HESI Pharmacology Specialty Exam
(2025/2026) – Verified Questions and
Correct Rationales | 100% Exam
Success Assured
Multiple-Choice Questions (1–30)
Question 1: A client taking atenolol for 2 years is switched to enalapril for blood pressure.
Which instruction should the nurse provide?
A) Take the medication at bedtime
B) Report increased bruising
C) Check pulse before taking medication
D) Rise slowly when getting out of bed or chair
Answer: D) Rise slowly when getting out of bed or chair
Rationale: Enalapril, an ACE inhibitor, causes vasodilation, which may lead to orthostatic
hypotension. Rising slowly prevents dizziness or fainting (,).
Question 2: A female client taking amoxicillin for 5 days reports vaginal itching and white
discharge. What should the nurse discuss?
A) Discontinue the antibiotic as symptoms have subsided
B) Continue medication until symptoms resolve
C) Consult the healthcare provider about treatment for this effect
D) Switch to a different antibiotic immediately
Answer: C) Consult the healthcare provider about treatment for this effect
Rationale: Vaginal itching and discharge suggest a yeast infection, a common side effect of
amoxicillin. The provider may prescribe antifungal treatment (,).
Question 3: A client with hyperparathyroidism has a serum calcium level of 13 mg/dL. Which
medication should the nurse prepare to administer?
A) Calcium chloride
B) Calcium gluconate
C) Calcitonin (Miacalcin)
D) Large doses of vitamin D
Answer: C) Calcitonin (Miacalcin)
Rationale: Hypercalcemia (normal: 8.6–10 mg/dL) is treated with calcitonin, which lowers
serum calcium by inhibiting bone resorption (,).
Question 4: A client with severe acne is prescribed isotretinoin. The nurse should contact the
provider if the client is also taking:
A) Digoxin
, B) Furosemide
C) Vitamin A
D) Phenytoin
Answer: C) Vitamin A
Rationale: Isotretinoin, a vitamin A metabolite, increases toxicity risk if taken with vitamin A
supplements (,).
Question 5: A client receives sublingual nitroglycerin for an acute anginal attack. Which finding
indicates the desired effect?
A) Pulse decreases from 120 to 90
B) Chest pain is relieved
C) Systolic blood pressure decreases from 180 to 90
D) SaO2 increases from 92% to 96%
Answer: B) Chest pain is relieved
Rationale: Nitroglycerin reduces myocardial oxygen demand, relieving angina. Chest pain relief
is the primary indicator (,).
Question 6: A client taking oral iron supplements for anemia should be instructed to take the
medication with:
A) Milk
B) Water
C) Apple juice
D) Orange juice
Answer: D) Orange juice
Rationale: Vitamin C in orange juice enhances iron absorption. Milk may reduce absorption (,).
Question 7: A client receiving mafenide acetate (Sulfamylon) for burns is monitored for which
systemic effect?
A) Hyperventilation
B) Elevated blood pressure
C) Local pain at the burn site
D) Local rash at the burn site
Answer: A) Hyperventilation
Rationale: Mafenide, a carbonic anhydrase inhibitor, can cause acidosis, leading to
compensatory hyperventilation (,).
Question 8: A client with a cold is prescribed a decongestant. What is the rationale for this
medication?
A) Reduces nasal inflammation by vasoconstriction
B) Neutralizes gastric acid
C) Prevents bacterial growth
D) Promotes expectoration
Answer: A) Reduces nasal inflammation by vasoconstriction
Rationale: Decongestants constrict blood vessels in nasal passages, reducing congestion (,).
(2025/2026) – Verified Questions and
Correct Rationales | 100% Exam
Success Assured
Multiple-Choice Questions (1–30)
Question 1: A client taking atenolol for 2 years is switched to enalapril for blood pressure.
Which instruction should the nurse provide?
A) Take the medication at bedtime
B) Report increased bruising
C) Check pulse before taking medication
D) Rise slowly when getting out of bed or chair
Answer: D) Rise slowly when getting out of bed or chair
Rationale: Enalapril, an ACE inhibitor, causes vasodilation, which may lead to orthostatic
hypotension. Rising slowly prevents dizziness or fainting (,).
Question 2: A female client taking amoxicillin for 5 days reports vaginal itching and white
discharge. What should the nurse discuss?
A) Discontinue the antibiotic as symptoms have subsided
B) Continue medication until symptoms resolve
C) Consult the healthcare provider about treatment for this effect
D) Switch to a different antibiotic immediately
Answer: C) Consult the healthcare provider about treatment for this effect
Rationale: Vaginal itching and discharge suggest a yeast infection, a common side effect of
amoxicillin. The provider may prescribe antifungal treatment (,).
Question 3: A client with hyperparathyroidism has a serum calcium level of 13 mg/dL. Which
medication should the nurse prepare to administer?
A) Calcium chloride
B) Calcium gluconate
C) Calcitonin (Miacalcin)
D) Large doses of vitamin D
Answer: C) Calcitonin (Miacalcin)
Rationale: Hypercalcemia (normal: 8.6–10 mg/dL) is treated with calcitonin, which lowers
serum calcium by inhibiting bone resorption (,).
Question 4: A client with severe acne is prescribed isotretinoin. The nurse should contact the
provider if the client is also taking:
A) Digoxin
, B) Furosemide
C) Vitamin A
D) Phenytoin
Answer: C) Vitamin A
Rationale: Isotretinoin, a vitamin A metabolite, increases toxicity risk if taken with vitamin A
supplements (,).
Question 5: A client receives sublingual nitroglycerin for an acute anginal attack. Which finding
indicates the desired effect?
A) Pulse decreases from 120 to 90
B) Chest pain is relieved
C) Systolic blood pressure decreases from 180 to 90
D) SaO2 increases from 92% to 96%
Answer: B) Chest pain is relieved
Rationale: Nitroglycerin reduces myocardial oxygen demand, relieving angina. Chest pain relief
is the primary indicator (,).
Question 6: A client taking oral iron supplements for anemia should be instructed to take the
medication with:
A) Milk
B) Water
C) Apple juice
D) Orange juice
Answer: D) Orange juice
Rationale: Vitamin C in orange juice enhances iron absorption. Milk may reduce absorption (,).
Question 7: A client receiving mafenide acetate (Sulfamylon) for burns is monitored for which
systemic effect?
A) Hyperventilation
B) Elevated blood pressure
C) Local pain at the burn site
D) Local rash at the burn site
Answer: A) Hyperventilation
Rationale: Mafenide, a carbonic anhydrase inhibitor, can cause acidosis, leading to
compensatory hyperventilation (,).
Question 8: A client with a cold is prescribed a decongestant. What is the rationale for this
medication?
A) Reduces nasal inflammation by vasoconstriction
B) Neutralizes gastric acid
C) Prevents bacterial growth
D) Promotes expectoration
Answer: A) Reduces nasal inflammation by vasoconstriction
Rationale: Decongestants constrict blood vessels in nasal passages, reducing congestion (,).
