1
HESI Pharmacology Evolve Exam B Questions
and Answers (2025-2026) (Verified Answers by
ExpertS PERSONALLY HANDPICKED) ACTUAL
QUESTIONS AND ANSWERS WITH DETAILED
RATIONALES GRADED A+ GUARANTEED PASS
BRAND
While taking a nursing history, the client states, "I am allergic to penicillin." What related allergy to another type
of anti-infective agent should the nurse ask the client about when taking the nursing history?
Aminoglycosides
Cephalosporins
Sulfonamides
Tetracyclines
- ANS :Cephalosporins.
If a client has a history of being allergic to penicillin (PCN); there is appears to be a cross sensitivity between
penicillins and 1st generation cephalosporins. According to research, there appears to be no cross sensitivity
between PCN and 3rd or 4th generation cephalosporins.
Dobutamine (Dobutrex) is an emergency drug most commonly prescribed for a client with which condition?
Shock
Asthma
1|Page
, 2
Hypotension
Heart failure –
ANS :Heart failure
Dobutamine is a beta-1 adrenergic agonist that is indicated for short term use in cardiac decompensation or
heart failure related to reduced cardiac contractility due to organic heart disease or cardiac surgical procedures.
On the other hand, alpha and beta adrenergic agonists, such as epinephrine and dopamine, are
sympathomimetics used in the treatment of shock. Other selective beta-2 adrenergic agonists, such as
terbutaline and isoproterenol, are indicated in the treatment of asthma. Although dobutamine improves cardiac
output, it is not used to treat hypotension.
The nurse is reviewing the use of the patient-controlled analgesia (PCA) pump with a client in the immediate
postoperative period. The client will receive morphine 1 mg IV per hour basal rate with 1 mg IV every 15 minutes
per PCA to total 5 mg IV maximally per hour. What assessment has the highest priority before initiating the PCA
pump?
The expiration date on the morphine syringe in the pump
The rate and depth of the client's respirations
The type of anesthesia used during the surgical proedure
The client's subjective and objective signs of pain
- ANS :The rate and depth of the client's respirations
A life-threatening side effect of intravenous administration of morphine sulfate, an opiate narcotic, is respiratory
depression. Prior to the initiation of the PCA pump, the nurse should assess the client's respirations to obtain a
baseline of their respiratory rate and depth. Once the PCA pump is initiated and if the client's respiratory rate
falls below 12 breaths per minute, the PCA pump should be stopped and the healthcare provider notified
immediately.
2|Page
, 3
A client has myxedema, which results from a deficiency of thyroid hormone synthesis in adults. The nurse knows
that which medication would be contraindicated for this client?
Liothyronine (Cytomel) to replace iodine
Furosemide (Lasix) for relief of fluid retention
Pentobarbital sodium (Nembutal Sodium) for sleep
Nitroglycerin (Nitrostat) for angina pain –
ANS :Pentobarbital sodium (Nembutal Sodium) for sleep
Persons with myxedema are dangerously hypersensitive to narcotics, barbiturates and anesthetics.
The nurse is transcribing a new prescription for spironolactone (Aldactone) for a client who receives an
angiotensin-converting enzyme (ACE) inhibitor. Which action should the nurse implement?
Verify both prescriptions with the healthcare provider
Report the medication interactions to the nurse manager
Hold the ACE inhibitor and give the new prescription
Transcribe and send the prescription to the pharmacy –
ANS :Verify both prescriptions with the healthcare provider
The concomitant use of an angiotensin-converting enzyme (ACE) inhibitor and a potassium-sparing diuretic such
as spironolactone, should be given with caution because the two drugs may interact to cause an elevation in
serum potassium levels. Although the client is currently receiving an ACE inhibitor, verifying both prescriptions
alerts the healthcare provider about the client's medication regimen and provides the safest action before
administering the medication.
Which method of medication administration provides the client with the greatest first-pass effect?
3|Page
, 4
Oral
Sublingual
Intravenous
Subcutaneous –
ANS :Oral
The first-pass effect is a pharmacokinetic phenomenon that is related to the drug's metabolism in the liver. After
oral medications are absorbed from the gastrointestinal tract, the drug is carried directly to the liver via the
hepatic portal circulation where hepatic inactivation occurs and reduces the bioavailability of the drug.
Alternative method of administration, such as sublingual, IV, and subcutaneous routes, avoid this first-pass
effect.
Which dosing schedule should the nurse teach the client to observe for a controlled-release oxycodone
prescription?
As needed
Every 12 hours
Every 24 hours
Every 4 to 6 hours
- ANS :Every 12 hours
A client who has been taking levodopa PO TID to control the symptoms of Parkinson's disease has a new
prescription for sustained release levodopa/carbidopa (Sinemet 25/100) PO BID. The client took his levodopa at
0800. Which instruction should the nurse include in the teaching plan for this client?
"Take the first dose of Sinemet today, as soon as your prescription is filled."
4|Page
HESI Pharmacology Evolve Exam B Questions
and Answers (2025-2026) (Verified Answers by
ExpertS PERSONALLY HANDPICKED) ACTUAL
QUESTIONS AND ANSWERS WITH DETAILED
RATIONALES GRADED A+ GUARANTEED PASS
BRAND
While taking a nursing history, the client states, "I am allergic to penicillin." What related allergy to another type
of anti-infective agent should the nurse ask the client about when taking the nursing history?
Aminoglycosides
Cephalosporins
Sulfonamides
Tetracyclines
- ANS :Cephalosporins.
If a client has a history of being allergic to penicillin (PCN); there is appears to be a cross sensitivity between
penicillins and 1st generation cephalosporins. According to research, there appears to be no cross sensitivity
between PCN and 3rd or 4th generation cephalosporins.
Dobutamine (Dobutrex) is an emergency drug most commonly prescribed for a client with which condition?
Shock
Asthma
1|Page
, 2
Hypotension
Heart failure –
ANS :Heart failure
Dobutamine is a beta-1 adrenergic agonist that is indicated for short term use in cardiac decompensation or
heart failure related to reduced cardiac contractility due to organic heart disease or cardiac surgical procedures.
On the other hand, alpha and beta adrenergic agonists, such as epinephrine and dopamine, are
sympathomimetics used in the treatment of shock. Other selective beta-2 adrenergic agonists, such as
terbutaline and isoproterenol, are indicated in the treatment of asthma. Although dobutamine improves cardiac
output, it is not used to treat hypotension.
The nurse is reviewing the use of the patient-controlled analgesia (PCA) pump with a client in the immediate
postoperative period. The client will receive morphine 1 mg IV per hour basal rate with 1 mg IV every 15 minutes
per PCA to total 5 mg IV maximally per hour. What assessment has the highest priority before initiating the PCA
pump?
The expiration date on the morphine syringe in the pump
The rate and depth of the client's respirations
The type of anesthesia used during the surgical proedure
The client's subjective and objective signs of pain
- ANS :The rate and depth of the client's respirations
A life-threatening side effect of intravenous administration of morphine sulfate, an opiate narcotic, is respiratory
depression. Prior to the initiation of the PCA pump, the nurse should assess the client's respirations to obtain a
baseline of their respiratory rate and depth. Once the PCA pump is initiated and if the client's respiratory rate
falls below 12 breaths per minute, the PCA pump should be stopped and the healthcare provider notified
immediately.
2|Page
, 3
A client has myxedema, which results from a deficiency of thyroid hormone synthesis in adults. The nurse knows
that which medication would be contraindicated for this client?
Liothyronine (Cytomel) to replace iodine
Furosemide (Lasix) for relief of fluid retention
Pentobarbital sodium (Nembutal Sodium) for sleep
Nitroglycerin (Nitrostat) for angina pain –
ANS :Pentobarbital sodium (Nembutal Sodium) for sleep
Persons with myxedema are dangerously hypersensitive to narcotics, barbiturates and anesthetics.
The nurse is transcribing a new prescription for spironolactone (Aldactone) for a client who receives an
angiotensin-converting enzyme (ACE) inhibitor. Which action should the nurse implement?
Verify both prescriptions with the healthcare provider
Report the medication interactions to the nurse manager
Hold the ACE inhibitor and give the new prescription
Transcribe and send the prescription to the pharmacy –
ANS :Verify both prescriptions with the healthcare provider
The concomitant use of an angiotensin-converting enzyme (ACE) inhibitor and a potassium-sparing diuretic such
as spironolactone, should be given with caution because the two drugs may interact to cause an elevation in
serum potassium levels. Although the client is currently receiving an ACE inhibitor, verifying both prescriptions
alerts the healthcare provider about the client's medication regimen and provides the safest action before
administering the medication.
Which method of medication administration provides the client with the greatest first-pass effect?
3|Page
, 4
Oral
Sublingual
Intravenous
Subcutaneous –
ANS :Oral
The first-pass effect is a pharmacokinetic phenomenon that is related to the drug's metabolism in the liver. After
oral medications are absorbed from the gastrointestinal tract, the drug is carried directly to the liver via the
hepatic portal circulation where hepatic inactivation occurs and reduces the bioavailability of the drug.
Alternative method of administration, such as sublingual, IV, and subcutaneous routes, avoid this first-pass
effect.
Which dosing schedule should the nurse teach the client to observe for a controlled-release oxycodone
prescription?
As needed
Every 12 hours
Every 24 hours
Every 4 to 6 hours
- ANS :Every 12 hours
A client who has been taking levodopa PO TID to control the symptoms of Parkinson's disease has a new
prescription for sustained release levodopa/carbidopa (Sinemet 25/100) PO BID. The client took his levodopa at
0800. Which instruction should the nurse include in the teaching plan for this client?
"Take the first dose of Sinemet today, as soon as your prescription is filled."
4|Page
