HESI PHARMACOLOGY PRACTICE EXAM
2026 UPDATE QUESTIONS AND CORRECT
VERIFIED ANSWERS ALREADY GRADED
A+ (BRAND NEW VISION)
A client is receiving metoprolol (Lopressor SR). What assessment is most important for
the nurse to obtain?
A) Temperature.
B) Lung sounds.
C) Blood pressure.
D) Urinary output. - ANS-C.
It is most important to monitor the blood pressure (C) of clients taking this
medication because Lopressor is an antianginal, antiarrhythmic, antihypertensive
agent. While (A and B) are important data to obtain on any client, they are not as
important for a client receiving Lopressor as (C). Intake and output ratios and
daily weights should be monitored while taking Lopressor to assess for signs
and symptoms of congestive heart failure, but (D) alone does not have the
importance of (C).
A client with osteoarthritis receives a new prescription for celecoxib (Celebrex) orally for
symptom management. The nurse notes the client is allergic to sulfa. Which action is
most important for the nurse to implement prior to administering the first dose?
A) Review the client's hemoglobin results.
B) Notify the healthcare provider.
C) Inquire about the reaction to sulfa.
D) Record the client's vital signs. - ANS-B.
Celebrex contains a sulfur molecule, which can lead to an allergic reaction in
individuals who are sensitive to sulfonamides, so the healthcare provider should
be notified of the client's allergies (B). Although (A, C, and D) are important
assessments, it is most important to notify the healthcare provider for an
alternate prescription.
Upon admission to the emergency center, an adult client with acute status asthmaticus
is prescribed this series of medications. In which order should the nurse administer the
prescribed medications? (Arrange from first to last.)
A) Prednisone (Deltasone) orally.
B) Gentamicin (Garamycin) IM.
C) Albuterol (Proventil) puffs.
D) Salmeterol (Serevent Diskus). - ANS-CDAB
,A client with coronary artery disease who is taking digoxin (Lanoxin) receives a new
prescription for atorvastatin (Lipitor). Two weeks after initiation of the Lipitor
prescription, the nurse assesses the client. Which finding requires the most immediate
intervention?
A) Heartburn.
B) Headache.
C) Constipation.
D) Vomiting. - ANS-d.
Vomiting, anorexia and abdominal pain are early indications of digitalis toxicity. Since
Lipitor increases the risk for digitalis toxicity, this finding requires the most immediate
intervention by the nurse (D). (A, B and C) are expected side effects of Lipitor.
A client with congestive heart failure (CHF) is being discharged with a new prescription
for the angiotensin-converting enzyme (ACE) inhibitor captopril (Capoten). The nurse's
discharge instruction should include reporting which problem to the healthcare provider?
A) Weight loss.
B) Dizziness.
C) Muscle cramps.
D) Dry mucous membranes. - ANS-B.
Angiotensin-converting enzyme (ACE) inhibitors are used in CHF to reduce
afterload by reversing vasoconstriction common in heart failure. This
vasodilation can cause hypotension and resultant dizziness (B). (A) is desired if
fluid overload is present, and may occur as the result of effective combination
drug therapy such as diuretics with ACE inhibitors. (C) often indicates
hypokalemia in the client receiving diuretics. Excessive diuretic administration
may result in fluid volume deficit, manifested by symptoms such as (D).
The nurse is teaching a client with cancer about opioid management for intractable pain
and tolerance related side effects. The nurse should prepare the client for which side
effect that is most likely to persist during long-term use of opioids?
A) Sedation.
B) Constipation.
C) Urinary retention.
D) Respiratory depression. - ANS-b.
The client should be prepared to implement measures for constipation (B) which
is the most likely persistent side effect related to opioid use. Tolerance to opiate
narcotics is common, and the client may experience less sedation (A) and
respiratory depression (D) as analgesic use continues. Opioids increase the tone
in the urinary bladder sphincter, which causes retention (C) but may subside.
The nitrate isosorbide dinitrate (Isordil) is prescribed for a client with angina. Which
instruction should the nurse include in this client's discharge teaching plan?
A) Quit taking the medication if dizziness occurs.
B) Do not get up quickly. Always rise slowly.
C) Take the medication with food only.
D) Increase your intake of potassium-rich foods. - ANS-B.
, An expected side effect of nitrates is orthostatic hypotension and the nurse
should address how to prevent it--by rising slowly (B). Dizziness is expected, and
the client should not quit taking the medication without notifying the healthcare
provider (A). (C and D) are not indicated when taking this medication.
In teaching a client who had a liver transplant about cyclosporine (Sandimmune), the
nurse should encourage the client to report which adverse response to the healthcare
provider?
A) Changes in urine color.
B) Presence of hand tremors.
C) Increasing body hirsutism.
D) Nausea and vomiting. - ANS-B.
Neurological complications, such as hand tremors (B), occur in about 50% of
clients taking cyclosporine and should be reported. Although this drug can be
nephrotoxic, (A) typically does not occur. (C and D) are common side effects, but
are not usually severe.
Which method of medication administration provides the client with the greatest first-
pass effect?
A) Oral.
B) Sublingual.
C) Intravenous.
D) Subcutaneous. - ANS-A.
The first-pass effect is a pharmacokinetic phenomenon that is related to the
drug's metabolism in the liver. After oral (A) medications are absorbed from the
gastrointestinal tract, the drug is carried directly to the liver via the hepatic portal
circulation where hepatic inactivation occurs and reduces the bioavailability of
the drug. Alternative method of administration, such as sublingual (B), IV (C), and
subcutaneous (D) routes, avoid this first-pass effect.
A client's dose of isosorbide dinitrate (Imdur) is increased from 40 mg to 60 mg PO
daily. When the client reports the onset of a headache prior to the next scheduled dose,
which action should the nurse implement?
A) Hold the next scheduled dose of Imdur 60 mg and administer a PRN dose of
acetaminophen (Tylenol).
B) Administer the 40 mg of Imdur and then contact the healthcare provider.
C) Administer the 60 mg dose of Imdur and a PRN dose of acetaminophen (Tylenol).
D) Do not administer the next dose of Imdur or any acetaminophen until notifying the
healthcare provider. - ANS-C.
Imdur is a nitrate which causes vasodilation. This vasodilation can result in
headaches, which can generally be controlled with acetaminophen (C) until the
client develops a tolerance to this adverse effect. (A and B) may result in the
onset of angina if a therapeutic level of Imdur is not maintained. Lying down (D) is
less likely to reduce the headache than is a mild analgesic.
2026 UPDATE QUESTIONS AND CORRECT
VERIFIED ANSWERS ALREADY GRADED
A+ (BRAND NEW VISION)
A client is receiving metoprolol (Lopressor SR). What assessment is most important for
the nurse to obtain?
A) Temperature.
B) Lung sounds.
C) Blood pressure.
D) Urinary output. - ANS-C.
It is most important to monitor the blood pressure (C) of clients taking this
medication because Lopressor is an antianginal, antiarrhythmic, antihypertensive
agent. While (A and B) are important data to obtain on any client, they are not as
important for a client receiving Lopressor as (C). Intake and output ratios and
daily weights should be monitored while taking Lopressor to assess for signs
and symptoms of congestive heart failure, but (D) alone does not have the
importance of (C).
A client with osteoarthritis receives a new prescription for celecoxib (Celebrex) orally for
symptom management. The nurse notes the client is allergic to sulfa. Which action is
most important for the nurse to implement prior to administering the first dose?
A) Review the client's hemoglobin results.
B) Notify the healthcare provider.
C) Inquire about the reaction to sulfa.
D) Record the client's vital signs. - ANS-B.
Celebrex contains a sulfur molecule, which can lead to an allergic reaction in
individuals who are sensitive to sulfonamides, so the healthcare provider should
be notified of the client's allergies (B). Although (A, C, and D) are important
assessments, it is most important to notify the healthcare provider for an
alternate prescription.
Upon admission to the emergency center, an adult client with acute status asthmaticus
is prescribed this series of medications. In which order should the nurse administer the
prescribed medications? (Arrange from first to last.)
A) Prednisone (Deltasone) orally.
B) Gentamicin (Garamycin) IM.
C) Albuterol (Proventil) puffs.
D) Salmeterol (Serevent Diskus). - ANS-CDAB
,A client with coronary artery disease who is taking digoxin (Lanoxin) receives a new
prescription for atorvastatin (Lipitor). Two weeks after initiation of the Lipitor
prescription, the nurse assesses the client. Which finding requires the most immediate
intervention?
A) Heartburn.
B) Headache.
C) Constipation.
D) Vomiting. - ANS-d.
Vomiting, anorexia and abdominal pain are early indications of digitalis toxicity. Since
Lipitor increases the risk for digitalis toxicity, this finding requires the most immediate
intervention by the nurse (D). (A, B and C) are expected side effects of Lipitor.
A client with congestive heart failure (CHF) is being discharged with a new prescription
for the angiotensin-converting enzyme (ACE) inhibitor captopril (Capoten). The nurse's
discharge instruction should include reporting which problem to the healthcare provider?
A) Weight loss.
B) Dizziness.
C) Muscle cramps.
D) Dry mucous membranes. - ANS-B.
Angiotensin-converting enzyme (ACE) inhibitors are used in CHF to reduce
afterload by reversing vasoconstriction common in heart failure. This
vasodilation can cause hypotension and resultant dizziness (B). (A) is desired if
fluid overload is present, and may occur as the result of effective combination
drug therapy such as diuretics with ACE inhibitors. (C) often indicates
hypokalemia in the client receiving diuretics. Excessive diuretic administration
may result in fluid volume deficit, manifested by symptoms such as (D).
The nurse is teaching a client with cancer about opioid management for intractable pain
and tolerance related side effects. The nurse should prepare the client for which side
effect that is most likely to persist during long-term use of opioids?
A) Sedation.
B) Constipation.
C) Urinary retention.
D) Respiratory depression. - ANS-b.
The client should be prepared to implement measures for constipation (B) which
is the most likely persistent side effect related to opioid use. Tolerance to opiate
narcotics is common, and the client may experience less sedation (A) and
respiratory depression (D) as analgesic use continues. Opioids increase the tone
in the urinary bladder sphincter, which causes retention (C) but may subside.
The nitrate isosorbide dinitrate (Isordil) is prescribed for a client with angina. Which
instruction should the nurse include in this client's discharge teaching plan?
A) Quit taking the medication if dizziness occurs.
B) Do not get up quickly. Always rise slowly.
C) Take the medication with food only.
D) Increase your intake of potassium-rich foods. - ANS-B.
, An expected side effect of nitrates is orthostatic hypotension and the nurse
should address how to prevent it--by rising slowly (B). Dizziness is expected, and
the client should not quit taking the medication without notifying the healthcare
provider (A). (C and D) are not indicated when taking this medication.
In teaching a client who had a liver transplant about cyclosporine (Sandimmune), the
nurse should encourage the client to report which adverse response to the healthcare
provider?
A) Changes in urine color.
B) Presence of hand tremors.
C) Increasing body hirsutism.
D) Nausea and vomiting. - ANS-B.
Neurological complications, such as hand tremors (B), occur in about 50% of
clients taking cyclosporine and should be reported. Although this drug can be
nephrotoxic, (A) typically does not occur. (C and D) are common side effects, but
are not usually severe.
Which method of medication administration provides the client with the greatest first-
pass effect?
A) Oral.
B) Sublingual.
C) Intravenous.
D) Subcutaneous. - ANS-A.
The first-pass effect is a pharmacokinetic phenomenon that is related to the
drug's metabolism in the liver. After oral (A) medications are absorbed from the
gastrointestinal tract, the drug is carried directly to the liver via the hepatic portal
circulation where hepatic inactivation occurs and reduces the bioavailability of
the drug. Alternative method of administration, such as sublingual (B), IV (C), and
subcutaneous (D) routes, avoid this first-pass effect.
A client's dose of isosorbide dinitrate (Imdur) is increased from 40 mg to 60 mg PO
daily. When the client reports the onset of a headache prior to the next scheduled dose,
which action should the nurse implement?
A) Hold the next scheduled dose of Imdur 60 mg and administer a PRN dose of
acetaminophen (Tylenol).
B) Administer the 40 mg of Imdur and then contact the healthcare provider.
C) Administer the 60 mg dose of Imdur and a PRN dose of acetaminophen (Tylenol).
D) Do not administer the next dose of Imdur or any acetaminophen until notifying the
healthcare provider. - ANS-C.
Imdur is a nitrate which causes vasodilation. This vasodilation can result in
headaches, which can generally be controlled with acetaminophen (C) until the
client develops a tolerance to this adverse effect. (A and B) may result in the
onset of angina if a therapeutic level of Imdur is not maintained. Lying down (D) is
less likely to reduce the headache than is a mild analgesic.
