HESI PHARMACOLOGY V1 REVISION
HANDBOOK 2026 ADVERSE DRUG EFFECTS
AND PATIENT SAFETY
◉ The healthcare provider prescribes pyridostigmine bromide
(Mestinon) tablets for a client with myasthenia gravis (MG). What
instruction should the nurse provide this client?
Answer: Take the medication 30 to 45 minutes before eating.
Mestinon, an acetylcholinesterase inhibitor, increases the amount of
neuromuscular transmitters to promote muscular strength and
swallowing, so the client should take the medication at least 30
minutes before meals.
◉ A client receives a new prescription for ciprofloxacin (Cipro), a
synthetic quinolone. When teaching about this drug, which
information in the client's history requires special emphasis by the
nurse?
Answer: Works twenty hours a week as a lifeguard at the local pool.
,Cipro can cause both dizziness and photosensitivity. Since the client
works as a lifeguard outdoors, measures related to these adverse
effects should be addressed.
◉ The nurse is providing medication teaching for a client who has
recently received a prescription for clozapine (Clozaril). Which
instruction should be included in this client's teaching plan?
Answer: Rise slowly from a lying position.
Orthostatic hypotension is a side effect of Clozaril, so the client
should be instructed to rise slowly from a lying down or sitting
position.
◉ A school-aged child is taking methylphenidate hydrochloride
(Ritalin, Biphentin) for the treatment of attention-deficit
hyperactivity disorder (ADHD). The mother tells the nurse that she
gives the medication at bedtime so it is "working" during school the
next morning. What modification to the administration plan should
the nurse recommend to this mother?
Answer: Administer at least six hours before bedtime.
Central nervous system stimulants, such as Ritalin, should be taken
at least six hours before bedtime to decrease insomnia.
,◉ A 38-year-old gravida 2 para 2 is diagnosed with bacterial
vaginosis 9-months postpartum. A prescription is written for
metronidazole (Flagyl). Which information is most important for the
nurse to obtain from the client before initiating treatment?
Answer: Method of infant feeding.
Flagyl is contraindicated if the woman is breastfeeding because high
concentrations have been found in breast milk fed to infants. If
Flagyl must be prescribed, the woman should be instructed to pump
and discard the milk during treatment and for 48 to 72 hours after
the last dose.
◉ The healthcare provider prescribes oral antifungal therapy for a
client with onychomycosis. What information should the nurse tell
the client?
Answer: The infection is difficult to eradicate and requires
prolonged therapy for 3 to 6 months.
Treatment of onychomycosis, a fungal infection of the fingernails
and toenails, is difficult to treat and requires prolonged therapy of 3
to 6 months for oral antifungal therapy.
◉ Miotic drug therapy for the treatment of glaucoma is based chiefly
upon which physiologic action?
, Answer: Enhancing aqueous humor outflow.
Miotic drugs act to enhance aqueous outflow through papillary
constriction with the goal to reduce intraocular pressure.
◉ A client at 30-weeks gestation is in preterm labor. The healthcare
provider prescribes two 12-mg doses of betamethasone (Celestone)
intramuscularly every 12 hours. The client asks the nurse why she is
receiving the Celestone. What information should the nurse use to
explain the action of the medication?
Answer: Stimulates fetal surfactant production.
Antenatal glucocorticoids, such as betamethasone (Celestone), are
given IM to the mother to stimulate surfactant production in the
fetus and accelerate fetal lung maturity, in the event the fetus is
delivered prematurely to minimize respiratory distress syndrome
associated with premature infants
◉ A client is beginning therapy with montelukast (Singulair) PO 10
mg once a day in the evening. The client asks the nurse, "When
should I begin to feel better?" How should the nurse respond?
Answer: Within 24 hours.
Maximal effects of montelukast (Singulair) develop within 24 hours
after initiating the first dose.
HANDBOOK 2026 ADVERSE DRUG EFFECTS
AND PATIENT SAFETY
◉ The healthcare provider prescribes pyridostigmine bromide
(Mestinon) tablets for a client with myasthenia gravis (MG). What
instruction should the nurse provide this client?
Answer: Take the medication 30 to 45 minutes before eating.
Mestinon, an acetylcholinesterase inhibitor, increases the amount of
neuromuscular transmitters to promote muscular strength and
swallowing, so the client should take the medication at least 30
minutes before meals.
◉ A client receives a new prescription for ciprofloxacin (Cipro), a
synthetic quinolone. When teaching about this drug, which
information in the client's history requires special emphasis by the
nurse?
Answer: Works twenty hours a week as a lifeguard at the local pool.
,Cipro can cause both dizziness and photosensitivity. Since the client
works as a lifeguard outdoors, measures related to these adverse
effects should be addressed.
◉ The nurse is providing medication teaching for a client who has
recently received a prescription for clozapine (Clozaril). Which
instruction should be included in this client's teaching plan?
Answer: Rise slowly from a lying position.
Orthostatic hypotension is a side effect of Clozaril, so the client
should be instructed to rise slowly from a lying down or sitting
position.
◉ A school-aged child is taking methylphenidate hydrochloride
(Ritalin, Biphentin) for the treatment of attention-deficit
hyperactivity disorder (ADHD). The mother tells the nurse that she
gives the medication at bedtime so it is "working" during school the
next morning. What modification to the administration plan should
the nurse recommend to this mother?
Answer: Administer at least six hours before bedtime.
Central nervous system stimulants, such as Ritalin, should be taken
at least six hours before bedtime to decrease insomnia.
,◉ A 38-year-old gravida 2 para 2 is diagnosed with bacterial
vaginosis 9-months postpartum. A prescription is written for
metronidazole (Flagyl). Which information is most important for the
nurse to obtain from the client before initiating treatment?
Answer: Method of infant feeding.
Flagyl is contraindicated if the woman is breastfeeding because high
concentrations have been found in breast milk fed to infants. If
Flagyl must be prescribed, the woman should be instructed to pump
and discard the milk during treatment and for 48 to 72 hours after
the last dose.
◉ The healthcare provider prescribes oral antifungal therapy for a
client with onychomycosis. What information should the nurse tell
the client?
Answer: The infection is difficult to eradicate and requires
prolonged therapy for 3 to 6 months.
Treatment of onychomycosis, a fungal infection of the fingernails
and toenails, is difficult to treat and requires prolonged therapy of 3
to 6 months for oral antifungal therapy.
◉ Miotic drug therapy for the treatment of glaucoma is based chiefly
upon which physiologic action?
, Answer: Enhancing aqueous humor outflow.
Miotic drugs act to enhance aqueous outflow through papillary
constriction with the goal to reduce intraocular pressure.
◉ A client at 30-weeks gestation is in preterm labor. The healthcare
provider prescribes two 12-mg doses of betamethasone (Celestone)
intramuscularly every 12 hours. The client asks the nurse why she is
receiving the Celestone. What information should the nurse use to
explain the action of the medication?
Answer: Stimulates fetal surfactant production.
Antenatal glucocorticoids, such as betamethasone (Celestone), are
given IM to the mother to stimulate surfactant production in the
fetus and accelerate fetal lung maturity, in the event the fetus is
delivered prematurely to minimize respiratory distress syndrome
associated with premature infants
◉ A client is beginning therapy with montelukast (Singulair) PO 10
mg once a day in the evening. The client asks the nurse, "When
should I begin to feel better?" How should the nurse respond?
Answer: Within 24 hours.
Maximal effects of montelukast (Singulair) develop within 24 hours
after initiating the first dose.
