HESI Pharmacology Exam Practice
QUESTIONS AND ANSWERS 2023/2024
1) A nurse is caring for a client with hyperparathyroidism and
notes that the client's serum calcium level is 13 mg/dL. Which
medication should the nurse prepare to administer as prescribed
to the client?
1. Calcium chloride
2. Calcium gluconate
3. Calcitonin (Miacalcin)
4. Large doses of vitamin D - CORRECT ANSWER 3.
Calcitonin (Miacalcin)
Rationale:
The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is
experiencing hypercalcemia. Calcium gluconate and calcium
chloride are medications used for the treatment of tetany, which
occurs as a result of acute hypocalcemia. In hypercalcemia, large
doses of vitamin D need to be avoided. Calcitonin, a thyroid
hormone, decreases the plasma calcium level by inhibiting bone
resorption and lowering the serum calcium concentration.
2.) Oral iron supplements are prescribed for a 6-year-old child
with iron deficiency anemia. The nurse instructs the mother to
administer the iron with which best food item?
1. Milk
2. Water
3. Apple juice
4. Orange juice - CORRECT ANSWER 4. Orange juice
Rationale:
Vitamin C increases the absorption of iron by the body. The
mother should be instructed to administer the medication with a
citrus fruit or a juice that is high in vitamin C. Milk may affect
,absorption of the iron. Water will not assist in absorption. Orange
juice contains a greater amount of vitamin C than apple juice.
3.) Salicylic acid is prescribed for a client with a diagnosis of
psoriasis. The nurse monitors the client, knowing that which of the
following would indicate the presence of systemic toxicity from
this medication?
1. Tinnitus
2. Diarrhea
3. Constipation
4. Decreased respirations - CORRECT ANSWER 1. Tinnitus
Rationale:
Salicylic acid is absorbed readily through the skin, and systemic
toxicity (salicylism) can result. Symptoms include tinnitus,
dizziness, hyperpnea, and psychological disturbances.
Constipation and diarrhea are not associated with salicylism.
4.) The camp nurse asks the children preparing to swim in the
lake if they have applied sunscreen. The nurse reminds the
children that chemical sunscreens are most effective when
applied:
1. Immediately before swimming
2. 15 minutes before exposure to the sun
3. Immediately before exposure to the sun
4. At least 30 minutes before exposure to the sun - CORRECT
ANSWER 4. At least 30 minutes before exposure to the sun
Rationale:
Sunscreens are most effective when applied at least 30 minutes
before exposure to the sun so that they can penetrate the skin. All
sunscreens should be reapplied after swimming or sweating.
5.) Mafenide acetate (Sulfamylon) is prescribed for the client with
a burn injury. When applying the medication, the client complains
of local discomfort and burning. Which of the following is the most
appropriate nursing action?
, 1. Notifying the registered nurse
2. Discontinuing the medication
3. Informing the client that this is normal
4. Applying a thinner film than prescribed to the burn site -
CORRECT ANSWER 3. Informing the client that this is normal
Rationale:
Mafenide acetate is bacteriostatic for gram-negative and gram-
positive organisms and is used to treat burns to reduce bacteria
present in avascular tissues. The client should be informed that
the medication will cause local discomfort and burning and that
this is a normal reaction; therefore options 1, 2, and 4 are
incorrect
6.) The burn client is receiving treatments of topical mafenide
acetate (Sulfamylon) to the site of injury. The nurse monitors the
client, knowing that which of the following indicates that a
systemic effect has occurred?
1.Hyperventilation
2.Elevated blood pressure
3.Local pain at the burn site
4.Local rash at the burn site - CORRECT ANSWER
1.Hyperventilation
Rationale:
Mafenide acetate is a carbonic anhydrase inhibitor and can
suppress renal excretion of acid, thereby causing acidosis. Clients
receiving this treatment should be monitored for signs of an acid-
base imbalance (hyperventilation). If this occurs, the medication
should be discontinued for 1 to 2 days. Options 3 and 4 describe
local rather than systemic effects. An elevated blood pressure
may be expected from the pain that occurs with a burn injury.
7.) Isotretinoin is prescribed for a client with severe acne. Before
the administration of this medication, the nurse anticipates that
which laboratory test will be prescribed?
1. Platelet count
, 2. Triglyceride level
3. Complete blood count
4. White blood cell count - CORRECT ANSWER 2. Triglyceride
level
Rationale:
Isotretinoin can elevate triglyceride levels. Blood triglyceride
levels should be measured before treatment and periodically
thereafter until the effect on the triglycerides has been evaluated.
Options 1, 3, and 4 do not need to be monitored specifically
during this treatment.
8.) A client with severe acne is seen in the clinic and the health
care provider (HCP) prescribes isotretinoin. The nurse reviews
the client's medication record and would contact the (HCP) if the
client is taking which medication?
1. Vitamin A
2. Digoxin (Lanoxin)
3. Furosemide (Lasix)
4. Phenytoin (Dilantin) - CORRECT ANSWER 1. Vitamin A
Rationale:
Isotretinoin is a metabolite of vitamin A and can produce
generalized intensification of isotretinoin toxicity. Because of the
potential for increased toxicity, vitamin A supplements should be
discontinued before isotretinoin therapy. Options 2, 3, and 4 are
not contraindicated with the use of isotretinoin.
9.) The nurse is applying a topical corticosteroid to a client with
eczema. The nurse would monitor for the potential for increased
systemic absorption of the medication if the medication were
being applied to which of the following body areas?
1. Back
2. Axilla
3. Soles of the feet
4. Palms of the hands - CORRECT ANSWER 2. Axilla
Rationale:
QUESTIONS AND ANSWERS 2023/2024
1) A nurse is caring for a client with hyperparathyroidism and
notes that the client's serum calcium level is 13 mg/dL. Which
medication should the nurse prepare to administer as prescribed
to the client?
1. Calcium chloride
2. Calcium gluconate
3. Calcitonin (Miacalcin)
4. Large doses of vitamin D - CORRECT ANSWER 3.
Calcitonin (Miacalcin)
Rationale:
The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is
experiencing hypercalcemia. Calcium gluconate and calcium
chloride are medications used for the treatment of tetany, which
occurs as a result of acute hypocalcemia. In hypercalcemia, large
doses of vitamin D need to be avoided. Calcitonin, a thyroid
hormone, decreases the plasma calcium level by inhibiting bone
resorption and lowering the serum calcium concentration.
2.) Oral iron supplements are prescribed for a 6-year-old child
with iron deficiency anemia. The nurse instructs the mother to
administer the iron with which best food item?
1. Milk
2. Water
3. Apple juice
4. Orange juice - CORRECT ANSWER 4. Orange juice
Rationale:
Vitamin C increases the absorption of iron by the body. The
mother should be instructed to administer the medication with a
citrus fruit or a juice that is high in vitamin C. Milk may affect
,absorption of the iron. Water will not assist in absorption. Orange
juice contains a greater amount of vitamin C than apple juice.
3.) Salicylic acid is prescribed for a client with a diagnosis of
psoriasis. The nurse monitors the client, knowing that which of the
following would indicate the presence of systemic toxicity from
this medication?
1. Tinnitus
2. Diarrhea
3. Constipation
4. Decreased respirations - CORRECT ANSWER 1. Tinnitus
Rationale:
Salicylic acid is absorbed readily through the skin, and systemic
toxicity (salicylism) can result. Symptoms include tinnitus,
dizziness, hyperpnea, and psychological disturbances.
Constipation and diarrhea are not associated with salicylism.
4.) The camp nurse asks the children preparing to swim in the
lake if they have applied sunscreen. The nurse reminds the
children that chemical sunscreens are most effective when
applied:
1. Immediately before swimming
2. 15 minutes before exposure to the sun
3. Immediately before exposure to the sun
4. At least 30 minutes before exposure to the sun - CORRECT
ANSWER 4. At least 30 minutes before exposure to the sun
Rationale:
Sunscreens are most effective when applied at least 30 minutes
before exposure to the sun so that they can penetrate the skin. All
sunscreens should be reapplied after swimming or sweating.
5.) Mafenide acetate (Sulfamylon) is prescribed for the client with
a burn injury. When applying the medication, the client complains
of local discomfort and burning. Which of the following is the most
appropriate nursing action?
, 1. Notifying the registered nurse
2. Discontinuing the medication
3. Informing the client that this is normal
4. Applying a thinner film than prescribed to the burn site -
CORRECT ANSWER 3. Informing the client that this is normal
Rationale:
Mafenide acetate is bacteriostatic for gram-negative and gram-
positive organisms and is used to treat burns to reduce bacteria
present in avascular tissues. The client should be informed that
the medication will cause local discomfort and burning and that
this is a normal reaction; therefore options 1, 2, and 4 are
incorrect
6.) The burn client is receiving treatments of topical mafenide
acetate (Sulfamylon) to the site of injury. The nurse monitors the
client, knowing that which of the following indicates that a
systemic effect has occurred?
1.Hyperventilation
2.Elevated blood pressure
3.Local pain at the burn site
4.Local rash at the burn site - CORRECT ANSWER
1.Hyperventilation
Rationale:
Mafenide acetate is a carbonic anhydrase inhibitor and can
suppress renal excretion of acid, thereby causing acidosis. Clients
receiving this treatment should be monitored for signs of an acid-
base imbalance (hyperventilation). If this occurs, the medication
should be discontinued for 1 to 2 days. Options 3 and 4 describe
local rather than systemic effects. An elevated blood pressure
may be expected from the pain that occurs with a burn injury.
7.) Isotretinoin is prescribed for a client with severe acne. Before
the administration of this medication, the nurse anticipates that
which laboratory test will be prescribed?
1. Platelet count
, 2. Triglyceride level
3. Complete blood count
4. White blood cell count - CORRECT ANSWER 2. Triglyceride
level
Rationale:
Isotretinoin can elevate triglyceride levels. Blood triglyceride
levels should be measured before treatment and periodically
thereafter until the effect on the triglycerides has been evaluated.
Options 1, 3, and 4 do not need to be monitored specifically
during this treatment.
8.) A client with severe acne is seen in the clinic and the health
care provider (HCP) prescribes isotretinoin. The nurse reviews
the client's medication record and would contact the (HCP) if the
client is taking which medication?
1. Vitamin A
2. Digoxin (Lanoxin)
3. Furosemide (Lasix)
4. Phenytoin (Dilantin) - CORRECT ANSWER 1. Vitamin A
Rationale:
Isotretinoin is a metabolite of vitamin A and can produce
generalized intensification of isotretinoin toxicity. Because of the
potential for increased toxicity, vitamin A supplements should be
discontinued before isotretinoin therapy. Options 2, 3, and 4 are
not contraindicated with the use of isotretinoin.
9.) The nurse is applying a topical corticosteroid to a client with
eczema. The nurse would monitor for the potential for increased
systemic absorption of the medication if the medication were
being applied to which of the following body areas?
1. Back
2. Axilla
3. Soles of the feet
4. Palms of the hands - CORRECT ANSWER 2. Axilla
Rationale:
