HESI PHARMACOLOGY EXAM 2023 ACTUAL EXAM
COMPLETE 60 QUESTIONS WITH DETAILED
VERIFIED ANSWERS AND RATIONALES (100%
CORRECT ANSWERS) /ALREADY GRADED A+
.) 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 - ANSWER4. 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.
) 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 - ANSWER1. 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.
.) A nurse is caring for a client after thyroidectomy and notes that calcium gluconate is
prescribed for the client. The nurse determines that this medication has been prescribed
to:
1. Treat thyroid storm.
2. Prevent cardiac irritability.
3. Treat hypocalcemic tetany.
4. Stimulate the release of parathyroid hormone. - ANSWER3. Treat hypocalcemic
tetany.
Rationale:
Hypocalcemia can develop after thyroidectomy if the parathyroid glands are accidentally
removed or injured during surgery. Manifestations develop 1 to 7 days after surgery. If
the client develops numbness and tingling around the mouth, fingertips, or toes or
muscle spasms or twitching, the health care provider is notified immediately. Calcium
gluconate should be kept at the bedside.
,23.) A client who has been newly diagnosed with diabetes mellitus has been stabilized
with daily insulin injections. Which information should the nurse teach when carrying out
plans for discharge?
1. Keep insulin vials refrigerated at all times.
2. Rotate the insulin injection sites systematically.
3. Increase the amount of insulin before unusual exercise.
4. Monitor the urine acetone level to determine the insulin dosage. - ANSWER2. Rotate
the insulin injection sites systematically.
Rationale:
Insulin dosages should not be adjusted or increased before unusual exercise. If acetone
is found in the urine, it may possibly indicate the need for additional insulin. To minimize
the discomfort associated with insulin injections, the insulin should be administered at
room temperature. Injection sites should be systematically rotated from one area to
another. The client should be instructed to give injections in one area, about 1 inch
apart, until the whole area has been used and then to change to another site. This
prevents dramatic changes in daily insulin absorption.
24.) A nurse is reinforcing teaching for a client regarding how to mix regular insulin and
NPH insulin in the same syringe. Which of the following actions, if performed by the
client, indicates the need for further teaching?
1. Withdraws the NPH insulin first
2. Withdraws the regular insulin first
3. Injects air into NPH insulin vial first
4. Injects an amount of air equal to the desired dose of insulin into the vial - ANSWER1.
Withdraws the NPH insulin first
Rationale:
When preparing a mixture of regular insulin with another insulin preparation, the regular
insulin is drawn into the syringe first. This sequence will avoid contaminating the vial of
regular insulin with insulin of another type. Options 2, 3, and 4 identify the correct
actions for preparing NPH and regular insulin.
25.) A home care nurse visits a client recently diagnosed with diabetes mellitus who is
taking Humulin NPH insulin daily. The client asks the nurse how to store the unopened
vials of insulin. The nurse tells the client to:
1. Freeze the insulin.
2. Refrigerate the insulin.
3. Store the insulin in a dark, dry place.
4. Keep the insulin at room temperature. - ANSWER2. Refrigerate the insulin.
Rationale:
Insulin in unopened vials should be stored under refrigeration until needed. Vials should
not be frozen. When stored unopened under refrigeration, insulin can be used up to the
expiration date on the vial. Options 1, 3, and 4 are incorrect.
, 27.) Sildenafil (Viagra) is prescribed to treat a client with erectile dysfunction. A nurse
reviews the client's medical record and would question the prescription if which of the
following is noted in the client's history?
1. Neuralgia
2. Insomnia
3. Use of nitroglycerin
4. Use of multivitamins - ANSWER3. Use of nitroglycerin
Rationale:
Sildenafil (Viagra) enhances the vasodilating effect of nitric oxide in the corpus
cavernosum of the penis, thus sustaining an erection. Because of the effect of the
medication, it is contraindicated with concurrent use of organic nitrates and
nitroglycerin. Sildenafil is not contraindicated with the use of vitamins. Neuralgia and
insomnia are side effects of the medication.
28.) The health care provider (HCP) prescribes exenatide (Byetta) for a client with type
1 diabetes mellitus who takes insulin. The nurse knows that which of the following is the
appropriate intervention?
1. The medication is administered within 60 minutes before the morning and evening
meal.
2. The medication is withheld and the HCP is called to question the prescription for the
client.
3. The client is monitored for gastrointestinal side effects after administration of the
medication.
4. The insulin is withdrawn from the Penlet into an insulin syringe to prepare for
administration. - ANSWER2. The medication is withheld and the HCP is called to
question the prescription for the client.
Rationale:
Exenatide (Byetta) is an incretin mimetic used for type 2 diabetes mellitus only. It is not
recommended for clients taking insulin. Hence, the nurse should hold the medication
and question the HCP regarding this prescription. Although options 1 and 3 are correct
statements about the medication, in this situation the medication should not be
administered. The medication is packaged in prefilled pens ready for injection without
the need for drawing it up into another syringe.
29.) A client is taking Humulin NPH insulin daily every morning. The nurse reinforces
instructions for the client and tells the client that the most likely time for a hypoglycemic
reaction to occur is:
1. 2 to 4 hours after administration
2. 4 to 12 hours after administration
3. 16 to 18 hours after administration
4. 18 to 24 hours after administration - ANSWER2. 4 to 12 hours after administration
Rationale:
Humulin NPH is an intermediate-acting insulin. The onset of action is 1.5 hours, it peaks
in 4 to 12 hours, and its duration of action is 24 hours. Hypoglycemic reactions most
likely occur during peak time.
COMPLETE 60 QUESTIONS WITH DETAILED
VERIFIED ANSWERS AND RATIONALES (100%
CORRECT ANSWERS) /ALREADY GRADED A+
.) 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 - ANSWER4. 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.
) 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 - ANSWER1. 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.
.) A nurse is caring for a client after thyroidectomy and notes that calcium gluconate is
prescribed for the client. The nurse determines that this medication has been prescribed
to:
1. Treat thyroid storm.
2. Prevent cardiac irritability.
3. Treat hypocalcemic tetany.
4. Stimulate the release of parathyroid hormone. - ANSWER3. Treat hypocalcemic
tetany.
Rationale:
Hypocalcemia can develop after thyroidectomy if the parathyroid glands are accidentally
removed or injured during surgery. Manifestations develop 1 to 7 days after surgery. If
the client develops numbness and tingling around the mouth, fingertips, or toes or
muscle spasms or twitching, the health care provider is notified immediately. Calcium
gluconate should be kept at the bedside.
,23.) A client who has been newly diagnosed with diabetes mellitus has been stabilized
with daily insulin injections. Which information should the nurse teach when carrying out
plans for discharge?
1. Keep insulin vials refrigerated at all times.
2. Rotate the insulin injection sites systematically.
3. Increase the amount of insulin before unusual exercise.
4. Monitor the urine acetone level to determine the insulin dosage. - ANSWER2. Rotate
the insulin injection sites systematically.
Rationale:
Insulin dosages should not be adjusted or increased before unusual exercise. If acetone
is found in the urine, it may possibly indicate the need for additional insulin. To minimize
the discomfort associated with insulin injections, the insulin should be administered at
room temperature. Injection sites should be systematically rotated from one area to
another. The client should be instructed to give injections in one area, about 1 inch
apart, until the whole area has been used and then to change to another site. This
prevents dramatic changes in daily insulin absorption.
24.) A nurse is reinforcing teaching for a client regarding how to mix regular insulin and
NPH insulin in the same syringe. Which of the following actions, if performed by the
client, indicates the need for further teaching?
1. Withdraws the NPH insulin first
2. Withdraws the regular insulin first
3. Injects air into NPH insulin vial first
4. Injects an amount of air equal to the desired dose of insulin into the vial - ANSWER1.
Withdraws the NPH insulin first
Rationale:
When preparing a mixture of regular insulin with another insulin preparation, the regular
insulin is drawn into the syringe first. This sequence will avoid contaminating the vial of
regular insulin with insulin of another type. Options 2, 3, and 4 identify the correct
actions for preparing NPH and regular insulin.
25.) A home care nurse visits a client recently diagnosed with diabetes mellitus who is
taking Humulin NPH insulin daily. The client asks the nurse how to store the unopened
vials of insulin. The nurse tells the client to:
1. Freeze the insulin.
2. Refrigerate the insulin.
3. Store the insulin in a dark, dry place.
4. Keep the insulin at room temperature. - ANSWER2. Refrigerate the insulin.
Rationale:
Insulin in unopened vials should be stored under refrigeration until needed. Vials should
not be frozen. When stored unopened under refrigeration, insulin can be used up to the
expiration date on the vial. Options 1, 3, and 4 are incorrect.
, 27.) Sildenafil (Viagra) is prescribed to treat a client with erectile dysfunction. A nurse
reviews the client's medical record and would question the prescription if which of the
following is noted in the client's history?
1. Neuralgia
2. Insomnia
3. Use of nitroglycerin
4. Use of multivitamins - ANSWER3. Use of nitroglycerin
Rationale:
Sildenafil (Viagra) enhances the vasodilating effect of nitric oxide in the corpus
cavernosum of the penis, thus sustaining an erection. Because of the effect of the
medication, it is contraindicated with concurrent use of organic nitrates and
nitroglycerin. Sildenafil is not contraindicated with the use of vitamins. Neuralgia and
insomnia are side effects of the medication.
28.) The health care provider (HCP) prescribes exenatide (Byetta) for a client with type
1 diabetes mellitus who takes insulin. The nurse knows that which of the following is the
appropriate intervention?
1. The medication is administered within 60 minutes before the morning and evening
meal.
2. The medication is withheld and the HCP is called to question the prescription for the
client.
3. The client is monitored for gastrointestinal side effects after administration of the
medication.
4. The insulin is withdrawn from the Penlet into an insulin syringe to prepare for
administration. - ANSWER2. The medication is withheld and the HCP is called to
question the prescription for the client.
Rationale:
Exenatide (Byetta) is an incretin mimetic used for type 2 diabetes mellitus only. It is not
recommended for clients taking insulin. Hence, the nurse should hold the medication
and question the HCP regarding this prescription. Although options 1 and 3 are correct
statements about the medication, in this situation the medication should not be
administered. The medication is packaged in prefilled pens ready for injection without
the need for drawing it up into another syringe.
29.) A client is taking Humulin NPH insulin daily every morning. The nurse reinforces
instructions for the client and tells the client that the most likely time for a hypoglycemic
reaction to occur is:
1. 2 to 4 hours after administration
2. 4 to 12 hours after administration
3. 16 to 18 hours after administration
4. 18 to 24 hours after administration - ANSWER2. 4 to 12 hours after administration
Rationale:
Humulin NPH is an intermediate-acting insulin. The onset of action is 1.5 hours, it peaks
in 4 to 12 hours, and its duration of action is 24 hours. Hypoglycemic reactions most
likely occur during peak time.
