PHARMACOLOGY HESI EXIT EXAM 2026 ALL
QUESTIONS AND CORRECT ANSWERS WITH
RATIONALE LATEST UPDATE!!!!!!!!!!!!
1) A nurse is caring for a client with hyperparathyroidism and notes that the client's
serum calcium level is 13 mg/dL. Which medication should the nurse prepare to
administer as prescribed to the client?
1. Calcium chloride
2. Calcium gluconate
3. Calcitonin (Miacalcin)
4. Large doses of vitamin D - ANS... -3. Calcitonin (Miacalcin)
Rationale:
The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is experiencing
hypercalcemia. Calcium gluconate and calcium chloride are medications used for
the treatment of tetany, which occurs as a result of acute hypocalcemia. In
hypercalcemia, large doses of vitamin D need to be avoided. Calcitonin, a thyroid
hormone, decreases the plasma calcium level by inhibiting bone resorption and
lowering the serum calcium concentration.
2.) Oral iron supplements are prescribed for a 6-year-old child with iron deficiency
anemia. The nurse instructs the mother to administer the iron with which best food
item?
1. Milk
2. Water
3. Apple juice
4. Orange juice - ANS... -4. Orange 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. Orange juice contains a greater amount of vitamin C than apple juice.
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 - ANS... -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 - ANS... -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 - ANS... -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 - ANS... -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 - ANS... -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) - ANS... -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
2. Axilla
3. Soles of the feet
4. Palms of the hands - ANS... -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. Herpes simplex - ANS... -1. Acne
Rationale:
Azelaic acid is a topical medication used to treat mild to moderate acne. 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 health care provider has prescribed silver sulfadiazine (Silvadene) for the
client with a partial-thickness burn, which has cultured positive for gram-negative
bacteria. 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." - ANS... -3. "The
medication will permanently stain my skin."
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.
QUESTIONS AND CORRECT ANSWERS WITH
RATIONALE LATEST UPDATE!!!!!!!!!!!!
1) A nurse is caring for a client with hyperparathyroidism and notes that the client's
serum calcium level is 13 mg/dL. Which medication should the nurse prepare to
administer as prescribed to the client?
1. Calcium chloride
2. Calcium gluconate
3. Calcitonin (Miacalcin)
4. Large doses of vitamin D - ANS... -3. Calcitonin (Miacalcin)
Rationale:
The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is experiencing
hypercalcemia. Calcium gluconate and calcium chloride are medications used for
the treatment of tetany, which occurs as a result of acute hypocalcemia. In
hypercalcemia, large doses of vitamin D need to be avoided. Calcitonin, a thyroid
hormone, decreases the plasma calcium level by inhibiting bone resorption and
lowering the serum calcium concentration.
2.) Oral iron supplements are prescribed for a 6-year-old child with iron deficiency
anemia. The nurse instructs the mother to administer the iron with which best food
item?
1. Milk
2. Water
3. Apple juice
4. Orange juice - ANS... -4. Orange 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. Orange juice contains a greater amount of vitamin C than apple juice.
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 - ANS... -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 - ANS... -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 - ANS... -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 - ANS... -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 - ANS... -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) - ANS... -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
2. Axilla
3. Soles of the feet
4. Palms of the hands - ANS... -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. Herpes simplex - ANS... -1. Acne
Rationale:
Azelaic acid is a topical medication used to treat mild to moderate acne. 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 health care provider has prescribed silver sulfadiazine (Silvadene) for the
client with a partial-thickness burn, which has cultured positive for gram-negative
bacteria. 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." - ANS... -3. "The
medication will permanently stain my skin."
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.
