2025 HESI Pharmacology Exam Study Guide –
Comprehensive Review with 50 Expert-Verified
Questions, Drug Classifications, and High-Yield
Nursing Concepts for Guaranteed Success
A client is to begin a 6-month course of therapy with isoniazid (INH). A nurse plans to
teach the client to:
1. Drink alcohol in small amounts only.
2. Report yellow eyes or skin immediately.
3. Increase intake of Swiss or aged cheeses. 4. Avoid vitamin supplements during
therapy. - - correct ans- -2. Report yellow eyes or skin immediately.
Rationale:
INH is hepatotoxic, and therefore the client is taught to report signs and symptoms of
hepatitis immediately (which include yellow skin and sclera). For the same reason,
alcohol should be avoided during therapy. The client should avoid intake of Swiss
cheese, fish such as tuna, and foods containing tyramine because they may cause a
reaction characterized by redness and itching of the skin, flushing, sweating,
tachycardia, headache, or lightheadedness. The client can avoid developing peripheral
neuritis by increasing the intake of pyridoxine (vitamin B6) during the course of INH
therapy for TB.
A client has been started on long-term therapy with rifampin (Rifadin). A nurse teaches
the client that the medication:
1. Should always be taken with food or antacids
2. Should be double-dosed if one dose is forgotten
3. Causes orange discoloration of sweat, tears, urine, and feces
4. May be discontinued independently if symptoms are gone in 3 months - - correct ans-
-3. Causes orange discoloration of sweat, tears, urine, and feces
,Rationale:
Rifampin should be taken exactly as directed as part of TB therapy. Doses should not be
doubled or skipped. The client should not stop therapy until directed to do so by a
health care provider. The medication should be administered on an empty stomach
unless it causes gastrointestinal upset, and then it may be taken with food. Antacids, if
prescribed, should be taken at least 1 hour before the medication. Rifampin causes
orange-red discoloration of body secretions and will permanently stain soft contact
lenses.
A nurse has given a client taking ethambutol (Myambutol) information about the
medication. The nurse determines that the client understands the instructions if the
client states that he or she will immediately report:
1. Impaired sense of hearing
2. Problems with visual acuity
3. Gastrointestinal (GI) side effects
4. Orange-red discoloration of body secretions - - correct ans- -2. Problems with visual
acuity
Rationale:
Ethambutol causes optic neuritis, which decreases visual acuity and the ability to
discriminate between the colors red and green. This poses a potential safety hazard
when a client is driving a motor vehicle. The client is taught to report this symptom
immediately. The client is also taught to take the medication with food if GI upset
occurs. Impaired hearing results from antitubercular therapy with streptomycin.
Orange-red discoloration of secretions occurs with rifampin (Rifadin).
Cycloserine (Seromycin) is added to the medication regimen for a client with
tuberculosis. Which of the following would the nurse include in the client-teaching plan
regarding this medication?1
. To take the medication before meals
2. To return to the clinic weekly for serum drug-level testing
3. It is not necessary to call the health care provider (HCP) if a skin rash occurs.
, 4. It is not necessary to restrict alcohol intake with this medication. - - correct ans- -2.
To return to the clinic weekly for serum drug-level testing
Rationale:
Cycloserine (Seromycin) is an antitubercular medication that requires weekly serum
drug level determinations to monitor for the potential of neurotoxicity. Serum drug levels
lower than 30 mcg/mL reduce the incidence of neurotoxicity. The medication must be
taken after meals to prevent gastrointestinal irritation. The client must be instructed to
notify the HCP if a skin rash or signs of central nervous system toxicity are noted.
Alcohol must be avoided because it increases the risk of seizure activity.
A client with tuberculosis is being started on antituberculosis therapy with isoniazid
(INH). Before giving the client the first dose, a nurse ensures that which of the following
baseline studies has been completed?
1. Electrolyte levels
2. Coagulation times
3. Liver enzyme levels
4. Serum creatinine level - - correct ans- -3. Liver enzyme levels
Rationale:
INH therapy can cause an elevation of hepatic enzyme levels and hepatitis. Therefore,
liver enzyme levels are monitored when therapy is initiated and during the first 3 months
of therapy. They may be monitored longer in the client who is greater than age 50 or
abuses alcohol.
Rifabutin (Mycobutin) is prescribed for a client with active Mycobacterium avium
complex (MAC) disease and tuberculosis. The nurse monitors for which side effects of
the medication? Select all that apply.
1. Signs of hepatitis
2. Flu-like syndrome
3. Low neutrophil count
4. Vitamin B6 deficiency
Comprehensive Review with 50 Expert-Verified
Questions, Drug Classifications, and High-Yield
Nursing Concepts for Guaranteed Success
A client is to begin a 6-month course of therapy with isoniazid (INH). A nurse plans to
teach the client to:
1. Drink alcohol in small amounts only.
2. Report yellow eyes or skin immediately.
3. Increase intake of Swiss or aged cheeses. 4. Avoid vitamin supplements during
therapy. - - correct ans- -2. Report yellow eyes or skin immediately.
Rationale:
INH is hepatotoxic, and therefore the client is taught to report signs and symptoms of
hepatitis immediately (which include yellow skin and sclera). For the same reason,
alcohol should be avoided during therapy. The client should avoid intake of Swiss
cheese, fish such as tuna, and foods containing tyramine because they may cause a
reaction characterized by redness and itching of the skin, flushing, sweating,
tachycardia, headache, or lightheadedness. The client can avoid developing peripheral
neuritis by increasing the intake of pyridoxine (vitamin B6) during the course of INH
therapy for TB.
A client has been started on long-term therapy with rifampin (Rifadin). A nurse teaches
the client that the medication:
1. Should always be taken with food or antacids
2. Should be double-dosed if one dose is forgotten
3. Causes orange discoloration of sweat, tears, urine, and feces
4. May be discontinued independently if symptoms are gone in 3 months - - correct ans-
-3. Causes orange discoloration of sweat, tears, urine, and feces
,Rationale:
Rifampin should be taken exactly as directed as part of TB therapy. Doses should not be
doubled or skipped. The client should not stop therapy until directed to do so by a
health care provider. The medication should be administered on an empty stomach
unless it causes gastrointestinal upset, and then it may be taken with food. Antacids, if
prescribed, should be taken at least 1 hour before the medication. Rifampin causes
orange-red discoloration of body secretions and will permanently stain soft contact
lenses.
A nurse has given a client taking ethambutol (Myambutol) information about the
medication. The nurse determines that the client understands the instructions if the
client states that he or she will immediately report:
1. Impaired sense of hearing
2. Problems with visual acuity
3. Gastrointestinal (GI) side effects
4. Orange-red discoloration of body secretions - - correct ans- -2. Problems with visual
acuity
Rationale:
Ethambutol causes optic neuritis, which decreases visual acuity and the ability to
discriminate between the colors red and green. This poses a potential safety hazard
when a client is driving a motor vehicle. The client is taught to report this symptom
immediately. The client is also taught to take the medication with food if GI upset
occurs. Impaired hearing results from antitubercular therapy with streptomycin.
Orange-red discoloration of secretions occurs with rifampin (Rifadin).
Cycloserine (Seromycin) is added to the medication regimen for a client with
tuberculosis. Which of the following would the nurse include in the client-teaching plan
regarding this medication?1
. To take the medication before meals
2. To return to the clinic weekly for serum drug-level testing
3. It is not necessary to call the health care provider (HCP) if a skin rash occurs.
, 4. It is not necessary to restrict alcohol intake with this medication. - - correct ans- -2.
To return to the clinic weekly for serum drug-level testing
Rationale:
Cycloserine (Seromycin) is an antitubercular medication that requires weekly serum
drug level determinations to monitor for the potential of neurotoxicity. Serum drug levels
lower than 30 mcg/mL reduce the incidence of neurotoxicity. The medication must be
taken after meals to prevent gastrointestinal irritation. The client must be instructed to
notify the HCP if a skin rash or signs of central nervous system toxicity are noted.
Alcohol must be avoided because it increases the risk of seizure activity.
A client with tuberculosis is being started on antituberculosis therapy with isoniazid
(INH). Before giving the client the first dose, a nurse ensures that which of the following
baseline studies has been completed?
1. Electrolyte levels
2. Coagulation times
3. Liver enzyme levels
4. Serum creatinine level - - correct ans- -3. Liver enzyme levels
Rationale:
INH therapy can cause an elevation of hepatic enzyme levels and hepatitis. Therefore,
liver enzyme levels are monitored when therapy is initiated and during the first 3 months
of therapy. They may be monitored longer in the client who is greater than age 50 or
abuses alcohol.
Rifabutin (Mycobutin) is prescribed for a client with active Mycobacterium avium
complex (MAC) disease and tuberculosis. The nurse monitors for which side effects of
the medication? Select all that apply.
1. Signs of hepatitis
2. Flu-like syndrome
3. Low neutrophil count
4. Vitamin B6 deficiency
