PHARMACOLOGY HESI EXAM NEWEST EXAM 2026 | ALL QUESTIONS AND CORRECT
ANSWERS WITH RATIONALES (PROFESSOR VERIFIED) | ALREADY GRADED A+ |
LATEST EXAM
Question 1
The nurse reviews the new prescription, phenelzine (Nardil), a monoamine oxidase inhibitor
(MAOI), for a client with depression on the psychiatric unit. Which information is most
important for the nurse to assess?
A) Therapeutic serum drug levels
B) Reports of nausea or vomiting
C) Consumption of any alcohol or tyramine-rich foods
D) Blood pressure and pulse prior to taking each dose
E) Daily intake of green leafy vegetables
Correct Answer: C) Consumption of any alcohol or tyramine-rich foods
Rationale: Phenelzine is an MAOI. Patients taking MAOIs must avoid foods high in
tyramine (such as aged cheeses, red wine, smoked meats, and overripe fruit) because the
interaction can cause a massive release of norepinephrine, leading to a hypertensive crisis,
which is a medical emergency.
Question 2
The nurse is administering haloperidol 0.5 mg IM PRN to a client for the first time. What side
effects should the nurse assess the client for during the initial dose?
A) Bradykinesia
B) Dystonia
C) Somatization
D) Akathisia
E) Tardive dyskinesia
Correct Answer: B) Dystonia
Rationale: Acute dystonia is a type of extrapyramidal symptom (EPS) that can occur within
hours of the first dose of a first-generation antipsychotic like haloperidol. It involves severe
muscle spasms, particularly of the neck (torticollis), jaw, and eyes (oculogyric crisis).
Akathisia and bradykinesia usually appear slightly later in therapy.
Question 3
While reviewing the client's electronic medical record (EMR), the nurse assesses a client who is
at risk for a possible interaction with an over-the-counter (OTC) decongestant. Which client
health history should the nurse report to the healthcare provider concerning the OTC medication?
(Select all that apply)
A) Type 1 diabetes mellitus (DM)
B) Closed-angle glaucoma
C) Chronic hypertension
D) Rheumatoid arthritis
E) Crohn's disease
, 2
Correct Answer: B, C) Closed-angle glaucoma and Chronic hypertension
Rationale: OTC decongestants (like pseudoephedrine) work via alpha-adrenergic
stimulation, which causes vasoconstriction and pupillary dilation. This can dangerously
increase blood pressure in patients with hypertension and increase intraocular pressure in
patients with closed-angle glaucoma, potentially leading to blindness.
Question 4
A client prescribed ipratropium reports nausea, blurred vision, headaches, and insomnia after
using the inhaler. Which action should the nurse implement first?
A) Withhold the medication and report symptoms and vital signs to the healthcare provider
B) Give PRN medication for nausea and vomiting and evaluate client in 30 minutes
C) Reassure client that the ipratropium given will alleviate the symptoms
D) Delay administration of ipratropium until the next maintenance medication is scheduled
E) Increase the client’s fluid intake to dilute the drug
Correct Answer: A) Withhold the medication and report symptoms and vital signs to the
healthcare provider
Rationale: Ipratropium is an anticholinergic. Symptoms like blurred vision and headaches
could indicate a significant systemic reaction or increased intraocular pressure. The nurse’s
priority is safety; therefore, the dose must be held and the provider notified for further
evaluation.
Question 5
A client diagnosed with multiple sclerosis is experiencing profound weakness, blurry vision, and
shooting pains in both legs. Which medication is considered the best course of treatment for the
nurse to administer during this acute exacerbation?
A) High-dose methylprednisolone intravenously
B) Baclofen three times a day
C) Broad-spectrum antibiotic coverage orally
D) Immunomodulatory drug therapy periodically
E) Acetaminophen for pain relief
Correct Answer: A) High-dose methylprednisolone intravenously
Rationale: Acute exacerbations of multiple sclerosis (MS) are caused by inflammation in the
central nervous system. High-dose IV corticosteroids (methylprednisolone) are the gold
standard for reducing inflammation quickly and shortening the duration of the relapse.
Question 6
The nurse administers 30 mL of lactulose for a client with stage 2 hepatic encephalopathy. Which
assessment finding would indicate the medication is being therapeutic?
A) A decrease in blood ammonia levels
B) A softening in the stools
C) An increase in glucose absorption
, 3
D) A suppression of gut acidification
E) Improvement in breath sounds
Correct Answer: A) A decrease in blood ammonia levels
Rationale: Lactulose is used in hepatic failure to draw ammonia from the blood into the
colon, where it is excreted through the stool. While it causes diarrhea/soft stools, the
therapeutic goal is the neurological improvement resulting from decreased serum
ammonia.
Question 7
The nurse is teaching a client who is newly diagnosed with type 1 diabetes about neutral
protamine Hagedorn (NPH) insulin. Which statement by the client indicates an understanding of
how the medication works?
A) It facilitates the transport of glucose into the cells
B) It stimulates the function of beta cells in the pancreas
C) It increases the intracellular receptor site sensitivity
D) It delays the carbohydrate digestion and absorption
E) It replaces the need for dietary exercise
Correct Answer: A) It facilitates the transport of glucose into the cells
Rationale: Insulin is a hormone that acts as a "key" to open the cell, allowing glucose to
move from the bloodstream into the cell for energy. Type 1 diabetics do not produce insulin,
so NPH (an intermediate-acting insulin) provides the necessary transport mechanism.
Question 8
The nurse should withhold which medication if a client reports nausea, vomiting, and diarrhea?
A) Colchicine (Mitigare, Colcrys)
B) Erythromycin (E-mycin)
C) Naproxen (Aleve, Naprosyn)
D) Labetalol (Normodyne)
E) Multivitamins
Correct Answer: A) Colchicine (Mitigare, Colcrys)
Rationale: Colchicine has a very narrow therapeutic index. Nausea, vomiting, and diarrhea
are the primary early signs of colchicine toxicity. If these symptoms occur, the medication
must be stopped immediately to prevent multi-organ failure and death.
Question 9
A client newly prescribed esomeprazole for gastroesophageal reflux disease (GERD) asks the
nurse how the medication will help. Which is the best explanation to provide the client?
A) It will promote rapid tissue healing
B) It will increase gastric emptying
C) It will improve esophageal peristalsis
D) It will neutralize gastric secretions
, 4
E) It will coat the stomach lining like a bandage
Correct Answer: A) It will promote rapid tissue healing
Rationale: Esomeprazole is a proton pump inhibitor (PPI) that significantly reduces the
production of stomach acid. By creating an environment with less acid, it allows the
inflamed esophageal tissue time to heal (re-epithelialization).
Question 10
A nurse is providing medication education for a client prescribed a beta-blocking agent eye drop
for treatment of glaucoma. Which statement by the client demonstrates an understanding of the
mechanism of the medication?
A) It inhibits the aqueous humor production
B) It enhances the aqueous humor outflow
C) It increases the intraocular pressure
D) It prevents extraocular infection
E) It constricts the pupil to let light in
Correct Answer: A) It inhibits the aqueous humor production
Rationale: In the treatment of glaucoma, beta-blockers (like timolol) lower intraocular
pressure primarily by decreasing the rate of aqueous humor production by the ciliary body.
Question 11
A nurse is planning a teaching session for a client newly prescribed a miotic drug for the
treatment of glaucoma. Which information should the nurse include?
A) The medication enhances the aqueous humor outflow
B) The medication inhibits the aqueous humor production
C) The medication dilates the pupils
D) The medication prevents extraocular infection
E) The medication improves distance vision
Correct Answer: A) The medication enhances the aqueous humor outflow
Rationale: Miotic drugs (like pilocarpine) cause pupillary constriction (miosis). This pulls
the iris away from the filtration angle, which facilitates the drainage (outflow) of aqueous
humor, thereby lowering intraocular pressure.
Question 12
The healthcare provider (HCP) prescribes a medication for an older adult client reporting
insomnia. The nurse should question which prescription due to safety concerns in the elderly?
A) Zolpidem (Ambien) 10 milligrams orally at bedtime
B) Eszopiclone (Lunesta) 10 milligrams orally at bedtime
C) Temazepam (Restoril) 7.5 milligrams orally at bedtime
D) Ramelteon (Rozerem) 8 milligrams orally at bedtime
E) Melatonin 3 milligrams at bedtime
Correct Answer: B) Eszopiclone (Lunesta) 10 milligrams orally at bedtime
ANSWERS WITH RATIONALES (PROFESSOR VERIFIED) | ALREADY GRADED A+ |
LATEST EXAM
Question 1
The nurse reviews the new prescription, phenelzine (Nardil), a monoamine oxidase inhibitor
(MAOI), for a client with depression on the psychiatric unit. Which information is most
important for the nurse to assess?
A) Therapeutic serum drug levels
B) Reports of nausea or vomiting
C) Consumption of any alcohol or tyramine-rich foods
D) Blood pressure and pulse prior to taking each dose
E) Daily intake of green leafy vegetables
Correct Answer: C) Consumption of any alcohol or tyramine-rich foods
Rationale: Phenelzine is an MAOI. Patients taking MAOIs must avoid foods high in
tyramine (such as aged cheeses, red wine, smoked meats, and overripe fruit) because the
interaction can cause a massive release of norepinephrine, leading to a hypertensive crisis,
which is a medical emergency.
Question 2
The nurse is administering haloperidol 0.5 mg IM PRN to a client for the first time. What side
effects should the nurse assess the client for during the initial dose?
A) Bradykinesia
B) Dystonia
C) Somatization
D) Akathisia
E) Tardive dyskinesia
Correct Answer: B) Dystonia
Rationale: Acute dystonia is a type of extrapyramidal symptom (EPS) that can occur within
hours of the first dose of a first-generation antipsychotic like haloperidol. It involves severe
muscle spasms, particularly of the neck (torticollis), jaw, and eyes (oculogyric crisis).
Akathisia and bradykinesia usually appear slightly later in therapy.
Question 3
While reviewing the client's electronic medical record (EMR), the nurse assesses a client who is
at risk for a possible interaction with an over-the-counter (OTC) decongestant. Which client
health history should the nurse report to the healthcare provider concerning the OTC medication?
(Select all that apply)
A) Type 1 diabetes mellitus (DM)
B) Closed-angle glaucoma
C) Chronic hypertension
D) Rheumatoid arthritis
E) Crohn's disease
, 2
Correct Answer: B, C) Closed-angle glaucoma and Chronic hypertension
Rationale: OTC decongestants (like pseudoephedrine) work via alpha-adrenergic
stimulation, which causes vasoconstriction and pupillary dilation. This can dangerously
increase blood pressure in patients with hypertension and increase intraocular pressure in
patients with closed-angle glaucoma, potentially leading to blindness.
Question 4
A client prescribed ipratropium reports nausea, blurred vision, headaches, and insomnia after
using the inhaler. Which action should the nurse implement first?
A) Withhold the medication and report symptoms and vital signs to the healthcare provider
B) Give PRN medication for nausea and vomiting and evaluate client in 30 minutes
C) Reassure client that the ipratropium given will alleviate the symptoms
D) Delay administration of ipratropium until the next maintenance medication is scheduled
E) Increase the client’s fluid intake to dilute the drug
Correct Answer: A) Withhold the medication and report symptoms and vital signs to the
healthcare provider
Rationale: Ipratropium is an anticholinergic. Symptoms like blurred vision and headaches
could indicate a significant systemic reaction or increased intraocular pressure. The nurse’s
priority is safety; therefore, the dose must be held and the provider notified for further
evaluation.
Question 5
A client diagnosed with multiple sclerosis is experiencing profound weakness, blurry vision, and
shooting pains in both legs. Which medication is considered the best course of treatment for the
nurse to administer during this acute exacerbation?
A) High-dose methylprednisolone intravenously
B) Baclofen three times a day
C) Broad-spectrum antibiotic coverage orally
D) Immunomodulatory drug therapy periodically
E) Acetaminophen for pain relief
Correct Answer: A) High-dose methylprednisolone intravenously
Rationale: Acute exacerbations of multiple sclerosis (MS) are caused by inflammation in the
central nervous system. High-dose IV corticosteroids (methylprednisolone) are the gold
standard for reducing inflammation quickly and shortening the duration of the relapse.
Question 6
The nurse administers 30 mL of lactulose for a client with stage 2 hepatic encephalopathy. Which
assessment finding would indicate the medication is being therapeutic?
A) A decrease in blood ammonia levels
B) A softening in the stools
C) An increase in glucose absorption
, 3
D) A suppression of gut acidification
E) Improvement in breath sounds
Correct Answer: A) A decrease in blood ammonia levels
Rationale: Lactulose is used in hepatic failure to draw ammonia from the blood into the
colon, where it is excreted through the stool. While it causes diarrhea/soft stools, the
therapeutic goal is the neurological improvement resulting from decreased serum
ammonia.
Question 7
The nurse is teaching a client who is newly diagnosed with type 1 diabetes about neutral
protamine Hagedorn (NPH) insulin. Which statement by the client indicates an understanding of
how the medication works?
A) It facilitates the transport of glucose into the cells
B) It stimulates the function of beta cells in the pancreas
C) It increases the intracellular receptor site sensitivity
D) It delays the carbohydrate digestion and absorption
E) It replaces the need for dietary exercise
Correct Answer: A) It facilitates the transport of glucose into the cells
Rationale: Insulin is a hormone that acts as a "key" to open the cell, allowing glucose to
move from the bloodstream into the cell for energy. Type 1 diabetics do not produce insulin,
so NPH (an intermediate-acting insulin) provides the necessary transport mechanism.
Question 8
The nurse should withhold which medication if a client reports nausea, vomiting, and diarrhea?
A) Colchicine (Mitigare, Colcrys)
B) Erythromycin (E-mycin)
C) Naproxen (Aleve, Naprosyn)
D) Labetalol (Normodyne)
E) Multivitamins
Correct Answer: A) Colchicine (Mitigare, Colcrys)
Rationale: Colchicine has a very narrow therapeutic index. Nausea, vomiting, and diarrhea
are the primary early signs of colchicine toxicity. If these symptoms occur, the medication
must be stopped immediately to prevent multi-organ failure and death.
Question 9
A client newly prescribed esomeprazole for gastroesophageal reflux disease (GERD) asks the
nurse how the medication will help. Which is the best explanation to provide the client?
A) It will promote rapid tissue healing
B) It will increase gastric emptying
C) It will improve esophageal peristalsis
D) It will neutralize gastric secretions
, 4
E) It will coat the stomach lining like a bandage
Correct Answer: A) It will promote rapid tissue healing
Rationale: Esomeprazole is a proton pump inhibitor (PPI) that significantly reduces the
production of stomach acid. By creating an environment with less acid, it allows the
inflamed esophageal tissue time to heal (re-epithelialization).
Question 10
A nurse is providing medication education for a client prescribed a beta-blocking agent eye drop
for treatment of glaucoma. Which statement by the client demonstrates an understanding of the
mechanism of the medication?
A) It inhibits the aqueous humor production
B) It enhances the aqueous humor outflow
C) It increases the intraocular pressure
D) It prevents extraocular infection
E) It constricts the pupil to let light in
Correct Answer: A) It inhibits the aqueous humor production
Rationale: In the treatment of glaucoma, beta-blockers (like timolol) lower intraocular
pressure primarily by decreasing the rate of aqueous humor production by the ciliary body.
Question 11
A nurse is planning a teaching session for a client newly prescribed a miotic drug for the
treatment of glaucoma. Which information should the nurse include?
A) The medication enhances the aqueous humor outflow
B) The medication inhibits the aqueous humor production
C) The medication dilates the pupils
D) The medication prevents extraocular infection
E) The medication improves distance vision
Correct Answer: A) The medication enhances the aqueous humor outflow
Rationale: Miotic drugs (like pilocarpine) cause pupillary constriction (miosis). This pulls
the iris away from the filtration angle, which facilitates the drainage (outflow) of aqueous
humor, thereby lowering intraocular pressure.
Question 12
The healthcare provider (HCP) prescribes a medication for an older adult client reporting
insomnia. The nurse should question which prescription due to safety concerns in the elderly?
A) Zolpidem (Ambien) 10 milligrams orally at bedtime
B) Eszopiclone (Lunesta) 10 milligrams orally at bedtime
C) Temazepam (Restoril) 7.5 milligrams orally at bedtime
D) Ramelteon (Rozerem) 8 milligrams orally at bedtime
E) Melatonin 3 milligrams at bedtime
Correct Answer: B) Eszopiclone (Lunesta) 10 milligrams orally at bedtime
