Pharmacology HESI A2 Exam
2026| Actual Exam Questions
and Verified Answers
1. A client receives a prescription for esomeprazole (Nexium) for heartburn. Which finding in the
client's history should the nurse report to the healthcare provider before administering the
prescription?
A) Eats spicy food three times a week.
B) History of deep vein thrombosis.
C) Drinks 2 alcoholic beverages on weekends.
D) Family history of diabetes mellitus.
Correct Answer: History of deep vein thrombosis.
Explanation: Long-term use of proton pump inhibitors like esomeprazole has been associated
with increased risk of fractures and potential interactions in clients with clotting history; the
nurse should report this finding for further evaluation.
2. A male client who is in the terminal stage of cancer is cared for at home by his family and
receives a prescription for morphine at a rate to control intractable pain. When the hospice nurse
visits, the client awakens, moans in severe pain, and asks for an increase in the morphine dosage.
After determining the client's respirations are 10 per minute, what is the best action for the nurse
to implement?
A) Titrate the morphine dose upward until the client has adequate pain relief.
B) Suggest to the family that they can also give the client ibuprofen, a non-narcotic analgesic.
C) Hold additional morphine until the client's respirations are at least 16 per minute.
D) Inform the client that an increased dose of morphine increases side effects without additional
pain control.
Correct Answer: Titrate the morphine dose upward until the client has adequate pain relief.
,Explanation: In end-of-life care, comfort is the priority. A respiratory rate of 10 is common with
opioids; titration is appropriate while continuing close monitoring.
3. A client with Paget's disease is started on calcitonin (Calcimar) 500 mcg subcutaneously daily.
During the initial treatment, what is the priority nursing action?
A) Assess the injection site for inflammation.
B) Evaluate the client's level of pain.
C) Monitor the client's alkaline phosphatase levels.
D) Observe the client for signs of hypersensitivity.
Correct Answer: Observe the client for signs of hypersensitivity.
Explanation: Calcitonin is a peptide; the initial dose carries the highest risk of hypersensitivity
reaction, making this the priority.
4. A client is taking cyclosporine for renal allograft rejection prevention. After 9 months of drug
therapy, the nurse reviews laboratory data and notes that the blood urea nitrogen level is 36
mg/dl. What additional finding should the nurse identify?
A) Hypotension.
B) White blood cell count 10,000.
C) Creatinine 28 mg/dl.
D) Anaphylactic reaction.
Correct Answer: Creatinine 28 mg/dl.
Explanation: Cyclosporine is highly nephrotoxic. Markedly elevated creatinine indicates
significant renal impairment, a serious adverse effect.
5. The nurse receives a unit of blood from the blood bank for a postoperative client who is
currently in the X-ray department. What action should the nurse implement?
A) Return the blood to the blood bank for refrigeration within 30 minutes.
B) Hang the blood transfusion as soon as the client returns to the unit.
C) Store the blood bag in the nursing unit's refrigerator until the client returns.
D) Take the unit of blood to the X-ray department to initiate the transfusion.
Correct Answer: Return the blood to the blood bank for refrigeration within 30 minutes.
Explanation: Unused blood must be returned within 30 minutes to maintain temperature control
and safety.
, 6. Which side effects should the nurse monitor for a client who is receiving dexamethasone
(Decadron) following neurosurgery? (Select all that apply.)
A) Mood swings.
B) Decreased appetite.
C) Increased weight gain.
D) Serum glucose level of 65 mg/dl.
E) Delayed incisional wound healing.
F) Serum hemoglobin level of 9 mg/dl.
Correct Answer: Mood swings. Increased weight gain. Delayed incisional wound healing. Serum
hemoglobin level of 9 mg/dl.
Explanation: Corticosteroids cause mood changes, fluid retention/weight gain, impaired wound
healing, and can contribute to anemia. Hypoglycemia is not typical.
7. A client is taking danazol (Danocrine) for endometriosis and calls the clinic nurse to complain
of a dark, swollen, and painful leg. What instructions should the nurse provide the client?
A) Wear support stockings.
B) Elevate both legs and apply heat.
C) Proceed to the closest emergency room.
D) Walk for 20 to 30 minutes to reduce muscle cramps.
Correct Answer: Proceed to the closest emergency room.
Explanation: Danazol increases thromboembolism risk. A dark, swollen, painful leg suggests
DVT and requires immediate evaluation.
8. A client asks the nurse to explain the meaning of a narrow therapeutic index of a medication.
What information should the nurse use to answer the question?
A) The onset of action for the medication occurs very quickly.
B) A small margin exists between safe and toxic plasma levels.
C) Bioavailability is significantly reduced by the first-pass effect.
D) Minimum dosage is needed for the medication to be effective.
Correct Answer: A small margin exists between safe and toxic plasma levels.
2026| Actual Exam Questions
and Verified Answers
1. A client receives a prescription for esomeprazole (Nexium) for heartburn. Which finding in the
client's history should the nurse report to the healthcare provider before administering the
prescription?
A) Eats spicy food three times a week.
B) History of deep vein thrombosis.
C) Drinks 2 alcoholic beverages on weekends.
D) Family history of diabetes mellitus.
Correct Answer: History of deep vein thrombosis.
Explanation: Long-term use of proton pump inhibitors like esomeprazole has been associated
with increased risk of fractures and potential interactions in clients with clotting history; the
nurse should report this finding for further evaluation.
2. A male client who is in the terminal stage of cancer is cared for at home by his family and
receives a prescription for morphine at a rate to control intractable pain. When the hospice nurse
visits, the client awakens, moans in severe pain, and asks for an increase in the morphine dosage.
After determining the client's respirations are 10 per minute, what is the best action for the nurse
to implement?
A) Titrate the morphine dose upward until the client has adequate pain relief.
B) Suggest to the family that they can also give the client ibuprofen, a non-narcotic analgesic.
C) Hold additional morphine until the client's respirations are at least 16 per minute.
D) Inform the client that an increased dose of morphine increases side effects without additional
pain control.
Correct Answer: Titrate the morphine dose upward until the client has adequate pain relief.
,Explanation: In end-of-life care, comfort is the priority. A respiratory rate of 10 is common with
opioids; titration is appropriate while continuing close monitoring.
3. A client with Paget's disease is started on calcitonin (Calcimar) 500 mcg subcutaneously daily.
During the initial treatment, what is the priority nursing action?
A) Assess the injection site for inflammation.
B) Evaluate the client's level of pain.
C) Monitor the client's alkaline phosphatase levels.
D) Observe the client for signs of hypersensitivity.
Correct Answer: Observe the client for signs of hypersensitivity.
Explanation: Calcitonin is a peptide; the initial dose carries the highest risk of hypersensitivity
reaction, making this the priority.
4. A client is taking cyclosporine for renal allograft rejection prevention. After 9 months of drug
therapy, the nurse reviews laboratory data and notes that the blood urea nitrogen level is 36
mg/dl. What additional finding should the nurse identify?
A) Hypotension.
B) White blood cell count 10,000.
C) Creatinine 28 mg/dl.
D) Anaphylactic reaction.
Correct Answer: Creatinine 28 mg/dl.
Explanation: Cyclosporine is highly nephrotoxic. Markedly elevated creatinine indicates
significant renal impairment, a serious adverse effect.
5. The nurse receives a unit of blood from the blood bank for a postoperative client who is
currently in the X-ray department. What action should the nurse implement?
A) Return the blood to the blood bank for refrigeration within 30 minutes.
B) Hang the blood transfusion as soon as the client returns to the unit.
C) Store the blood bag in the nursing unit's refrigerator until the client returns.
D) Take the unit of blood to the X-ray department to initiate the transfusion.
Correct Answer: Return the blood to the blood bank for refrigeration within 30 minutes.
Explanation: Unused blood must be returned within 30 minutes to maintain temperature control
and safety.
, 6. Which side effects should the nurse monitor for a client who is receiving dexamethasone
(Decadron) following neurosurgery? (Select all that apply.)
A) Mood swings.
B) Decreased appetite.
C) Increased weight gain.
D) Serum glucose level of 65 mg/dl.
E) Delayed incisional wound healing.
F) Serum hemoglobin level of 9 mg/dl.
Correct Answer: Mood swings. Increased weight gain. Delayed incisional wound healing. Serum
hemoglobin level of 9 mg/dl.
Explanation: Corticosteroids cause mood changes, fluid retention/weight gain, impaired wound
healing, and can contribute to anemia. Hypoglycemia is not typical.
7. A client is taking danazol (Danocrine) for endometriosis and calls the clinic nurse to complain
of a dark, swollen, and painful leg. What instructions should the nurse provide the client?
A) Wear support stockings.
B) Elevate both legs and apply heat.
C) Proceed to the closest emergency room.
D) Walk for 20 to 30 minutes to reduce muscle cramps.
Correct Answer: Proceed to the closest emergency room.
Explanation: Danazol increases thromboembolism risk. A dark, swollen, painful leg suggests
DVT and requires immediate evaluation.
8. A client asks the nurse to explain the meaning of a narrow therapeutic index of a medication.
What information should the nurse use to answer the question?
A) The onset of action for the medication occurs very quickly.
B) A small margin exists between safe and toxic plasma levels.
C) Bioavailability is significantly reduced by the first-pass effect.
D) Minimum dosage is needed for the medication to be effective.
Correct Answer: A small margin exists between safe and toxic plasma levels.
