EVOLVE HESI PHARM EXAM - PRACTICE
QUESTIONS WITH ANSWERS AND
RATIONALES LATEST 2026
Question 1
A client is experiencing an adverse effect of metoclopramide
HCl. Which assessment finding would require immediate
intervention by the nurse?
A. Dizziness when first getting up
B. An unpleasant metallic taste in the mouth
C. Parkinson-like symptoms
D. Inability to see well at night
Correct Answer: C) Parkinson-like symptoms
Rationale: Metoclopramide HCl blocks dopamine receptors in
the brain, which can cause extrapyramidal symptoms
associated with Parkinson disease. These symptoms require
immediate intervention as they indicate a serious adverse
effect. Dizziness and metallic taste are common but less
serious side effects .
,Question 2
A client with heart failure is prescribed digoxin. Which
finding indicates digoxin toxicity?
A. Anorexia, nausea, and vomiting
B. Tachycardia
C. Hyperkalemia
D. Weight gain
Correct Answer: A) Anorexia, nausea, and vomiting
Rationale: Anorexia, nausea, and vomiting are early signs of
digoxin toxicity. Other signs include visual disturbances
(yellow-green halos), bradycardia, and dysrhythmias.
Hypokalemia, not hyperkalemia, increases the risk of digoxin
toxicity .
Question 3
The nurse is teaching a client about warfarin therapy. Which
statement indicates understanding?
A. "I will use an electric razor for shaving."
B. "I will take ibuprofen for headaches."
C. "I will increase my intake of leafy green vegetables."
D. "I can stop this medication if I have no side effects."
,Correct Answer: A) "I will use an electric razor for
shaving."
Rationale: Warfarin is an anticoagulant that increases
bleeding risk. Using an electric razor reduces the risk of cuts
and bleeding. Ibuprofen increases bleeding risk and should be
avoided. Consistent vitamin K intake is important; clients
should not significantly increase leafy green vegetables.
Warfarin must not be stopped without provider approval .
Question 4
A 67-year-old client has tested positive for influenza A. The
client also has asthma. Which drug should be avoided in this
client?
A. Ribavirin
B. Zanamivir
C. Oseltamivir
D. Amantadine
Correct Answer: B) Zanamivir
Rationale: Zanamivir is contraindicated in clients with asthma
or chronic respiratory disease because it can cause
bronchospasm and decreased respiratory function.
Oseltamivir is preferred for clients with underlying
respiratory conditions .
, Question 5
Which first-line medication is used to treat anaphylactic
reactions?
A. Epinephrine
B. Norepinephrine
C. Dexamethasone
D. Diphenhydramine
Correct Answer: A) Epinephrine
Rationale: Epinephrine is the drug of choice for anaphylaxis.
It acts as a potent sympathomimetic that reverses
bronchoconstriction, vasodilation, and hypotension. While
diphenhydramine and corticosteroids are used as adjunct
therapy, epinephrine is the immediate first-line treatment .
Question 6
A mother complains that her child's teeth have become yellow
in color. With prolonged use, which medication may be
responsible?
A. Tetracycline
B. Promethazine
QUESTIONS WITH ANSWERS AND
RATIONALES LATEST 2026
Question 1
A client is experiencing an adverse effect of metoclopramide
HCl. Which assessment finding would require immediate
intervention by the nurse?
A. Dizziness when first getting up
B. An unpleasant metallic taste in the mouth
C. Parkinson-like symptoms
D. Inability to see well at night
Correct Answer: C) Parkinson-like symptoms
Rationale: Metoclopramide HCl blocks dopamine receptors in
the brain, which can cause extrapyramidal symptoms
associated with Parkinson disease. These symptoms require
immediate intervention as they indicate a serious adverse
effect. Dizziness and metallic taste are common but less
serious side effects .
,Question 2
A client with heart failure is prescribed digoxin. Which
finding indicates digoxin toxicity?
A. Anorexia, nausea, and vomiting
B. Tachycardia
C. Hyperkalemia
D. Weight gain
Correct Answer: A) Anorexia, nausea, and vomiting
Rationale: Anorexia, nausea, and vomiting are early signs of
digoxin toxicity. Other signs include visual disturbances
(yellow-green halos), bradycardia, and dysrhythmias.
Hypokalemia, not hyperkalemia, increases the risk of digoxin
toxicity .
Question 3
The nurse is teaching a client about warfarin therapy. Which
statement indicates understanding?
A. "I will use an electric razor for shaving."
B. "I will take ibuprofen for headaches."
C. "I will increase my intake of leafy green vegetables."
D. "I can stop this medication if I have no side effects."
,Correct Answer: A) "I will use an electric razor for
shaving."
Rationale: Warfarin is an anticoagulant that increases
bleeding risk. Using an electric razor reduces the risk of cuts
and bleeding. Ibuprofen increases bleeding risk and should be
avoided. Consistent vitamin K intake is important; clients
should not significantly increase leafy green vegetables.
Warfarin must not be stopped without provider approval .
Question 4
A 67-year-old client has tested positive for influenza A. The
client also has asthma. Which drug should be avoided in this
client?
A. Ribavirin
B. Zanamivir
C. Oseltamivir
D. Amantadine
Correct Answer: B) Zanamivir
Rationale: Zanamivir is contraindicated in clients with asthma
or chronic respiratory disease because it can cause
bronchospasm and decreased respiratory function.
Oseltamivir is preferred for clients with underlying
respiratory conditions .
, Question 5
Which first-line medication is used to treat anaphylactic
reactions?
A. Epinephrine
B. Norepinephrine
C. Dexamethasone
D. Diphenhydramine
Correct Answer: A) Epinephrine
Rationale: Epinephrine is the drug of choice for anaphylaxis.
It acts as a potent sympathomimetic that reverses
bronchoconstriction, vasodilation, and hypotension. While
diphenhydramine and corticosteroids are used as adjunct
therapy, epinephrine is the immediate first-line treatment .
Question 6
A mother complains that her child's teeth have become yellow
in color. With prolonged use, which medication may be
responsible?
A. Tetracycline
B. Promethazine
