Pharm HESI Exam Graded A 2025

1. A client is scheduled for a spinal computed tomography (CT scan with contrast to evaluate for pulmonary embolism. Which information in the client's history requires follow-up by the nurse? - Takes metformin hydrochloride for type 2 diabetes 2. A client recently diagnosed with multiple sclerosis who self administers beta-1a interferon reports feeling increasingly depressed. Which action should the nurse implement? - Notify the healthcare provider of the findings immediately 3. Before administering the initial dose of sumatriptan succinate to a client with a migraine headache, it is most important to determine if the client's history includes which problem? - Coronary Artery Disease 4. Before administering a laxative to a bedfast client, it is most important for the nurse to perform which assessment? - Determine the frequency and consistency of bowel movements 5. Hormone replacement therapy with levothyroxine sodium is prescribed for a client with hypothyroidism. The nurse should instruct the client which symptom because it indicates that the client is taking too much? - Restlessness 6. A male client reports to the nurse that he is experiencing gastrointestinal distress from a high dose of a corticosteroid and is planning to stop taking the medication. In response to the client's statement, which nursing action is most important for the nurse to implement? - Advise the client that the medication should be stopped gradually rather than abruptly 7. A client is receiving pilocarpine hydrochloride opthalmic drops for glaucoma. The client calls the clinic nurse and reports difficulty seeing at night. Which explanation should the nurse provide? - The eye drops slow pupil response to accommodate for darkness 8. A client is receiving rifampin, an antitubercular medication. Which statement by this client should prompt the nurse to notify the healthcare provider of a potential problem? - Complains of persistent tinnitus 9. Which action should the nurse implement to assess the effectiveness of the calcium channel blocker amlodipine - Measure the client's bp 10. A male client has been receiving the antibiotic gentamycin sulfate, IV piggyback every 12 hours for several days. Which observation by the nurse indicates that the client may be experiencing an adverse effect of gentamicin. - Hearing has decreased 11. An older adult client with restless leg syndrome begins taking melatonin at bedtime. When evaluating the effectiveness of the herb, which client assessment should the nurse complete? - Determine sleep patterns 12. The nurse prepares to administer a scheduled dose of labetalol by mouth to a client with hypertension. The client's vital signs are 99F, HR 48, RR 16, and BP 150/90. Which action should the nurse take? - Withhold the scheduled dose and notify the healthcare provider. 13. To evaluate the effectiveness of a client's prescription for rosuvastatin, which action should the nurse implement? - Obtain the client's heart rate and blood pressure 14. The nurse is planning discharge teaching for a client with diabetes mellitus who has a new prescription for insulin glargine. Which action should the nurse plan to include in the discharge teaching? - Teach the client self-injection skills for daily subQ administration 15. The nurse is caring for a client who takes methotrexate for rheumatoid arthritis and is now prescribed adalimumab. Which instructions should the nurse provide the client? - Have a chest x-ray prior to your first dose 16. The nurse is providing discharge instructions to a client who has been prescribed gabapentin 300 mg by mouth three times a day for post herpetic neuralgia. Which symptom should the nurse tell the client to report to the healthcare provider? - Gastric irritation 17. A client receives a prescription for itraconazole. Which information provided by the client requires additional instruction by the nurse? - Take the medication with antacids 18. The nurse is preparing a client with chronic obstructive pulmonary disease (COPD) and a chronic productive cough for discharged home. Which prescribed medication should the nurse review with the client to manage this symptom? - Guaifenesin 19. When caring for a client with diabetes insipidus, who is receiving an antidiuretic hormone intranasally, which serum lab test is most important for the nurse to monitor? - Osmolality 20. A client receiving tamsulosin, an alpha adrenergic blocking agent, for the management of urinary retention due to benign prostatic hyperplasia (BPH). Which instruction is most important for the nurse to provide? - Stand up and sit up slowly 21. A client with chemotherapy induced nausea receives a prescription for metoclopramide. Which adverse effect is most important for the nurse to report? - Involuntary movements 22. A client is receiving orlistat as part of a weight management program. Which ongoing assessment should be included in the plan of care to determine the effectiveness of the medication? - BMI 23. A client who received a renal transplant three months ago is readmitted to the acute care unit with signs of graft rejection. While taking the client's history, the nurse determines that the client has been self-administering St. John's Wort, an herbal preparation. Which info is significant about this finding? - Wort can decrease plasma concentrations of cyclosporine 24. When preparing to apply a scheduled fentanyl transdermal patch, the nurse notes that the previously applied patch is intact on the client's upper back and the client denies pain. Which action should the nurse take? - Apply the new patch in a different location after removing the original patch 25. During a home visit, the nurse assesses a client with Alzheimer's who recently started a new prescription for rivastigmine. The caregiver reports that the client seems to be thinking more clearly but is not sleeping well at night. Which action should the nurse take? - Explain to the caregiver that insomnia is a common and temporary side effect when the medication is first started 26. Based on a client's serum digoxin level, the client is diagnosed with digoxin toxicity. Which action should the nurse expect to implement? - Begin cardioversion to stabilize heart rhythm 27. The nurse is administering IV fluconazole to a client who has systemic candidiasis. After reviewing the client's diagnostic studies, the nurse identifies a rising trend in the liver enzyme for aspartate aminotransferase. Which action should the nurse implement?