HESI PHARMACOLOGY EXAM 1 2026 (100% VERIFIED) b b b b b b
LATEST UPDATED 2026 b b b
A patient receiving lamotrigine therapy has started using oral contraceptives. What is essential for the
b b b b b b b b b b b b b b
nurse to teach the patient?
b b b b b
"With oral contraceptive use, you may need more lamotrigine."- When given with oral contraceptives,
b b b b b b b b b b b b b
lamotrigine [1] [2] may need an increased dose to be effective because the oralcontraceptives also compete
b b b b b b b b b b b b b b b b b
for the CYP450 enzyme pathway.
b b b b b
What is appropriate information for the nurse to give the patient who is taking an antiepileptic drug witha
b b b b b b b b b b b b b b b b b b
narrow therapeutic index?
b b b
Make certain the drug is taken at the same time daily.
b b b b b b b b b b
What is the appropriate way for the nurse to prepare a dosage of a suspension medication for a pediatric
b b b b b b b b b b b b b b b b b b
patient?
b
Draw it up in an oral syringe
b b b b b b
A patient is receiving carbamazepine to treat trigeminal neuralgia. What assessment indicates atherapeutic
b b b b b b b b b b b b b
response to the medication?
b b b b
The patient states no facial pain.
b b b b b
A nurse is caring for a patient who has been started on antiepileptic drug therapy for seizures. What
b b b b b b b b b b b b b b b b b
information should be included in the teaching plan for the patient?
b b b b b b b b b b b
Take the medication at the sametime each day.
b b b b b b b b
Which intervention will best maintain therapeutic levels of an antiepileptic drug?
b b b b b b b b b b
Establish a drugregimen based on the half-life of the medication.
b b b b b b b b b b
Which patient should the nurse assess first?
b b b b b b b
The patient taking carbamazepine who is not oriented to place or time.. - Any patient who is not oriented has
b b b b b b b b b b b b b b b b b b b
a potential risk to his safety. The patient who is notoriented and taking carbamazepine could be experiencing
b b b b b b b b b b b b b b b b b b
adverse effects of therapy. This is the patient the nurse should assess first.
b b b b b b b b b b b b b
Which patient is most likely to have toxic effects of antiepileptic therapy?
b b b b b b b b b b b
The patient with a carbamazepine level of 15 mcg/mL- The only value listed that is above therapeutic plasma
b b b b b b b b b b b b b b b b b
levels is thecarbamazepine, which has a therapeutic range of 4 to 12 mcg/mL; this patient is most likely to
b b b b b b b b b b b b b b b b b b b b
have toxic effects of therapy.
b b b b b
A patient is receiving phenobarbital. What information is essential to include in the discharge teachingplan?
b b b b b b b b b b b b b b b
Select all that apply.
b b b b
"This medication may cause confusion.", "Good dental care is essential while on this medication."
b b b b b b b b b b b b b
"Don't drive until you determine how the medication affects you."- The most common adverse effects are
b b b b b b b b b b b b b b b
lethargy and cognitive changes as well as gingival hyperplasia. Confusion can be a result of this therapy.
b b b b b b b b b b b b b b b b b
,Good dental care is essential because the medication can cause gingival hyperplasia. The patientshould
b b b b b b b b b b b b b b b
evaluate how the drug affects him before driving.
b b b b b b b b
The nurse is caring for a patient with a phenytoin level of 12 mcg/mL. What is the nurse's best action?
b b b b b b b b b b b b b b b b b b b
Continue to monitor the patient on this medication. b b b b b b b
The nurse instructs a patient receiving phenytoin to visit the dentist regularly and perform frequent oral
b b b b b b b b b b b b b b b
hygiene. What side effect will these interventions assist in preventing?
b b b b b b b b b b
Gingival hyperplasia b
What is the goal of antiepileptic therapy?
b b b b b b
Maximally reducing seizure activity while minimizing sideeffects of medication therapy.
b b b b b b b b b b
The patient was started on an antiepileptic medication 6 weeks ago. The nurse notes that the patient'sblood
b b b b b b b b b b b b b b b b b
level of the medication is very low after 6 weeks of therapy. How will the nurse interpret this result?
b b b b b b b b b b b b b b b b b b b
The patient may not be taking the medication as ordered.
b b b b b b b b b
The nurse is teaching a patient about therapy for a newly diagnosed seizure disorder. What statementshould
b b b b b b b b b b b b b b b b
the nurse include?"
b b b
Your medication is chosen based on your type of seizure."
b b b b b b b b b
What is the reason for many potential drug interactions with antiepileptic drug therapy?
b b b b b b b b b b b b
Altered CYP450 enzyme metabolism b b b
What is important to teach the patient taking valproic acid for seizure management?
b b b b b b b b b b b b
Do not take the medication with milk or carbonated beverages. - Oral forms of valproic acid are not to be given
b b b b b b b b b b b b b b b b b b b b
with milk,because this may cause the drug to dissolve early and irritate the mucosa. Carbonated beverages
b b b b b b b b b b b b b b b b b
must also be avoided during the time of drug administration.
b b b b b b b b b b
The health care provider has ordered once-daily phenytoin for an 8-year-old child who has a seizure
b b b b b b b b b b b b b b b
disorder. The parents state the child cannot swallow pills. What intervention would the nurse recommend
b b b b b b b b b b b b b b b
to the health care provider?
b b b b b
Ask for a suspension form of the medication to be prescribed.
b b b b b b b b b b
The nurse is administering intravenous diazepam. When will the nurse expect the onset of action tooccur?
b b b b b b b b b b b b b b b b
Immediately
What intervention is appropriate to include in discharge teaching for a patient prescribed phenytointherapy?
b b b b b b b b b b b b b b
Perform good oral hygiene. b b b
The nurse is assessing a patient who is receiving antiepileptic drug therapy with phenytoin. What
b b b b b b b b b b b b b b
assessment finding requires immediate action?
b b b b b
Nystagmus - The patient who has nystagmus may be presenting with adverse effects to phenytoin therapy
b b b b b b b b b b b b b b b
and should be assessed for other signs of toxicity.
b b b b b b b b b
Which assessment is a priority for the patient starting on gabapentin therapy for a seizure disorder?
b b b b b b b b b b b b b b b
, Neurologic assessment - Gabapentin requires a thorough neurologic assessment, including baselineenergy
b b b b b b b b b b b
levels, vision level, sensory and motor functioning, and any changes in speech.
b b b b b b b b b b b b
The nurse is caring for a patient who has been taking phenytoin for the past week and has developed arash.
b b b b b b b b b b b b b b b b b b b b
What is the first action the nurse should take?
b b b b b b b b b
Assess the patient. b b
A patient with a seizure disorder is taking oral phenytoin. He is nothing by mouth (NPO) for electivesurgery.
b b b b b b b b b b b b b b b b b b
What is the appropriate nursing action?
b b b b b b
Call the health care provider to clarify medication orders.
b b b b b b b b
What assessment indicates the patient is having a therapeutic response to valproic acid?
b b b b b b b b b b b b
Absence of seizures b b
A patient has been taking valproic acid and is being switched to another medication due to elevated liver
b b b b b b b b b b b b b b b b b
function tests. What nursing action is appropriate?
b b b b b b b
Taper the valproic acid while starting the new medication.
b b b b b b b b
A patient is admitted who has reportedly stopped taking her antiepileptic medication. What is the
b b b b b b b b b b b b b b
appropriate nursing action?
b b b
Monitor for rebound seizure activity.
b b b b
What intervention is essential before a patient starts therapy with lamotrigine?
b b b b b b b b b b
Assessment of risk forStevens-Johnson syndrome b b b b b
The nurse is administering intravenous phenytoin. When will the nurse expect the onset of the drug to
b b b b b b b b b b b b b b b b
occur?
b
Within 1 to 2 hours b b b b
What information should the nurse provide to a patient who will self-administer an antiepileptic agentfor
b b b b b b b b b b b b b b b
the first time at home?
b b b b b
"Wait to see how you react to the medication before driving."
b b b b b b b b b b
The nurse is administering morning medications. Which administration technique is in error?1The
b b b b b b b b b b b b
b nurse administers carbamazepine with grapefruit juice.
b b b b b
LATEST UPDATED 2026 b b b
A patient receiving lamotrigine therapy has started using oral contraceptives. What is essential for the
b b b b b b b b b b b b b b
nurse to teach the patient?
b b b b b
"With oral contraceptive use, you may need more lamotrigine."- When given with oral contraceptives,
b b b b b b b b b b b b b
lamotrigine [1] [2] may need an increased dose to be effective because the oralcontraceptives also compete
b b b b b b b b b b b b b b b b b
for the CYP450 enzyme pathway.
b b b b b
What is appropriate information for the nurse to give the patient who is taking an antiepileptic drug witha
b b b b b b b b b b b b b b b b b b
narrow therapeutic index?
b b b
Make certain the drug is taken at the same time daily.
b b b b b b b b b b
What is the appropriate way for the nurse to prepare a dosage of a suspension medication for a pediatric
b b b b b b b b b b b b b b b b b b
patient?
b
Draw it up in an oral syringe
b b b b b b
A patient is receiving carbamazepine to treat trigeminal neuralgia. What assessment indicates atherapeutic
b b b b b b b b b b b b b
response to the medication?
b b b b
The patient states no facial pain.
b b b b b
A nurse is caring for a patient who has been started on antiepileptic drug therapy for seizures. What
b b b b b b b b b b b b b b b b b
information should be included in the teaching plan for the patient?
b b b b b b b b b b b
Take the medication at the sametime each day.
b b b b b b b b
Which intervention will best maintain therapeutic levels of an antiepileptic drug?
b b b b b b b b b b
Establish a drugregimen based on the half-life of the medication.
b b b b b b b b b b
Which patient should the nurse assess first?
b b b b b b b
The patient taking carbamazepine who is not oriented to place or time.. - Any patient who is not oriented has
b b b b b b b b b b b b b b b b b b b
a potential risk to his safety. The patient who is notoriented and taking carbamazepine could be experiencing
b b b b b b b b b b b b b b b b b b
adverse effects of therapy. This is the patient the nurse should assess first.
b b b b b b b b b b b b b
Which patient is most likely to have toxic effects of antiepileptic therapy?
b b b b b b b b b b b
The patient with a carbamazepine level of 15 mcg/mL- The only value listed that is above therapeutic plasma
b b b b b b b b b b b b b b b b b
levels is thecarbamazepine, which has a therapeutic range of 4 to 12 mcg/mL; this patient is most likely to
b b b b b b b b b b b b b b b b b b b b
have toxic effects of therapy.
b b b b b
A patient is receiving phenobarbital. What information is essential to include in the discharge teachingplan?
b b b b b b b b b b b b b b b
Select all that apply.
b b b b
"This medication may cause confusion.", "Good dental care is essential while on this medication."
b b b b b b b b b b b b b
"Don't drive until you determine how the medication affects you."- The most common adverse effects are
b b b b b b b b b b b b b b b
lethargy and cognitive changes as well as gingival hyperplasia. Confusion can be a result of this therapy.
b b b b b b b b b b b b b b b b b
,Good dental care is essential because the medication can cause gingival hyperplasia. The patientshould
b b b b b b b b b b b b b b b
evaluate how the drug affects him before driving.
b b b b b b b b
The nurse is caring for a patient with a phenytoin level of 12 mcg/mL. What is the nurse's best action?
b b b b b b b b b b b b b b b b b b b
Continue to monitor the patient on this medication. b b b b b b b
The nurse instructs a patient receiving phenytoin to visit the dentist regularly and perform frequent oral
b b b b b b b b b b b b b b b
hygiene. What side effect will these interventions assist in preventing?
b b b b b b b b b b
Gingival hyperplasia b
What is the goal of antiepileptic therapy?
b b b b b b
Maximally reducing seizure activity while minimizing sideeffects of medication therapy.
b b b b b b b b b b
The patient was started on an antiepileptic medication 6 weeks ago. The nurse notes that the patient'sblood
b b b b b b b b b b b b b b b b b
level of the medication is very low after 6 weeks of therapy. How will the nurse interpret this result?
b b b b b b b b b b b b b b b b b b b
The patient may not be taking the medication as ordered.
b b b b b b b b b
The nurse is teaching a patient about therapy for a newly diagnosed seizure disorder. What statementshould
b b b b b b b b b b b b b b b b
the nurse include?"
b b b
Your medication is chosen based on your type of seizure."
b b b b b b b b b
What is the reason for many potential drug interactions with antiepileptic drug therapy?
b b b b b b b b b b b b
Altered CYP450 enzyme metabolism b b b
What is important to teach the patient taking valproic acid for seizure management?
b b b b b b b b b b b b
Do not take the medication with milk or carbonated beverages. - Oral forms of valproic acid are not to be given
b b b b b b b b b b b b b b b b b b b b
with milk,because this may cause the drug to dissolve early and irritate the mucosa. Carbonated beverages
b b b b b b b b b b b b b b b b b
must also be avoided during the time of drug administration.
b b b b b b b b b b
The health care provider has ordered once-daily phenytoin for an 8-year-old child who has a seizure
b b b b b b b b b b b b b b b
disorder. The parents state the child cannot swallow pills. What intervention would the nurse recommend
b b b b b b b b b b b b b b b
to the health care provider?
b b b b b
Ask for a suspension form of the medication to be prescribed.
b b b b b b b b b b
The nurse is administering intravenous diazepam. When will the nurse expect the onset of action tooccur?
b b b b b b b b b b b b b b b b
Immediately
What intervention is appropriate to include in discharge teaching for a patient prescribed phenytointherapy?
b b b b b b b b b b b b b b
Perform good oral hygiene. b b b
The nurse is assessing a patient who is receiving antiepileptic drug therapy with phenytoin. What
b b b b b b b b b b b b b b
assessment finding requires immediate action?
b b b b b
Nystagmus - The patient who has nystagmus may be presenting with adverse effects to phenytoin therapy
b b b b b b b b b b b b b b b
and should be assessed for other signs of toxicity.
b b b b b b b b b
Which assessment is a priority for the patient starting on gabapentin therapy for a seizure disorder?
b b b b b b b b b b b b b b b
, Neurologic assessment - Gabapentin requires a thorough neurologic assessment, including baselineenergy
b b b b b b b b b b b
levels, vision level, sensory and motor functioning, and any changes in speech.
b b b b b b b b b b b b
The nurse is caring for a patient who has been taking phenytoin for the past week and has developed arash.
b b b b b b b b b b b b b b b b b b b b
What is the first action the nurse should take?
b b b b b b b b b
Assess the patient. b b
A patient with a seizure disorder is taking oral phenytoin. He is nothing by mouth (NPO) for electivesurgery.
b b b b b b b b b b b b b b b b b b
What is the appropriate nursing action?
b b b b b b
Call the health care provider to clarify medication orders.
b b b b b b b b
What assessment indicates the patient is having a therapeutic response to valproic acid?
b b b b b b b b b b b b
Absence of seizures b b
A patient has been taking valproic acid and is being switched to another medication due to elevated liver
b b b b b b b b b b b b b b b b b
function tests. What nursing action is appropriate?
b b b b b b b
Taper the valproic acid while starting the new medication.
b b b b b b b b
A patient is admitted who has reportedly stopped taking her antiepileptic medication. What is the
b b b b b b b b b b b b b b
appropriate nursing action?
b b b
Monitor for rebound seizure activity.
b b b b
What intervention is essential before a patient starts therapy with lamotrigine?
b b b b b b b b b b
Assessment of risk forStevens-Johnson syndrome b b b b b
The nurse is administering intravenous phenytoin. When will the nurse expect the onset of the drug to
b b b b b b b b b b b b b b b b
occur?
b
Within 1 to 2 hours b b b b
What information should the nurse provide to a patient who will self-administer an antiepileptic agentfor
b b b b b b b b b b b b b b b
the first time at home?
b b b b b
"Wait to see how you react to the medication before driving."
b b b b b b b b b b
The nurse is administering morning medications. Which administration technique is in error?1The
b b b b b b b b b b b b
b nurse administers carbamazepine with grapefruit juice.
b b b b b
