ACE YOUR PHARM HESI EXAM LATEST 2026 PRACTICE
TEST AND STUDY GUIDE / PHARM HESI PRACTICE EXAM
2026: COMPREHENSIVE TEST PREP AND ANSWERS
ACTUAL QUESTION AND CORRECT DETAILED ANSWERS..
2026 PHARM HESI PRACTICE QUESTIONS: EXAM
PREPARATION AND TIPS!!!!!!
The nurse is caring for a client who has taken atenolol for 2 years. The
healthcare provider recently changed the medication to enalapril to
manage the client's blood pressure. Which instruction should the nurse
provide the client regarding the new medication?
A. Take the medication at bedtime.
B. Report the presence of increased bruising.
C. Check the pulse before taking the medication.
D. Rise slowly when getting out of bed or chair.
Correct Answer: D. Rise slowly when getting out of bed or chair.
Expert Rationale:
Enalapril is an angiotensin-converting enzyme (ACE) inhibitor that causes
vasodilation, leading to a reduction in blood pressure. A common and
significant adverse effect of ACE inhibitors is orthostatic hypotension, which
is a sudden drop in blood pressure upon standing. This can result in
dizziness, lightheadedness, and syncope. Therefore, the nurse should
instruct the client to rise slowly from a lying or sitting position to minimize
this effect and prevent falls. Taking the medication at bedtime (A) is not a
standard instruction for enalapril. Increased bruising (B) is not a typical side
effect of ACE inhibitors. Checking the pulse before taking the medication (C)
is more appropriate for beta-blockers like atenolol, not for ACE inhibitors.
,A female client calls the clinic and talks with the nurse to inquire about a
possible reaction after taking amoxicillin for 5 days. She reports having
vaginal discomfort, itching, and a white discharge. The nurse should
discuss which action with the client?
A. Discontinue the antibiotic because original symptoms have subsided.
B. Continue taking medication until finished until the symptoms subside.
C. Consult with the healthcare provider about another treatment for this
effect.
D. Use an over-the-counter (OTC) vaginal wash to flush out the secretions.
Correct Answer: C. Consult with the healthcare provider about another
treatment for this effect.
Expert Rationale:
The client is experiencing symptoms of a vaginal yeast infection (vulvovaginal
candidiasis), a common adverse effect of broad-spectrum antibiotics like
amoxicillin. Antibiotics disrupt the normal vaginal flora, leading to an
overgrowth of Candida species. The nurse should advise the client to consult
with the healthcare provider for appropriate treatment, which may include
an antifungal medication. The client should not discontinue the antibiotic (A)
unless instructed by the provider, as this could lead to antibiotic resistance
and incomplete treatment of the original infection. Continuing the
medication until finished (B) without addressing the yeast infection would
not alleviate the symptoms. Using an OTC vaginal wash (D) is not a
recommended treatment and could further disrupt the vaginal flora.
The nurse is making early morning rounds on a group of clients when a
client begins exhibiting symptoms of an acute asthma attack. The nurse
administers a PRN prescription for a Beta-2 receptor agonist agent. Which
client response should the nurse expect? (Select all that apply.)
A. Tachycardia.
B. Increased blood pressure.
,C. Rapid resolution of wheezing.
D. Improved pulse oximetry values.
E. Reduced fever and airway inflammation.
Correct Answers: C, D
Expert Rationale:
Beta-2 receptor agonists (such as albuterol) are bronchodilators that work by
stimulating beta-2 adrenergic receptors in the bronchial smooth muscle,
leading to relaxation and bronchodilation. The expected therapeutic
responses are:
• Rapid resolution of wheezing (C): Bronchodilation reduces airway
resistance, improving airflow and clearing wheezing.
• Improved pulse oximetry values (D): Improved airflow enhances
oxygenation, leading to an increase in SpO2.
Tachycardia (A) and increased blood pressure (B) are potential adverse
effects (due to beta-1 stimulation), not desired therapeutic effects.
Reduced fever and inflammation (E) is an effect of corticosteroids, not
beta-2 agonists.
A client prescribed atenolol has a blood pressure of 120/68 mmHg,
displaying a sinus bradycardia with a rate of 58 beats/minute, and a P-R
interval of 0.24. Which action should the nurse take?
A. Lower the head of the bed and assess the client for orthostatic vital sign
changes.
B. Give the medication as prescribed and continue to monitor the client.
C. Prepare to administer atropine sulfate IV push.
D. Hold the prescribed dose and contact the healthcare provider.
Correct Answer: B. Give the medication as prescribed and continue to
monitor the client.
, Expert Rationale:
Atenolol is a cardioselective beta-1 blocker used to treat hypertension and
angina. A heart rate of 58 beats per minute is within the normal range (60-
100) and is not considered bradycardia in a client who is asymptomatic. The
P-R interval of 0.24 seconds is within the normal range (0.12-0.20 seconds),
though it is at the upper limit. This is a common effect of beta-blockers and
is generally not a contraindication to administering the medication. The
nurse should administer the medication as prescribed and continue to
monitor the client. Lowering the head of the bed (A) is not indicated.
Atropine (C) is used for symptomatic bradycardia, which the client does not
have. Holding the dose and contacting the provider (D) is not necessary.
The nurse is preparing the 0900 dose of losartan (Cozaar), an angiotensin II
receptor blocker (ARB), for a client with hypertension and heart failure.
The nurse reviews the client's laboratory results and notes that the client's
serum potassium level is 5.9 mEq/L. Which action should the nurse take
first?
A. Withhold the scheduled dose.
B. Check the client's apical pulse.
C. Notify the healthcare provider.
D. Repeat the serum potassium level.
Correct Answer: A. Withhold the scheduled dose.
Expert Rationale:
Losartan is an angiotensin II receptor blocker (ARB). A known adverse effect
of ARBs is hyperkalemia (elevated serum potassium), as they can reduce
aldosterone secretion, leading to potassium retention. A serum potassium
level of 5.9 mEq/L is significantly above the normal range (3.5-5.0 mEq/L)
and is a critical finding. The nurse should first withhold the scheduled dose
of losartan to prevent further potassium elevation. After withholding the
dose, the nurse should notify the healthcare provider (C). Checking the
TEST AND STUDY GUIDE / PHARM HESI PRACTICE EXAM
2026: COMPREHENSIVE TEST PREP AND ANSWERS
ACTUAL QUESTION AND CORRECT DETAILED ANSWERS..
2026 PHARM HESI PRACTICE QUESTIONS: EXAM
PREPARATION AND TIPS!!!!!!
The nurse is caring for a client who has taken atenolol for 2 years. The
healthcare provider recently changed the medication to enalapril to
manage the client's blood pressure. Which instruction should the nurse
provide the client regarding the new medication?
A. Take the medication at bedtime.
B. Report the presence of increased bruising.
C. Check the pulse before taking the medication.
D. Rise slowly when getting out of bed or chair.
Correct Answer: D. Rise slowly when getting out of bed or chair.
Expert Rationale:
Enalapril is an angiotensin-converting enzyme (ACE) inhibitor that causes
vasodilation, leading to a reduction in blood pressure. A common and
significant adverse effect of ACE inhibitors is orthostatic hypotension, which
is a sudden drop in blood pressure upon standing. This can result in
dizziness, lightheadedness, and syncope. Therefore, the nurse should
instruct the client to rise slowly from a lying or sitting position to minimize
this effect and prevent falls. Taking the medication at bedtime (A) is not a
standard instruction for enalapril. Increased bruising (B) is not a typical side
effect of ACE inhibitors. Checking the pulse before taking the medication (C)
is more appropriate for beta-blockers like atenolol, not for ACE inhibitors.
,A female client calls the clinic and talks with the nurse to inquire about a
possible reaction after taking amoxicillin for 5 days. She reports having
vaginal discomfort, itching, and a white discharge. The nurse should
discuss which action with the client?
A. Discontinue the antibiotic because original symptoms have subsided.
B. Continue taking medication until finished until the symptoms subside.
C. Consult with the healthcare provider about another treatment for this
effect.
D. Use an over-the-counter (OTC) vaginal wash to flush out the secretions.
Correct Answer: C. Consult with the healthcare provider about another
treatment for this effect.
Expert Rationale:
The client is experiencing symptoms of a vaginal yeast infection (vulvovaginal
candidiasis), a common adverse effect of broad-spectrum antibiotics like
amoxicillin. Antibiotics disrupt the normal vaginal flora, leading to an
overgrowth of Candida species. The nurse should advise the client to consult
with the healthcare provider for appropriate treatment, which may include
an antifungal medication. The client should not discontinue the antibiotic (A)
unless instructed by the provider, as this could lead to antibiotic resistance
and incomplete treatment of the original infection. Continuing the
medication until finished (B) without addressing the yeast infection would
not alleviate the symptoms. Using an OTC vaginal wash (D) is not a
recommended treatment and could further disrupt the vaginal flora.
The nurse is making early morning rounds on a group of clients when a
client begins exhibiting symptoms of an acute asthma attack. The nurse
administers a PRN prescription for a Beta-2 receptor agonist agent. Which
client response should the nurse expect? (Select all that apply.)
A. Tachycardia.
B. Increased blood pressure.
,C. Rapid resolution of wheezing.
D. Improved pulse oximetry values.
E. Reduced fever and airway inflammation.
Correct Answers: C, D
Expert Rationale:
Beta-2 receptor agonists (such as albuterol) are bronchodilators that work by
stimulating beta-2 adrenergic receptors in the bronchial smooth muscle,
leading to relaxation and bronchodilation. The expected therapeutic
responses are:
• Rapid resolution of wheezing (C): Bronchodilation reduces airway
resistance, improving airflow and clearing wheezing.
• Improved pulse oximetry values (D): Improved airflow enhances
oxygenation, leading to an increase in SpO2.
Tachycardia (A) and increased blood pressure (B) are potential adverse
effects (due to beta-1 stimulation), not desired therapeutic effects.
Reduced fever and inflammation (E) is an effect of corticosteroids, not
beta-2 agonists.
A client prescribed atenolol has a blood pressure of 120/68 mmHg,
displaying a sinus bradycardia with a rate of 58 beats/minute, and a P-R
interval of 0.24. Which action should the nurse take?
A. Lower the head of the bed and assess the client for orthostatic vital sign
changes.
B. Give the medication as prescribed and continue to monitor the client.
C. Prepare to administer atropine sulfate IV push.
D. Hold the prescribed dose and contact the healthcare provider.
Correct Answer: B. Give the medication as prescribed and continue to
monitor the client.
, Expert Rationale:
Atenolol is a cardioselective beta-1 blocker used to treat hypertension and
angina. A heart rate of 58 beats per minute is within the normal range (60-
100) and is not considered bradycardia in a client who is asymptomatic. The
P-R interval of 0.24 seconds is within the normal range (0.12-0.20 seconds),
though it is at the upper limit. This is a common effect of beta-blockers and
is generally not a contraindication to administering the medication. The
nurse should administer the medication as prescribed and continue to
monitor the client. Lowering the head of the bed (A) is not indicated.
Atropine (C) is used for symptomatic bradycardia, which the client does not
have. Holding the dose and contacting the provider (D) is not necessary.
The nurse is preparing the 0900 dose of losartan (Cozaar), an angiotensin II
receptor blocker (ARB), for a client with hypertension and heart failure.
The nurse reviews the client's laboratory results and notes that the client's
serum potassium level is 5.9 mEq/L. Which action should the nurse take
first?
A. Withhold the scheduled dose.
B. Check the client's apical pulse.
C. Notify the healthcare provider.
D. Repeat the serum potassium level.
Correct Answer: A. Withhold the scheduled dose.
Expert Rationale:
Losartan is an angiotensin II receptor blocker (ARB). A known adverse effect
of ARBs is hyperkalemia (elevated serum potassium), as they can reduce
aldosterone secretion, leading to potassium retention. A serum potassium
level of 5.9 mEq/L is significantly above the normal range (3.5-5.0 mEq/L)
and is a critical finding. The nurse should first withhold the scheduled dose
of losartan to prevent further potassium elevation. After withholding the
dose, the nurse should notify the healthcare provider (C). Checking the
