HESI PRACTICE EXAM-PHARM 315
UPDATED QUESTIONS AND
ANSWERS/100% CORRECT/GRADED
A+/UPDATED 2025/COMPLETE
Which client should the nurse identify as being at highest risk for complications during the use of an
opioid analgesic? - ANSWER-A young adult with inflammatory bowel disease.
Rationale:
The principal indication for opioid use is acute pain, and a client with inflammatory bowel disease is at
risk for toxic megacolon or paralytic ileus related to slowed peristalsis, a side effect of morphine.
Adverse effects of morphine do not pose as great a risk for clients with diabetes or a fracture as for the
client with bowel disease.
The healthcare provider prescribes digitalis (Digoxin) for a client diagnosed with heart failure. Which
intervention should the nurse implement prior to administering the digoxin? - ANSWER-Assess the
serum potassium level.
Rationale:
Hypokalemia (decreased serum potassium) will precipitate digitalis toxicity in persons receiving digoxin.
The nurse should monitor the client's serum potassium levels. Blood pressure and respiratory rate will
not inform the nurse about potential safety issues with digitalis.
A client with hyperlipidemia receives a prescription for niacin (Niaspan). Which client teaching is most
important for the nurse to provide? - ANSWER-Expected duration of flushing.
Rationale:
Flushing of the face and neck, lasting up to an hour, is a frequent reason for discontinuing niacin.
Inclusion of this effect in client teaching may promote compliance in taking the medication. While
nutrition tips and managing pruritis are worthwhile instructions to help clients minimize or cope with
normal side effects associated with niacin (Niaspan), flushing is intense and causes the most concern for
the client.
,A client who was prescribed atorvastatin (Lipitor) one month ago calls the triage nurse at the clinic
complaining of muscle pain and weakness in his legs. Which statement reflects the correct drug-specific
teaching the nurse should provide to this client? - ANSWER-Make an appointment to see the healthcare
provider, because muscle pain may be an indication of a serious side effect.
Rationale:
Myopathy, suggested by the leg pain and weakness, is a serious, and potentially life-threatening,
complication of Lipitor, and should be evaluated immediately by the healthcare provider.
An antacid (Maalox) is prescribed for a client with peptic ulcer disease. The nurse knows that the
purpose of this medication is to - ANSWER-maintain a gastric pH of 3.5 or above.
Rationale:
The objective of antacids is to neutralize gastric acids and keep pH of 3.5 or above which is necessary for
pepsinogen inactivity.
Which dosing schedule should the nurse teach the client to observe for a controlled-release oxycodone
prescription? - ANSWER-Every 12 hours.
Rationale:
A controlled-release oxycodone provides long-acting analgesia to relieve moderate to severe pain, so a
dosing schedule of every 12 hours provides the best around-the-clock pain management. Controlled-
release oxycodone is not prescribed for breakthrough pain on a PRN or as needed schedule. Using a
schedule of every 4 to 6 hours may jeopardize patient safety due to cumulative effects.
A client with osteoarthritis receives a new prescription for celecoxib (Celebrex) orally for symptom
management. The nurse notes the client is allergic to sulfa. Which action is most important for the nurse
to implement prior to administering the first dose? - ANSWER-Notify the healthcare provider.
Rationale:
Celebrex contains a sulfur molecule, which can lead to an allergic reaction in individuals who are
sensitive to sulfonamides, so the healthcare provider should be notified of the client's allergies.
, The nurse is assessing a client who is experiencing anaphylaxis from an insect sting. Which prescription
should the nurse prepare to administer this client? - ANSWER-Epinephrine.
Rationale:
Epinephrine is an adrenergic agent that stimulates beta receptors to increase cardiac automaticity in
cardiac arrest and relax bronchospasms in anaphylaxis. On the ither hand, dopamine is a vasopressor
used to treat clients with shock. Ephedrine causes peripheral vasoconstriction and is used in the
treatment of nasal congestion. Diphenhydramine is an antihistamine decongestant used in the
treatment of mild allergic reactions and motion sickness. Epinephrine is the medication of choice in
treating anaphylaxis.
A client is being treated for osteoporosis with alendronate (Fosamax), and the nurse has completed
discharge teaching regarding medication administration. Which morning schedule would indicate to the
nurse that the client teaching has been effective? - ANSWER-Take medication, go for a 30 minute
morning walk, then eat breakfast.
Rationale:
Alendronate (Fosamax) is best absorbed when taken thirty minutes before eating in the morning. The
client should also be advised to remain in an upright position for at least thirty minutes after taking the
medication to reduce the risk of esophageal reflux and irritation.
After abdominal surgery, a male client is prescribed low molecular weight heparin (LMWH). During
administration of the medication, the client asks the nurse why he is receiving this medication. Which is
the best response for the nurse to provide? - ANSWER-This medication is a blood thinner given to
prevent blood clot formation.
Rationale:
Unfractionated heparin or low molecular weight heparin (LMWH) is an anticoagulant that inhibits
thrombin-mediated conversion of fibrinogen to fibrin and is given prophylactically to prevent
postoperative venous thrombosis in order to prevent pulmonary embolism or deep vein thrombosis
following knee and abdominal surgeries.
Which symptoms are serious adverse effects of beta-adrenergic blockers such as propranolol (Inderal)? -
ANSWER-Wheezing, hypotension, and AV block.
UPDATED QUESTIONS AND
ANSWERS/100% CORRECT/GRADED
A+/UPDATED 2025/COMPLETE
Which client should the nurse identify as being at highest risk for complications during the use of an
opioid analgesic? - ANSWER-A young adult with inflammatory bowel disease.
Rationale:
The principal indication for opioid use is acute pain, and a client with inflammatory bowel disease is at
risk for toxic megacolon or paralytic ileus related to slowed peristalsis, a side effect of morphine.
Adverse effects of morphine do not pose as great a risk for clients with diabetes or a fracture as for the
client with bowel disease.
The healthcare provider prescribes digitalis (Digoxin) for a client diagnosed with heart failure. Which
intervention should the nurse implement prior to administering the digoxin? - ANSWER-Assess the
serum potassium level.
Rationale:
Hypokalemia (decreased serum potassium) will precipitate digitalis toxicity in persons receiving digoxin.
The nurse should monitor the client's serum potassium levels. Blood pressure and respiratory rate will
not inform the nurse about potential safety issues with digitalis.
A client with hyperlipidemia receives a prescription for niacin (Niaspan). Which client teaching is most
important for the nurse to provide? - ANSWER-Expected duration of flushing.
Rationale:
Flushing of the face and neck, lasting up to an hour, is a frequent reason for discontinuing niacin.
Inclusion of this effect in client teaching may promote compliance in taking the medication. While
nutrition tips and managing pruritis are worthwhile instructions to help clients minimize or cope with
normal side effects associated with niacin (Niaspan), flushing is intense and causes the most concern for
the client.
,A client who was prescribed atorvastatin (Lipitor) one month ago calls the triage nurse at the clinic
complaining of muscle pain and weakness in his legs. Which statement reflects the correct drug-specific
teaching the nurse should provide to this client? - ANSWER-Make an appointment to see the healthcare
provider, because muscle pain may be an indication of a serious side effect.
Rationale:
Myopathy, suggested by the leg pain and weakness, is a serious, and potentially life-threatening,
complication of Lipitor, and should be evaluated immediately by the healthcare provider.
An antacid (Maalox) is prescribed for a client with peptic ulcer disease. The nurse knows that the
purpose of this medication is to - ANSWER-maintain a gastric pH of 3.5 or above.
Rationale:
The objective of antacids is to neutralize gastric acids and keep pH of 3.5 or above which is necessary for
pepsinogen inactivity.
Which dosing schedule should the nurse teach the client to observe for a controlled-release oxycodone
prescription? - ANSWER-Every 12 hours.
Rationale:
A controlled-release oxycodone provides long-acting analgesia to relieve moderate to severe pain, so a
dosing schedule of every 12 hours provides the best around-the-clock pain management. Controlled-
release oxycodone is not prescribed for breakthrough pain on a PRN or as needed schedule. Using a
schedule of every 4 to 6 hours may jeopardize patient safety due to cumulative effects.
A client with osteoarthritis receives a new prescription for celecoxib (Celebrex) orally for symptom
management. The nurse notes the client is allergic to sulfa. Which action is most important for the nurse
to implement prior to administering the first dose? - ANSWER-Notify the healthcare provider.
Rationale:
Celebrex contains a sulfur molecule, which can lead to an allergic reaction in individuals who are
sensitive to sulfonamides, so the healthcare provider should be notified of the client's allergies.
, The nurse is assessing a client who is experiencing anaphylaxis from an insect sting. Which prescription
should the nurse prepare to administer this client? - ANSWER-Epinephrine.
Rationale:
Epinephrine is an adrenergic agent that stimulates beta receptors to increase cardiac automaticity in
cardiac arrest and relax bronchospasms in anaphylaxis. On the ither hand, dopamine is a vasopressor
used to treat clients with shock. Ephedrine causes peripheral vasoconstriction and is used in the
treatment of nasal congestion. Diphenhydramine is an antihistamine decongestant used in the
treatment of mild allergic reactions and motion sickness. Epinephrine is the medication of choice in
treating anaphylaxis.
A client is being treated for osteoporosis with alendronate (Fosamax), and the nurse has completed
discharge teaching regarding medication administration. Which morning schedule would indicate to the
nurse that the client teaching has been effective? - ANSWER-Take medication, go for a 30 minute
morning walk, then eat breakfast.
Rationale:
Alendronate (Fosamax) is best absorbed when taken thirty minutes before eating in the morning. The
client should also be advised to remain in an upright position for at least thirty minutes after taking the
medication to reduce the risk of esophageal reflux and irritation.
After abdominal surgery, a male client is prescribed low molecular weight heparin (LMWH). During
administration of the medication, the client asks the nurse why he is receiving this medication. Which is
the best response for the nurse to provide? - ANSWER-This medication is a blood thinner given to
prevent blood clot formation.
Rationale:
Unfractionated heparin or low molecular weight heparin (LMWH) is an anticoagulant that inhibits
thrombin-mediated conversion of fibrinogen to fibrin and is given prophylactically to prevent
postoperative venous thrombosis in order to prevent pulmonary embolism or deep vein thrombosis
following knee and abdominal surgeries.
Which symptoms are serious adverse effects of beta-adrenergic blockers such as propranolol (Inderal)? -
ANSWER-Wheezing, hypotension, and AV block.
