"*
Question 4
Atomoxetine (Strattera)
Correct Answer
Which drug is linked with increased suicidal thinking and behaviors in adolescents?
Question 5
Hypokalemia with Digoxin
Correct Answer
Monitoring the potassium and heart rate is very important
Page 2 of 337
,Question 6
In developing a nursing care plan for a 9-month-old infant with cystic fibrosis, the
nurse writes a nursing diagnosis of Alteration in nutrition: less than body
requirements, related to inadequate digestion of nutrients. Which intervention would
best meet this child's needs?
Correct Answer
Give pancrelipase (Cotazym-S) capsule mixed with applesauce before each meal.
Question 7
-ane
Correct Answer
general anesthetics
ex: cyclohexane, flourane
Question 8
SE of furosemide (Lasix)
Correct Answer
-dizziness,
-headache
-tinnitus
-Nausea, vomiting, diarrhea
-decreased potassium
-hyperglycemia
-ototoxicity with aminoglycosides (-mycin drugs)
Question 9
What are symptoms of ineffective drug management of multiple sclerosis?
Correct Answer
Ptosis and decreased oral secretions
Page 3 of 337
, Question 10
) A client is receiving baclofen (Lioresal) for muscle spasms caused by a spinal cord
injury. The nurse monitors the client, knowing that which of the following is a side
effect of this medication?
1. Muscle pain
2. Hypertension
3. Slurred speech
4. Photosensitivity
Correct Answer
Rationale:
Side effects of baclofen include drowsiness, dizziness, weakness, and nausea.
Occasional side effects include headache, paresthesia of the hands and feet,
constipation or diarrhea, anorexia, hypotension, confusion, and nasal congestion.
Paradoxical central nervous system excitement and restlessness can occur, along
with slurred speech, tremor, dry mouth, nocturia, and impotence.
*Option 3 is most closely associated with a neurological disorder*
Question 11
1
Correct Answer
A client who has been prescribed tetracycline continues the course of treatment
during the first trimester of pregnancy. Which teratogenic effect may occur in the
fetus?
1 Bone anomalies
2 Central nervous system malformations
3 Facial malformations
4 Internal organ defects
Page 4 of 337
QUESTIONS AND ANSWERS
Question 1
A client with diabetes mellitus visits a health care clinic. The client's diabetes mellitus
previously had been well controlled with glyburide (DiaBeta) daily, but recently the
fasting blood glucose level has been 180 to 200 mg/dL. Which medication, if added
to the client's regimen, may have contributed to the hyperglycemia?
1. Prednisone
2. Phenelzine (Nardil)
3. Atenolol (Tenormin)
4. Allopurinol (Zyloprim)
Correct Answer
1. Prednisone
Rationale:
Prednisone may decrease the effect of oral hypoglycemics, insulin, diuretics, and
potassium supplements. Option 2, a monoamine oxidase inhibitor, and option 3, a
β-blocker, have their own intrinsic hypoglycemic activity. Option 4 decreases urinary
excretion of sulfonylurea agents, causing increased levels of the oral agents, which
can lead to hypoglycemia.
Question 2
Long-term corticosteroids should be taken at what time of the day?
Correct Answer
Morning since the drug should be given around the time of the natural release of
cortisol--day time.
Page 1 of 337
,Question 3
) A client with a history of simple partial seizures is taking clorazepate (Tranxene), and
asks the nurse if there is a risk of addiction. The nurse's response is based on the
understanding that clorazepate:
1. Is not habit forming, either physically or psychologically
2. Leads to physical tolerance, but only after 10 or more years of therapy
3. Leads to physical and psychological dependence with prolonged high-dose therapy
4. Can result in psychological dependence only, because of the nature of the
medication
Correct Answer
3. Leads to physical and psychological dependence with prolonged high-dose
therapy
Rationale:
Clorazepate is classified as an anticonvulsant, antianxiety agent, and sedative-
hypnotic (benzodiazepine). One of the concerns with clorazepate therapy is that the
medication can lead to physical or psychological dependence with prolonged
therapy at high doses. For this reason, the amount of medication that is readily
available to the client at any one time is restricted.
*Eliminate options 2 and 4 first because of the closed-ended word "only"*
Question 4
Atomoxetine (Strattera)
Correct Answer
Which drug is linked with increased suicidal thinking and behaviors in adolescents?
Question 5
Hypokalemia with Digoxin
Correct Answer
Monitoring the potassium and heart rate is very important
Page 2 of 337
,Question 6
In developing a nursing care plan for a 9-month-old infant with cystic fibrosis, the
nurse writes a nursing diagnosis of Alteration in nutrition: less than body
requirements, related to inadequate digestion of nutrients. Which intervention would
best meet this child's needs?
Correct Answer
Give pancrelipase (Cotazym-S) capsule mixed with applesauce before each meal.
Question 7
-ane
Correct Answer
general anesthetics
ex: cyclohexane, flourane
Question 8
SE of furosemide (Lasix)
Correct Answer
-dizziness,
-headache
-tinnitus
-Nausea, vomiting, diarrhea
-decreased potassium
-hyperglycemia
-ototoxicity with aminoglycosides (-mycin drugs)
Question 9
What are symptoms of ineffective drug management of multiple sclerosis?
Correct Answer
Ptosis and decreased oral secretions
Page 3 of 337
, Question 10
) A client is receiving baclofen (Lioresal) for muscle spasms caused by a spinal cord
injury. The nurse monitors the client, knowing that which of the following is a side
effect of this medication?
1. Muscle pain
2. Hypertension
3. Slurred speech
4. Photosensitivity
Correct Answer
Rationale:
Side effects of baclofen include drowsiness, dizziness, weakness, and nausea.
Occasional side effects include headache, paresthesia of the hands and feet,
constipation or diarrhea, anorexia, hypotension, confusion, and nasal congestion.
Paradoxical central nervous system excitement and restlessness can occur, along
with slurred speech, tremor, dry mouth, nocturia, and impotence.
*Option 3 is most closely associated with a neurological disorder*
Question 11
1
Correct Answer
A client who has been prescribed tetracycline continues the course of treatment
during the first trimester of pregnancy. Which teratogenic effect may occur in the
fetus?
1 Bone anomalies
2 Central nervous system malformations
3 Facial malformations
4 Internal organ defects
Page 4 of 337
