2025 HESI Pharmacology Exam Study Guide –
Comprehensive Review with 50 Expert-Verified
Questions, Drug Classifications, and High-Yield
Nursing Concepts for Guaranteed Success
A nurse has given a client taking ethambutol (Myambutol) information about the
medication. The nurse determines that the client understands the instructions if the
client states that he or she will immediately report:
1. Impaired sense of hearing
2. Problems with visual acuity
3. Gastrointestinal (GI) side effects
4. Orange-red discoloration of body secretions - - correct ans- -2. Problems with visual
acuity
Rationale:
Ethambutol causes optic neuritis, which decreases visual acuity and the ability to
discriminate between the colors red and green. This poses a potential safety hazard
when a client is driving a motor vehicle. The client is taught to report this symptom
immediately. The client is also taught to take the medication with food if GI upset
occurs. Impaired hearing results from antitubercular therapy with streptomycin.
Orange-red discoloration of secretions occurs with rifampin (Rifadin).
Cycloserine (Seromycin) is added to the medication regimen for a client with
tuberculosis. Which of the following would the nurse include in the client-teaching plan
regarding this medication?1
. To take the medication before meals
2. To return to the clinic weekly for serum drug-level testing
3. It is not necessary to call the health care provider (HCP) if a skin rash occurs.
4. It is not necessary to restrict alcohol intake with this medication. - - correct ans- -2.
To return to the clinic weekly for serum drug-level testing
,Rationale:
Cycloserine (Seromycin) is an antitubercular medication that requires weekly serum
drug level determinations to monitor for the potential of neurotoxicity. Serum drug levels
lower than 30 mcg/mL reduce the incidence of neurotoxicity. The medication must be
taken after meals to prevent gastrointestinal irritation. The client must be instructed to
notify the HCP if a skin rash or signs of central nervous system toxicity are noted.
Alcohol must be avoided because it increases the risk of seizure activity.
A client with tuberculosis is being started on antituberculosis therapy with isoniazid
(INH). Before giving the client the first dose, a nurse ensures that which of the following
baseline studies has been completed?
1. Electrolyte levels
2. Coagulation times
3. Liver enzyme levels
4. Serum creatinine level - - correct ans- -3. Liver enzyme levels
Rationale:
INH therapy can cause an elevation of hepatic enzyme levels and hepatitis. Therefore,
liver enzyme levels are monitored when therapy is initiated and during the first 3 months
of therapy. They may be monitored longer in the client who is greater than age 50 or
abuses alcohol.
Rifabutin (Mycobutin) is prescribed for a client with active Mycobacterium avium
complex (MAC) disease and tuberculosis. The nurse monitors for which side effects of
the medication? Select all that apply.
1. Signs of hepatitis
2. Flu-like syndrome
3. Low neutrophil count
4. Vitamin B6 deficiency
5. Ocular pain or blurred vision
6. Tingling and numbness of the fingers - - correct ans- -1. Signs of hepatitis
, 2. Flu-like syndrome
3. Low neutrophil count
5. Ocular pain or blurred vision
Rationale:
Rifabutin (Mycobutin) may be prescribed for a client with active MAC disease and
tuberculosis. It inhibits mycobacterial DNA-dependent RNA polymerase and
suppresses protein synthesis. Side effects include rash, gastrointestinal disturbances,
neutropenia (low neutrophil count), red-orange body secretions, uveitis (blurred vision
and eye pain), myositis, arthralgia, hepatitis, chest pain with dyspnea, and flu-like
syndrome. Vitamin B6 deficiency and numbness and tingling in the extremities are
associated with the use of isoniazid (INH). Ethambutol (Myambutol) also causes
peripheral neuritis.
A nurse reinforces discharge instructions to a postoperative client who is taking warfarin
sodium (Coumadin). Which statement, if made by the client, reflects the need for
further teaching?
1. "I will take my pills every day at the same time."
2. "I will be certain to avoid alcohol consumption."
3. "I have already called my family to pick up a Medic-Alert bracelet."
4. "I will take Ecotrin (enteric-coated aspirin) for my headaches because it is coated." - -
correct ans- -4. "I will take Ecotrin (enteric-coated aspirin) for my headaches because it
is coated."
Rationale:
Ecotrin is an aspirin-containing product and should be avoided. Alcohol consumption
should be avoided by a client taking warfarin sodium. Taking prescribed medication at
the same time each day increases client compliance. The Medic-Alert bracelet provides
health care personnel emergency information.
A client who is receiving digoxin (Lanoxin) daily has a serum potassium level of 3.0
mEq/L and is complaining of anorexia. A health care provider prescribes a digoxin level
Comprehensive Review with 50 Expert-Verified
Questions, Drug Classifications, and High-Yield
Nursing Concepts for Guaranteed Success
A nurse has given a client taking ethambutol (Myambutol) information about the
medication. The nurse determines that the client understands the instructions if the
client states that he or she will immediately report:
1. Impaired sense of hearing
2. Problems with visual acuity
3. Gastrointestinal (GI) side effects
4. Orange-red discoloration of body secretions - - correct ans- -2. Problems with visual
acuity
Rationale:
Ethambutol causes optic neuritis, which decreases visual acuity and the ability to
discriminate between the colors red and green. This poses a potential safety hazard
when a client is driving a motor vehicle. The client is taught to report this symptom
immediately. The client is also taught to take the medication with food if GI upset
occurs. Impaired hearing results from antitubercular therapy with streptomycin.
Orange-red discoloration of secretions occurs with rifampin (Rifadin).
Cycloserine (Seromycin) is added to the medication regimen for a client with
tuberculosis. Which of the following would the nurse include in the client-teaching plan
regarding this medication?1
. To take the medication before meals
2. To return to the clinic weekly for serum drug-level testing
3. It is not necessary to call the health care provider (HCP) if a skin rash occurs.
4. It is not necessary to restrict alcohol intake with this medication. - - correct ans- -2.
To return to the clinic weekly for serum drug-level testing
,Rationale:
Cycloserine (Seromycin) is an antitubercular medication that requires weekly serum
drug level determinations to monitor for the potential of neurotoxicity. Serum drug levels
lower than 30 mcg/mL reduce the incidence of neurotoxicity. The medication must be
taken after meals to prevent gastrointestinal irritation. The client must be instructed to
notify the HCP if a skin rash or signs of central nervous system toxicity are noted.
Alcohol must be avoided because it increases the risk of seizure activity.
A client with tuberculosis is being started on antituberculosis therapy with isoniazid
(INH). Before giving the client the first dose, a nurse ensures that which of the following
baseline studies has been completed?
1. Electrolyte levels
2. Coagulation times
3. Liver enzyme levels
4. Serum creatinine level - - correct ans- -3. Liver enzyme levels
Rationale:
INH therapy can cause an elevation of hepatic enzyme levels and hepatitis. Therefore,
liver enzyme levels are monitored when therapy is initiated and during the first 3 months
of therapy. They may be monitored longer in the client who is greater than age 50 or
abuses alcohol.
Rifabutin (Mycobutin) is prescribed for a client with active Mycobacterium avium
complex (MAC) disease and tuberculosis. The nurse monitors for which side effects of
the medication? Select all that apply.
1. Signs of hepatitis
2. Flu-like syndrome
3. Low neutrophil count
4. Vitamin B6 deficiency
5. Ocular pain or blurred vision
6. Tingling and numbness of the fingers - - correct ans- -1. Signs of hepatitis
, 2. Flu-like syndrome
3. Low neutrophil count
5. Ocular pain or blurred vision
Rationale:
Rifabutin (Mycobutin) may be prescribed for a client with active MAC disease and
tuberculosis. It inhibits mycobacterial DNA-dependent RNA polymerase and
suppresses protein synthesis. Side effects include rash, gastrointestinal disturbances,
neutropenia (low neutrophil count), red-orange body secretions, uveitis (blurred vision
and eye pain), myositis, arthralgia, hepatitis, chest pain with dyspnea, and flu-like
syndrome. Vitamin B6 deficiency and numbness and tingling in the extremities are
associated with the use of isoniazid (INH). Ethambutol (Myambutol) also causes
peripheral neuritis.
A nurse reinforces discharge instructions to a postoperative client who is taking warfarin
sodium (Coumadin). Which statement, if made by the client, reflects the need for
further teaching?
1. "I will take my pills every day at the same time."
2. "I will be certain to avoid alcohol consumption."
3. "I have already called my family to pick up a Medic-Alert bracelet."
4. "I will take Ecotrin (enteric-coated aspirin) for my headaches because it is coated." - -
correct ans- -4. "I will take Ecotrin (enteric-coated aspirin) for my headaches because it
is coated."
Rationale:
Ecotrin is an aspirin-containing product and should be avoided. Alcohol consumption
should be avoided by a client taking warfarin sodium. Taking prescribed medication at
the same time each day increases client compliance. The Medic-Alert bracelet provides
health care personnel emergency information.
A client who is receiving digoxin (Lanoxin) daily has a serum potassium level of 3.0
mEq/L and is complaining of anorexia. A health care provider prescribes a digoxin level
