HESI Pharmacology
Version 1 (100 Questions
and Answers with
Rationale) 2021/2022
,2021 HESI Pharmacology Version 1 – Questions 1
through 100
1) A nurse is caring for a client with hyperparathyroidism and notes that the client's
serum calcium level is 13 mg/dL. Which medication should the nurse prepare to
administer as prescribed to the client?
1. Calcium chloride
2. Calcium gluconate
3. Calcitonin (Miacalcin)
4. Large doses of vitamin D 3. Calcitonin (Miacalcin)
Rationale:
The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is experiencing
hypercalcemia. Calcium gluconate and calcium chloride are medications used for
the treatment of tetany, which occurs as a result of acute hypocalcemia. In
hypercalcemia, large doses of vitamin D need to be avoided. Calcitonin, a thyroid
hormone, decreases the plasma calcium level by inhibiting bone resorption and
lowering the serum calcium concentration.
2.) Oral iron supplements are prescribed for a 6-year-old child with iron deficiency anemia. The
nurse instructs the mother to administer the iron with which best food item?
1. Milk
2. Water
3. Apple juice
4. Orange juice 4. Orange juice
Rationale:
Vitamin C increases the absorption of iron by the body. The mother should be
instructed to administer the medication with a citrus fruit or a juice that is high in
vitamin C. Milk may affect absorption of the iron. Water will not assist in absorption.
Orange juice contains a greater amount of vitamin C than apple juice.
3.) Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse
monitors the client, knowing that which of the following would indicate the presence
of systemic toxicity from this medication?
1. Tinnitus
2. Diarrhea
3. Constipation
4. Decreased respirations 1. Tinnitus
Rationale:
,Salicylic acid is absorbed readily through the skin, and systemic toxicity (salicylism)
can result. Symptoms include tinnitus, dizziness, hyperpnea, and psychological
disturbances. Constipation and diarrhea are not associated with salicylism.
4.) The camp nurse asks the children preparing to swim in the lake if they have
applied sunscreen. The nurse reminds the children that chemical sunscreens are
most effective when applied:
1. Immediately before swimming
2. 15 minutes before exposure to the sun
3. Immediately before exposure to the sun
4. At least 30 minutes before exposure to the sun 4. At least 30 minutes before
exposure to the sun
Rationale:
Sunscreens are most effective when applied at least 30 minutes before exposure to
the sun so that they can penetrate the skin. All sunscreens should be reapplied after
swimming or sweating.
5.) Mafenide acetate (Sulfamylon) is prescribed for the client with a burn injury.
When applying the medication, the client complains of local discomfort and burning.
Which of the following is the most appropriate nursing action?
1. Notifying the registered nurse
2. Discontinuing the medication
3. Informing the client that this is normal
4. Applying a thinner film than prescribed to the burn site 3. Informing the client
that this is normal
Rationale:
Mafenide acetate is bacteriostatic for gram-negative and gram-positive organisms
and is used to treat burns to reduce bacteria present in avascular tissues. The client
should be informed that the medication will cause local discomfort and burning and
that this is a normal reaction; therefore options 1, 2, and 4 are incorrect
6.) The burn client is receiving treatments of topical mafenide acetate (Sulfamylon)
to the site of injury. The nurse monitors the client, knowing that which of the
following indicates that a systemic effect has occurred?
1.Hyperventilation
2.Elevated blood pressure
3.Local pain at the burn site
4.Local rash at the burn site 1.Hyperventilation
, Rationale:
Mafenide acetate is a carbonic anhydrase inhibitor and can suppress renal excretion
of acid, thereby causing acidosis. Clients receiving this treatment should be
monitored for signs of an acid-base imbalance (hyperventilation). If this occurs, the
medication should be discontinued for 1 to 2 days. Options 3 and 4 describe local
rather than systemic effects. An elevated blood pressure may be expected from the
pain that occurs with a burn injury.
7.) Isotretinoin is prescribed for a client with severe acne. Before the administration
of this medication, the nurse anticipates that which laboratory test will be
prescribed?
1. Platelet count
2. Triglyceride level
3. Complete blood count
4. White blood cell count 2. Triglyceride level
Rationale:
Isotretinoin can elevate triglyceride levels. Blood triglyceride levels should be
measured before treatment and periodically thereafter until the effect on the
triglycerides has been evaluated. Options 1, 3, and 4 do not need to be monitored
specifically during this treatment.
8.) A client with severe acne is seen in the clinic and the health care provider (HCP)
prescribes isotretinoin. The nurse reviews the client's medication record and would
contact the (HCP) if the client is taking which medication?
1. Vitamin A
2. Digoxin (Lanoxin)
3. Furosemide (Lasix)
4. Phenytoin (Dilantin) 1. Vitamin A
Rationale:
Isotretinoin is a metabolite of vitamin A and can produce generalized intensification
of isotretinoin toxicity. Because of the potential for increased toxicity, vitamin A
supplements should be discontinued before isotretinoin therapy. Options 2, 3, and 4
are not contraindicated with the use of isotretinoin.
9.) The nurse is applying a topical corticosteroid to a client with eczema. The nurse
would monitor for the potential for increased systemic absorption of the medication
if the medication were being applied to which of the following body areas?
1. Back
2. Axilla
Version 1 (100 Questions
and Answers with
Rationale) 2021/2022
,2021 HESI Pharmacology Version 1 – Questions 1
through 100
1) A nurse is caring for a client with hyperparathyroidism and notes that the client's
serum calcium level is 13 mg/dL. Which medication should the nurse prepare to
administer as prescribed to the client?
1. Calcium chloride
2. Calcium gluconate
3. Calcitonin (Miacalcin)
4. Large doses of vitamin D 3. Calcitonin (Miacalcin)
Rationale:
The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is experiencing
hypercalcemia. Calcium gluconate and calcium chloride are medications used for
the treatment of tetany, which occurs as a result of acute hypocalcemia. In
hypercalcemia, large doses of vitamin D need to be avoided. Calcitonin, a thyroid
hormone, decreases the plasma calcium level by inhibiting bone resorption and
lowering the serum calcium concentration.
2.) Oral iron supplements are prescribed for a 6-year-old child with iron deficiency anemia. The
nurse instructs the mother to administer the iron with which best food item?
1. Milk
2. Water
3. Apple juice
4. Orange juice 4. Orange juice
Rationale:
Vitamin C increases the absorption of iron by the body. The mother should be
instructed to administer the medication with a citrus fruit or a juice that is high in
vitamin C. Milk may affect absorption of the iron. Water will not assist in absorption.
Orange juice contains a greater amount of vitamin C than apple juice.
3.) Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse
monitors the client, knowing that which of the following would indicate the presence
of systemic toxicity from this medication?
1. Tinnitus
2. Diarrhea
3. Constipation
4. Decreased respirations 1. Tinnitus
Rationale:
,Salicylic acid is absorbed readily through the skin, and systemic toxicity (salicylism)
can result. Symptoms include tinnitus, dizziness, hyperpnea, and psychological
disturbances. Constipation and diarrhea are not associated with salicylism.
4.) The camp nurse asks the children preparing to swim in the lake if they have
applied sunscreen. The nurse reminds the children that chemical sunscreens are
most effective when applied:
1. Immediately before swimming
2. 15 minutes before exposure to the sun
3. Immediately before exposure to the sun
4. At least 30 minutes before exposure to the sun 4. At least 30 minutes before
exposure to the sun
Rationale:
Sunscreens are most effective when applied at least 30 minutes before exposure to
the sun so that they can penetrate the skin. All sunscreens should be reapplied after
swimming or sweating.
5.) Mafenide acetate (Sulfamylon) is prescribed for the client with a burn injury.
When applying the medication, the client complains of local discomfort and burning.
Which of the following is the most appropriate nursing action?
1. Notifying the registered nurse
2. Discontinuing the medication
3. Informing the client that this is normal
4. Applying a thinner film than prescribed to the burn site 3. Informing the client
that this is normal
Rationale:
Mafenide acetate is bacteriostatic for gram-negative and gram-positive organisms
and is used to treat burns to reduce bacteria present in avascular tissues. The client
should be informed that the medication will cause local discomfort and burning and
that this is a normal reaction; therefore options 1, 2, and 4 are incorrect
6.) The burn client is receiving treatments of topical mafenide acetate (Sulfamylon)
to the site of injury. The nurse monitors the client, knowing that which of the
following indicates that a systemic effect has occurred?
1.Hyperventilation
2.Elevated blood pressure
3.Local pain at the burn site
4.Local rash at the burn site 1.Hyperventilation
, Rationale:
Mafenide acetate is a carbonic anhydrase inhibitor and can suppress renal excretion
of acid, thereby causing acidosis. Clients receiving this treatment should be
monitored for signs of an acid-base imbalance (hyperventilation). If this occurs, the
medication should be discontinued for 1 to 2 days. Options 3 and 4 describe local
rather than systemic effects. An elevated blood pressure may be expected from the
pain that occurs with a burn injury.
7.) Isotretinoin is prescribed for a client with severe acne. Before the administration
of this medication, the nurse anticipates that which laboratory test will be
prescribed?
1. Platelet count
2. Triglyceride level
3. Complete blood count
4. White blood cell count 2. Triglyceride level
Rationale:
Isotretinoin can elevate triglyceride levels. Blood triglyceride levels should be
measured before treatment and periodically thereafter until the effect on the
triglycerides has been evaluated. Options 1, 3, and 4 do not need to be monitored
specifically during this treatment.
8.) A client with severe acne is seen in the clinic and the health care provider (HCP)
prescribes isotretinoin. The nurse reviews the client's medication record and would
contact the (HCP) if the client is taking which medication?
1. Vitamin A
2. Digoxin (Lanoxin)
3. Furosemide (Lasix)
4. Phenytoin (Dilantin) 1. Vitamin A
Rationale:
Isotretinoin is a metabolite of vitamin A and can produce generalized intensification
of isotretinoin toxicity. Because of the potential for increased toxicity, vitamin A
supplements should be discontinued before isotretinoin therapy. Options 2, 3, and 4
are not contraindicated with the use of isotretinoin.
9.) The nurse is applying a topical corticosteroid to a client with eczema. The nurse
would monitor for the potential for increased systemic absorption of the medication
if the medication were being applied to which of the following body areas?
1. Back
2. Axilla
