COURSE: HESI PHARM DATE TIME
TITLE: Pharmacology Examination — / — / —— 120 Min
◆
Pharmacology HESI Test
Comprehensive Assessment Examination
ALL QUESTIONS ARE COMPULSORY
A MULTIPLE CHOICE QUESTIONS ◆ Complete Set
Choose the single best answer for each question unless "Select all that apply" is indicated.
1. A client forgot her oral contraceptives for the past two days. Which instruction is best?
A. Take 2 pills a day for 2 days and use alternate contraception for 7 days
B. Quit pills this cycle and resume on fifth day of menstruation
C. Take one extra pill per day for rest of cycle
D. Take 4 pills now and use alternate contraception for rest of cycle
◆A — Take 2 pills a day for 2 days and use alternate contraception for 7 days
RATIONALE: Standard missed pill protocol for 2 missed pills: take 2 pills daily for next 2 days and use backup contraception for 7 days. Option D (4
pills at once) risks severe nausea.
2. A client with pneumonia receives tetracycline. What precaution should the nurse include?
A. Take with orange juice
B. Avoid OTC medications containing alcohol
C. Avoid dairy products for 2 hours after taking
D. Do not use teeth whitening agents
◆C — Avoid dairy products for 2 hours after taking
RATIONALE: Tetracycline binds to calcium in dairy, forming nonabsorbable complexes. Separate by 2 hours. Orange juice (A) is not contraindicated.
3. A client receives pentazocine (Talwin), a mixed opioid agonist-antagonist, after an opioid agonist is discontinued. What
is the advantage?
A. Tolerance does not occur
B. Less agitation is experienced
C. The analgesic ceiling is higher
D. Respiratory depression is less
◆D — Respiratory depression is less
RATIONALE: Mixed agonist-antagonists produce less respiratory depression than pure mu agonists because of their antagonist activity at mu
receptors and agonist activity at kappa receptors.
4. The nurse should instruct a client to avoid which product while taking carisoprodol (Soma) for muscle spasms?
A. Aspirin products
B. Antacids
C. Alcoholic beverages
D. Dairy products
◆C — Alcoholic beverages
RATIONALE: Carisoprodol is a CNS depressant. Alcohol enhances sedation and respiratory depression—additive CNS depression is dangerous.
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, 5. Which heparin concentration should the nurse use to convert an IV site to a heparin lock?
A. 10 units/mL
B. 100 units/mL
C. 1,000 units/mL
D. 10,000 units/mL
◆B — 100 units/mL
RATIONALE: Heparin lock flush is 100 units/mL. Higher concentrations (1,000 and 10,000) are therapeutic doses, not flush solutions.
6. Which common side effect should the nurse alert a female client about when medroxyprogesterone (Depo-Provera) is
prescribed?
A. Leg or calf pain
B. Headaches or visual changes
C. Vaginal bleeding after discontinuing the medication
D. Jaundice during first 3 weeks
◆C — Vaginal bleeding after discontinuing the medication
RATIONALE: Withdrawal vaginal bleeding typically occurs 3–7 days after the last cyclic dose of medroxyprogesterone. Leg pain (A) could indicate DVT
—a serious but less common effect.
7. A client taking sulfisoxazole for UTI complains of nausea. Which additional adverse reaction should the nurse instruct
the client to report?
A. Rash
B. Diarrhea
C. Hematuria
D. Muscle cramping
◆A — Rash
RATIONALE: Sulfonamides can cause Stevens-Johnson syndrome. Rash may be the first sign of severe hypersensitivity requiring immediate
discontinuation.
8. A client receives an ACE inhibitor. What history contraindicates its use?
A. Asthma
B. Heart failure
C. Renal artery stenosis
D. Coronary artery disease
◆C — Renal artery stenosis
RATIONALE: ACE inhibitors can cause severe renal insufficiency in bilateral renal artery stenosis. Heart failure (B) is actually an indication.
9. What action supports the expected outcome for chronic cancer pain treated with imipramine (Tofranil)?
A. Increases pain threshold by stimulating opiate receptors
B. Decreases pain perception by blocking opiate receptors
C. Decreases pain impulse transmission by altering serotonin and norepinephrine at synapses
D. Increases pain tolerance through depression relief
◆C — Decreases pain impulse transmission by altering serotonin and norepinephrine at synapses
RATIONALE: TCAs provide analgesia by enhancing descending inhibitory pain pathways through serotonin/norepinephrine reuptake inhibition—
independent of antidepressant effects.
Page 2 of 14
TITLE: Pharmacology Examination — / — / —— 120 Min
◆
Pharmacology HESI Test
Comprehensive Assessment Examination
ALL QUESTIONS ARE COMPULSORY
A MULTIPLE CHOICE QUESTIONS ◆ Complete Set
Choose the single best answer for each question unless "Select all that apply" is indicated.
1. A client forgot her oral contraceptives for the past two days. Which instruction is best?
A. Take 2 pills a day for 2 days and use alternate contraception for 7 days
B. Quit pills this cycle and resume on fifth day of menstruation
C. Take one extra pill per day for rest of cycle
D. Take 4 pills now and use alternate contraception for rest of cycle
◆A — Take 2 pills a day for 2 days and use alternate contraception for 7 days
RATIONALE: Standard missed pill protocol for 2 missed pills: take 2 pills daily for next 2 days and use backup contraception for 7 days. Option D (4
pills at once) risks severe nausea.
2. A client with pneumonia receives tetracycline. What precaution should the nurse include?
A. Take with orange juice
B. Avoid OTC medications containing alcohol
C. Avoid dairy products for 2 hours after taking
D. Do not use teeth whitening agents
◆C — Avoid dairy products for 2 hours after taking
RATIONALE: Tetracycline binds to calcium in dairy, forming nonabsorbable complexes. Separate by 2 hours. Orange juice (A) is not contraindicated.
3. A client receives pentazocine (Talwin), a mixed opioid agonist-antagonist, after an opioid agonist is discontinued. What
is the advantage?
A. Tolerance does not occur
B. Less agitation is experienced
C. The analgesic ceiling is higher
D. Respiratory depression is less
◆D — Respiratory depression is less
RATIONALE: Mixed agonist-antagonists produce less respiratory depression than pure mu agonists because of their antagonist activity at mu
receptors and agonist activity at kappa receptors.
4. The nurse should instruct a client to avoid which product while taking carisoprodol (Soma) for muscle spasms?
A. Aspirin products
B. Antacids
C. Alcoholic beverages
D. Dairy products
◆C — Alcoholic beverages
RATIONALE: Carisoprodol is a CNS depressant. Alcohol enhances sedation and respiratory depression—additive CNS depression is dangerous.
Page 1 of 14
, 5. Which heparin concentration should the nurse use to convert an IV site to a heparin lock?
A. 10 units/mL
B. 100 units/mL
C. 1,000 units/mL
D. 10,000 units/mL
◆B — 100 units/mL
RATIONALE: Heparin lock flush is 100 units/mL. Higher concentrations (1,000 and 10,000) are therapeutic doses, not flush solutions.
6. Which common side effect should the nurse alert a female client about when medroxyprogesterone (Depo-Provera) is
prescribed?
A. Leg or calf pain
B. Headaches or visual changes
C. Vaginal bleeding after discontinuing the medication
D. Jaundice during first 3 weeks
◆C — Vaginal bleeding after discontinuing the medication
RATIONALE: Withdrawal vaginal bleeding typically occurs 3–7 days after the last cyclic dose of medroxyprogesterone. Leg pain (A) could indicate DVT
—a serious but less common effect.
7. A client taking sulfisoxazole for UTI complains of nausea. Which additional adverse reaction should the nurse instruct
the client to report?
A. Rash
B. Diarrhea
C. Hematuria
D. Muscle cramping
◆A — Rash
RATIONALE: Sulfonamides can cause Stevens-Johnson syndrome. Rash may be the first sign of severe hypersensitivity requiring immediate
discontinuation.
8. A client receives an ACE inhibitor. What history contraindicates its use?
A. Asthma
B. Heart failure
C. Renal artery stenosis
D. Coronary artery disease
◆C — Renal artery stenosis
RATIONALE: ACE inhibitors can cause severe renal insufficiency in bilateral renal artery stenosis. Heart failure (B) is actually an indication.
9. What action supports the expected outcome for chronic cancer pain treated with imipramine (Tofranil)?
A. Increases pain threshold by stimulating opiate receptors
B. Decreases pain perception by blocking opiate receptors
C. Decreases pain impulse transmission by altering serotonin and norepinephrine at synapses
D. Increases pain tolerance through depression relief
◆C — Decreases pain impulse transmission by altering serotonin and norepinephrine at synapses
RATIONALE: TCAs provide analgesia by enhancing descending inhibitory pain pathways through serotonin/norepinephrine reuptake inhibition—
independent of antidepressant effects.
Page 2 of 14
