COURSE CODE: PHARMACOLOGY HESI EXAM DATE TIME
COURSE TITLE: Evolve Pharmacology — HESI Practice
—/—/ ALLOWED
Examination
—— 120 Minutes
INSTRUCTOR: —
Evolve Pharmacology HESI Practice
Comprehensive Pharmacology — Medication Administration, Therapeutic Effects, Adverse Reactions & Client
Education
ALL QUESTIONS ARE COMPULSORY
A MULTIPLE CHOICE QUESTIONS (48 Marks)
Choose the single best answer for each question. Write the correct letter (A, B, C, or D) in the space provided.
1. A client who has been taking phenazopyridine (Pyridium) for symptoms of urethritis
and cystitis comes to the clinic because her urine is reddish-orange. Which question
should the practical nurse ask to determine if the medication has been effective?
A. How much water have you been drinking each day?
B. Does the urine color stain your toilet bowl or undergarments?
C. Have you had any relief from urinary pain, burning, or urgency?
D. Did your urine appear cloudy or have a foul odor on voiding?
✦ CORRECT ANSWER: C — Have you had any relief from urinary pain, burning, or urgency?
Phenazopyridine is an over-the-counter urinary analgesic that acts on the mucosa of the urinary tract to relieve
urinary pain, burning, itching, or urgency associated with urethritis and cystitis. Reddish-orange urine is an
expected, harmless side effect, not an indication of effectiveness. Therapeutic response is measured by relief
of urinary discomfort.
,2. A male client who has been receiving an antineoplastic drug has developed
thrombocytopenia. What instructions should the practical nurse (PN) reinforce?
A. Use suppository form of drugs.
B. Avoid large public gatherings.
C. Rise slowly when standing up.
D. Shave with an electric razor.
✦ CORRECT ANSWER: D — Shave with an electric razor.
Thrombocytopenia (low platelet count) is a common side effect of bone marrow depression caused by
antineoplastic agents. Using an electric razor reduces the risk of bleeding from nicks and cuts. Suppositories
should be avoided (risk of rectal bleeding). Avoiding crowds is for neutropenia (low white blood cells). Rising
slowly addresses orthostatic hypotension.
3. The practical nurse (PN) is caring for a client who has been taking prednisone
(Deltasone) daily for a year. Which adverse effect should the PN document in the
client's record?
A. Photosensitivity.
B. Weight gain.
C. Loss of hair.
D. Pale skin color.
✦ CORRECT ANSWER: B — Weight gain.
Long-term prednisone use causes fluid retention and redistribution of fat deposition (moon face, truncal
obesity, buffalo hump). Weight gain and moon face are characteristic adverse effects. Photosensitivity, hair
loss, and pale skin are not typical prednisone effects. Other long-term effects include hyperglycaemia,
osteoporosis, skin fragility, and gastric bleeding due to decreased gastric mucus protection.
, 4. A female client with recurring headaches tells the practical nurse (PN) that she has
been taking at least 4 grams of acetaminophen a day. Which laboratory studies should
the PN review for this client?
A. Creatinine clearance.
B. Hepatic enzymes.
C. Coagulation values.
D. Arterial blood gases.
✦ CORRECT ANSWER: B — Hepatic enzymes.
Acetaminophen in doses exceeding 4 grams daily can cause hepatotoxicity due to depletion of glutathione and
accumulation of the toxic metabolite NAPQI. Hepatic enzyme levels (AST, ALT) should be monitored for
elevation indicating liver damage. Creatinine clearance assesses kidney function, not acetaminophen toxicity.
Coagulation values may be affected late in liver failure but are not primary monitoring.
5. Which action should the practical nurse implement when administering a buccal
medication?
A. Encourage the client to swallow.
B. Administer water with medication.
C. Ensure the medication is positioned under the tongue.
D. Place the medication between the upper molar teeth and cheek.
✦ CORRECT ANSWER: D — Place the medication between the upper molar teeth and cheek.
Buccal medications are placed between the upper molar teeth and the cheek for absorption by the capillaries
of the oral mucosa. The client should be cautioned against swallowing. Buccal medications are not
administered with water. Sublingual administration places medication under the tongue — a different route
with its own absorption characteristics.
COURSE TITLE: Evolve Pharmacology — HESI Practice
—/—/ ALLOWED
Examination
—— 120 Minutes
INSTRUCTOR: —
Evolve Pharmacology HESI Practice
Comprehensive Pharmacology — Medication Administration, Therapeutic Effects, Adverse Reactions & Client
Education
ALL QUESTIONS ARE COMPULSORY
A MULTIPLE CHOICE QUESTIONS (48 Marks)
Choose the single best answer for each question. Write the correct letter (A, B, C, or D) in the space provided.
1. A client who has been taking phenazopyridine (Pyridium) for symptoms of urethritis
and cystitis comes to the clinic because her urine is reddish-orange. Which question
should the practical nurse ask to determine if the medication has been effective?
A. How much water have you been drinking each day?
B. Does the urine color stain your toilet bowl or undergarments?
C. Have you had any relief from urinary pain, burning, or urgency?
D. Did your urine appear cloudy or have a foul odor on voiding?
✦ CORRECT ANSWER: C — Have you had any relief from urinary pain, burning, or urgency?
Phenazopyridine is an over-the-counter urinary analgesic that acts on the mucosa of the urinary tract to relieve
urinary pain, burning, itching, or urgency associated with urethritis and cystitis. Reddish-orange urine is an
expected, harmless side effect, not an indication of effectiveness. Therapeutic response is measured by relief
of urinary discomfort.
,2. A male client who has been receiving an antineoplastic drug has developed
thrombocytopenia. What instructions should the practical nurse (PN) reinforce?
A. Use suppository form of drugs.
B. Avoid large public gatherings.
C. Rise slowly when standing up.
D. Shave with an electric razor.
✦ CORRECT ANSWER: D — Shave with an electric razor.
Thrombocytopenia (low platelet count) is a common side effect of bone marrow depression caused by
antineoplastic agents. Using an electric razor reduces the risk of bleeding from nicks and cuts. Suppositories
should be avoided (risk of rectal bleeding). Avoiding crowds is for neutropenia (low white blood cells). Rising
slowly addresses orthostatic hypotension.
3. The practical nurse (PN) is caring for a client who has been taking prednisone
(Deltasone) daily for a year. Which adverse effect should the PN document in the
client's record?
A. Photosensitivity.
B. Weight gain.
C. Loss of hair.
D. Pale skin color.
✦ CORRECT ANSWER: B — Weight gain.
Long-term prednisone use causes fluid retention and redistribution of fat deposition (moon face, truncal
obesity, buffalo hump). Weight gain and moon face are characteristic adverse effects. Photosensitivity, hair
loss, and pale skin are not typical prednisone effects. Other long-term effects include hyperglycaemia,
osteoporosis, skin fragility, and gastric bleeding due to decreased gastric mucus protection.
, 4. A female client with recurring headaches tells the practical nurse (PN) that she has
been taking at least 4 grams of acetaminophen a day. Which laboratory studies should
the PN review for this client?
A. Creatinine clearance.
B. Hepatic enzymes.
C. Coagulation values.
D. Arterial blood gases.
✦ CORRECT ANSWER: B — Hepatic enzymes.
Acetaminophen in doses exceeding 4 grams daily can cause hepatotoxicity due to depletion of glutathione and
accumulation of the toxic metabolite NAPQI. Hepatic enzyme levels (AST, ALT) should be monitored for
elevation indicating liver damage. Creatinine clearance assesses kidney function, not acetaminophen toxicity.
Coagulation values may be affected late in liver failure but are not primary monitoring.
5. Which action should the practical nurse implement when administering a buccal
medication?
A. Encourage the client to swallow.
B. Administer water with medication.
C. Ensure the medication is positioned under the tongue.
D. Place the medication between the upper molar teeth and cheek.
✦ CORRECT ANSWER: D — Place the medication between the upper molar teeth and cheek.
Buccal medications are placed between the upper molar teeth and the cheek for absorption by the capillaries
of the oral mucosa. The client should be cautioned against swallowing. Buccal medications are not
administered with water. Sublingual administration places medication under the tongue — a different route
with its own absorption characteristics.
