HESI Pharmacology Evolve Practice Exam Questions
with 100% Correct Answers
A client who has been taking phenazopyridine (Pyridium) for symptoms of urethritis and cystitis
comes to the clinic because her urine is reddish-orange. Which question should the practical nurse ask
to determine if the medication has been effective?
A) How much water have you been drinking each day?
B) Does the urine color stain your toilet bowl or undergarments?
C) Have you had any relief from urinary pain, burning, or urgency?
D) Did your urine appear cloudy or have a foul odor on voiding?
C) Have you had any relief from urinary pain, burning, or urgency?
Feedback:
Phenazopyridine, an over-the-counter urinary analgesic, acts on the mucosa of the urinary tract to
relieve urinary pain, burning, itching, or urgency (C) associated with urethritis and cystitis. Although
determining if the client is forcing fluids (A), experiencing staining from Pyridium's side effect (B), or
having signs of a urinary infection (D) are worthwhile assessments, the therapeutic response of
Pyridium is related to urinary discomforts only.
A male client who has been receiving an antineoplastic drug has developed thrombocytopenia. What
instructions should the practical nurse (PN) reinforce?
A) Use suppository form of drugs.
B) Avoid large public gatherings.
C) Rise slowly when standing up.
D) Shave with an electric razor.
D) Shave with an electric razor.
Feedback:
Thrombocytopenia is a common side effect of bone marrow depression caused by several
antineoplastic agents. The client is experiencing a low platelet count and should use an electric razor
(D) to reduce his risk of bleeding. (A, B, and C) are not indicated for a client who needs to implement
thrombocytopenia precautions.
The practical nurse (PN) is caring for a client who has been taking prednisone (Deltasone) daily for a
year. Which adverse effect should the PN document in the client's record?
A) Photosensitvity.
B) Weight gain.
C) Loss of hair.
D) Pale skin color.
B) Weight gain.
Feedback:
Long term use of prednisone causes fluid retention and redistribution of fat deposition. Weight gain
(B) and moon face reflect adverse effects of long-term prednisone use and should be documented. (A,
C, and D) do not occur with treatment using prednisone.
A female client with recurring headaches tells the practical nurse (PN) that she has been taking at
least 4 grams of acetaminophen a day. Which laboratory studies should the PN review for this client?
A) Creatinine clearance.
B) Hepatic enzymes.
C) Coagulation values.
D) Arterial blood gases.
B) Hepatic enzymes.
Feedback:
Liver toxicity can occur when doses of acetaminophen exceed 4 grams a day, resulting in an elevation
in hepatic enzyme values (B). (A, C, and D) do not reveal findings related to acetaminophen toxicity.
,A client receives a prescription for an oral opioid analgesic for post-operative pain. Which adverse
effect should the practical nurse (PN) monitor for with the client?
A) Constipation.
B) Photosensitivity.
C) Decreased heart rate.
D) Frequent urination.
A) Constipation.
Feedback:
Opioid analgesics slow peristalsis, which leads to constipation (A), a common side effect of opiates. (B,
C, and D) are not associated with opioid analgesics.
Which action should the practical nurse implement when administering a buccal medication?
A) Encourage the client to swallow.
B) Administer water with medication.
C) Ensure the medication is positioned under the tongue.
D) Place the medication between the upper molar teeth and cheek.
D) Place the medication between the upper molar teeth and cheek.
Feedback:
Buccal medications are placed between the upper molar teeth and the cheek (D) for absorption by
the capillaries of the oral mucosa. The client should be cautioned against swallowing, not (A). Buccal
medications are not administered with water (B). (C) describes sublingual administration.
What assessment is most important for the practical nurse (PN) to obtain prior to initiating
medication therapy with phenelzine (Nardil) for a client with depression?
A) Activity level.
B) Mood and affect.
C) Understanding of diet modification.
D) The client's support system.
C) Understanding of diet modification.
Feedback:
To prevent a potentially lethal hypertensive crisis, a tyramine-free diet should be maintained during
antidepressant therapy with Nardil, a monoamine oxidase inhibitor (MAOI). It is most important to
determine if the client understands diet modification (C) before Nardil is initiated to prevent
consumption of foods that interact with Nardil. Although a client's activity level (A) and mood and
affect (B) should be monitored during antidepressant therapy, it is most important that the client
understand diet modifications. The client's support system (D) and network of family and friends is
important, but the client should understand the responsibility of dietary compliance with the
medication regimen.
The practical nurse (PN) is unable to arouse a client who is receiving meperidine (Demerol) for
postoperative pain. The client is stuporous, has constricted pupils, and a respiratory rate of 8
breaths/minute. Which PRN prescription should the PN give the client?
A) Naloxone (Narcan).
B) Promethazine (Phenergan).
C) Metoclopramide (Reglan).
D) Bethanechol (Urecholine).
A) Naloxone (Narcan).
Feedback:
Narcan (A) is an opioid antagonist and should be administered to reverse the effects of a Demerol, an
opioid, overdose. (B, C, and D) are common postoperative PRN prescriptions but are not indicated for
narcotic overdose.
, On which therapeutic action should the practical nurse (PN) base an explanation to a client who is
receiving a cardiac glycoside?
A) Decreased cardiac output.
B) Increased renal perfusion.
C) Decreased rate of contraction.
D) Increased blood volume.
C) Decreased rate of contraction.
Feedback:
Cardiac glycosides increase the force of cardiac contraction (inotropy) and decrease the heart rate
(chronotropy) (C) by decreasing the speed of conduction through the heart (dromotropy). (A, B, and
D) are incorrect.
A client with type 1 diabetes mellitus received an early AM dose of regular insulin per sliding scale. At
10:00 AM, the practical nurse (PN) should report which signs indicative of hypoglycemia?
A) Urticaria and rash.
B) Nausea and diarrhea.
C) Irritability and confusion.
D) Fruity, acetone odor to the breath.
C) Irritability and confusion.
Feedback:
Irritability and confusion (C) are early signs of hypoglycemia. (A, B, and D) are not signs of
hypoglycemia.
Which prescription should the practical nurse (PN) administer for a client who is experiencing an
anaphylactic reaction to an antibiotic?
A) Ephedra (ma-huang).
B) Epinephrine (Adrenalin).
C) Phenylephrin (Neo-Synephrine).
D) Fexofenadine with pseudoephedrine (Allegra D).
B) Epinephrine (Adrenalin).
Feedback:
Epinephrine (Adrenalin), a potent sympathomimetic, is the drug of choice for the treatment of
anaphylaxis (B). (A, C, and D) are not used for an acute immunololgical dysfunction that causes
cardiovascular effects.
An older adult client receives a prescription for hydrochlorothiazide (HydroDIURIL), a thiazide diuretic
for the treatment of heart failure. Which side effect(s) should the practical nurse reinforce with the
client? (Select all that apply.)
A) Constipation.
B) Fatigue.
C) Edema.
D) Nausea.
E) Dehydration.
F) Blurred vision.
B) Fatigue.
E) Dehydration.
Feedback:
Hydrochlorothiazide (HydroDIURIL), a thiazide diuretic, reduces blood pressure by reducing blood
volume and reducing arterial resistance. Adverse effects of thiazides include hypokalemia, fatigue (B),
dehydration (E), hyperglycemia, and hyperuricemia. Although (A, C, D and F) may be associated with
aging or other pathology, they are not side effects commonly associated with HydroDIURIL.
with 100% Correct Answers
A client who has been taking phenazopyridine (Pyridium) for symptoms of urethritis and cystitis
comes to the clinic because her urine is reddish-orange. Which question should the practical nurse ask
to determine if the medication has been effective?
A) How much water have you been drinking each day?
B) Does the urine color stain your toilet bowl or undergarments?
C) Have you had any relief from urinary pain, burning, or urgency?
D) Did your urine appear cloudy or have a foul odor on voiding?
C) Have you had any relief from urinary pain, burning, or urgency?
Feedback:
Phenazopyridine, an over-the-counter urinary analgesic, acts on the mucosa of the urinary tract to
relieve urinary pain, burning, itching, or urgency (C) associated with urethritis and cystitis. Although
determining if the client is forcing fluids (A), experiencing staining from Pyridium's side effect (B), or
having signs of a urinary infection (D) are worthwhile assessments, the therapeutic response of
Pyridium is related to urinary discomforts only.
A male client who has been receiving an antineoplastic drug has developed thrombocytopenia. What
instructions should the practical nurse (PN) reinforce?
A) Use suppository form of drugs.
B) Avoid large public gatherings.
C) Rise slowly when standing up.
D) Shave with an electric razor.
D) Shave with an electric razor.
Feedback:
Thrombocytopenia is a common side effect of bone marrow depression caused by several
antineoplastic agents. The client is experiencing a low platelet count and should use an electric razor
(D) to reduce his risk of bleeding. (A, B, and C) are not indicated for a client who needs to implement
thrombocytopenia precautions.
The practical nurse (PN) is caring for a client who has been taking prednisone (Deltasone) daily for a
year. Which adverse effect should the PN document in the client's record?
A) Photosensitvity.
B) Weight gain.
C) Loss of hair.
D) Pale skin color.
B) Weight gain.
Feedback:
Long term use of prednisone causes fluid retention and redistribution of fat deposition. Weight gain
(B) and moon face reflect adverse effects of long-term prednisone use and should be documented. (A,
C, and D) do not occur with treatment using prednisone.
A female client with recurring headaches tells the practical nurse (PN) that she has been taking at
least 4 grams of acetaminophen a day. Which laboratory studies should the PN review for this client?
A) Creatinine clearance.
B) Hepatic enzymes.
C) Coagulation values.
D) Arterial blood gases.
B) Hepatic enzymes.
Feedback:
Liver toxicity can occur when doses of acetaminophen exceed 4 grams a day, resulting in an elevation
in hepatic enzyme values (B). (A, C, and D) do not reveal findings related to acetaminophen toxicity.
,A client receives a prescription for an oral opioid analgesic for post-operative pain. Which adverse
effect should the practical nurse (PN) monitor for with the client?
A) Constipation.
B) Photosensitivity.
C) Decreased heart rate.
D) Frequent urination.
A) Constipation.
Feedback:
Opioid analgesics slow peristalsis, which leads to constipation (A), a common side effect of opiates. (B,
C, and D) are not associated with opioid analgesics.
Which action should the practical nurse implement when administering a buccal medication?
A) Encourage the client to swallow.
B) Administer water with medication.
C) Ensure the medication is positioned under the tongue.
D) Place the medication between the upper molar teeth and cheek.
D) Place the medication between the upper molar teeth and cheek.
Feedback:
Buccal medications are placed between the upper molar teeth and the cheek (D) for absorption by
the capillaries of the oral mucosa. The client should be cautioned against swallowing, not (A). Buccal
medications are not administered with water (B). (C) describes sublingual administration.
What assessment is most important for the practical nurse (PN) to obtain prior to initiating
medication therapy with phenelzine (Nardil) for a client with depression?
A) Activity level.
B) Mood and affect.
C) Understanding of diet modification.
D) The client's support system.
C) Understanding of diet modification.
Feedback:
To prevent a potentially lethal hypertensive crisis, a tyramine-free diet should be maintained during
antidepressant therapy with Nardil, a monoamine oxidase inhibitor (MAOI). It is most important to
determine if the client understands diet modification (C) before Nardil is initiated to prevent
consumption of foods that interact with Nardil. Although a client's activity level (A) and mood and
affect (B) should be monitored during antidepressant therapy, it is most important that the client
understand diet modifications. The client's support system (D) and network of family and friends is
important, but the client should understand the responsibility of dietary compliance with the
medication regimen.
The practical nurse (PN) is unable to arouse a client who is receiving meperidine (Demerol) for
postoperative pain. The client is stuporous, has constricted pupils, and a respiratory rate of 8
breaths/minute. Which PRN prescription should the PN give the client?
A) Naloxone (Narcan).
B) Promethazine (Phenergan).
C) Metoclopramide (Reglan).
D) Bethanechol (Urecholine).
A) Naloxone (Narcan).
Feedback:
Narcan (A) is an opioid antagonist and should be administered to reverse the effects of a Demerol, an
opioid, overdose. (B, C, and D) are common postoperative PRN prescriptions but are not indicated for
narcotic overdose.
, On which therapeutic action should the practical nurse (PN) base an explanation to a client who is
receiving a cardiac glycoside?
A) Decreased cardiac output.
B) Increased renal perfusion.
C) Decreased rate of contraction.
D) Increased blood volume.
C) Decreased rate of contraction.
Feedback:
Cardiac glycosides increase the force of cardiac contraction (inotropy) and decrease the heart rate
(chronotropy) (C) by decreasing the speed of conduction through the heart (dromotropy). (A, B, and
D) are incorrect.
A client with type 1 diabetes mellitus received an early AM dose of regular insulin per sliding scale. At
10:00 AM, the practical nurse (PN) should report which signs indicative of hypoglycemia?
A) Urticaria and rash.
B) Nausea and diarrhea.
C) Irritability and confusion.
D) Fruity, acetone odor to the breath.
C) Irritability and confusion.
Feedback:
Irritability and confusion (C) are early signs of hypoglycemia. (A, B, and D) are not signs of
hypoglycemia.
Which prescription should the practical nurse (PN) administer for a client who is experiencing an
anaphylactic reaction to an antibiotic?
A) Ephedra (ma-huang).
B) Epinephrine (Adrenalin).
C) Phenylephrin (Neo-Synephrine).
D) Fexofenadine with pseudoephedrine (Allegra D).
B) Epinephrine (Adrenalin).
Feedback:
Epinephrine (Adrenalin), a potent sympathomimetic, is the drug of choice for the treatment of
anaphylaxis (B). (A, C, and D) are not used for an acute immunololgical dysfunction that causes
cardiovascular effects.
An older adult client receives a prescription for hydrochlorothiazide (HydroDIURIL), a thiazide diuretic
for the treatment of heart failure. Which side effect(s) should the practical nurse reinforce with the
client? (Select all that apply.)
A) Constipation.
B) Fatigue.
C) Edema.
D) Nausea.
E) Dehydration.
F) Blurred vision.
B) Fatigue.
E) Dehydration.
Feedback:
Hydrochlorothiazide (HydroDIURIL), a thiazide diuretic, reduces blood pressure by reducing blood
volume and reducing arterial resistance. Adverse effects of thiazides include hypokalemia, fatigue (B),
dehydration (E), hyperglycemia, and hyperuricemia. Although (A, C, D and F) may be associated with
aging or other pathology, they are not side effects commonly associated with HydroDIURIL.
