COURSE: HESI PHARM 2025 DATE TIME
TITLE: Pharmacology Practice Examination — / — / —— 120 Min
◆
Pharmacology HESI Practice 2025
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 prescribed atorvastatin one month ago reports muscle pain and weakness. Which statement reflects correct
drug-specific teaching?
A. Increase potassium-rich foods
B. Have serum electrolytes checked
C. Make appointment to see provider; muscle pain may indicate serious side effect
D. Consume low-cholesterol diet
◆C — Make appointment to see provider; muscle pain may indicate serious side effect
RATIONALE: Statin-induced myopathy can progress to rhabdomyolysis—a life-threatening condition. Muscle pain requires immediate provider
evaluation with CK levels. This is not simple cramping.
2. The nurse prepares the 0900 dose of losartan for a client with potassium 5.9 mEq/L. What action should the nurse take
first?
A. Withhold the scheduled dose
B. Check apical pulse
C. Notify healthcare provider
D. Repeat serum potassium level
◆A — Withhold the scheduled dose
RATIONALE: ARBs can cause hyperkalemia. K+ 5.9 is dangerously elevated. Withhold the dose first, then notify provider. Administering could worsen
hyperkalemia and risk cardiac dysrhythmias.
3. A peak and trough level must be drawn for a client receiving antibiotic therapy. When should the nurse obtain the
trough level?
A. Sixty minutes after the antibiotic dose
B. Immediately before the next antibiotic dose
C. When the next blood glucose is checked
D. Thirty minutes before the next antibiotic dose
◆B — Immediately before the next antibiotic dose
RATIONALE: The trough is the lowest drug concentration, drawn immediately before the next scheduled dose. Peak is drawn after infusion
completion. Timing is critical for accurate therapeutic drug monitoring.
Page 1 of 15
, 4. Which change indicates the desired effect of valsartan (Diovan) has been achieved?
A. Dependent edema reduced from +3 to +1
B. Serum HDL increased from 35 to 55
C. Pulse rate reduced from 150 to 90
D. Blood pressure reduced from 160/90 to 130/80
◆D — Blood pressure reduced from 160/90 to 130/80
RATIONALE: Valsartan is an ARB; its primary effect is BP reduction. Edema reduction (A) may occur with HF use but BP is the direct measure. HDL (B)
and pulse (C) are not primary ARB effects.
5. A beta-1 agonist is most commonly prescribed for which condition?
A. Glaucoma
B. Hypertension
C. Heart failure
D. Asthma
◆C — Heart failure
RATIONALE: Beta-1 agonists (dobutamine) increase cardiac contractility and output, used in acute HF. Asthma (D) uses beta-2 agonists. Hypertension
(B) uses beta-blockers (antagonists). Glaucoma (A) uses topical beta-blockers.
6. A client receives methylprednisolone 40 mg IV daily. Which lab value is expected to increase?
A. Serum glucose
B. Serum calcium
C. Red blood cells
D. Serum potassium
◆A — Serum glucose
RATIONALE: Corticosteroids increase gluconeogenesis and decrease glucose uptake, causing hyperglycemia. Blood glucose monitoring is essential.
Calcium (B) and potassium (D) typically decrease. RBCs (C) are not directly affected.
7. A client receiving albuterol tablets complains of nausea with the 9:00 p.m. dose. What action should the nurse take?
A. Change the time of the dose
B. Hold the 9 p.m. dose
C. Administer the dose with a snack
D. Administer an antiemetic with the dose
◆C — Administer the dose with a snack
RATIONALE: Oral beta-agonists commonly cause GI upset. Taking with food reduces gastric irritation. Holding the dose (B) is inappropriate without
provider order.
8. A client admitted for possible MG receives IV edrophonium (Tensilon). What is the expected outcome?
A. Progressive difficulty swallowing
B. Decreased respiratory effort
C. Improvement in generalized fatigue
D. Decreased muscle weakness
◆D — Decreased muscle weakness
RATIONALE: Edrophonium temporarily improves muscle strength in MG by increasing acetylcholine at the NMJ. Decreased weakness confirms MG
diagnosis. Worsening (A, B) suggests cholinergic crisis.
Page 2 of 15
TITLE: Pharmacology Practice Examination — / — / —— 120 Min
◆
Pharmacology HESI Practice 2025
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 prescribed atorvastatin one month ago reports muscle pain and weakness. Which statement reflects correct
drug-specific teaching?
A. Increase potassium-rich foods
B. Have serum electrolytes checked
C. Make appointment to see provider; muscle pain may indicate serious side effect
D. Consume low-cholesterol diet
◆C — Make appointment to see provider; muscle pain may indicate serious side effect
RATIONALE: Statin-induced myopathy can progress to rhabdomyolysis—a life-threatening condition. Muscle pain requires immediate provider
evaluation with CK levels. This is not simple cramping.
2. The nurse prepares the 0900 dose of losartan for a client with potassium 5.9 mEq/L. What action should the nurse take
first?
A. Withhold the scheduled dose
B. Check apical pulse
C. Notify healthcare provider
D. Repeat serum potassium level
◆A — Withhold the scheduled dose
RATIONALE: ARBs can cause hyperkalemia. K+ 5.9 is dangerously elevated. Withhold the dose first, then notify provider. Administering could worsen
hyperkalemia and risk cardiac dysrhythmias.
3. A peak and trough level must be drawn for a client receiving antibiotic therapy. When should the nurse obtain the
trough level?
A. Sixty minutes after the antibiotic dose
B. Immediately before the next antibiotic dose
C. When the next blood glucose is checked
D. Thirty minutes before the next antibiotic dose
◆B — Immediately before the next antibiotic dose
RATIONALE: The trough is the lowest drug concentration, drawn immediately before the next scheduled dose. Peak is drawn after infusion
completion. Timing is critical for accurate therapeutic drug monitoring.
Page 1 of 15
, 4. Which change indicates the desired effect of valsartan (Diovan) has been achieved?
A. Dependent edema reduced from +3 to +1
B. Serum HDL increased from 35 to 55
C. Pulse rate reduced from 150 to 90
D. Blood pressure reduced from 160/90 to 130/80
◆D — Blood pressure reduced from 160/90 to 130/80
RATIONALE: Valsartan is an ARB; its primary effect is BP reduction. Edema reduction (A) may occur with HF use but BP is the direct measure. HDL (B)
and pulse (C) are not primary ARB effects.
5. A beta-1 agonist is most commonly prescribed for which condition?
A. Glaucoma
B. Hypertension
C. Heart failure
D. Asthma
◆C — Heart failure
RATIONALE: Beta-1 agonists (dobutamine) increase cardiac contractility and output, used in acute HF. Asthma (D) uses beta-2 agonists. Hypertension
(B) uses beta-blockers (antagonists). Glaucoma (A) uses topical beta-blockers.
6. A client receives methylprednisolone 40 mg IV daily. Which lab value is expected to increase?
A. Serum glucose
B. Serum calcium
C. Red blood cells
D. Serum potassium
◆A — Serum glucose
RATIONALE: Corticosteroids increase gluconeogenesis and decrease glucose uptake, causing hyperglycemia. Blood glucose monitoring is essential.
Calcium (B) and potassium (D) typically decrease. RBCs (C) are not directly affected.
7. A client receiving albuterol tablets complains of nausea with the 9:00 p.m. dose. What action should the nurse take?
A. Change the time of the dose
B. Hold the 9 p.m. dose
C. Administer the dose with a snack
D. Administer an antiemetic with the dose
◆C — Administer the dose with a snack
RATIONALE: Oral beta-agonists commonly cause GI upset. Taking with food reduces gastric irritation. Holding the dose (B) is inappropriate without
provider order.
8. A client admitted for possible MG receives IV edrophonium (Tensilon). What is the expected outcome?
A. Progressive difficulty swallowing
B. Decreased respiratory effort
C. Improvement in generalized fatigue
D. Decreased muscle weakness
◆D — Decreased muscle weakness
RATIONALE: Edrophonium temporarily improves muscle strength in MG by increasing acetylcholine at the NMJ. Decreased weakness confirms MG
diagnosis. Worsening (A, B) suggests cholinergic crisis.
Page 2 of 15
