• PN HESI
Pharmacology 09/11/2026
Exam
Evolve Pharmacology PN HESI Exam 2026 Test
Bank | 180 Questions with Correct Answers &
Detailed Rationales | Evolve HESI PN
Pharmacology Review - Complete A+ Guide
Meperidine hydrochloride (Demerol) is prescribed for the client with pain. Which of the following would the
nurse monitor for as a side effect of this medication?
1. Diarrhea
2. Bradycardia
3. Hypertension
P 1
, • PN HESI
Pharmacology 09/11/2026
Exam
4. Urinary retention - Correct Answer :4. Urinary retention
Rationale:
Meperidine hydrochloride (Demerol) is an opioid analgesic. Side effects of this medication include respiratory
depression, orthostatic hypotension, tachycardia, drowsiness and mental clouding, constipation, and urinary
retention.
161.) A nurse is caring for a client with severe back pain, and codeine sulfate has been prescribed for the client.
Which of the following would the nurse include in the plan of care while the client is taking this medication?
1. Restrict fluid intake.
2. Monitor bowel activity.
3. Monitor for hypertension.
4. Monitor peripheral pulses. - Correct Answer :2. Monitor bowel activity.
Rationale:
While the client is taking codeine sulfate, an opioid analgesic, the nurse would monitor vital signs and monitor for
hypotension. The nurse should also increase fluid intake, palpate the bladder for urinary retention, auscultate
bowel sounds, and monitor the pattern of daily bowel activity and stool consistency (codeine can cause
constipation). The nurse should monitor respiratory status and initiate breathing and coughing exercises. In
addition, the nurse monitors the effectiveness of the pain medication.
162.) Carbamazepine (Tegretol) is prescribed for a client with a diagnosis of psychomotor seizures. The nurse
reviews the client's health history, knowing that this medication is contraindicated if which of the following
disorders is present?
1. Headaches
2. Liver disease
3. Hypothyroidism
4. Diabetes mellitus - Correct Answer :2. Liver disease
Rationale:
Carbamazepine (Tegretol) is contraindicated in liver disease, and liver function tests are routinely prescribed for
baseline purposes and are monitored during therapy. It is also contraindicated if the client has a history of blood
dyscrasias. It is not contraindicated in the conditions noted in the incorrect options.
P 2
, • PN HESI
Pharmacology 09/11/2026
Exam
163.) A client with trigeminal neuralgia tells the nurse that acetaminophen (Tylenol) is taken on a frequent daily
basis for relief of generalized discomfort. The nurse reviews the client's laboratory results and determines that
which of the following indicates toxicity associated with the medication?
1. Sodium of 140 mEq/L
2. Prothrombin time of 12 seconds
3. Platelet count of 400,000 cells/mm3
4. A direct bilirubin level of 2 mg/dL - Correct Answer :4. A direct bilirubin level of 2 mg/dL
Rationale:
In adults, overdose of acetaminophen (Tylenol) causes liver damage. Option 4 is an indicator of liver function
and is the only option that indicates an abnormal laboratory value. The normal direct bilirubin is 0 to 0.4 mg/dL.
The normal platelet count is 150,000 to 400,000 cells/mm3. The normal prothrombin time is 10 to 13 seconds.
The normal sodium level is 135 to 145 mEq/L.
164.) A client receives a prescription for methocarbamol (Robaxin), and the nurse reinforces instructions to the
client regarding the medication. Which client statement would indicate a need for further instructions?
1. "My urine may turn brown or green."
2. "This medication is prescribed to help relieve my muscle spasms."
3. "If my vision becomes blurred, I don't need to be concerned about it."
4. "I need to call my doctor if I experience nasal congestion from this medication." - Correct Answer :3. "If my
vision becomes blurred, I don't need to be concerned about it."
Rationale:
The client needs to be told that the urine may turn brown, black, or green. Other adverse effects include blurred
vision, nasal congestion, urticaria, and rash. The client needs to be instructed that, if these adverse effects occur,
the health care provider needs to be notified. The medication is used to relieve muscle spasms.
165.) The client has been on treatment for rheumatoid arthritis for 3 weeks. During the administration of
etanercept (Enbrel), it is most important for the nurse to assess:
1. The injection site for itching and edema
2. The white blood cell counts and platelet counts
P 3
, • PN HESI
Pharmacology 09/11/2026
Exam
3. Whether the client is experiencing fatigue and joint pain
4. A metallic taste in the mouth and a loss of appetite - Correct Answer :2. The white blood cell counts and
platelet counts
Rationale:
Infection and pancytopenia are adverse effects of etanercept (Enbrel). Laboratory studies are performed before
and during treatment. The appearance of abnormal white blood cell counts and abnormal platelet counts can
alert the nurse to a potential life-threatening infection. Injection site itching is a common occurrence following
administration of the medication. In early treatment, residual fatigue and joint pain may still be apparent. A
metallic taste and loss of appetite are not common signs of side effects of this medication.
166.) Alendronate (Fosamax) is prescribed for a client with osteoporosis. The client taking this medication is
instructed to:
1. Take the medication at bedtime.
2. Take the medication in the morning with breakfast.
3. Lie down for 30 minutes after taking the medication.
4. Take the medication with a full glass of water after rising in the morning. - Correct Answer :4. Take the
medication with a full glass of water after rising in the morning.
Rationale:
Precautions need to be taken with administration of alendronate to prevent gastrointestinal side effects
(especially esophageal irritation) and to increase absorption of the medication. The medication needs to be
taken with a full glass of water after rising in the morning. The client should not eat or drink anything for 30
minutes following administration and should not lie down after taking the medication.
167.) A nurse prepares to reinforce instructions to a client who is taking allopurinol (Zyloprim). The nurse plans to
include which of the following in the instructions?
1. Instruct the client to drink 3000 mL of fluid per day.
2. Instruct the client to take the medication on an empty stomach.
3. Inform the client that the effect of the medication will occur immediately.
4. Instruct the client that, if swelling of the lips occurs, this is a normal expected response. - Correct Answer :1.
Instruct the client to drink 3000 mL of fluid per day.
P 4
Pharmacology 09/11/2026
Exam
Evolve Pharmacology PN HESI Exam 2026 Test
Bank | 180 Questions with Correct Answers &
Detailed Rationales | Evolve HESI PN
Pharmacology Review - Complete A+ Guide
Meperidine hydrochloride (Demerol) is prescribed for the client with pain. Which of the following would the
nurse monitor for as a side effect of this medication?
1. Diarrhea
2. Bradycardia
3. Hypertension
P 1
, • PN HESI
Pharmacology 09/11/2026
Exam
4. Urinary retention - Correct Answer :4. Urinary retention
Rationale:
Meperidine hydrochloride (Demerol) is an opioid analgesic. Side effects of this medication include respiratory
depression, orthostatic hypotension, tachycardia, drowsiness and mental clouding, constipation, and urinary
retention.
161.) A nurse is caring for a client with severe back pain, and codeine sulfate has been prescribed for the client.
Which of the following would the nurse include in the plan of care while the client is taking this medication?
1. Restrict fluid intake.
2. Monitor bowel activity.
3. Monitor for hypertension.
4. Monitor peripheral pulses. - Correct Answer :2. Monitor bowel activity.
Rationale:
While the client is taking codeine sulfate, an opioid analgesic, the nurse would monitor vital signs and monitor for
hypotension. The nurse should also increase fluid intake, palpate the bladder for urinary retention, auscultate
bowel sounds, and monitor the pattern of daily bowel activity and stool consistency (codeine can cause
constipation). The nurse should monitor respiratory status and initiate breathing and coughing exercises. In
addition, the nurse monitors the effectiveness of the pain medication.
162.) Carbamazepine (Tegretol) is prescribed for a client with a diagnosis of psychomotor seizures. The nurse
reviews the client's health history, knowing that this medication is contraindicated if which of the following
disorders is present?
1. Headaches
2. Liver disease
3. Hypothyroidism
4. Diabetes mellitus - Correct Answer :2. Liver disease
Rationale:
Carbamazepine (Tegretol) is contraindicated in liver disease, and liver function tests are routinely prescribed for
baseline purposes and are monitored during therapy. It is also contraindicated if the client has a history of blood
dyscrasias. It is not contraindicated in the conditions noted in the incorrect options.
P 2
, • PN HESI
Pharmacology 09/11/2026
Exam
163.) A client with trigeminal neuralgia tells the nurse that acetaminophen (Tylenol) is taken on a frequent daily
basis for relief of generalized discomfort. The nurse reviews the client's laboratory results and determines that
which of the following indicates toxicity associated with the medication?
1. Sodium of 140 mEq/L
2. Prothrombin time of 12 seconds
3. Platelet count of 400,000 cells/mm3
4. A direct bilirubin level of 2 mg/dL - Correct Answer :4. A direct bilirubin level of 2 mg/dL
Rationale:
In adults, overdose of acetaminophen (Tylenol) causes liver damage. Option 4 is an indicator of liver function
and is the only option that indicates an abnormal laboratory value. The normal direct bilirubin is 0 to 0.4 mg/dL.
The normal platelet count is 150,000 to 400,000 cells/mm3. The normal prothrombin time is 10 to 13 seconds.
The normal sodium level is 135 to 145 mEq/L.
164.) A client receives a prescription for methocarbamol (Robaxin), and the nurse reinforces instructions to the
client regarding the medication. Which client statement would indicate a need for further instructions?
1. "My urine may turn brown or green."
2. "This medication is prescribed to help relieve my muscle spasms."
3. "If my vision becomes blurred, I don't need to be concerned about it."
4. "I need to call my doctor if I experience nasal congestion from this medication." - Correct Answer :3. "If my
vision becomes blurred, I don't need to be concerned about it."
Rationale:
The client needs to be told that the urine may turn brown, black, or green. Other adverse effects include blurred
vision, nasal congestion, urticaria, and rash. The client needs to be instructed that, if these adverse effects occur,
the health care provider needs to be notified. The medication is used to relieve muscle spasms.
165.) The client has been on treatment for rheumatoid arthritis for 3 weeks. During the administration of
etanercept (Enbrel), it is most important for the nurse to assess:
1. The injection site for itching and edema
2. The white blood cell counts and platelet counts
P 3
, • PN HESI
Pharmacology 09/11/2026
Exam
3. Whether the client is experiencing fatigue and joint pain
4. A metallic taste in the mouth and a loss of appetite - Correct Answer :2. The white blood cell counts and
platelet counts
Rationale:
Infection and pancytopenia are adverse effects of etanercept (Enbrel). Laboratory studies are performed before
and during treatment. The appearance of abnormal white blood cell counts and abnormal platelet counts can
alert the nurse to a potential life-threatening infection. Injection site itching is a common occurrence following
administration of the medication. In early treatment, residual fatigue and joint pain may still be apparent. A
metallic taste and loss of appetite are not common signs of side effects of this medication.
166.) Alendronate (Fosamax) is prescribed for a client with osteoporosis. The client taking this medication is
instructed to:
1. Take the medication at bedtime.
2. Take the medication in the morning with breakfast.
3. Lie down for 30 minutes after taking the medication.
4. Take the medication with a full glass of water after rising in the morning. - Correct Answer :4. Take the
medication with a full glass of water after rising in the morning.
Rationale:
Precautions need to be taken with administration of alendronate to prevent gastrointestinal side effects
(especially esophageal irritation) and to increase absorption of the medication. The medication needs to be
taken with a full glass of water after rising in the morning. The client should not eat or drink anything for 30
minutes following administration and should not lie down after taking the medication.
167.) A nurse prepares to reinforce instructions to a client who is taking allopurinol (Zyloprim). The nurse plans to
include which of the following in the instructions?
1. Instruct the client to drink 3000 mL of fluid per day.
2. Instruct the client to take the medication on an empty stomach.
3. Inform the client that the effect of the medication will occur immediately.
4. Instruct the client that, if swelling of the lips occurs, this is a normal expected response. - Correct Answer :1.
Instruct the client to drink 3000 mL of fluid per day.
P 4
