1|Page
EVOLVE Elsevier HESI Pharmacology Exam Versions 1–4
Study Guide 2025 | Comprehensive Pharmacology Practice
Questions, Answers, and NCLEX-RN Drug Review
Prepare for the HESI Pharmacology Exams (Versions 1, 2, 3, and 4) with the most complete
Elsevier-based study and review guide. Includes updated drug classifications, dosage
calculations, adverse effects, and nursing implications. Perfect for NCLEX prep and HESI
exit exam success using the 2025 testing blueprint.
• HESI Pharmacology Exam Version 1
• HESI Pharmacology Exam Version 2
• HESI Pharmacology Exam Version 3
• HESI Pharmacology Exam Version 4
•
A client with HIV who was recently diagnosed with tuberculosis (TB) asks the nurse, "Why do I
need to take all of these medications for TB?" What information should the nurse provide?
A. Antiretroviral medications decrease the efficacy of the TB drugs.
B. Multiple drugs prevent the development of resistant organisms.
C. Duration of the medication regimen is shortened.
D. Potential adverse drug reactions are minimized. - ANSWER-B. Multiple drugs prevent the
development of resistant organisms.
,2|Page
A multidrug regimen is prescribed for a client with HIV and TB to prevent the development of
resistance of the tubercle bacilli. Although antitubercular medications can inhibit some
antiretrovirals, a multidrug regimen is needed to inhibit the proliferation of the virulent tubercle
bacilli. The duration of antitubercular therapy is typically 6 to 9 months and is not shortened by
the use of multiple medications. A client who is receiving HIV and TB therapy is at an increased
risk of adverse reactions because of the complex medication regimens and complications
secondary to immunosuppression.
A 67-year-old client is discharged from the hospital with a prescription for digoxin, 0.25 mg
daily. Which instruction should the nurse include in this client's discharge teaching plan?
A. Take the medication in the morning before rising.
B. Take and record radial pulse rate daily.
C. Expect some vision changes caused by the medication.
D. Increase intake of foods rich in vitamin K. - ANSWER-B. Take and record radial pulse rate daily.
Monitoring pulse rate is very important when taking digoxin. The client should be further
instructed to report pulse rates <60 or >110 beats/min and to withhold the dosage until
consulting with the health care provider in such a case. Options A and D are not necessary.
Option C is an indication of drug toxicity, and the client should be instructed to report this
immediately.
During therapy with isoniazid, it is most important for the nurse to monitor which laboratory
value closely?
A. Liver enzyme levels
B. Blood urea nitrogen (BUN) level
C. Serum electrolyte levels
D. Complete blood count (CBC) - ANSWER-A. Liver enzyme levels
,3|Page
The client receiving isoniazid is at risk for the development of hepatitis; therefore, liver function
test results should be monitored carefully during drug therapy. Options B, C, and D are not
specific indicators of liver function, so they are not monitored closely during isoniazid therapy.
A client with mild parkinsonism is started on oral amantadine. Which statement accurately
describes the action of this medication?
A. Viral organisms that provide the underlyling pathophysiology for parkinsonism are
eliminated.
B. Acetylcholine in the myoneural junction is enhanced.
C. Dopamine in the central nervous system is increased.
D. Norepinephrine release is reduced within the peripheral system as the final step in dopamine
uptake. - ANSWER-C. Dopamine in the central nervous system is increased.
Amantadine is a dopamine-releasing agent; therefore, this medication increases the amount of
dopamine present in the central nervous system. Although this medication is also an antiviral
agent, the antiviral effect is not significant in the treatment of parkinsonism. Options B and D
are not affected by amantadine.
A client is taking famotidine. Which client statement should the nurse further assess because it
may indicate that the client is experiencing a side effect of this drug?
A. "I have heartburn whenever I lie down."
B. "I am never hungry. I've lost weight in the past 2 weeks."
C. "I have a funny metallic taste in my mouth."
D. "I seem to be having difficulty thinking clearly." - ANSWER-D. "I seem to be having difficulty
thinking clearly."
, 4|Page
A common side effect of of famotidine is confusion. Options A, B, and C are not side effects of
this medication.
A client is prescribed a cholinesterase inhibitor, and a family member asks the nurse how this
medication works. Which pharmacophysiologic explanation should the nurse use to describe
this class of drug?
A. Promotes excretion of neurotoxins.
B. Slows nerve cell degeneration.
C. Improves nerve impulse transmission.
D. Stimulates nerve cell regeneration. - ANSWER-C. Improves nerve impulse transmission.
Cholinesterase inhibitors work to increase the availability of acetylcholine at cholinergic
synapses, which aids in neuronal transmission and assists in memory formation. Basing an
explanation on this concept, option C should provide an accurate explanation that the family
can understand. Options A, B, and D are incorrect.
In developing a nursing care plan for a 9-month-old infant with cystic fibrosis, the nurse writes a
nursing diagnosis of alteration in nutrition: less than body requirements, related to inadequate
digestion of nutrients. Which intervention would best meet this child's needs?
A. Give aluminum hydroxide and magnesium hydroxide after meals.
B. Give pancrelipase capsule mixed with applesauce before each meal.
C. Administer cholestyramine resin before each meal and at bedtime.
D. Administer omeprazole for gastroesophageal reflux. - ANSWER-B. Give pancrelipase capsule
mixed with applesauce before each meal.
Pancreatic enzyme replacement with pancrelipase is a major component of cystic fibrosis
nutritional management. Aluminum hydroxide and magnesium hydroxide may be given before
EVOLVE Elsevier HESI Pharmacology Exam Versions 1–4
Study Guide 2025 | Comprehensive Pharmacology Practice
Questions, Answers, and NCLEX-RN Drug Review
Prepare for the HESI Pharmacology Exams (Versions 1, 2, 3, and 4) with the most complete
Elsevier-based study and review guide. Includes updated drug classifications, dosage
calculations, adverse effects, and nursing implications. Perfect for NCLEX prep and HESI
exit exam success using the 2025 testing blueprint.
• HESI Pharmacology Exam Version 1
• HESI Pharmacology Exam Version 2
• HESI Pharmacology Exam Version 3
• HESI Pharmacology Exam Version 4
•
A client with HIV who was recently diagnosed with tuberculosis (TB) asks the nurse, "Why do I
need to take all of these medications for TB?" What information should the nurse provide?
A. Antiretroviral medications decrease the efficacy of the TB drugs.
B. Multiple drugs prevent the development of resistant organisms.
C. Duration of the medication regimen is shortened.
D. Potential adverse drug reactions are minimized. - ANSWER-B. Multiple drugs prevent the
development of resistant organisms.
,2|Page
A multidrug regimen is prescribed for a client with HIV and TB to prevent the development of
resistance of the tubercle bacilli. Although antitubercular medications can inhibit some
antiretrovirals, a multidrug regimen is needed to inhibit the proliferation of the virulent tubercle
bacilli. The duration of antitubercular therapy is typically 6 to 9 months and is not shortened by
the use of multiple medications. A client who is receiving HIV and TB therapy is at an increased
risk of adverse reactions because of the complex medication regimens and complications
secondary to immunosuppression.
A 67-year-old client is discharged from the hospital with a prescription for digoxin, 0.25 mg
daily. Which instruction should the nurse include in this client's discharge teaching plan?
A. Take the medication in the morning before rising.
B. Take and record radial pulse rate daily.
C. Expect some vision changes caused by the medication.
D. Increase intake of foods rich in vitamin K. - ANSWER-B. Take and record radial pulse rate daily.
Monitoring pulse rate is very important when taking digoxin. The client should be further
instructed to report pulse rates <60 or >110 beats/min and to withhold the dosage until
consulting with the health care provider in such a case. Options A and D are not necessary.
Option C is an indication of drug toxicity, and the client should be instructed to report this
immediately.
During therapy with isoniazid, it is most important for the nurse to monitor which laboratory
value closely?
A. Liver enzyme levels
B. Blood urea nitrogen (BUN) level
C. Serum electrolyte levels
D. Complete blood count (CBC) - ANSWER-A. Liver enzyme levels
,3|Page
The client receiving isoniazid is at risk for the development of hepatitis; therefore, liver function
test results should be monitored carefully during drug therapy. Options B, C, and D are not
specific indicators of liver function, so they are not monitored closely during isoniazid therapy.
A client with mild parkinsonism is started on oral amantadine. Which statement accurately
describes the action of this medication?
A. Viral organisms that provide the underlyling pathophysiology for parkinsonism are
eliminated.
B. Acetylcholine in the myoneural junction is enhanced.
C. Dopamine in the central nervous system is increased.
D. Norepinephrine release is reduced within the peripheral system as the final step in dopamine
uptake. - ANSWER-C. Dopamine in the central nervous system is increased.
Amantadine is a dopamine-releasing agent; therefore, this medication increases the amount of
dopamine present in the central nervous system. Although this medication is also an antiviral
agent, the antiviral effect is not significant in the treatment of parkinsonism. Options B and D
are not affected by amantadine.
A client is taking famotidine. Which client statement should the nurse further assess because it
may indicate that the client is experiencing a side effect of this drug?
A. "I have heartburn whenever I lie down."
B. "I am never hungry. I've lost weight in the past 2 weeks."
C. "I have a funny metallic taste in my mouth."
D. "I seem to be having difficulty thinking clearly." - ANSWER-D. "I seem to be having difficulty
thinking clearly."
, 4|Page
A common side effect of of famotidine is confusion. Options A, B, and C are not side effects of
this medication.
A client is prescribed a cholinesterase inhibitor, and a family member asks the nurse how this
medication works. Which pharmacophysiologic explanation should the nurse use to describe
this class of drug?
A. Promotes excretion of neurotoxins.
B. Slows nerve cell degeneration.
C. Improves nerve impulse transmission.
D. Stimulates nerve cell regeneration. - ANSWER-C. Improves nerve impulse transmission.
Cholinesterase inhibitors work to increase the availability of acetylcholine at cholinergic
synapses, which aids in neuronal transmission and assists in memory formation. Basing an
explanation on this concept, option C should provide an accurate explanation that the family
can understand. Options A, B, and D are incorrect.
In developing a nursing care plan for a 9-month-old infant with cystic fibrosis, the nurse writes a
nursing diagnosis of alteration in nutrition: less than body requirements, related to inadequate
digestion of nutrients. Which intervention would best meet this child's needs?
A. Give aluminum hydroxide and magnesium hydroxide after meals.
B. Give pancrelipase capsule mixed with applesauce before each meal.
C. Administer cholestyramine resin before each meal and at bedtime.
D. Administer omeprazole for gastroesophageal reflux. - ANSWER-B. Give pancrelipase capsule
mixed with applesauce before each meal.
Pancreatic enzyme replacement with pancrelipase is a major component of cystic fibrosis
nutritional management. Aluminum hydroxide and magnesium hydroxide may be given before
