• PN HESI
Pharmacology 09/11/2026
Exam
Evolve Pharmacology PN HESI Exam 1 2026 Test
Bank | 180 Questions with Correct Answers &
Detailed Rationales | Evolve HESI PN
Pharmacology Review - Complete A+ Guide
211.) A client with epilepsy is taking the prescribed dose of phenytoin (Dilantin) to control seizures. A phenytoin
blood level is drawn, and the results reveal a level of 35 mcg/ml. Which of the following symptoms would be
expected as a result of this laboratory result?
1. Nystagmus
2. Tachycardia
3. Slurred speech
4. No symptoms, because this is a normal therapeutic level - Correct Answer :3. Slurred speech
Rationale:
P 1
, • PN HESI
Pharmacology 09/11/2026
Exam
The therapeutic phenytoin level is 10 to 20 mcg/mL. At a level higher than 20 mcg/mL, involuntary movements of
the eyeballs (nystagmus) appear. At a level higher than 30 mcg/mL, ataxia and slurred speech occur.
212.) Mannitol (Osmitrol) is being administered to a client with increased intracranial pressure following a head
injury. The nurse assisting in caring for the client knows that which of the following indicates the therapeutic
action of this medication?
1. Prevents the filtration of sodium and water through the kidneys
2. Prevents the filtration of sodium and potassium through the kidneys
3. Decreases water loss by promoting the reabsorption of sodium and water in the loop of Henle
4. Induces diuresis by raising the osmotic pressure of glomerular filtrate, thereby inhibiting tubular reabsorption
of water and solutes - Correct Answer :4. Induces diuresis by raising the osmotic pressure of glomerular filtrate,
thereby inhibiting tubular reabsorption of water and solutes
Rationale:
Mannitol is an osmotic diuretic that induces diuresis by raising the osmotic pressure of glomerular filtrate,
thereby inhibiting tubular reabsorption of water and solutes. It is used to reduce intracranial pressure in the
client with head trauma.
213.) A client is admitted to the hospital with complaints of back spasms. The client states, "I have been taking
two or three aspirin every 4 hours for the past week and it hasn't helped my back." Aspirin intoxication is
suspected. Which of the following complaints would indicate aspirin intoxication?
1. Tinnitus
2. Constipation
3. Photosensitivity
4. Abdominal cramps - Correct Answer :1. Tinnitus
Rationale:
Mild intoxication with acetylsalicylic acid (aspirin) is called salicylism and is commonly experienced when the daily
dosage is higher than 4 g. Tinnitus (ringing in the ears) is the most frequently occurring effect noted with
intoxication. Hyperventilation may occur because salicylate stimulates the respiratory center. Fever may result
because salicylate interferes with the metabolic pathways involved with oxygen consumption and heat
production. Options 2, 3, and 4 are incorrect.
P 2
, • PN HESI
Pharmacology 09/11/2026
Exam
214.) A health care provider initiates carbidopa/levodopa (Sinemet) therapy for the client with Parkinson's
disease. A few days after the client starts the medication, the client complains of nausea and vomiting. The nurse
tells the client that:
1. Taking an antiemetic is the best measure to prevent the nausea.
2. Taking the medication with food will help to prevent the nausea.
3. This is an expected side effect of the medication and will decrease over time.
4. The nausea and vomiting will decrease when the dose of levodopa is stabilized. - Correct Answer :2. Taking
the medication with food will help to prevent the nausea.
Rationale:
If carbidopa/levodopa is causing nausea and vomiting, the nurse would tell the client that taking the medication
with food will prevent the nausea. Additionally, the client should be instructed not to take the medication with a
high-protein meal because the high-protein will affect absorption. Antiemetics from the phenothiazine class
should not be used because they block the therapeutic action of dopamine.
**eliminate options 3 and 4 because they are comparable or alike**
215.) A client with rheumatoid arthritis is taking acetylsalicylic acid (aspirin) on a daily basis. Which medication
dose should the nurse expect the client to be taking?
1. 1 g daily
2. 4 g daily
3. 325 mg daily
4. 1000 mg daily - Correct Answer :2. 4 g daily
Rationale:
Aspirin may be used to treat the client with rheumatoid arthritis. It may also be used to reduce the risk of
recurrent transient ischemic attack (TIA) or brain attack (stroke) or reduce the risk of myocardial infarction (MI)
in clients with unstable angina or a history of a previous MI. The normal dose for clients being treated with aspirin
to decrease thrombosis and MI is 300 to 325 mg/day. Clients being treated to prevent TIAs are usually prescribed
1.3 g/day in two to four divided doses. Clients with rheumatoid arthritis are treated with 3.6 to 5.4 g/day in
divided doses.
**Eliminate options 1 and 4 because they are alike**
P 3
, • PN HESI
Pharmacology 09/11/2026
Exam
216.) A nurse is caring for a client with gout who is taking Colcrys (colchicine). The client has been instructed to
restrict the diet to low-purine foods. Which of the following foods should the nurse instruct the client to avoid
while taking this medication?
1. Spinach
2. Scallops
3. Potatoes
4. Ice cream - Correct Answer :2. Scallops
Rationale:
Colchicine is a medication used for clients with gout to inhibit the reabsorption of uric acid by the kidney and
promote excretion of uric acid in the urine. Uric acid is produced when purine is catabolized. Clients are
instructed to modify their diet and limit excessive purine intake. High-purine foods to avoid or limit include organ
meats, roe, sardines, scallops, anchovies, broth, mincemeat, herring, shrimp, mackerel, gravy, and yeast.
217.) A health care provider prescribes auranofin (Ridaura) for a client with rheumatoid arthritis. Which of the
following would indicate to the nurse that the client is experiencing toxicity related to the medication?
1. Joint pain
2. Constipation
3. Ringing in the ears
4. Complaints of a metallic taste in the mouth - Correct Answer :4. Complaints of a metallic taste in the mouth
Rationale:
Ridaura is the one gold preparation that is given orally rather than by injection. Gastrointestinal reactions
including diarrhea, abdominal pain, nausea, and loss of appetite are common early in therapy, but these usually
subside in the first 3 months of therapy. Early symptoms of toxicity include a rash, purple blotches, pruritus,
mouth lesions, and a metallic taste in the mouth.
218.) A film-coated form of diflunisal has been prescribed for a client for the treatment of chronic rheumatoid
arthritis. The client calls the clinic nurse because of difficulty swallowing the tablets. Which initial instruction
should the nurse provide to the client?
1. "Crush the tablets and mix them with food."
2. "Notify the health care provider for a medication change."
P 4
Pharmacology 09/11/2026
Exam
Evolve Pharmacology PN HESI Exam 1 2026 Test
Bank | 180 Questions with Correct Answers &
Detailed Rationales | Evolve HESI PN
Pharmacology Review - Complete A+ Guide
211.) A client with epilepsy is taking the prescribed dose of phenytoin (Dilantin) to control seizures. A phenytoin
blood level is drawn, and the results reveal a level of 35 mcg/ml. Which of the following symptoms would be
expected as a result of this laboratory result?
1. Nystagmus
2. Tachycardia
3. Slurred speech
4. No symptoms, because this is a normal therapeutic level - Correct Answer :3. Slurred speech
Rationale:
P 1
, • PN HESI
Pharmacology 09/11/2026
Exam
The therapeutic phenytoin level is 10 to 20 mcg/mL. At a level higher than 20 mcg/mL, involuntary movements of
the eyeballs (nystagmus) appear. At a level higher than 30 mcg/mL, ataxia and slurred speech occur.
212.) Mannitol (Osmitrol) is being administered to a client with increased intracranial pressure following a head
injury. The nurse assisting in caring for the client knows that which of the following indicates the therapeutic
action of this medication?
1. Prevents the filtration of sodium and water through the kidneys
2. Prevents the filtration of sodium and potassium through the kidneys
3. Decreases water loss by promoting the reabsorption of sodium and water in the loop of Henle
4. Induces diuresis by raising the osmotic pressure of glomerular filtrate, thereby inhibiting tubular reabsorption
of water and solutes - Correct Answer :4. Induces diuresis by raising the osmotic pressure of glomerular filtrate,
thereby inhibiting tubular reabsorption of water and solutes
Rationale:
Mannitol is an osmotic diuretic that induces diuresis by raising the osmotic pressure of glomerular filtrate,
thereby inhibiting tubular reabsorption of water and solutes. It is used to reduce intracranial pressure in the
client with head trauma.
213.) A client is admitted to the hospital with complaints of back spasms. The client states, "I have been taking
two or three aspirin every 4 hours for the past week and it hasn't helped my back." Aspirin intoxication is
suspected. Which of the following complaints would indicate aspirin intoxication?
1. Tinnitus
2. Constipation
3. Photosensitivity
4. Abdominal cramps - Correct Answer :1. Tinnitus
Rationale:
Mild intoxication with acetylsalicylic acid (aspirin) is called salicylism and is commonly experienced when the daily
dosage is higher than 4 g. Tinnitus (ringing in the ears) is the most frequently occurring effect noted with
intoxication. Hyperventilation may occur because salicylate stimulates the respiratory center. Fever may result
because salicylate interferes with the metabolic pathways involved with oxygen consumption and heat
production. Options 2, 3, and 4 are incorrect.
P 2
, • PN HESI
Pharmacology 09/11/2026
Exam
214.) A health care provider initiates carbidopa/levodopa (Sinemet) therapy for the client with Parkinson's
disease. A few days after the client starts the medication, the client complains of nausea and vomiting. The nurse
tells the client that:
1. Taking an antiemetic is the best measure to prevent the nausea.
2. Taking the medication with food will help to prevent the nausea.
3. This is an expected side effect of the medication and will decrease over time.
4. The nausea and vomiting will decrease when the dose of levodopa is stabilized. - Correct Answer :2. Taking
the medication with food will help to prevent the nausea.
Rationale:
If carbidopa/levodopa is causing nausea and vomiting, the nurse would tell the client that taking the medication
with food will prevent the nausea. Additionally, the client should be instructed not to take the medication with a
high-protein meal because the high-protein will affect absorption. Antiemetics from the phenothiazine class
should not be used because they block the therapeutic action of dopamine.
**eliminate options 3 and 4 because they are comparable or alike**
215.) A client with rheumatoid arthritis is taking acetylsalicylic acid (aspirin) on a daily basis. Which medication
dose should the nurse expect the client to be taking?
1. 1 g daily
2. 4 g daily
3. 325 mg daily
4. 1000 mg daily - Correct Answer :2. 4 g daily
Rationale:
Aspirin may be used to treat the client with rheumatoid arthritis. It may also be used to reduce the risk of
recurrent transient ischemic attack (TIA) or brain attack (stroke) or reduce the risk of myocardial infarction (MI)
in clients with unstable angina or a history of a previous MI. The normal dose for clients being treated with aspirin
to decrease thrombosis and MI is 300 to 325 mg/day. Clients being treated to prevent TIAs are usually prescribed
1.3 g/day in two to four divided doses. Clients with rheumatoid arthritis are treated with 3.6 to 5.4 g/day in
divided doses.
**Eliminate options 1 and 4 because they are alike**
P 3
, • PN HESI
Pharmacology 09/11/2026
Exam
216.) A nurse is caring for a client with gout who is taking Colcrys (colchicine). The client has been instructed to
restrict the diet to low-purine foods. Which of the following foods should the nurse instruct the client to avoid
while taking this medication?
1. Spinach
2. Scallops
3. Potatoes
4. Ice cream - Correct Answer :2. Scallops
Rationale:
Colchicine is a medication used for clients with gout to inhibit the reabsorption of uric acid by the kidney and
promote excretion of uric acid in the urine. Uric acid is produced when purine is catabolized. Clients are
instructed to modify their diet and limit excessive purine intake. High-purine foods to avoid or limit include organ
meats, roe, sardines, scallops, anchovies, broth, mincemeat, herring, shrimp, mackerel, gravy, and yeast.
217.) A health care provider prescribes auranofin (Ridaura) for a client with rheumatoid arthritis. Which of the
following would indicate to the nurse that the client is experiencing toxicity related to the medication?
1. Joint pain
2. Constipation
3. Ringing in the ears
4. Complaints of a metallic taste in the mouth - Correct Answer :4. Complaints of a metallic taste in the mouth
Rationale:
Ridaura is the one gold preparation that is given orally rather than by injection. Gastrointestinal reactions
including diarrhea, abdominal pain, nausea, and loss of appetite are common early in therapy, but these usually
subside in the first 3 months of therapy. Early symptoms of toxicity include a rash, purple blotches, pruritus,
mouth lesions, and a metallic taste in the mouth.
218.) A film-coated form of diflunisal has been prescribed for a client for the treatment of chronic rheumatoid
arthritis. The client calls the clinic nurse because of difficulty swallowing the tablets. Which initial instruction
should the nurse provide to the client?
1. "Crush the tablets and mix them with food."
2. "Notify the health care provider for a medication change."
P 4
