HESI Pharmacology
Practice Exam (Latest 2026
Update)
Questions and 100% Verified
Correct Answers
1. A 43-year-old female client is receiving thyroid
replacement hormone following a thyroidectomy.
What adverse effects associated with thyroid
hormone toxicity should the nurse instruct the client
to report promptly to the healthcare provider?
A) Tinnitus and dizziness.
B) Tachycardia and chest pain.
C) Dry skin and intolerance to cold.
D) Weight gain and increased appetite.
Answer: B. Tachycardia and chest pain.
Rationale: Thyroid replacement hormone increases
the metabolic rate of all tissues, so common signs and
symptoms of toxicity include tachycardia and chest
pain (B). (A, C, and D) do not indicate a thyroid
hormone toxicity.
2. A category X drug is prescribed for a young adult
female client. Which instruction is most important for
the nurse to teach this client?
A) Use a reliable form of birth control.
B) Avoid exposure to ultra violet light.
C) Refuse this medication if planning pregnancy.
D) Abstain from intercourse while on this drug.
Answer: A. Use a reliable form of birth control.
Rationale: Drugs classified in the category X place a
client who is in the first trimester of pregnancy at risk
for teratogenesis, so women in the childbearing years
should be counseled to use a reliable form of birth
control (A) during drug therapy. (B) is not a specific
precaution with Category X drugs. The client should
1
,be encouraged to discuss plans for pregnancy with
the healthcare provider, so a safer alternative
prescription (C) can be provided if pregnancy occurs.
Although the risk of birth defects during pregnancy
explains the restriction of these drugs during
pregnancy, (D) is not indicated.
3. A client asks the nurse if glipizide (Glucotrol) is an
oral insulin. Which response should the nurse
provide?
A. Yes it is an oral insulin and has the same actions and
properties as intermediate insulin.
B. Yes, it is an oral insulin and is distributed, metabolized,
and excreted in the same manner as insulin.
C. No it is not an oral insulin and can be used only when
some beta cell function is present.
D. No, it is not an oral insulin, but it is effective for those who
are resistant to injectable insulins.
Answer: C. No it is not an oral insulin and can be used
only when some beta cell function is present.
Rationale: Glipizide (Glucotrol) is an oral
hypoglycemic agent that stimulates the pancreas to
release insulin. It is not insulin and requires some
functioning beta cells in the pancreas to be effective.
4. A client has a continuous IV infusion of dopamine
and an IV of normal saline at 50ml/hour. The nurse
notes that the client's urinary output has been
20ml/hour for the last two hours. Which intervention
should the nurse initiate?
A. Stop the infusion of dopamine.
B. Change the normal saline to a keep open rate.
C. Replace the urinary catheter.
D. Notify the healthcare provider of the urinary output.
Answer: D. Notify the healthcare provider of the
urinary output.
Rationale: A urinary output of less than 30 mL/hour
indicates inadequate renal perfusion and should be
reported to the healthcare provider immediately.
Dopamine is used to improve cardiac output and renal
perfusion, so the low urine output may indicate that
2
,the medication is not effective or the dose needs
adjustment.
5. A client has myxedema, which results from a
deficiency of thyroid hormone synthesis in adults. The
nurse knows that which medication should be
contraindicated for this client?
A. Liothyronine (Cytomel) to replace iodine.
B. Furosemide (Lasix) for relief of fluid retention.
C. Pentobarbital sodium for sleep.
D. Nitroglycerin for angina pain.
Answer: C. Pentobarbital sodium for sleep.
Rationale: Persons with myxedema are dangerously
hypersensitive to narcotics, barbiturates, and
anesthetics. They do not tolerate liothyronine and
usually receive iodine replacement therapy. These
clients are also susceptible to heart problems such as
angina for which nitroglycerin would be indicated and
congestive heart failure for which furosemide would
be indicated.
6. A client is admitted to the coronary care unit with a
medical diagnosis of acute myocardial infarction.
Which medication prescription decreases both preload
and afterload?
A. Nitroglycerin.
B. Propranolol.
C. Propranolol.
D. Captopril.
Answer: A. Nitroglycerin.
Rationale: Nitroglycerin is a nitrate that causes
peripheral vasodilation and decreases contractility,
thereby decreasing both preload and afterload.
7. A client is admitted to the hospital for diagnostic
testing for possible myasthenia gravis. The nurse
prepares for intravenous administration of
edrophonium chloride (Tensilon). What is the
3
, expected outcome for this client following
administration of this pharmacologic agent?
A) Progressive difficulty with swallowing.
B) Decreased respiratory effort.
C) Improvement in generalized fatigue.
D) Decreased muscle weakness.
Answer: D. Decreased muscle weakness.
Rationale: Administration of edrophonium chloride
(Tensilon), a cholinergic agent, will temporarily
reduce muscle weakness (D), the most common
complaint of newly-diagnosed clients with myasthenia
gravis. This medication is used to diagnose
myasthenia gravis due to its short duration of action.
This drug would temporarily reverse (A and B), not
increase these symptoms. (C) is not a typical
complaint of clients with myasthenia gravis, but
weakness of specific muscles, especially after
prolonged use, is a common symptom.
8. A client is being treated for hyperthyroidism with
propylthiouracil (PTU). The nurse knows that the
action of this drug is to
A. Decrease the amount of the thyroid-stimulating hormone
circulating in the blood.
B. Increase the amount of thyroid-stimulating hormone
circulating in the blood.
C. Increase the amount of T4 and decrease the amount of T3
produced by the thyroid.
D. Inhibit synthesis of T3 and T4 by the thyroid gland.
Answer: D. Inhibit synthesis of T3 and T4 by the
thyroid gland.
Rationale: PTU is an adjunct therapy used to control
hyperthyroidism by inhibiting production of thyroid
hormones. It is often prescribed in preparation for
thyroidectomy or radioactive iodine therapy.
9. A client is being treated for osteoporosis with
alendronate (Fosamax), and the nurse has completed
discharge teaching regarding medication
administration. Which morning schedule would
4
Practice Exam (Latest 2026
Update)
Questions and 100% Verified
Correct Answers
1. A 43-year-old female client is receiving thyroid
replacement hormone following a thyroidectomy.
What adverse effects associated with thyroid
hormone toxicity should the nurse instruct the client
to report promptly to the healthcare provider?
A) Tinnitus and dizziness.
B) Tachycardia and chest pain.
C) Dry skin and intolerance to cold.
D) Weight gain and increased appetite.
Answer: B. Tachycardia and chest pain.
Rationale: Thyroid replacement hormone increases
the metabolic rate of all tissues, so common signs and
symptoms of toxicity include tachycardia and chest
pain (B). (A, C, and D) do not indicate a thyroid
hormone toxicity.
2. A category X drug is prescribed for a young adult
female client. Which instruction is most important for
the nurse to teach this client?
A) Use a reliable form of birth control.
B) Avoid exposure to ultra violet light.
C) Refuse this medication if planning pregnancy.
D) Abstain from intercourse while on this drug.
Answer: A. Use a reliable form of birth control.
Rationale: Drugs classified in the category X place a
client who is in the first trimester of pregnancy at risk
for teratogenesis, so women in the childbearing years
should be counseled to use a reliable form of birth
control (A) during drug therapy. (B) is not a specific
precaution with Category X drugs. The client should
1
,be encouraged to discuss plans for pregnancy with
the healthcare provider, so a safer alternative
prescription (C) can be provided if pregnancy occurs.
Although the risk of birth defects during pregnancy
explains the restriction of these drugs during
pregnancy, (D) is not indicated.
3. A client asks the nurse if glipizide (Glucotrol) is an
oral insulin. Which response should the nurse
provide?
A. Yes it is an oral insulin and has the same actions and
properties as intermediate insulin.
B. Yes, it is an oral insulin and is distributed, metabolized,
and excreted in the same manner as insulin.
C. No it is not an oral insulin and can be used only when
some beta cell function is present.
D. No, it is not an oral insulin, but it is effective for those who
are resistant to injectable insulins.
Answer: C. No it is not an oral insulin and can be used
only when some beta cell function is present.
Rationale: Glipizide (Glucotrol) is an oral
hypoglycemic agent that stimulates the pancreas to
release insulin. It is not insulin and requires some
functioning beta cells in the pancreas to be effective.
4. A client has a continuous IV infusion of dopamine
and an IV of normal saline at 50ml/hour. The nurse
notes that the client's urinary output has been
20ml/hour for the last two hours. Which intervention
should the nurse initiate?
A. Stop the infusion of dopamine.
B. Change the normal saline to a keep open rate.
C. Replace the urinary catheter.
D. Notify the healthcare provider of the urinary output.
Answer: D. Notify the healthcare provider of the
urinary output.
Rationale: A urinary output of less than 30 mL/hour
indicates inadequate renal perfusion and should be
reported to the healthcare provider immediately.
Dopamine is used to improve cardiac output and renal
perfusion, so the low urine output may indicate that
2
,the medication is not effective or the dose needs
adjustment.
5. A client has myxedema, which results from a
deficiency of thyroid hormone synthesis in adults. The
nurse knows that which medication should be
contraindicated for this client?
A. Liothyronine (Cytomel) to replace iodine.
B. Furosemide (Lasix) for relief of fluid retention.
C. Pentobarbital sodium for sleep.
D. Nitroglycerin for angina pain.
Answer: C. Pentobarbital sodium for sleep.
Rationale: Persons with myxedema are dangerously
hypersensitive to narcotics, barbiturates, and
anesthetics. They do not tolerate liothyronine and
usually receive iodine replacement therapy. These
clients are also susceptible to heart problems such as
angina for which nitroglycerin would be indicated and
congestive heart failure for which furosemide would
be indicated.
6. A client is admitted to the coronary care unit with a
medical diagnosis of acute myocardial infarction.
Which medication prescription decreases both preload
and afterload?
A. Nitroglycerin.
B. Propranolol.
C. Propranolol.
D. Captopril.
Answer: A. Nitroglycerin.
Rationale: Nitroglycerin is a nitrate that causes
peripheral vasodilation and decreases contractility,
thereby decreasing both preload and afterload.
7. A client is admitted to the hospital for diagnostic
testing for possible myasthenia gravis. The nurse
prepares for intravenous administration of
edrophonium chloride (Tensilon). What is the
3
, expected outcome for this client following
administration of this pharmacologic agent?
A) Progressive difficulty with swallowing.
B) Decreased respiratory effort.
C) Improvement in generalized fatigue.
D) Decreased muscle weakness.
Answer: D. Decreased muscle weakness.
Rationale: Administration of edrophonium chloride
(Tensilon), a cholinergic agent, will temporarily
reduce muscle weakness (D), the most common
complaint of newly-diagnosed clients with myasthenia
gravis. This medication is used to diagnose
myasthenia gravis due to its short duration of action.
This drug would temporarily reverse (A and B), not
increase these symptoms. (C) is not a typical
complaint of clients with myasthenia gravis, but
weakness of specific muscles, especially after
prolonged use, is a common symptom.
8. A client is being treated for hyperthyroidism with
propylthiouracil (PTU). The nurse knows that the
action of this drug is to
A. Decrease the amount of the thyroid-stimulating hormone
circulating in the blood.
B. Increase the amount of thyroid-stimulating hormone
circulating in the blood.
C. Increase the amount of T4 and decrease the amount of T3
produced by the thyroid.
D. Inhibit synthesis of T3 and T4 by the thyroid gland.
Answer: D. Inhibit synthesis of T3 and T4 by the
thyroid gland.
Rationale: PTU is an adjunct therapy used to control
hyperthyroidism by inhibiting production of thyroid
hormones. It is often prescribed in preparation for
thyroidectomy or radioactive iodine therapy.
9. A client is being treated for osteoporosis with
alendronate (Fosamax), and the nurse has completed
discharge teaching regarding medication
administration. Which morning schedule would
4
