HESI PHARMACOLOGY EXIT EXAM
(NCLEX-PN QUESTION BANK) | NEWEST
ACTUAL EXAM COMPREHENSIVE
QUESTIONS AND VERIFIED ANSWERS
GRADED A+ | 100% PASS | 2025\2026
UPDATE!
1.) Cinoxacin (Cinobac), a urinary antiseptic, is prescribed for the client.
The nurse reviews the client's medical record and should contact the
health care provider (HCP) regarding which documented finding to
verify the prescription? Refer to chart.
1. Renal insufficiency
2. Chest x-ray: normal
3. Blood glucose, 102 mg/dL
4. Folic acid (vitamin B6) 0.5 mg, orally daily Answer
> 1. Renal insufficiency Rationale:
Cinoxacin should be administered with caution in clients with renal
impairment. The dosage should be reduced, and failure to do so could
result in accumulation of cinoxacin to toxic levels. Therefore the nurse
would verify the prescription if the client had a documented history of
renal insufficiency. The laboratory and diagnostic test results are
normal findings. Folic acid (vitamin B6) may be prescribed for a client
with renal insufficiency to prevent anemia
,2.) After kidney transplantation, cyclosporine (Sand immune) is
prescribed for a client. Which laboratory result would indicate an
adverse effect from the use of this medication?
1. Decreased creatinine level
2. Decreased hemoglobin level
3. Elevated blood urea nitrogen level
4. Decreased white blood cell count ANSWER 3. Elevated blood urea
nitrogen level Rationale:
Nephrotoxicity can occur from the use of cyclosporine (Sandimmune).
Nephrotoxicity is evaluated by monitoring for elevated blood urea
nitrogen (BUN) and serum creatinine levels. Cyclosporine is an
immunosuppressant but does not depress the bone marrow.
3.) A client with myasthenia gravis is suspected of having cholinergic
crisis. Which of the following indicate that this crisis exists?
1. Ataxia
2. Mouth sores
3. Hypotension
4. Hypertension ANSWER 4. Hypertension Rationale:
Cholinergic crisis occurs as a result of an overdose of medication.
Indications of cholinergic crisis include gastrointestinal disturbances,
nausea, vomiting, diarrhea, abdominal cramps, increased salivation and
,tearing, miosis, hypertension, sweating, and increased bronchial
secretions.
4.) A client with myasthenia gravis is receiving pyridostigmine
(Mestinon). The nurse monitors for signs and symptoms of cholinergic
crisis caused by overdose of the medication. The nurse checks the
medication supply to ensure that which medication is available for
administration if a cholinergic crisis occurs?
1. Vitamin K
2. Atropine sulfate
3. Protamine sulfate
4. Acetylcysteine (Mucomyst) ANSWER 2. Atropine sulfate
Rationale:
The antidote for cholinergic crisis is atropine sulfate. Vitamin K is the
antidote for warfarin (Coumadin). Protamine sulfate is the antidote for
heparin, and acetylcysteine (Mucomyst) is the antidote for
acetaminophen (Tylenol).
5.) A client with myasthenia gravis becomes increasingly weak. The
health care provider prepares to identify whether the client is reacting
to an overdose of the medication (cholinergic crisis) or increasing
severity of the disease (myasthenic crisis). An injection of edrophonium
(Enlon) is administered. Which of the following indicates that the client
is in cholinergic crisis?
1. No change in the condition
, 2. Complaints of muscle spasms
3. An improvement of the weakness
4. A temporary worsening of the condition ANSWER
4. A temporary worsening of the condition Rationale:
An edrophonium (Enlon) injection, a cholinergic drug, makes the client
in cholinergic crisis temporarily worse. This is known as a negative test.
An improvement of weakness would occur if the client were
experiencing myasthenia gravis. Options 1 and 2 would not occur in
either crisis.
6.) Carbidopa-levodopa (Sinemet) is prescribed for a client with
Parkinson's disease, and the nurse monitors the client for adverse
reactions to the medication. Which of the following indicates that the
client is experiencing an adverse reaction?
1. Pruritus
2. Tachycardia
3. Hypertension
4. Impaired voluntary movements ANSWER 4. Impaired voluntary
movements Rationale:
Dyskinesia and impaired voluntary movement may occur with high
levodopa dosages. Nausea, anorexia, dizziness, orthostatic
hypotension, bradycardia, and akinesia (the temporary muscle
weakness that lasts 1 minute to 1 hour, also known as the "on-off
phenomenon") are frequent side effects of the medication.
(NCLEX-PN QUESTION BANK) | NEWEST
ACTUAL EXAM COMPREHENSIVE
QUESTIONS AND VERIFIED ANSWERS
GRADED A+ | 100% PASS | 2025\2026
UPDATE!
1.) Cinoxacin (Cinobac), a urinary antiseptic, is prescribed for the client.
The nurse reviews the client's medical record and should contact the
health care provider (HCP) regarding which documented finding to
verify the prescription? Refer to chart.
1. Renal insufficiency
2. Chest x-ray: normal
3. Blood glucose, 102 mg/dL
4. Folic acid (vitamin B6) 0.5 mg, orally daily Answer
> 1. Renal insufficiency Rationale:
Cinoxacin should be administered with caution in clients with renal
impairment. The dosage should be reduced, and failure to do so could
result in accumulation of cinoxacin to toxic levels. Therefore the nurse
would verify the prescription if the client had a documented history of
renal insufficiency. The laboratory and diagnostic test results are
normal findings. Folic acid (vitamin B6) may be prescribed for a client
with renal insufficiency to prevent anemia
,2.) After kidney transplantation, cyclosporine (Sand immune) is
prescribed for a client. Which laboratory result would indicate an
adverse effect from the use of this medication?
1. Decreased creatinine level
2. Decreased hemoglobin level
3. Elevated blood urea nitrogen level
4. Decreased white blood cell count ANSWER 3. Elevated blood urea
nitrogen level Rationale:
Nephrotoxicity can occur from the use of cyclosporine (Sandimmune).
Nephrotoxicity is evaluated by monitoring for elevated blood urea
nitrogen (BUN) and serum creatinine levels. Cyclosporine is an
immunosuppressant but does not depress the bone marrow.
3.) A client with myasthenia gravis is suspected of having cholinergic
crisis. Which of the following indicate that this crisis exists?
1. Ataxia
2. Mouth sores
3. Hypotension
4. Hypertension ANSWER 4. Hypertension Rationale:
Cholinergic crisis occurs as a result of an overdose of medication.
Indications of cholinergic crisis include gastrointestinal disturbances,
nausea, vomiting, diarrhea, abdominal cramps, increased salivation and
,tearing, miosis, hypertension, sweating, and increased bronchial
secretions.
4.) A client with myasthenia gravis is receiving pyridostigmine
(Mestinon). The nurse monitors for signs and symptoms of cholinergic
crisis caused by overdose of the medication. The nurse checks the
medication supply to ensure that which medication is available for
administration if a cholinergic crisis occurs?
1. Vitamin K
2. Atropine sulfate
3. Protamine sulfate
4. Acetylcysteine (Mucomyst) ANSWER 2. Atropine sulfate
Rationale:
The antidote for cholinergic crisis is atropine sulfate. Vitamin K is the
antidote for warfarin (Coumadin). Protamine sulfate is the antidote for
heparin, and acetylcysteine (Mucomyst) is the antidote for
acetaminophen (Tylenol).
5.) A client with myasthenia gravis becomes increasingly weak. The
health care provider prepares to identify whether the client is reacting
to an overdose of the medication (cholinergic crisis) or increasing
severity of the disease (myasthenic crisis). An injection of edrophonium
(Enlon) is administered. Which of the following indicates that the client
is in cholinergic crisis?
1. No change in the condition
, 2. Complaints of muscle spasms
3. An improvement of the weakness
4. A temporary worsening of the condition ANSWER
4. A temporary worsening of the condition Rationale:
An edrophonium (Enlon) injection, a cholinergic drug, makes the client
in cholinergic crisis temporarily worse. This is known as a negative test.
An improvement of weakness would occur if the client were
experiencing myasthenia gravis. Options 1 and 2 would not occur in
either crisis.
6.) Carbidopa-levodopa (Sinemet) is prescribed for a client with
Parkinson's disease, and the nurse monitors the client for adverse
reactions to the medication. Which of the following indicates that the
client is experiencing an adverse reaction?
1. Pruritus
2. Tachycardia
3. Hypertension
4. Impaired voluntary movements ANSWER 4. Impaired voluntary
movements Rationale:
Dyskinesia and impaired voluntary movement may occur with high
levodopa dosages. Nausea, anorexia, dizziness, orthostatic
hypotension, bradycardia, and akinesia (the temporary muscle
weakness that lasts 1 minute to 1 hour, also known as the "on-off
phenomenon") are frequent side effects of the medication.
