HESI PN Pharmacology Exam Test Bank
2025/2026: Comprehensive Q&A with Rationales
for Guaranteed Success
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 - answer-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 - answer-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 - answer-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.
49.) A client has been started on long-term therapy with rifampin (Rifadin). A
nurse teaches the client that the medication:
1. Should always be taken with food or antacids
2. Should be double-dosed if one dose is forgotten
3. Causes orange discoloration of sweat, tears, urine, and feces
,4. May be discontinued independently if symptoms are gone in 3 months -
answer-3. Causes orange discoloration of sweat, tears, urine, and feces
Rationale:
Rifampin should be taken exactly as directed as part of TB therapy. Doses
should not be doubled or skipped. The client should not stop therapy until
directed to do so by a health care provider. The medication should be
administered on an empty stomach unless it causes gastrointestinal upset, and
then it may be taken with food. Antacids, if prescribed, should be taken at least
1 hour before the medication. Rifampin causes orange-red discoloration of
body secretions and will permanently stain soft contact lenses.
50.) 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 - answer-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).
, 51.) 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. - answer-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.
52.) 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 - answer-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
2025/2026: Comprehensive Q&A with Rationales
for Guaranteed Success
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 - answer-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 - answer-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 - answer-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.
49.) A client has been started on long-term therapy with rifampin (Rifadin). A
nurse teaches the client that the medication:
1. Should always be taken with food or antacids
2. Should be double-dosed if one dose is forgotten
3. Causes orange discoloration of sweat, tears, urine, and feces
,4. May be discontinued independently if symptoms are gone in 3 months -
answer-3. Causes orange discoloration of sweat, tears, urine, and feces
Rationale:
Rifampin should be taken exactly as directed as part of TB therapy. Doses
should not be doubled or skipped. The client should not stop therapy until
directed to do so by a health care provider. The medication should be
administered on an empty stomach unless it causes gastrointestinal upset, and
then it may be taken with food. Antacids, if prescribed, should be taken at least
1 hour before the medication. Rifampin causes orange-red discoloration of
body secretions and will permanently stain soft contact lenses.
50.) 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 - answer-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).
, 51.) 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. - answer-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.
52.) 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 - answer-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
