HESI PHARMACOLOGY EXAM SCRIPT 2026
COMPLETE QUESTIONS AND ANSWERS
◉ 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. 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. 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. 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. 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. 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). 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
COMPLETE QUESTIONS AND ANSWERS
◉ 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. 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. 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. 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. 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. 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). 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
