HESI PHARMACOLOGY Practice
EXAM 2023 ACTUAL EXAM COMPLETE 300
QUESTIONS WITH DETAILED VERIFIED ANSWERS
AND RATIONALES (100% CORRECT ANSWERS)
/ALREADY GRADED A+
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 - ANSWER3. 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.
The clinic nurse is performing an admission assessment on a client. The nurse notes
that the client is taking azelaic acid (Azelex). Because of the medication prescription,
the nurse would suspect that the client is being treated for:
1. Acne
2. Eczema
3. Hair loss
4. Herpes simplex - ANSWER1. Acne
Rationale:
Azelaic acid is a topical medication used to treat mild to moderate acne. The acid
appears to work by suppressing the growth of Propionibacterium acnes and decreasing
the proliferation of keratinocytes. Options 2, 3, and 4 are incorrect.
Saquinavir (Invirase) is prescribed for the client who is human immunodeficiency virus
seropositive. The nurse reinforces medication instructions and tells the client to:
1. Avoid sun exposure.
2. Eat low-calorie foods.
3. Eat foods that are low in fat.
4. Take the medication on an empty stomach. - ANSWER1. Avoid sun exposure.
Rationale:
,Saquinavir (Invirase) is an antiretroviral (protease inhibitor) used with other antiretroviral
medications to manage human immunodeficiency virus infection. Saquinavir is
administered with meals and is best absorbed if the client consumes high-calorie, high-
fat meals. Saquinavir can cause photosensitivity, and the nurse should instruct the client
to avoid sun exposure.
101.) Ketoconazole is prescribed for a client with a diagnosis of candidiasis. Select the
interventions that the nurse includes when administering this medication. Select all that
apply.
1. Restrict fluid intake.
2. Instruct the client to avoid alcohol.
3. Monitor hepatic and liver function studies.
4. Administer the medication with an antacid.
5. Instruct the client to avoid exposure to the sun.
6. Administer the medication on an empty stomach. - ANSWER2. Instruct the client to
avoid alcohol.
3. Monitor hepatic and liver function studies.
5. Instruct the client to avoid exposure to the sun.
Rationale:
Ketoconazole is an antifungal medication. It is administered with food (not on an empty
stomach) and antacids are avoided for 2 hours after taking the medication to ensure
absorption. The medication is hepatotoxic and the nurse monitors liver function studies.
The client is instructed to avoid exposure to the sun because the medication increases
photosensitivity. The client is also instructed to avoid alcohol. There is no reason for the
client to restrict fluid intake. In fact, this could be harmful to the client.
102.) A client with human immunodeficiency virus is taking nevirapine (Viramune). The
nurse should monitor for which adverse effects of the medication? Select all that apply.
1. Rash
2. Hepatotoxicity
3. Hyperglycemia
4. Peripheral neuropathy
5. Reduced bone mineral density - ANSWER1. Rash
2. Hepatotoxicity
Rationale:
Nevirapine (Viramune) is a non-nucleoside reverse transcriptase inhibitors (NRTI) that
is used to treat HIV infection. It is used in combination with other antiretroviral
medications to treat HIV. Adverse effects include rash, Stevens-Johnson syndrome,
hepatitis, and increased transaminase levels. Hyperglycemia, peripheral neuropathy,
and reduced bone density are not adverse effects of this medication.
103.) A nurse is caring for a hospitalized client who has been taking clozapine (Clozaril)
for the treatment of a schizophrenic disorder. Which laboratory study prescribed for the
client will the nurse specifically review to monitor for an adverse effect associated with
the use of this medication?
1. Platelet count
, 2. Cholesterol level
3. White blood cell count
4. Blood urea nitrogen level - ANSWER3. White blood cell count
Rationale:
Hematological reactions can occur in the client taking clozapine and include
agranulocytosis and mild leukopenia. The white blood cell count should be checked
before initiating treatment and should be monitored closely during the use of this
medication. The client should also be monitored for signs indicating agranulocytosis,
which may include sore throat, malaise, and fever. Options 1, 2, and 4 are unrelated to
this medication.
104.) Disulfiram (Antabuse) is prescribed for a client who is seen in the psychiatric
health care clinic. The nurse is collecting data on the client and is providing instructions
regarding the use of this medication. Which is most important for the nurse to determine
before administration of this medication?
1. A history of hyperthyroidism
2. A history of diabetes insipidus
3. When the last full meal was consumed
4. When the last alcoholic drink was consumed - ANSWER4. When the last alcoholic
drink was consumed
Rationale:
Disulfiram is used as an adjunct treatment for selected clients with chronic alcoholism
who want to remain in a state of enforced sobriety. Clients must abstain from alcohol
intake for at least 12 hours before the initial dose of the medication is administered. The
most important data are to determine when the last alcoholic drink was consumed. The
medication is used with caution in clients with diabetes mellitus, hypothyroidism,
epilepsy, cerebral damage, nephritis, and hepatic disease. It is also contraindicated in
severe heart disease, psychosis, or hypersensitivity related to the medication.
105.) A nurse is collecting data from a client and the client's spouse reports that the
client is taking donepezil hydrochloride (Aricept). Which disorder would the nurse
suspect that this client may have based on the use of this medication?
1. Dementia
2. Schizophrenia
3. Seizure disorder
4. Obsessive-compulsive disorder - ANSWER1. Dementia
Rationale:
Donepezil hydrochloride is a cholinergic agent used in the treatment of mild to moderate
dementia of the Alzheimer type. It enhances cholinergic functions by increasing the
concentration of acetylcholine. It slows the progression of Alzheimer's disease. Options
2, 3, and 4 are incorrect.
106.) Fluoxetine (Prozac) is prescribed for the client. The nurse reinforces instructions
to the client regarding the administration of the medication. Which statement by the
client indicates an understanding about administration of the medication?
1. "I should take the medication with my evening meal."
, 2. "I should take the medication at noon with an antacid."
3. "I should take the medication in the morning when I first arise."
4. "I should take the medication right before bedtime with a snack." - ANSWER3. "I
should take the medication in the morning when I first arise."
Rationale:
Fluoxetine hydrochloride is administered in the early morning without consideration to
meals.
**Eliminate options 1, 2, and 4 because they are comparable or alike and indicate taking
the medication with an antacid or food.**
107.) A client receiving a tricyclic antidepressant arrives at the mental health clinic.
Which observation indicates that the client is correctly following the medication plan?
1. Reports not going to work for this past week
2. Complains of not being able to "do anything" anymore
3. Arrives at the clinic neat and appropriate in appearance
4. Reports sleeping 12 hours per night and 3 to 4 hours during the day - ANSWER3.
Arrives at the clinic neat and appropriate in appearance
Rationale:
Depressed individuals will sleep for long periods, are not able to go to work, and feel as
if they cannot "do anything." Once they have had some therapeutic effect from their
medication, they will report resolution of many of these complaints as well as
demonstrate an improvement in their appearance.
108.) A nurse is performing a follow-up teaching session with a client discharged 1
month ago who is taking fluoxetine (Prozac). What information would be important for
the nurse to gather regarding the adverse effects related to the medication?
1. Cardiovascular symptoms
2. Gastrointestinal dysfunctions
3. Problems with mouth dryness
4. Problems with excessive sweating - ANSWER2. Gastrointestinal dysfunctions
Rationale:
The most common adverse effects related to fluoxetine include central nervous system
(CNS) and gastrointestinal (GI) system dysfunction. This medication affects the GI
system by causing nausea and vomiting, cramping, and diarrhea. Options 1, 3, and 4
are not adverse effects of this medication.
109.) A client taking buspirone (BuSpar) for 1 month returns to the clinic for a follow-up
visit. Which of the following would indicate medication effectiveness?
1. No rapid heartbeats or anxiety
2. No paranoid thought processes
3. No thought broadcasting or delusions
4. No reports of alcohol withdrawal symptoms - ANSWER1. No rapid heartbeats or
anxiety
Rationale:
Buspirone hydrochloride is not recommended for the treatment of drug or alcohol
withdrawal, paranoid thought disorders, or schizophrenia (thought broadcasting or
EXAM 2023 ACTUAL EXAM COMPLETE 300
QUESTIONS WITH DETAILED VERIFIED ANSWERS
AND RATIONALES (100% CORRECT ANSWERS)
/ALREADY GRADED A+
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 - ANSWER3. 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.
The clinic nurse is performing an admission assessment on a client. The nurse notes
that the client is taking azelaic acid (Azelex). Because of the medication prescription,
the nurse would suspect that the client is being treated for:
1. Acne
2. Eczema
3. Hair loss
4. Herpes simplex - ANSWER1. Acne
Rationale:
Azelaic acid is a topical medication used to treat mild to moderate acne. The acid
appears to work by suppressing the growth of Propionibacterium acnes and decreasing
the proliferation of keratinocytes. Options 2, 3, and 4 are incorrect.
Saquinavir (Invirase) is prescribed for the client who is human immunodeficiency virus
seropositive. The nurse reinforces medication instructions and tells the client to:
1. Avoid sun exposure.
2. Eat low-calorie foods.
3. Eat foods that are low in fat.
4. Take the medication on an empty stomach. - ANSWER1. Avoid sun exposure.
Rationale:
,Saquinavir (Invirase) is an antiretroviral (protease inhibitor) used with other antiretroviral
medications to manage human immunodeficiency virus infection. Saquinavir is
administered with meals and is best absorbed if the client consumes high-calorie, high-
fat meals. Saquinavir can cause photosensitivity, and the nurse should instruct the client
to avoid sun exposure.
101.) Ketoconazole is prescribed for a client with a diagnosis of candidiasis. Select the
interventions that the nurse includes when administering this medication. Select all that
apply.
1. Restrict fluid intake.
2. Instruct the client to avoid alcohol.
3. Monitor hepatic and liver function studies.
4. Administer the medication with an antacid.
5. Instruct the client to avoid exposure to the sun.
6. Administer the medication on an empty stomach. - ANSWER2. Instruct the client to
avoid alcohol.
3. Monitor hepatic and liver function studies.
5. Instruct the client to avoid exposure to the sun.
Rationale:
Ketoconazole is an antifungal medication. It is administered with food (not on an empty
stomach) and antacids are avoided for 2 hours after taking the medication to ensure
absorption. The medication is hepatotoxic and the nurse monitors liver function studies.
The client is instructed to avoid exposure to the sun because the medication increases
photosensitivity. The client is also instructed to avoid alcohol. There is no reason for the
client to restrict fluid intake. In fact, this could be harmful to the client.
102.) A client with human immunodeficiency virus is taking nevirapine (Viramune). The
nurse should monitor for which adverse effects of the medication? Select all that apply.
1. Rash
2. Hepatotoxicity
3. Hyperglycemia
4. Peripheral neuropathy
5. Reduced bone mineral density - ANSWER1. Rash
2. Hepatotoxicity
Rationale:
Nevirapine (Viramune) is a non-nucleoside reverse transcriptase inhibitors (NRTI) that
is used to treat HIV infection. It is used in combination with other antiretroviral
medications to treat HIV. Adverse effects include rash, Stevens-Johnson syndrome,
hepatitis, and increased transaminase levels. Hyperglycemia, peripheral neuropathy,
and reduced bone density are not adverse effects of this medication.
103.) A nurse is caring for a hospitalized client who has been taking clozapine (Clozaril)
for the treatment of a schizophrenic disorder. Which laboratory study prescribed for the
client will the nurse specifically review to monitor for an adverse effect associated with
the use of this medication?
1. Platelet count
, 2. Cholesterol level
3. White blood cell count
4. Blood urea nitrogen level - ANSWER3. White blood cell count
Rationale:
Hematological reactions can occur in the client taking clozapine and include
agranulocytosis and mild leukopenia. The white blood cell count should be checked
before initiating treatment and should be monitored closely during the use of this
medication. The client should also be monitored for signs indicating agranulocytosis,
which may include sore throat, malaise, and fever. Options 1, 2, and 4 are unrelated to
this medication.
104.) Disulfiram (Antabuse) is prescribed for a client who is seen in the psychiatric
health care clinic. The nurse is collecting data on the client and is providing instructions
regarding the use of this medication. Which is most important for the nurse to determine
before administration of this medication?
1. A history of hyperthyroidism
2. A history of diabetes insipidus
3. When the last full meal was consumed
4. When the last alcoholic drink was consumed - ANSWER4. When the last alcoholic
drink was consumed
Rationale:
Disulfiram is used as an adjunct treatment for selected clients with chronic alcoholism
who want to remain in a state of enforced sobriety. Clients must abstain from alcohol
intake for at least 12 hours before the initial dose of the medication is administered. The
most important data are to determine when the last alcoholic drink was consumed. The
medication is used with caution in clients with diabetes mellitus, hypothyroidism,
epilepsy, cerebral damage, nephritis, and hepatic disease. It is also contraindicated in
severe heart disease, psychosis, or hypersensitivity related to the medication.
105.) A nurse is collecting data from a client and the client's spouse reports that the
client is taking donepezil hydrochloride (Aricept). Which disorder would the nurse
suspect that this client may have based on the use of this medication?
1. Dementia
2. Schizophrenia
3. Seizure disorder
4. Obsessive-compulsive disorder - ANSWER1. Dementia
Rationale:
Donepezil hydrochloride is a cholinergic agent used in the treatment of mild to moderate
dementia of the Alzheimer type. It enhances cholinergic functions by increasing the
concentration of acetylcholine. It slows the progression of Alzheimer's disease. Options
2, 3, and 4 are incorrect.
106.) Fluoxetine (Prozac) is prescribed for the client. The nurse reinforces instructions
to the client regarding the administration of the medication. Which statement by the
client indicates an understanding about administration of the medication?
1. "I should take the medication with my evening meal."
, 2. "I should take the medication at noon with an antacid."
3. "I should take the medication in the morning when I first arise."
4. "I should take the medication right before bedtime with a snack." - ANSWER3. "I
should take the medication in the morning when I first arise."
Rationale:
Fluoxetine hydrochloride is administered in the early morning without consideration to
meals.
**Eliminate options 1, 2, and 4 because they are comparable or alike and indicate taking
the medication with an antacid or food.**
107.) A client receiving a tricyclic antidepressant arrives at the mental health clinic.
Which observation indicates that the client is correctly following the medication plan?
1. Reports not going to work for this past week
2. Complains of not being able to "do anything" anymore
3. Arrives at the clinic neat and appropriate in appearance
4. Reports sleeping 12 hours per night and 3 to 4 hours during the day - ANSWER3.
Arrives at the clinic neat and appropriate in appearance
Rationale:
Depressed individuals will sleep for long periods, are not able to go to work, and feel as
if they cannot "do anything." Once they have had some therapeutic effect from their
medication, they will report resolution of many of these complaints as well as
demonstrate an improvement in their appearance.
108.) A nurse is performing a follow-up teaching session with a client discharged 1
month ago who is taking fluoxetine (Prozac). What information would be important for
the nurse to gather regarding the adverse effects related to the medication?
1. Cardiovascular symptoms
2. Gastrointestinal dysfunctions
3. Problems with mouth dryness
4. Problems with excessive sweating - ANSWER2. Gastrointestinal dysfunctions
Rationale:
The most common adverse effects related to fluoxetine include central nervous system
(CNS) and gastrointestinal (GI) system dysfunction. This medication affects the GI
system by causing nausea and vomiting, cramping, and diarrhea. Options 1, 3, and 4
are not adverse effects of this medication.
109.) A client taking buspirone (BuSpar) for 1 month returns to the clinic for a follow-up
visit. Which of the following would indicate medication effectiveness?
1. No rapid heartbeats or anxiety
2. No paranoid thought processes
3. No thought broadcasting or delusions
4. No reports of alcohol withdrawal symptoms - ANSWER1. No rapid heartbeats or
anxiety
Rationale:
Buspirone hydrochloride is not recommended for the treatment of drug or alcohol
withdrawal, paranoid thought disorders, or schizophrenia (thought broadcasting or
