HESI Pharmacology V1 EXAM LATEST 2026-2027 100
QUESTIONS AND 100% Verified ANSWERS
A nurse is planning to administer hydrochlorothiazide (HydroDIURIL) to a client. The nurse understands that which
of the following are concerns related to the administration of this medication?
1. Hypouricemia, hyperkalemia
2. Increased risk of osteoporosis
3. Hypokalemia, hyperglycemia, sulfa allergy
4. Hyperkalemia, hypoglycemia, penicillin allergy - answer>>3. Hypokalemia, hyperglycemia, sulfa allergy
Rationale:
Thiazide diuretics such as hydrochlorothiazide are sulfa-based medications, and a client with a sulfa allergy is at
risk for an allergic reaction. Also, clients are at risk for hypokalemia, hyperglycemia, hypercalcemia,
hyperlipidemia, and hyperuricemia.
A home health care nurse is visiting a client with elevated triglyceride levels and a serum cholesterol level of 398
mg/dL. The client is taking cholestyramine (Questran). Which of the following statements, if made by the client,
indicates the need for further education?
1. "Constipation and bloating might be a problem."
2. "I'll continue to watch my diet and reduce my fats."
3. "Walking a mile each day will help the whole process."
4. "I'll continue my nicotinic acid from the health food store." - answer>>4. "I'll continue my nicotinic acid from the
health food store."
Rationale:
Nicotinic acid, even an over-the-counter form, should be avoided because it may lead to liver abnormalities. All
lipid-lowering medications also can cause liver abnormalities, so a combination of nicotinic acid and
cholestyramine resin is to be avoided. Constipation and bloating are the two most common side effects. Walking
and the reduction of fats in the diet are therapeutic measures to reduce cholesterol and triglyceride levels.
A client is on nicotinic acid (niacin) for hyperlipidemia and the nurse provides instructions to the client about the
medication. Which statement by the client would indicate an understanding of the instructions?
,1. "It is not necessary to avoid the use of alcohol."
2. "The medication should be taken with meals to decrease flushing."
3. "Clay-colored stools are a common side effect and should not be of concern."
4. "Ibuprofen (Motrin) taken 30 minutes before the nicotinic acid should decrease the flushing." - answer>>4.
"Ibuprofen (Motrin) taken 30 minutes before the nicotinic acid should decrease the flushing."
Rationale:
Flushing is a side effect of this medication. Aspirin or a nonsteroidal anti-inflammatory drug can be taken 30
minutes before taking the medication to decrease flushing. Alcohol consumption needs to be avoided because it
will enhance this side effect. The medication should be taken with meals, this will decrease gastrointestinal upset.
Taking the medication with meals has no effect on the flushing. Clay-colored stools are a sign of hepatic
dysfunction and should be immediately reported to the health care provider (HCP).
A client with coronary artery disease complains of substernal chest pain. After checking the client's heart rate and
blood pressure, a nurse administers nitroglycerin, 0.4 mg, sublingually. After 5 minutes, the client states, "My
chest still hurts." Select the appropriate actions that the nurse should take. Select all that apply.
1. Call a code blue.
2. Contact the registered nurse
.3. Contact the client's family.
4. Assess the client's pain level.
5. Check the client's blood pressure.
6. Administer a second nitroglycerin, 0.4 mg, sublingually. - answer>>2. Contact the registered nurse.
4. Assess the client's pain level.
5. Check the client's blood pressure.
6. Administer a second nitroglycerin, 0.4 mg, sublingually.
Rationale:
The usual guideline for administering nitroglycerin tablets for a hospitalized client with chest pain is to administer
one tablet every 5 minutes PRN for chest pain, for a total dose of three tablets. The registered nurse should be
notified of the client's condition, who will then notify the health care provider as appropriate. Because the client is
still complaining of chest pain, the nurse would administer a second nitroglycerin tablet. The nurse would assess
the client's pain level and check the client's blood pressure before administering each nitroglycerin dose. There are
,no data in the question that indicate the need to call a code blue. In addition, it is not necessary to contact the
client's family unless the client has requested this.
Nalidixic acid (NegGram) is prescribed for a client with a urinary tract infection. On review of the client's record,
the nurse notes that the client is taking warfarin sodium (Coumadin) daily. Which prescription should the nurse
anticipate for this client?
1. Discontinuation of warfarin sodium (Coumadin)
2. A decrease in the warfarin sodium (Coumadin) dosage
3. An increase in the warfarin sodium (Coumadin) dosage
4. A decrease in the usual dose of nalidixic acid (NegGram) - answer>>2. A decrease in the warfarin sodium
(Coumadin) dosage
Rationale:
Nalidixic acid can intensify the effects of oral anticoagulants by displacing these agents from binding sites on
plasma protein. When an oral anticoagulant is combined with nalidixic acid, a decrease in the anticoagulant
dosage may be needed.
A nurse is reinforcing discharge instructions to a client receiving sulfisoxazole. Which of the following should be
included in the list of instructions?
1. Restrict fluid intake.
2. Maintain a high fluid intake.
3. If the urine turns dark brown, call the health care provider (HCP) immediately.
4. Decrease the dosage when symptoms are improving to prevent an allergic response - answer>>2. Maintain a
high fluid intake.
Rationale:
Each dose of sulfisoxazole should be administered with a full glass of water, and the client should maintain a high
fluid intake. The medication is more soluble in alkaline urine. The client should not be instructed to taper or
discontinue the dose. Some forms of sulfisoxazole cause urine to turn dark brown or red. This does not indicate
the need to notify the HCP.
Trimethoprim-sulfamethoxazole (TMP-SMZ) is prescribed for a client. A nurse should instruct the client to report
which symptom if it developed during the course of this medication therapy?
, 1. Nausea
2. Diarrhea
3. Headache
4. Sore throat - answer>>4. Sore throat
Rationale:
Clients taking trimethoprim-sulfamethoxazole (TMP-SMZ) should be informed about early signs of blood disorders
that can occur from this medication. These include sore throat, fever, and pallor, and the client should be
instructed to notify the health care provider if these symptoms occur. The other options do not require health
care provider notification.
Phenazopyridine hydrochloride (Pyridium) is prescribed for a client for symptomatic relief of pain resulting from a
lower urinary tract infection. The nurse reinforces to the client:
1. To take the medication at bedtime
2. To take the medication before meals
3. To discontinue the medication if a headache occurs
4. That a reddish orange discoloration of the urine may occur - answer>>4. That a reddish orange discoloration of
the urine may occur
Rationale:
The nurse should instruct the client that a reddish-orange discoloration of urine may occur. The nurse also should
instruct the client that this discoloration can stain fabric. The medication should be taken after meals to reduce
the possibility of gastrointestinal upset. A headache is an occasional side effect of the medication and does not
warrant discontinuation of the medication.
Bethanechol chloride (Urecholine) is prescribed for a client with urinary retention. Which disorder would be a
contraindication to the administration of this medication?
1. Gastric atony
2. Urinary strictures
3. Neurogenic atony
4. Gastroesophageal reflux - answer>>2. Urinary strictures
QUESTIONS AND 100% Verified ANSWERS
A nurse is planning to administer hydrochlorothiazide (HydroDIURIL) to a client. The nurse understands that which
of the following are concerns related to the administration of this medication?
1. Hypouricemia, hyperkalemia
2. Increased risk of osteoporosis
3. Hypokalemia, hyperglycemia, sulfa allergy
4. Hyperkalemia, hypoglycemia, penicillin allergy - answer>>3. Hypokalemia, hyperglycemia, sulfa allergy
Rationale:
Thiazide diuretics such as hydrochlorothiazide are sulfa-based medications, and a client with a sulfa allergy is at
risk for an allergic reaction. Also, clients are at risk for hypokalemia, hyperglycemia, hypercalcemia,
hyperlipidemia, and hyperuricemia.
A home health care nurse is visiting a client with elevated triglyceride levels and a serum cholesterol level of 398
mg/dL. The client is taking cholestyramine (Questran). Which of the following statements, if made by the client,
indicates the need for further education?
1. "Constipation and bloating might be a problem."
2. "I'll continue to watch my diet and reduce my fats."
3. "Walking a mile each day will help the whole process."
4. "I'll continue my nicotinic acid from the health food store." - answer>>4. "I'll continue my nicotinic acid from the
health food store."
Rationale:
Nicotinic acid, even an over-the-counter form, should be avoided because it may lead to liver abnormalities. All
lipid-lowering medications also can cause liver abnormalities, so a combination of nicotinic acid and
cholestyramine resin is to be avoided. Constipation and bloating are the two most common side effects. Walking
and the reduction of fats in the diet are therapeutic measures to reduce cholesterol and triglyceride levels.
A client is on nicotinic acid (niacin) for hyperlipidemia and the nurse provides instructions to the client about the
medication. Which statement by the client would indicate an understanding of the instructions?
,1. "It is not necessary to avoid the use of alcohol."
2. "The medication should be taken with meals to decrease flushing."
3. "Clay-colored stools are a common side effect and should not be of concern."
4. "Ibuprofen (Motrin) taken 30 minutes before the nicotinic acid should decrease the flushing." - answer>>4.
"Ibuprofen (Motrin) taken 30 minutes before the nicotinic acid should decrease the flushing."
Rationale:
Flushing is a side effect of this medication. Aspirin or a nonsteroidal anti-inflammatory drug can be taken 30
minutes before taking the medication to decrease flushing. Alcohol consumption needs to be avoided because it
will enhance this side effect. The medication should be taken with meals, this will decrease gastrointestinal upset.
Taking the medication with meals has no effect on the flushing. Clay-colored stools are a sign of hepatic
dysfunction and should be immediately reported to the health care provider (HCP).
A client with coronary artery disease complains of substernal chest pain. After checking the client's heart rate and
blood pressure, a nurse administers nitroglycerin, 0.4 mg, sublingually. After 5 minutes, the client states, "My
chest still hurts." Select the appropriate actions that the nurse should take. Select all that apply.
1. Call a code blue.
2. Contact the registered nurse
.3. Contact the client's family.
4. Assess the client's pain level.
5. Check the client's blood pressure.
6. Administer a second nitroglycerin, 0.4 mg, sublingually. - answer>>2. Contact the registered nurse.
4. Assess the client's pain level.
5. Check the client's blood pressure.
6. Administer a second nitroglycerin, 0.4 mg, sublingually.
Rationale:
The usual guideline for administering nitroglycerin tablets for a hospitalized client with chest pain is to administer
one tablet every 5 minutes PRN for chest pain, for a total dose of three tablets. The registered nurse should be
notified of the client's condition, who will then notify the health care provider as appropriate. Because the client is
still complaining of chest pain, the nurse would administer a second nitroglycerin tablet. The nurse would assess
the client's pain level and check the client's blood pressure before administering each nitroglycerin dose. There are
,no data in the question that indicate the need to call a code blue. In addition, it is not necessary to contact the
client's family unless the client has requested this.
Nalidixic acid (NegGram) is prescribed for a client with a urinary tract infection. On review of the client's record,
the nurse notes that the client is taking warfarin sodium (Coumadin) daily. Which prescription should the nurse
anticipate for this client?
1. Discontinuation of warfarin sodium (Coumadin)
2. A decrease in the warfarin sodium (Coumadin) dosage
3. An increase in the warfarin sodium (Coumadin) dosage
4. A decrease in the usual dose of nalidixic acid (NegGram) - answer>>2. A decrease in the warfarin sodium
(Coumadin) dosage
Rationale:
Nalidixic acid can intensify the effects of oral anticoagulants by displacing these agents from binding sites on
plasma protein. When an oral anticoagulant is combined with nalidixic acid, a decrease in the anticoagulant
dosage may be needed.
A nurse is reinforcing discharge instructions to a client receiving sulfisoxazole. Which of the following should be
included in the list of instructions?
1. Restrict fluid intake.
2. Maintain a high fluid intake.
3. If the urine turns dark brown, call the health care provider (HCP) immediately.
4. Decrease the dosage when symptoms are improving to prevent an allergic response - answer>>2. Maintain a
high fluid intake.
Rationale:
Each dose of sulfisoxazole should be administered with a full glass of water, and the client should maintain a high
fluid intake. The medication is more soluble in alkaline urine. The client should not be instructed to taper or
discontinue the dose. Some forms of sulfisoxazole cause urine to turn dark brown or red. This does not indicate
the need to notify the HCP.
Trimethoprim-sulfamethoxazole (TMP-SMZ) is prescribed for a client. A nurse should instruct the client to report
which symptom if it developed during the course of this medication therapy?
, 1. Nausea
2. Diarrhea
3. Headache
4. Sore throat - answer>>4. Sore throat
Rationale:
Clients taking trimethoprim-sulfamethoxazole (TMP-SMZ) should be informed about early signs of blood disorders
that can occur from this medication. These include sore throat, fever, and pallor, and the client should be
instructed to notify the health care provider if these symptoms occur. The other options do not require health
care provider notification.
Phenazopyridine hydrochloride (Pyridium) is prescribed for a client for symptomatic relief of pain resulting from a
lower urinary tract infection. The nurse reinforces to the client:
1. To take the medication at bedtime
2. To take the medication before meals
3. To discontinue the medication if a headache occurs
4. That a reddish orange discoloration of the urine may occur - answer>>4. That a reddish orange discoloration of
the urine may occur
Rationale:
The nurse should instruct the client that a reddish-orange discoloration of urine may occur. The nurse also should
instruct the client that this discoloration can stain fabric. The medication should be taken after meals to reduce
the possibility of gastrointestinal upset. A headache is an occasional side effect of the medication and does not
warrant discontinuation of the medication.
Bethanechol chloride (Urecholine) is prescribed for a client with urinary retention. Which disorder would be a
contraindication to the administration of this medication?
1. Gastric atony
2. Urinary strictures
3. Neurogenic atony
4. Gastroesophageal reflux - answer>>2. Urinary strictures
