HESI Pharmacology Exam Practice 2025 (NCLEX PN) 2
VERSIONS Exam 2025–2026 Accurate Real Exam
Questions and Verified Correct Answers JUST RELEASED
1) A client with hyperparathyroidism is being cared for by a nurse, and the client's serum calcium level is
13 mg/dL. Which medication should the nurse prepare to administer as prescribed to the client?
1. Chlorine calcium 2. Calcium gluconate
3. Calcitonin (Miacalcin)
4. Large doses of vitamin D - answer>>>3. Calcitonin (Miacalcin)
Rationale:
The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is experiencing hypercalcemia. Tetany,
a condition caused by acute hypocalcemia, can be treated with calcium gluconate and calcium chloride
medications. Vitamin D supplements in large amounts should be avoided in hypercalcemia. Calcitonin, a
thyroid hormone, decreases the plasma calcium level by inhibiting bone resorption and lowering the
serum calcium concentration.
2.) A child who suffers from iron deficiency anemia and is six years old is given oral iron supplements.
The mother is instructed by the nurse to administer the iron with which of the best foods? 1. Milk
2. Water
3. Apple juice
4. Orange juice - answer>>>4. Grapefruit 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. Vitamin C is found in greater quantities in orange juice than in
apple juice. 3.) A client who has been diagnosed with psoriasis receives a prescription for salicylic acid.
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 can cause systemic toxicity (salicylism) because it is easily absorbed through the skin.
Symptoms include tinnitus, dizziness, hyperpnea, and psychological disturbances. Constipation and
diarrhea are not associated with salicylism.
4.) Children who are getting ready to swim in the lake are asked by the camp nurse 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 the very least 30 minutes prior to sun exposure - answer>>>4. At least 30 minutes before
exposure to the sun
Rationale:
In order to fully penetrate the skin, sunscreens should be applied at least 30 minutes before sun
exposure. 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 used to treat burns to reduce the amount of bacteria that are present in avascular
tissues. It is bacteriostatic for both gram-negative and gram-positive organisms. 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.) Topical mafenide acetate (Sulfamylon) treatments are being applied to the burn patient's injury site.
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. Those receiving this treatment should be watched for hyperventilation (signs of an
acid-base imbalance). 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. Total number of blood cells 4. White blood cell count - answer>>>2. Level of triglycerides Rationale:
Isotretinoin can elevate triglyceride levels. Before starting treatment and on a regular basis thereafter,
blood triglyceride levels should be checked to see how it affects them. During this treatment, Options 1,
3, and 4 need not be specifically monitored. 8.) The health care provider (HCP) gives isotretinoin to a
client who has severe acne when they visit the clinic. 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 (Salmeterol) 4. Phenytoin (Dilantin) - answer>>>1. Vitamin A
Rationale:
Isotretinoin is a metabolite of vitamin A and can produce generalized intensification of isotretinoin
toxicity. Before beginning isotretinoin therapy, it is recommended to stop taking vitamin A supplements
due to the possibility of increased toxicity. 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. If the medication were
applied to which of the following body parts, the nurse would keep an eye out for any signs that the
medication might be absorbed more deeply throughout the body. 1. Back
2. Axilla
3. The bottoms of the feet 4. Palms of the hands - 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. Simplex herpes - answer:>>>1. Acne
Rationale:
Acne that is mild to moderate can be treated with a topical medication called azelaic acid. 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 patient, who has a partial-thickness burn and has cultured positive for gram-negative bacteria,
has been prescribed silver sulfadiazine (Silvadene). 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."
4. "The medication should be applied directly to the wound." - answer>>>3. "My skin will be
permanently stained by the medication." Rationale:
Silver sulfadiazine (Silvadene) is an antibacterial that has a broad spectrum of activity against gram-
negative bacteria, gram-positive bacteria, and yeast. It is applied directly to the wound to assist in
healing. It does not stain the skin.
12.) Antineoplastic medication is being administered intravenously (IV) to a client by a nurse. During the
infusion, the client complains of pain at the insertion site. During an inspection of the site, the nurse
notes redness and swelling and that the rate of infusion of the medication has slowed. The nurse should
take which appropriate action?
1. Inform the licensed nurse. 2. Administer pain medication to reduce the discomfort.
3. Apply ice and maintain the infusion rate, as prescribed.
4. Elevate the extremity of the IV site, and slow the infusion. - answer>>>1. Notify the registered
nurse.
Rationale:
When antineoplastic medications (Chemotheraputic Agents) are administered via IV, great care must be
taken to prevent the medication from escaping into the tissues surrounding the injection site, because
pain, tissue damage, and necrosis can result. The nurse keeps an eye out for signs of extravasation, like
redness or swelling at the site of the insertion and a slower rate of infusion. The registered nurse will
then get in touch with the health care provider in the event of extravasation. 13.) The client with
squamous cell carcinoma of the larynx is receiving bleomycin intravenously. The nurse caring for the
client anticipates that which diagnostic study will be prescribed?
1. Echocardiography
2. Electrocardiography
3. Cervical radiography
4. Pulmonary function studies - answer>>>4. Pulmonary function studies
Rationale:
Bleomycin is an antineoplastic medication (Chemotheraputic Agents) that can cause interstitial
pneumonitis, which can progress to pulmonary fibrosis. Pulmonary function studies along with
hematological, hepatic, and renal function tests need to be monitored. The nurse needs to monitor lung
sounds for dyspnea and crackles, which indicate pulmonary toxicity. If pulmonary toxicity occurs, the
medication must be stopped immediately. Options 1, 2, and 3 are unrelated to the specific use of this
medication.14.) The client with acute myelocytic leukemia is being treated with busulfan (Myleran).
Which laboratory value would the nurse specifically monitor during treatment with this medication?
1. Clotting time
2. Uric acid level
VERSIONS Exam 2025–2026 Accurate Real Exam
Questions and Verified Correct Answers JUST RELEASED
1) A client with hyperparathyroidism is being cared for by a nurse, and the client's serum calcium level is
13 mg/dL. Which medication should the nurse prepare to administer as prescribed to the client?
1. Chlorine calcium 2. Calcium gluconate
3. Calcitonin (Miacalcin)
4. Large doses of vitamin D - answer>>>3. Calcitonin (Miacalcin)
Rationale:
The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is experiencing hypercalcemia. Tetany,
a condition caused by acute hypocalcemia, can be treated with calcium gluconate and calcium chloride
medications. Vitamin D supplements in large amounts should be avoided in hypercalcemia. Calcitonin, a
thyroid hormone, decreases the plasma calcium level by inhibiting bone resorption and lowering the
serum calcium concentration.
2.) A child who suffers from iron deficiency anemia and is six years old is given oral iron supplements.
The mother is instructed by the nurse to administer the iron with which of the best foods? 1. Milk
2. Water
3. Apple juice
4. Orange juice - answer>>>4. Grapefruit 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. Vitamin C is found in greater quantities in orange juice than in
apple juice. 3.) A client who has been diagnosed with psoriasis receives a prescription for salicylic acid.
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 can cause systemic toxicity (salicylism) because it is easily absorbed through the skin.
Symptoms include tinnitus, dizziness, hyperpnea, and psychological disturbances. Constipation and
diarrhea are not associated with salicylism.
4.) Children who are getting ready to swim in the lake are asked by the camp nurse 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 the very least 30 minutes prior to sun exposure - answer>>>4. At least 30 minutes before
exposure to the sun
Rationale:
In order to fully penetrate the skin, sunscreens should be applied at least 30 minutes before sun
exposure. 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 used to treat burns to reduce the amount of bacteria that are present in avascular
tissues. It is bacteriostatic for both gram-negative and gram-positive organisms. 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.) Topical mafenide acetate (Sulfamylon) treatments are being applied to the burn patient's injury site.
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. Those receiving this treatment should be watched for hyperventilation (signs of an
acid-base imbalance). 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. Total number of blood cells 4. White blood cell count - answer>>>2. Level of triglycerides Rationale:
Isotretinoin can elevate triglyceride levels. Before starting treatment and on a regular basis thereafter,
blood triglyceride levels should be checked to see how it affects them. During this treatment, Options 1,
3, and 4 need not be specifically monitored. 8.) The health care provider (HCP) gives isotretinoin to a
client who has severe acne when they visit the clinic. 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 (Salmeterol) 4. Phenytoin (Dilantin) - answer>>>1. Vitamin A
Rationale:
Isotretinoin is a metabolite of vitamin A and can produce generalized intensification of isotretinoin
toxicity. Before beginning isotretinoin therapy, it is recommended to stop taking vitamin A supplements
due to the possibility of increased toxicity. 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. If the medication were
applied to which of the following body parts, the nurse would keep an eye out for any signs that the
medication might be absorbed more deeply throughout the body. 1. Back
2. Axilla
3. The bottoms of the feet 4. Palms of the hands - 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. Simplex herpes - answer:>>>1. Acne
Rationale:
Acne that is mild to moderate can be treated with a topical medication called azelaic acid. 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 patient, who has a partial-thickness burn and has cultured positive for gram-negative bacteria,
has been prescribed silver sulfadiazine (Silvadene). 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."
4. "The medication should be applied directly to the wound." - answer>>>3. "My skin will be
permanently stained by the medication." Rationale:
Silver sulfadiazine (Silvadene) is an antibacterial that has a broad spectrum of activity against gram-
negative bacteria, gram-positive bacteria, and yeast. It is applied directly to the wound to assist in
healing. It does not stain the skin.
12.) Antineoplastic medication is being administered intravenously (IV) to a client by a nurse. During the
infusion, the client complains of pain at the insertion site. During an inspection of the site, the nurse
notes redness and swelling and that the rate of infusion of the medication has slowed. The nurse should
take which appropriate action?
1. Inform the licensed nurse. 2. Administer pain medication to reduce the discomfort.
3. Apply ice and maintain the infusion rate, as prescribed.
4. Elevate the extremity of the IV site, and slow the infusion. - answer>>>1. Notify the registered
nurse.
Rationale:
When antineoplastic medications (Chemotheraputic Agents) are administered via IV, great care must be
taken to prevent the medication from escaping into the tissues surrounding the injection site, because
pain, tissue damage, and necrosis can result. The nurse keeps an eye out for signs of extravasation, like
redness or swelling at the site of the insertion and a slower rate of infusion. The registered nurse will
then get in touch with the health care provider in the event of extravasation. 13.) The client with
squamous cell carcinoma of the larynx is receiving bleomycin intravenously. The nurse caring for the
client anticipates that which diagnostic study will be prescribed?
1. Echocardiography
2. Electrocardiography
3. Cervical radiography
4. Pulmonary function studies - answer>>>4. Pulmonary function studies
Rationale:
Bleomycin is an antineoplastic medication (Chemotheraputic Agents) that can cause interstitial
pneumonitis, which can progress to pulmonary fibrosis. Pulmonary function studies along with
hematological, hepatic, and renal function tests need to be monitored. The nurse needs to monitor lung
sounds for dyspnea and crackles, which indicate pulmonary toxicity. If pulmonary toxicity occurs, the
medication must be stopped immediately. Options 1, 2, and 3 are unrelated to the specific use of this
medication.14.) The client with acute myelocytic leukemia is being treated with busulfan (Myleran).
Which laboratory value would the nurse specifically monitor during treatment with this medication?
1. Clotting time
2. Uric acid level
