NGN HESI PHARMACOLOGY REAL LATEST EXAM
WITH ALL 350 QUESTIONS AND CORRECT
ANSWERS / HESI PHARMACOLOGY REAL EXAM
WITH NGN 2025/2026 GRADED A+ (BRAND
NEW!!)
1) 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 - CORRECT ANSWER-3. 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.
2.) Oral iron supplements are prescribed for a 6-year-old child with iron deficiency anemia. The
nurse instructs the mother to administer the iron with which best food item?
1. Milk
2. Water
3. Apple juice
4. Orange juice - CORRECT ANSWER-4. Orange juice
Rationale:
Vitamin C increases the absorption of iron by the body. The mother should be instructed to
administer the medication with a citrus fruit or a juice that is high in vitamin C. Milk may affect
absorption of the iron. Water will not assist in absorption. Orange juice contains a greater amount of
vitamin C than apple juice.
,3.) Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse monitors the client,
knowing that which of the following would indicate the presence of systemic toxicity from this
medication?
1. Tinnitus
2. Diarrhea
3. Constipation
4. Decreased respirations - CORRECT ANSWER-1. Tinnitus
Rationale:
Salicylic acid is absorbed readily through the skin, and systemic toxicity (salicylism) can result.
Symptoms include tinnitus, dizziness, hyperpnea, and psychological disturbances. Constipation and
diarrhea are not associated with salicylism.
4.) The camp nurse asks the children preparing to swim in the lake if they have applied sunscreen.
The nurse reminds the children that chemical sunscreens are most effective when applied:
1. Immediately before swimming
2. 15 minutes before exposure to the sun
3. Immediately before exposure to the sun
4. At least 30 minutes before exposure to the sun - CORRECT ANSWER-4. At least 30 minutes before
exposure to the sun
Rationale:
Sunscreens are most effective when applied at least 30 minutes before exposure to the sun so that
they can penetrate the skin. All sunscreens should be reapplied after swimming or sweating.
5.) Mafenide acetate (Sulfamylon) is prescribed for the client with a burn injury. When applying the
medication, the client complains of local discomfort and burning. Which of the following is the most
appropriate nursing action?
1. Notifying the registered nurse
2. Discontinuing the medication
3. Informing the client that this is normal
4. Applying a thinner film than prescribed to the burn site - CORRECT ANSWER-3. Informing the
client that this is normal
Rationale:
Mafenide acetate is bacteriostatic for gram-negative and gram-positive organisms and is used to
treat burns to reduce bacteria present in avascular tissues. The client should be informed that the
medication will cause local discomfort and burning and that this is a normal reaction; therefore
options 1, 2, and 4 are incorrect
,6.) The burn client is receiving treatments of topical mafenide acetate (Sulfamylon) to the site of
injury. The nurse monitors the client, knowing that which of the following indicates that a systemic
effect has occurred?
1.Hyperventilation
2.Elevated blood pressure
3.Local pain at the burn site
4.Local rash at the burn site - CORRECT ANSWER-1.Hyperventilation
Rationale:
Mafenide acetate is a carbonic anhydrase inhibitor and can suppress renal excretion of acid, thereby
causing acidosis. Clients receiving this treatment should be monitored for signs of an acid-base
imbalance (hyperventilation). If this occurs, the medication should be discontinued for 1 to 2 days.
Options 3 and 4 describe local rather than systemic effects. An elevated blood pressure may be
expected from the pain that occurs with a burn injury.
7.) Isotretinoin is prescribed for a client with severe acne. Before the administration of this
medication, the nurse anticipates that which laboratory test will be prescribed?
1. Platelet count
2. Triglyceride level
3. Complete blood count
4. White blood cell count - CORRECT ANSWER-2. Triglyceride level
Rationale:
Isotretinoin can elevate triglyceride levels. Blood triglyceride levels should be measured before
treatment and periodically thereafter until the effect on the triglycerides has been evaluated.
Options 1, 3, and 4 do not need to be monitored specifically during this treatment.
8.) A client with severe acne is seen in the clinic and the health care provider (HCP) prescribes
isotretinoin. The nurse reviews the client's medication record and would contact the (HCP) if the
client is taking which medication?
1. Vitamin A
2. Digoxin (Lanoxin)
3. Furosemide (Lasix)
4. Phenytoin (Dilantin) - CORRECT ANSWER-1. Vitamin A
Rationale:
, Isotretinoin is a metabolite of vitamin A and can produce generalized intensification of isotretinoin
toxicity. Because of the potential for increased toxicity, vitamin A supplements should be
discontinued before isotretinoin therapy. Options 2, 3, and 4 are not contraindicated with the use of
isotretinoin.
9.) The nurse is applying a topical corticosteroid to a client with eczema. The nurse would monitor
for the potential for increased systemic absorption of the medication if the medication were being
applied to which of the following body areas?
1. Back
2. Axilla
3. Soles of the feet
4. Palms of the hands - CORRECT ANSWER-2. Axilla
Rationale:
Topical corticosteroids can be absorbed into the systemic circulation. Absorption is higher from
regions where the skin is especially permeable (scalp, axilla, face, eyelids, neck, perineum, genitalia),
and lower from regions in which permeability is poor (back, palms, soles).
10.) 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 - CORRECT ANSWER-1. 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.
11.) The health care provider has prescribed silver sulfadiazine (Silvadene) for the client with a
partial-thickness burn, which has cultured positive for gram-negative bacteria. The nurse is
reinforcing information to the client about the medication. Which statement made by the client
indicates a lack of understanding about the treatments?
1. "The medication is an antibacterial."
2. "The medication will help heal the burn."
3. "The medication will permanently stain my skin."
WITH ALL 350 QUESTIONS AND CORRECT
ANSWERS / HESI PHARMACOLOGY REAL EXAM
WITH NGN 2025/2026 GRADED A+ (BRAND
NEW!!)
1) 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 - CORRECT ANSWER-3. 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.
2.) Oral iron supplements are prescribed for a 6-year-old child with iron deficiency anemia. The
nurse instructs the mother to administer the iron with which best food item?
1. Milk
2. Water
3. Apple juice
4. Orange juice - CORRECT ANSWER-4. Orange juice
Rationale:
Vitamin C increases the absorption of iron by the body. The mother should be instructed to
administer the medication with a citrus fruit or a juice that is high in vitamin C. Milk may affect
absorption of the iron. Water will not assist in absorption. Orange juice contains a greater amount of
vitamin C than apple juice.
,3.) Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse monitors the client,
knowing that which of the following would indicate the presence of systemic toxicity from this
medication?
1. Tinnitus
2. Diarrhea
3. Constipation
4. Decreased respirations - CORRECT ANSWER-1. Tinnitus
Rationale:
Salicylic acid is absorbed readily through the skin, and systemic toxicity (salicylism) can result.
Symptoms include tinnitus, dizziness, hyperpnea, and psychological disturbances. Constipation and
diarrhea are not associated with salicylism.
4.) The camp nurse asks the children preparing to swim in the lake if they have applied sunscreen.
The nurse reminds the children that chemical sunscreens are most effective when applied:
1. Immediately before swimming
2. 15 minutes before exposure to the sun
3. Immediately before exposure to the sun
4. At least 30 minutes before exposure to the sun - CORRECT ANSWER-4. At least 30 minutes before
exposure to the sun
Rationale:
Sunscreens are most effective when applied at least 30 minutes before exposure to the sun so that
they can penetrate the skin. All sunscreens should be reapplied after swimming or sweating.
5.) Mafenide acetate (Sulfamylon) is prescribed for the client with a burn injury. When applying the
medication, the client complains of local discomfort and burning. Which of the following is the most
appropriate nursing action?
1. Notifying the registered nurse
2. Discontinuing the medication
3. Informing the client that this is normal
4. Applying a thinner film than prescribed to the burn site - CORRECT ANSWER-3. Informing the
client that this is normal
Rationale:
Mafenide acetate is bacteriostatic for gram-negative and gram-positive organisms and is used to
treat burns to reduce bacteria present in avascular tissues. The client should be informed that the
medication will cause local discomfort and burning and that this is a normal reaction; therefore
options 1, 2, and 4 are incorrect
,6.) The burn client is receiving treatments of topical mafenide acetate (Sulfamylon) to the site of
injury. The nurse monitors the client, knowing that which of the following indicates that a systemic
effect has occurred?
1.Hyperventilation
2.Elevated blood pressure
3.Local pain at the burn site
4.Local rash at the burn site - CORRECT ANSWER-1.Hyperventilation
Rationale:
Mafenide acetate is a carbonic anhydrase inhibitor and can suppress renal excretion of acid, thereby
causing acidosis. Clients receiving this treatment should be monitored for signs of an acid-base
imbalance (hyperventilation). If this occurs, the medication should be discontinued for 1 to 2 days.
Options 3 and 4 describe local rather than systemic effects. An elevated blood pressure may be
expected from the pain that occurs with a burn injury.
7.) Isotretinoin is prescribed for a client with severe acne. Before the administration of this
medication, the nurse anticipates that which laboratory test will be prescribed?
1. Platelet count
2. Triglyceride level
3. Complete blood count
4. White blood cell count - CORRECT ANSWER-2. Triglyceride level
Rationale:
Isotretinoin can elevate triglyceride levels. Blood triglyceride levels should be measured before
treatment and periodically thereafter until the effect on the triglycerides has been evaluated.
Options 1, 3, and 4 do not need to be monitored specifically during this treatment.
8.) A client with severe acne is seen in the clinic and the health care provider (HCP) prescribes
isotretinoin. The nurse reviews the client's medication record and would contact the (HCP) if the
client is taking which medication?
1. Vitamin A
2. Digoxin (Lanoxin)
3. Furosemide (Lasix)
4. Phenytoin (Dilantin) - CORRECT ANSWER-1. Vitamin A
Rationale:
, Isotretinoin is a metabolite of vitamin A and can produce generalized intensification of isotretinoin
toxicity. Because of the potential for increased toxicity, vitamin A supplements should be
discontinued before isotretinoin therapy. Options 2, 3, and 4 are not contraindicated with the use of
isotretinoin.
9.) The nurse is applying a topical corticosteroid to a client with eczema. The nurse would monitor
for the potential for increased systemic absorption of the medication if the medication were being
applied to which of the following body areas?
1. Back
2. Axilla
3. Soles of the feet
4. Palms of the hands - CORRECT ANSWER-2. Axilla
Rationale:
Topical corticosteroids can be absorbed into the systemic circulation. Absorption is higher from
regions where the skin is especially permeable (scalp, axilla, face, eyelids, neck, perineum, genitalia),
and lower from regions in which permeability is poor (back, palms, soles).
10.) 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 - CORRECT ANSWER-1. 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.
11.) The health care provider has prescribed silver sulfadiazine (Silvadene) for the client with a
partial-thickness burn, which has cultured positive for gram-negative bacteria. The nurse is
reinforcing information to the client about the medication. Which statement made by the client
indicates a lack of understanding about the treatments?
1. "The medication is an antibacterial."
2. "The medication will help heal the burn."
3. "The medication will permanently stain my skin."
