2026 HESI Pharmacology Exit Exam V1 | 100%
Questions & Answers | Graded A+ with Rationales
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?
A. Calcium chloride
B. Calcium gluconate
C. Calcitonin (Miacalcin)
D. Large doses of vitamin D
Answer: C. 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 used for the treatment of
tetany, which occurs as a result of acute hypocalcemia. In hypercalcemia, large doses of
vitamin D should 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?
A. Milk
B. Water
C. Apple juice
D. Orange juice
Answer: D. 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 reduce the absorption of 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?
A. Tinnitus
B. Diarrhea
C. Constipation
D. Increased appetite
Answer: A. Tinnitus
, Rationale:
Salicylic acid can be absorbed systemically in high doses and has aspirin‑like effects.
Tinnitus and other auditory changes are early signs of salicylate toxicity. Diarrhea,
constipation, and increased appetite are not classic signs of salicylate toxicity.
4. A nurse is caring for a client receiving heparin therapy. Which of the following laboratory
results should the nurse monitor closely for therapeutic effect?
A. PT/INR
B. aPTT
C. Platelet count
D. Serum creatinine
Answer: B. aPTT
Rationale:
The therapeutic effect of unfractionated heparin is monitored using the activated partial
thromboplastin time (aPTT). PT/INR is used to monitor warfarin therapy. Platelet count is
monitored for heparin‑induced thrombocytopenia, and serum creatinine is used to assess
renal function, not heparin’s anticoagulant level.
5. A nurse is caring for a client prescribed digoxin for heart failure. Which finding should
the nurse prioritize as a sign of toxicity?
A. Bradycardia
B. Hypertension
C. Diarrhea
D. Increased urine output
Answer: A. Bradycardia
Rationale:
Digoxin toxicity commonly presents with bradycardia, nausea, vomiting, and visual
disturbances. Hypertension and increased urine output are not typical signs. Diarrhea is
less common than cardiac manifestations.
6. A client with type 2 diabetes mellitus is prescribed metformin. Which statement by the
client indicates the need for further teaching?
A. “I will take this medication with meals to avoid stomach upset.”
B. “I will avoid alcohol while taking this.”
C. “I will stop taking it if my blood sugar is low.”
D. “I will get my kidney function checked regularly.”
Answer: C. “I will stop taking it if my blood sugar is low.”
Rationale:
Metformin does not typically cause hypoglycemia alone; stopping it for low blood sugar
is incorrect. It should be taken with meals, alcohol avoided due to lactic acidosis risk, and
kidney function monitored.
,7. A nurse is caring for a client receiving warfarin for atrial fibrillation. Which food should
the nurse advise the client to maintain in a consistent intake?
A. Spinach
B. Apples
C. Rice
D. Chicken
Answer: A. Spinach
Rationale:
Spinach is high in vitamin K, which antagonizes warfarin. Inconsistent intake can alter
INR. Apples, rice, and chicken have minimal vitamin K and are safer to maintain.
8. A client is prescribed lisinopril for hypertension. Which adverse effect should the nurse
monitor for most closely?
A. Dry cough
B. Constipation
C. Hyperglycemia
D. Diarrhea
Answer: A. Dry cough
Rationale:
ACE inhibitors like lisinopril commonly cause a persistent dry cough due to bradykinin
buildup. Constipation and diarrhea are not typical. Hyperglycemia is rare.
9. A nurse is teaching a client about simvastatin. Which statement by the client indicates
understanding?
A. “I will take it with grapefruit juice every morning.”
B. “I will limit alcohol and report muscle pain.”
C. “I can skip doses if my cholesterol is good.”
D. “I will stop if I see red urine.”
Answer: B. “I will limit alcohol and report muscle pain.”
Rationale:
Simvastatin can cause hepatotoxicity and myopathy; alcohol should be limited, and
muscle pain reported. Grapefruit juice increases risk of toxicity. Skipping doses is not
advised.
10.A client with asthma is prescribed albuterol via inhaler. Which action should the nurse
prioritize first?
A. Check for tachycardia and tremors.
B. Assess lung sounds and peak flow.
C. Monitor blood pressure for hypotension.
D. Inquire about headache.
Answer: A. Check for tachycardia and tremors.
Rationale:
, Albuterol is a beta‑2 agonist causing tachycardia and tremors as common side effects.
Assessing for toxicity is priority over routine monitoring.
11. A nurse is caring for a client receiving morphine sulfate for severe pain. Which finding
indicates the priority need for intervention?
A. Respiratory rate of 8 breaths/min
B. Nausea
C. Constipation
D. Drowsiness
Answer: A. Respiratory rate of 8 breaths/min
Rationale:
Opioids like morphine can cause respiratory depression; a rate under 10 is
life‑threatening. Nausea, constipation, and drowsiness are common but less urgent.
12.A client is prescribed vancomycin for a methicillin‑resistant Staphylococcus aureus
infection. Which adverse effect should the nurse monitor for?
A. Red man syndrome
B. Hyperkalemia
C. Hypoglycemia
D. Constipation
Answer: A. Red man syndrome
Rationale:
Vancomycin can cause red man syndrome (flushing, rash) with rapid infusion.
Hyperkalemia, hypoglycemia, and constipation are not typical.
13.A nurse is teaching a client about nitroglycerin for angina. Which statement by the client
indicates the need for further teaching?
A. “I will sit down before taking it.”
B. “I will store it in a cool, dark place.”
C. “I will swallow it with water.”
D. “I will call 911 if pain persists after three doses.”
Answer: C. “I will swallow it with water.”
Rationale:
Nitroglycerin sublingual tablets should dissolve under the tongue, not swallowed. Sitting
prevents hypotension syncope. Storing cool and seeking help if pain persists are correct.
14.A client with Parkinson’s disease is prescribed levodopa/carbidopa. Which adverse effect
should the nurse prioritize educating about?
A. Dyskinesias
B. Diarrhea
C. Hypertension
D. Constipation
Answer: A. Dyskinesias
Questions & Answers | Graded A+ with Rationales
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?
A. Calcium chloride
B. Calcium gluconate
C. Calcitonin (Miacalcin)
D. Large doses of vitamin D
Answer: C. 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 used for the treatment of
tetany, which occurs as a result of acute hypocalcemia. In hypercalcemia, large doses of
vitamin D should 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?
A. Milk
B. Water
C. Apple juice
D. Orange juice
Answer: D. 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 reduce the absorption of 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?
A. Tinnitus
B. Diarrhea
C. Constipation
D. Increased appetite
Answer: A. Tinnitus
, Rationale:
Salicylic acid can be absorbed systemically in high doses and has aspirin‑like effects.
Tinnitus and other auditory changes are early signs of salicylate toxicity. Diarrhea,
constipation, and increased appetite are not classic signs of salicylate toxicity.
4. A nurse is caring for a client receiving heparin therapy. Which of the following laboratory
results should the nurse monitor closely for therapeutic effect?
A. PT/INR
B. aPTT
C. Platelet count
D. Serum creatinine
Answer: B. aPTT
Rationale:
The therapeutic effect of unfractionated heparin is monitored using the activated partial
thromboplastin time (aPTT). PT/INR is used to monitor warfarin therapy. Platelet count is
monitored for heparin‑induced thrombocytopenia, and serum creatinine is used to assess
renal function, not heparin’s anticoagulant level.
5. A nurse is caring for a client prescribed digoxin for heart failure. Which finding should
the nurse prioritize as a sign of toxicity?
A. Bradycardia
B. Hypertension
C. Diarrhea
D. Increased urine output
Answer: A. Bradycardia
Rationale:
Digoxin toxicity commonly presents with bradycardia, nausea, vomiting, and visual
disturbances. Hypertension and increased urine output are not typical signs. Diarrhea is
less common than cardiac manifestations.
6. A client with type 2 diabetes mellitus is prescribed metformin. Which statement by the
client indicates the need for further teaching?
A. “I will take this medication with meals to avoid stomach upset.”
B. “I will avoid alcohol while taking this.”
C. “I will stop taking it if my blood sugar is low.”
D. “I will get my kidney function checked regularly.”
Answer: C. “I will stop taking it if my blood sugar is low.”
Rationale:
Metformin does not typically cause hypoglycemia alone; stopping it for low blood sugar
is incorrect. It should be taken with meals, alcohol avoided due to lactic acidosis risk, and
kidney function monitored.
,7. A nurse is caring for a client receiving warfarin for atrial fibrillation. Which food should
the nurse advise the client to maintain in a consistent intake?
A. Spinach
B. Apples
C. Rice
D. Chicken
Answer: A. Spinach
Rationale:
Spinach is high in vitamin K, which antagonizes warfarin. Inconsistent intake can alter
INR. Apples, rice, and chicken have minimal vitamin K and are safer to maintain.
8. A client is prescribed lisinopril for hypertension. Which adverse effect should the nurse
monitor for most closely?
A. Dry cough
B. Constipation
C. Hyperglycemia
D. Diarrhea
Answer: A. Dry cough
Rationale:
ACE inhibitors like lisinopril commonly cause a persistent dry cough due to bradykinin
buildup. Constipation and diarrhea are not typical. Hyperglycemia is rare.
9. A nurse is teaching a client about simvastatin. Which statement by the client indicates
understanding?
A. “I will take it with grapefruit juice every morning.”
B. “I will limit alcohol and report muscle pain.”
C. “I can skip doses if my cholesterol is good.”
D. “I will stop if I see red urine.”
Answer: B. “I will limit alcohol and report muscle pain.”
Rationale:
Simvastatin can cause hepatotoxicity and myopathy; alcohol should be limited, and
muscle pain reported. Grapefruit juice increases risk of toxicity. Skipping doses is not
advised.
10.A client with asthma is prescribed albuterol via inhaler. Which action should the nurse
prioritize first?
A. Check for tachycardia and tremors.
B. Assess lung sounds and peak flow.
C. Monitor blood pressure for hypotension.
D. Inquire about headache.
Answer: A. Check for tachycardia and tremors.
Rationale:
, Albuterol is a beta‑2 agonist causing tachycardia and tremors as common side effects.
Assessing for toxicity is priority over routine monitoring.
11. A nurse is caring for a client receiving morphine sulfate for severe pain. Which finding
indicates the priority need for intervention?
A. Respiratory rate of 8 breaths/min
B. Nausea
C. Constipation
D. Drowsiness
Answer: A. Respiratory rate of 8 breaths/min
Rationale:
Opioids like morphine can cause respiratory depression; a rate under 10 is
life‑threatening. Nausea, constipation, and drowsiness are common but less urgent.
12.A client is prescribed vancomycin for a methicillin‑resistant Staphylococcus aureus
infection. Which adverse effect should the nurse monitor for?
A. Red man syndrome
B. Hyperkalemia
C. Hypoglycemia
D. Constipation
Answer: A. Red man syndrome
Rationale:
Vancomycin can cause red man syndrome (flushing, rash) with rapid infusion.
Hyperkalemia, hypoglycemia, and constipation are not typical.
13.A nurse is teaching a client about nitroglycerin for angina. Which statement by the client
indicates the need for further teaching?
A. “I will sit down before taking it.”
B. “I will store it in a cool, dark place.”
C. “I will swallow it with water.”
D. “I will call 911 if pain persists after three doses.”
Answer: C. “I will swallow it with water.”
Rationale:
Nitroglycerin sublingual tablets should dissolve under the tongue, not swallowed. Sitting
prevents hypotension syncope. Storing cool and seeking help if pain persists are correct.
14.A client with Parkinson’s disease is prescribed levodopa/carbidopa. Which adverse effect
should the nurse prioritize educating about?
A. Dyskinesias
B. Diarrhea
C. Hypertension
D. Constipation
Answer: A. Dyskinesias
