2023 mHESImEXAMmREVIE
W
HESI Pharmacology Exit EXAM STUDY
m m m m m
GUIDE 2023- m
2024 SESSION GRADED A+ WITH SOL
m m m m m
UTIONS NEW m
1) Followingmdischargemteaching, mammalemclient mwithmduodenalmulcermtellsmthemnursemthemhemw
ill mdrinkmplentymof mdairymproducts,msuchmasmmilk,mtomhelpmcoat mand mprotect mhismulcer.mWhat
mismthembest mfollow-upmactionmbymthemnurse?
Review m withm them client m them need m tom avoid m foodsm that m arem richm inm milkm a
nd mcream
2) A mmalemclient mwithmhypertension,mwhomreceived mnew mantihypertensivemprescriptions mat mhi
smlast mvisit mreturnsmtomthemclinicmtwomweeksmlatermtomevaluatemhismblood mpressurem (BP).mHi
smBPmism158/106mand mhemadmitsmthat mhemhasmnot mbeenmtakingmthemprescribed mmedicationmb
ecausemthemdrugsmmakemhimm―feelmbad‖.mInmexplainingmthemneed mformhypertensionmcontrol,
mthemnursemshould mstressmthat manmelevated mBPmplacesmthemclient mat mriskmformwhichmpathoph
ysiologicalmcondition?
Stroke secondary
tomhemorrhage
3) Themnursemobservesmanmunlicensed massistive mpersonnelm(UAP)mpositioningmamnewly mad
mitted mclient mwhomhasmamseizuremdisorder.mThemclient mismsupinemand mthemUAPmismplacing
msoft mpillowsmalongmthemsidemrails.mWhat mactionmshould mthemnursemimplement?
Instruct mthemUAPmtomobtainmsoft mblanketsmtomsecuremtomthemsidemrailsminstead mof
pillows.
4) Anmadolescent mwithmmajormdepressivemdisordermhasmbeenmtakingmduloxetinem(Cymbalta)mf
ormthempast m12mdays.mWhichmassessment mfindingmrequiresmimmediatemfollow-up?
Describes life without
mpurpose
5) A m60-year-
old mfemalemclient mwithmampositivemfamilymhistorymof movarianmcancermhasmdeveloped manmab
dominalmmassmand mismbeingmevaluated mformpossiblemovarianmcancer.mHermPapanicolaum(Pa
p)msmearmresultsmaremnegative.mWhat minformationmshould mthemnursemincludeminmthemclient’
Further evaluation involving surgerym may
bemneeded
smteachingmplan?
6) A mclient mwhomrecentlymunderwearmamtracheostomymismbeingmprepared mformdischargemtomhome.
Whichminstructionsmismmost mimportant mformth
emTeach tracheal
suctioningnursemtomincludeminmthemdischargemplan?mtechniques
, m
lOMoAR cPSD|
m 11518826
7) Inmassessingmanmadult mclient mwithmampartialmrebreathermmask,mthemnursemnotesmthat mthemoxyg
enmreservoirmbagmdoesmnot mdeflatemcompletelymduringminspirationmand mthemclient’smrespirat
orymrate
ism14mbreathsm/mminute.mWhat mactionmshould mthemnurse Document the
assessment implement?
data
• Rational:mreservoirmbagmshould mnot mdeflatemcompletelymduringminspirationmand mthemclient
’smrespiratorymratemismwithinmnormalmlimits.
8) Duringmshift mreport,mthemcentralmelectrocardiogramm(EKG)mmonitoringmsystemmalarms.
Whichmclient malarmmshould mthemnurseminvestigate
firs? Respiratorymapneamof m30mseconds
9) Duringmamhomemvisit,mthemnursemobserved manmelderlymclient mwithmdiabetesmslipmand mfall.mWhat
Checkmfrthe client for lacerations or actionmshould mthemnursemtakemfirst?
actures
10) At 0600mwhilemadmittingmamwomanmforma
schedulemrepeat mcesareanm sectionm(C-
Section),mthemclient mtellsmthemnursemthat mshemdrankmamcupmamcoffeemat m0400mbecausemshemwa
nted mtomavoid mgettingmamheadache.mWhichmactionmshould mthemnursemtakemfirst?
Inform anesthesia care
the
11) After provider
placingmamstethoscopemasmseenminmthempicture,mt
hemnursemauscultatesmS1mand mS2mheart msounds.mTomdeterminemif manmS3mheart msound mismprese
nt,mwhat mactionmshould mthemnursemtakemfirst?
• Listenmwithmthembellmat mthemsamemlocation
12) A m66-year-
old mwomanmismretiringmand mwillmnomlongermhavemamhealthminsurancemthroughmhermplacemo
f memployment.mWhichmagencymshould mthemclient mbemreferred mtombymthememployeemhealth
mnursemformhealthminsurancemneeds?
Medicare
13) A mclient mwhomismtakingmanmoralmdosemof mamtetracyclinemcomplainsmof mgastrointestinalmups
et.mWhat msnackmshould mthemnurseminstruct mthemclient mtomtakemwithmthemtetracycline?
Toasted mwheat mbread mand mjelly
14) Followingmamlumbarmpuncture,mamclient mvoicesmseveralmcomplaints.mWhat mcomplai
nt mindicated mtomthemnursemthat mthemclient mismexperiencingmamcomplication?
“Im havem am headachem thatm getsm worsem whenm Im s
itmup”
• ―I mammhavingmpainminmmymlower mback mwhenmI mmovemmymlegs‖
• ―Mymthroat mhurtsmwhenmI mswallow‖
• “Imfeelmsickmtommymstomachmandmammgoingmtomthrowmup”
,2023 mHESImEXAMmREVIE
W
15) Anmelderlymclient mseemsmconfused mand mreportsmthemonset mof mnausea,mdysuria,mand murgen
cymwithmincontinence.mWhichmactionmshould mthemnursemimplement?
Obtainms a clean catch mid-stream
pecimen
16) Themnursemismassistingmthem mothermof mamchild mwithmphenylketonuriam(PKU)mtomselect mfoo
dsmthat mareminmkeepingmwithmthemchild’smdietarymrestrictions.mWhichmfoodsmaremcontraindi
cated mformthismchild?
Foods sweetened
withmaspartame
17) Beforempreparingmamclient mformthemfirst msurgicalmcasemof mthemday,mampart-
timemscrubmnursemasksmthemcirculatingmnurse mif mam3mminutemsurgical mhand mscrubmis madequat
empreparationmformthis
client.
mDirect mthemnursemtomcontinuemthemsurgicalmhand mscrubmformam5m minuteWhichm dur
ation
responsemshould mthemcirculatingmnursemprovide?
18) Whichmbreakfast mselectionmindicatesmthat mthemclient munderstandsmthemnurse’sminstructio
nsmabout themdietarymmanagement mof mosteoporosis?
Bagelmwithmjellymand m skimmmi
lk
19) Themchargemnursemof mamcriticalmcaremunit misminformed mat mthembeginningmof mthemshift mthat mle
ssmthanmthemoptimalmnumbermof mregistered mnursesmwillmbemworkingmthat mshift.mInmplanning
massignments,mwhichmclient mshould mreceivemthemmost mcaremhoursmbymamregistered mnursem(R
N)?
• mAnm82-year-old mclient mwithmAlzheimer’smdiseasemnewly-fracturesmfemurmwhomhasma
mFoleymcathetermand msoft mwrist mrestrainsmapplied
20) A mmothermbringsmherm6-year-
old mchild,mwhomhasmjust mstepped monmamrustymnail,mtomthempediatrician’smoffice.mUponminspe
ction,mthemnursemnotesmthat mthemnailmwent mthroughmthemshoemand mpierced mthembottommof mthe
mchild’smfoot.mWhichmactionmshould mthemnursemimplement
first?
Cleansem them footm withm soapm andm watermandm applym anm antibiot
• icmointment
Providemteachingmabout mthemneed mformamtetanusmboostermwithinmthemnext m72mhours.
havemthe
mmothermcheckmthemchild'smtemperaturemq4hmformthemnext m24mhours
• transfermthemchild mtomthememergencymdepartment mtomreceivemamgammamglobul
inminjection
21) Themmothermof manmadolescent mtellsmthemclinicmnurse,m―Mymsonmhasmathlete’s mfoot,mI mhavemb
eenmapplyingmtriplemantibioticmointment mformtwomdays,mbut mtheremhasmbeenmnomimproveme
nt.‖ mWhat minstructionmshould mthemnursemprovide?
• Stopmusingmthemointment mand mencouragemcompletemdryingmof mthemfeet mand mweari
ngmcleanmsocks.
22) A m26-year-
old mfemalemclient mismadmitted mtomthemhospitalmformtreatment mof mamsimplemgoiter,mand mlev
othyroxinemsodiumm(Synthroid)mismprescribed.mWhichmsymptomsmindicatemtomthemnurse
mthat mthemprescribed mdosagemismtoomhighmformthismclient?mThemclient mexperiences
, m
lOMoAR cPSD|
m 11518826
• Bradycardiamand mconstipation
• Lethargymand mlackmof mappetite
• Musclemcrampingmand mdry,mflushed mskin
Palpitations shortness of
23) A and client mwithmamhistorymof mheart mfailure
breath
presentsmto mthemclinicmwithmamnausea,mvomiting,myellow mvisionmand mpalpitations.mWhich
findingmismmost mimportant mfo
rmthe Obtainm am list m of m medicationsm takenm form cardiacnursemtomassessmtomthemclient?
history
24) ThemhealthcaremprovidermprescribesmanmIV msolutionmof misoproterenolm(Isuprel)m1m mgmin m2
50mmlmof mD5 Wmat m300mmcg/hour.mThemnursemshould mprogrammtheminfusionmpumpmtomdelive
rmhow mmanyml/hour?m(Entermnumericmvaluemonly.)
75
• Rationale:mConvert mmgmtommcgmand musemthemformulamD/H mxmQ.m300mmcg/hou
rm/m1,000mmcgmxm250mmlm=m3/1mxm25m=m75mml/hour
25) Thempathophysiologicalmmechanismmaremresponsiblemformascitesmrelated mtomlivermfailure?
Fluid mshiftsmfrommintravascularmtominterstitialmareamduemtomdecreased mserummprotein
Increased mhydrostaticmpressureminmportalmcirculationmincreasesmfluid mshiftsmint
omabdomen
Increased m circulatingm aldosteronem levelsm that m increasem sodiumm and m wate
rmretention
(Select mallmthat mapply)
26) Themnursem ismauscultatingmamclient’smheart msounds.mWhichmdescriptionmshould mthemnursemu
semto
document mthismsound?m(Pleasemlistenmtomthemaudiomfirst mtomselect mthemopti
onmthat m Murmurapplies)
• Rationale:mAmmurmurmism auscultated masmamswishingmsound mthatmismassociated mwithmthemblo
od mturbulencemcreated mbymthemheart mormvalvularmdefect.
27) Themhealthcaremprovidermprescribes mceltazidimem (Fortax)m35m mgmeverym8mhours mIMmforma
nminfant.mThem500mmg mvialmismlabeled mwithmtheminstructionmtomadd m5.3mmlmdiluent mtomprovi
demamconcentrationmof m100mmg/ml.mHow mmanymmlmshould mthemnursemadministered mformeac
hmdose?
(Entermnumericmvaluemonly.mIf mroundingmismrequired,mround mtomthemnearest mtenth)
0.4
W
HESI Pharmacology Exit EXAM STUDY
m m m m m
GUIDE 2023- m
2024 SESSION GRADED A+ WITH SOL
m m m m m
UTIONS NEW m
1) Followingmdischargemteaching, mammalemclient mwithmduodenalmulcermtellsmthemnursemthemhemw
ill mdrinkmplentymof mdairymproducts,msuchmasmmilk,mtomhelpmcoat mand mprotect mhismulcer.mWhat
mismthembest mfollow-upmactionmbymthemnurse?
Review m withm them client m them need m tom avoid m foodsm that m arem richm inm milkm a
nd mcream
2) A mmalemclient mwithmhypertension,mwhomreceived mnew mantihypertensivemprescriptions mat mhi
smlast mvisit mreturnsmtomthemclinicmtwomweeksmlatermtomevaluatemhismblood mpressurem (BP).mHi
smBPmism158/106mand mhemadmitsmthat mhemhasmnot mbeenmtakingmthemprescribed mmedicationmb
ecausemthemdrugsmmakemhimm―feelmbad‖.mInmexplainingmthemneed mformhypertensionmcontrol,
mthemnursemshould mstressmthat manmelevated mBPmplacesmthemclient mat mriskmformwhichmpathoph
ysiologicalmcondition?
Stroke secondary
tomhemorrhage
3) Themnursemobservesmanmunlicensed massistive mpersonnelm(UAP)mpositioningmamnewly mad
mitted mclient mwhomhasmamseizuremdisorder.mThemclient mismsupinemand mthemUAPmismplacing
msoft mpillowsmalongmthemsidemrails.mWhat mactionmshould mthemnursemimplement?
Instruct mthemUAPmtomobtainmsoft mblanketsmtomsecuremtomthemsidemrailsminstead mof
pillows.
4) Anmadolescent mwithmmajormdepressivemdisordermhasmbeenmtakingmduloxetinem(Cymbalta)mf
ormthempast m12mdays.mWhichmassessment mfindingmrequiresmimmediatemfollow-up?
Describes life without
mpurpose
5) A m60-year-
old mfemalemclient mwithmampositivemfamilymhistorymof movarianmcancermhasmdeveloped manmab
dominalmmassmand mismbeingmevaluated mformpossiblemovarianmcancer.mHermPapanicolaum(Pa
p)msmearmresultsmaremnegative.mWhat minformationmshould mthemnursemincludeminmthemclient’
Further evaluation involving surgerym may
bemneeded
smteachingmplan?
6) A mclient mwhomrecentlymunderwearmamtracheostomymismbeingmprepared mformdischargemtomhome.
Whichminstructionsmismmost mimportant mformth
emTeach tracheal
suctioningnursemtomincludeminmthemdischargemplan?mtechniques
, m
lOMoAR cPSD|
m 11518826
7) Inmassessingmanmadult mclient mwithmampartialmrebreathermmask,mthemnursemnotesmthat mthemoxyg
enmreservoirmbagmdoesmnot mdeflatemcompletelymduringminspirationmand mthemclient’smrespirat
orymrate
ism14mbreathsm/mminute.mWhat mactionmshould mthemnurse Document the
assessment implement?
data
• Rational:mreservoirmbagmshould mnot mdeflatemcompletelymduringminspirationmand mthemclient
’smrespiratorymratemismwithinmnormalmlimits.
8) Duringmshift mreport,mthemcentralmelectrocardiogramm(EKG)mmonitoringmsystemmalarms.
Whichmclient malarmmshould mthemnurseminvestigate
firs? Respiratorymapneamof m30mseconds
9) Duringmamhomemvisit,mthemnursemobserved manmelderlymclient mwithmdiabetesmslipmand mfall.mWhat
Checkmfrthe client for lacerations or actionmshould mthemnursemtakemfirst?
actures
10) At 0600mwhilemadmittingmamwomanmforma
schedulemrepeat mcesareanm sectionm(C-
Section),mthemclient mtellsmthemnursemthat mshemdrankmamcupmamcoffeemat m0400mbecausemshemwa
nted mtomavoid mgettingmamheadache.mWhichmactionmshould mthemnursemtakemfirst?
Inform anesthesia care
the
11) After provider
placingmamstethoscopemasmseenminmthempicture,mt
hemnursemauscultatesmS1mand mS2mheart msounds.mTomdeterminemif manmS3mheart msound mismprese
nt,mwhat mactionmshould mthemnursemtakemfirst?
• Listenmwithmthembellmat mthemsamemlocation
12) A m66-year-
old mwomanmismretiringmand mwillmnomlongermhavemamhealthminsurancemthroughmhermplacemo
f memployment.mWhichmagencymshould mthemclient mbemreferred mtombymthememployeemhealth
mnursemformhealthminsurancemneeds?
Medicare
13) A mclient mwhomismtakingmanmoralmdosemof mamtetracyclinemcomplainsmof mgastrointestinalmups
et.mWhat msnackmshould mthemnurseminstruct mthemclient mtomtakemwithmthemtetracycline?
Toasted mwheat mbread mand mjelly
14) Followingmamlumbarmpuncture,mamclient mvoicesmseveralmcomplaints.mWhat mcomplai
nt mindicated mtomthemnursemthat mthemclient mismexperiencingmamcomplication?
“Im havem am headachem thatm getsm worsem whenm Im s
itmup”
• ―I mammhavingmpainminmmymlower mback mwhenmI mmovemmymlegs‖
• ―Mymthroat mhurtsmwhenmI mswallow‖
• “Imfeelmsickmtommymstomachmandmammgoingmtomthrowmup”
,2023 mHESImEXAMmREVIE
W
15) Anmelderlymclient mseemsmconfused mand mreportsmthemonset mof mnausea,mdysuria,mand murgen
cymwithmincontinence.mWhichmactionmshould mthemnursemimplement?
Obtainms a clean catch mid-stream
pecimen
16) Themnursemismassistingmthem mothermof mamchild mwithmphenylketonuriam(PKU)mtomselect mfoo
dsmthat mareminmkeepingmwithmthemchild’smdietarymrestrictions.mWhichmfoodsmaremcontraindi
cated mformthismchild?
Foods sweetened
withmaspartame
17) Beforempreparingmamclient mformthemfirst msurgicalmcasemof mthemday,mampart-
timemscrubmnursemasksmthemcirculatingmnurse mif mam3mminutemsurgical mhand mscrubmis madequat
empreparationmformthis
client.
mDirect mthemnursemtomcontinuemthemsurgicalmhand mscrubmformam5m minuteWhichm dur
ation
responsemshould mthemcirculatingmnursemprovide?
18) Whichmbreakfast mselectionmindicatesmthat mthemclient munderstandsmthemnurse’sminstructio
nsmabout themdietarymmanagement mof mosteoporosis?
Bagelmwithmjellymand m skimmmi
lk
19) Themchargemnursemof mamcriticalmcaremunit misminformed mat mthembeginningmof mthemshift mthat mle
ssmthanmthemoptimalmnumbermof mregistered mnursesmwillmbemworkingmthat mshift.mInmplanning
massignments,mwhichmclient mshould mreceivemthemmost mcaremhoursmbymamregistered mnursem(R
N)?
• mAnm82-year-old mclient mwithmAlzheimer’smdiseasemnewly-fracturesmfemurmwhomhasma
mFoleymcathetermand msoft mwrist mrestrainsmapplied
20) A mmothermbringsmherm6-year-
old mchild,mwhomhasmjust mstepped monmamrustymnail,mtomthempediatrician’smoffice.mUponminspe
ction,mthemnursemnotesmthat mthemnailmwent mthroughmthemshoemand mpierced mthembottommof mthe
mchild’smfoot.mWhichmactionmshould mthemnursemimplement
first?
Cleansem them footm withm soapm andm watermandm applym anm antibiot
• icmointment
Providemteachingmabout mthemneed mformamtetanusmboostermwithinmthemnext m72mhours.
havemthe
mmothermcheckmthemchild'smtemperaturemq4hmformthemnext m24mhours
• transfermthemchild mtomthememergencymdepartment mtomreceivemamgammamglobul
inminjection
21) Themmothermof manmadolescent mtellsmthemclinicmnurse,m―Mymsonmhasmathlete’s mfoot,mI mhavemb
eenmapplyingmtriplemantibioticmointment mformtwomdays,mbut mtheremhasmbeenmnomimproveme
nt.‖ mWhat minstructionmshould mthemnursemprovide?
• Stopmusingmthemointment mand mencouragemcompletemdryingmof mthemfeet mand mweari
ngmcleanmsocks.
22) A m26-year-
old mfemalemclient mismadmitted mtomthemhospitalmformtreatment mof mamsimplemgoiter,mand mlev
othyroxinemsodiumm(Synthroid)mismprescribed.mWhichmsymptomsmindicatemtomthemnurse
mthat mthemprescribed mdosagemismtoomhighmformthismclient?mThemclient mexperiences
, m
lOMoAR cPSD|
m 11518826
• Bradycardiamand mconstipation
• Lethargymand mlackmof mappetite
• Musclemcrampingmand mdry,mflushed mskin
Palpitations shortness of
23) A and client mwithmamhistorymof mheart mfailure
breath
presentsmto mthemclinicmwithmamnausea,mvomiting,myellow mvisionmand mpalpitations.mWhich
findingmismmost mimportant mfo
rmthe Obtainm am list m of m medicationsm takenm form cardiacnursemtomassessmtomthemclient?
history
24) ThemhealthcaremprovidermprescribesmanmIV msolutionmof misoproterenolm(Isuprel)m1m mgmin m2
50mmlmof mD5 Wmat m300mmcg/hour.mThemnursemshould mprogrammtheminfusionmpumpmtomdelive
rmhow mmanyml/hour?m(Entermnumericmvaluemonly.)
75
• Rationale:mConvert mmgmtommcgmand musemthemformulamD/H mxmQ.m300mmcg/hou
rm/m1,000mmcgmxm250mmlm=m3/1mxm25m=m75mml/hour
25) Thempathophysiologicalmmechanismmaremresponsiblemformascitesmrelated mtomlivermfailure?
Fluid mshiftsmfrommintravascularmtominterstitialmareamduemtomdecreased mserummprotein
Increased mhydrostaticmpressureminmportalmcirculationmincreasesmfluid mshiftsmint
omabdomen
Increased m circulatingm aldosteronem levelsm that m increasem sodiumm and m wate
rmretention
(Select mallmthat mapply)
26) Themnursem ismauscultatingmamclient’smheart msounds.mWhichmdescriptionmshould mthemnursemu
semto
document mthismsound?m(Pleasemlistenmtomthemaudiomfirst mtomselect mthemopti
onmthat m Murmurapplies)
• Rationale:mAmmurmurmism auscultated masmamswishingmsound mthatmismassociated mwithmthemblo
od mturbulencemcreated mbymthemheart mormvalvularmdefect.
27) Themhealthcaremprovidermprescribes mceltazidimem (Fortax)m35m mgmeverym8mhours mIMmforma
nminfant.mThem500mmg mvialmismlabeled mwithmtheminstructionmtomadd m5.3mmlmdiluent mtomprovi
demamconcentrationmof m100mmg/ml.mHow mmanymmlmshould mthemnursemadministered mformeac
hmdose?
(Entermnumericmvaluemonly.mIf mroundingmismrequired,mround mtomthemnearest mtenth)
0.4
