HESI Pharmacology Exam Questions & Answers Version 2
2023 Update
Ketoconazole is prescribed for a client with a diagnosis of candidiasis. Select the interventions that the nurse
includes when administering this medication. Select all that apply.
✓ Instruct the client to avoid alcohol.
✓ Monitor hepatic and liver function studies.
✓ Instruct the client to avoid exposure to the sun.
Rationale:
Ketoconazole is an antifungal medication. It is administered with food (not on an empty stomach) and antacids
are avoided for hours after taking the medication to ensure absorption. The medication is hepatotoxic and the
nurse monitors liver function studies. The client is instructed to avoid exposure to the sun because the
medication increases photosensitivity. The client is also instructed to avoid alcohol. There is no reason for the
client to restrict fluid intake. In fact, this could be harmful to the client.
A client with human immunodeficiency virus is taking nevirapine (Viramune). The nurse should monitor for
which adverse effects of the medication? Select all that apply.
✓ Rash
✓ Hepatotoxicity
Rationale:
Nevirapine (Viramune) is a non-nucleoside reverse transcriptase inhibitors (NRTI) that is used to treat HIV
infection. It is used in combination with other antiretroviral medications to treat HIV. Adverse effects include
rash, Stevens-Johnson syndrome, hepatitis, and increased transaminase levels. Hyperglycemia, peripheral
neuropathy, and reduced bone density are not adverse effects of this medication.
A nurse is caring for a hospitalized client who has been taking clozapine (Clozaril) for the treatment of a
schizophrenic disorder. Which laboratory study prescribed for the client will the nurse specifically review to
monitor for an adverse effect associated with the use of this medication?
White blood cell count
Rationale:
Hematological reactions can occur in the client taking clozapine and include agranulocytosis and mild
leukopenia. The white blood cell count should be checked before initiating treatment and should be monitored
closely during the use of this medication. The client should also be monitored for signs indicating
agranulocytosis, which may include sore throat, malaise, and fever.
Disulfiram (Antabuse) is prescribed for a client who is seen in the psychiatric health care clinic. The nurse is
collecting data on the client and is providing instructions regarding the use of this medication. Which is
most important for the nurse to determine before administration of this medication?
When the last alcoholic drink was consumed
Rationale:
Disulfiram is used as an adjunct treatment for selected clients with chronic alcoholism who want to remain in a
state of enforced sobriety. Clients must abstain from alcohol intake for at least hours before the initial dose of
the medication is administered. The most important data are to determine when the last alcoholic drink was
consumed. The medication is used with caution in clients with diabetes mellitus, hypothyroidism, epilepsy,
cerebral damage, nephritis, and hepatic disease. It is also contraindicated in severe heart disease, psychosis, or
hypersensitivity related to the medication.
,A nurse is collecting data from a client and the client's spouse reports that the client is taking donepezil
hydrochloride (Aricept). Which disorder would the nurse suspect that this client may have based on the use of
this medication?
Dementia
Rationale:
Donepezil hydrochloride is a cholinergic agent used in the treatment of mild to moderate dementia of the
Alzheimer type. It enhances cholinergic functions by increasing the concentration of acetylcholine. It slows the
progression of Alzheimer's disease.
, Fluoxetine (Prozac) is prescribed for the client. The nurse reinforces instructions to the client regarding the
administration of the medication. Which statement by the client indicates an understanding about
administration of the medication?
"I should take the medication in the morning when I first arise."
Rationale:
Fluoxetine hydrochloride is administered in the early morning without consideration to meals.
A client receiving a tricyclic antidepressant arrives at the mental health clinic. Which observation indicates that
the client is correctly following the medication plan?
Arrives at the clinic neat and appropriate in appearance
Rationale:
Depressed individuals will sleep for long periods, are not able to go to work, and feel as if they cannot "do
anything." Once they have had some therapeutic effect from their medication, they will report resolution of
many of these complaints as well as demonstrate an improvement in their appearance.
A nurse is performing a follow-up teaching session with a client discharged month ago who is taking fluoxetine
(Prozac). What information would be important for the nurse to gather regarding the adverse effects related to
the medication?
Gastrointestinal dysfunctions
Rationale:
The most common adverse effects related to fluoxetine include central nervous system (CNS) and
gastrointestinal (GI) system dysfunction. This medication affects the GI system by causing nausea and
vomiting, cramping, and diarrhea.
A client taking buspirone (BuSpar) for month returns to the clinic for a follow-up visit. Which of the following
would indicate medication effectiveness?
No rapid heartbeats or anxiety
Rationale:
Buspirone hydrochloride is not recommended for the treatment of drug or alcohol withdrawal, paranoid thought
disorders, or schizophrenia (thought broadcasting or delusions). Buspirone hydrochloride is most often
indicated for the treatment of anxiety and aggression.
A client taking lithium carbonate (Lithobid) reports vomiting, abdominal pain, diarrhea, blurred vision, tinnitus,
and tremors. The lithium level is checked as a part of the routine follow-up and the level is 2. mEq/L. The
nurse knows that this level is:
Toxic
Rationale:
The therapeutic serum level of lithium is . 0.8 to 1.2 . mEq/L.
A client arrives at the health care clinic and tells the nurse that he has been doubling his daily dosage of
bupropion hydrochloride (Wellbutrin) to help him get better faster. The nurse understands that the client is now
at risk for which of the following?
Seizure activity
Rationale:
Bupropion does not cause significant orthostatic blood pressure changes. Seizure activity is common in dosages
greater than mg daily. Bupropion frequently causes a drop in body weight. Insomnia is a side effect, but seizure
activity causes a greater client risk.
2023 Update
Ketoconazole is prescribed for a client with a diagnosis of candidiasis. Select the interventions that the nurse
includes when administering this medication. Select all that apply.
✓ Instruct the client to avoid alcohol.
✓ Monitor hepatic and liver function studies.
✓ Instruct the client to avoid exposure to the sun.
Rationale:
Ketoconazole is an antifungal medication. It is administered with food (not on an empty stomach) and antacids
are avoided for hours after taking the medication to ensure absorption. The medication is hepatotoxic and the
nurse monitors liver function studies. The client is instructed to avoid exposure to the sun because the
medication increases photosensitivity. The client is also instructed to avoid alcohol. There is no reason for the
client to restrict fluid intake. In fact, this could be harmful to the client.
A client with human immunodeficiency virus is taking nevirapine (Viramune). The nurse should monitor for
which adverse effects of the medication? Select all that apply.
✓ Rash
✓ Hepatotoxicity
Rationale:
Nevirapine (Viramune) is a non-nucleoside reverse transcriptase inhibitors (NRTI) that is used to treat HIV
infection. It is used in combination with other antiretroviral medications to treat HIV. Adverse effects include
rash, Stevens-Johnson syndrome, hepatitis, and increased transaminase levels. Hyperglycemia, peripheral
neuropathy, and reduced bone density are not adverse effects of this medication.
A nurse is caring for a hospitalized client who has been taking clozapine (Clozaril) for the treatment of a
schizophrenic disorder. Which laboratory study prescribed for the client will the nurse specifically review to
monitor for an adverse effect associated with the use of this medication?
White blood cell count
Rationale:
Hematological reactions can occur in the client taking clozapine and include agranulocytosis and mild
leukopenia. The white blood cell count should be checked before initiating treatment and should be monitored
closely during the use of this medication. The client should also be monitored for signs indicating
agranulocytosis, which may include sore throat, malaise, and fever.
Disulfiram (Antabuse) is prescribed for a client who is seen in the psychiatric health care clinic. The nurse is
collecting data on the client and is providing instructions regarding the use of this medication. Which is
most important for the nurse to determine before administration of this medication?
When the last alcoholic drink was consumed
Rationale:
Disulfiram is used as an adjunct treatment for selected clients with chronic alcoholism who want to remain in a
state of enforced sobriety. Clients must abstain from alcohol intake for at least hours before the initial dose of
the medication is administered. The most important data are to determine when the last alcoholic drink was
consumed. The medication is used with caution in clients with diabetes mellitus, hypothyroidism, epilepsy,
cerebral damage, nephritis, and hepatic disease. It is also contraindicated in severe heart disease, psychosis, or
hypersensitivity related to the medication.
,A nurse is collecting data from a client and the client's spouse reports that the client is taking donepezil
hydrochloride (Aricept). Which disorder would the nurse suspect that this client may have based on the use of
this medication?
Dementia
Rationale:
Donepezil hydrochloride is a cholinergic agent used in the treatment of mild to moderate dementia of the
Alzheimer type. It enhances cholinergic functions by increasing the concentration of acetylcholine. It slows the
progression of Alzheimer's disease.
, Fluoxetine (Prozac) is prescribed for the client. The nurse reinforces instructions to the client regarding the
administration of the medication. Which statement by the client indicates an understanding about
administration of the medication?
"I should take the medication in the morning when I first arise."
Rationale:
Fluoxetine hydrochloride is administered in the early morning without consideration to meals.
A client receiving a tricyclic antidepressant arrives at the mental health clinic. Which observation indicates that
the client is correctly following the medication plan?
Arrives at the clinic neat and appropriate in appearance
Rationale:
Depressed individuals will sleep for long periods, are not able to go to work, and feel as if they cannot "do
anything." Once they have had some therapeutic effect from their medication, they will report resolution of
many of these complaints as well as demonstrate an improvement in their appearance.
A nurse is performing a follow-up teaching session with a client discharged month ago who is taking fluoxetine
(Prozac). What information would be important for the nurse to gather regarding the adverse effects related to
the medication?
Gastrointestinal dysfunctions
Rationale:
The most common adverse effects related to fluoxetine include central nervous system (CNS) and
gastrointestinal (GI) system dysfunction. This medication affects the GI system by causing nausea and
vomiting, cramping, and diarrhea.
A client taking buspirone (BuSpar) for month returns to the clinic for a follow-up visit. Which of the following
would indicate medication effectiveness?
No rapid heartbeats or anxiety
Rationale:
Buspirone hydrochloride is not recommended for the treatment of drug or alcohol withdrawal, paranoid thought
disorders, or schizophrenia (thought broadcasting or delusions). Buspirone hydrochloride is most often
indicated for the treatment of anxiety and aggression.
A client taking lithium carbonate (Lithobid) reports vomiting, abdominal pain, diarrhea, blurred vision, tinnitus,
and tremors. The lithium level is checked as a part of the routine follow-up and the level is 2. mEq/L. The
nurse knows that this level is:
Toxic
Rationale:
The therapeutic serum level of lithium is . 0.8 to 1.2 . mEq/L.
A client arrives at the health care clinic and tells the nurse that he has been doubling his daily dosage of
bupropion hydrochloride (Wellbutrin) to help him get better faster. The nurse understands that the client is now
at risk for which of the following?
Seizure activity
Rationale:
Bupropion does not cause significant orthostatic blood pressure changes. Seizure activity is common in dosages
greater than mg daily. Bupropion frequently causes a drop in body weight. Insomnia is a side effect, but seizure
activity causes a greater client risk.
