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HESI RN ADVANCED PHARMACOLOGY EXAM NEWEST 2025
ACTUAL EXAM COMPLETE 160 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS)
|ALREADY GRADED A+
In teaching a client who had a liver transplant about cyclosporine (Sandimmune), the nurse
should encourage the client to report which adverse response to the healthcare provider?
A. Changes in urine color.
B. Presence of hand tremors.
C. Increasing body hirsutism.
D. Nausea and vomiting.
B. Presence of hand tremors.
- Neurological complications, such as hand tremors, occur in about 50% of clients taking
cyclosporine and should be reported. Although this drug can be nephrotoxic, changes in urine
color typically does not occur. Nausea is a common side effects, but is not usually severe.
Dobutamine (Dobutrex) is an emergency drug most commonly prescribed for a client with
which condition?
A. Shock.
B. Asthma.
C. Hypotension.
D. Heart failure.
D. Heart failure.
- Dobutamine is a beta-1 adrenergic agonist that is indicated for short term use in cardiac
decompensation or heart failure related to reduced cardiac contractility due to organic heart
disease or cardiac surgical procedures. On the other hand, alpha and beta adrenergic agonists,
such as epinephrine and dopamine, are sympathomimetics used in the treatment of shock.
,2|Page
Other selective beta-2 adrenergic agonists, such as terbutaline and isoproterenol, are
indicated in the treatment of asthma. Although dobutamine improves cardiac output, it is not
used to treat hypotension.
The nitrate isosorbide dinitrate (Isordil) is prescribed for a client with angina. Which
instruction should the nurse include in this client's discharge teaching plan?
A. Quit taking the medication if dizziness occurs.
B. Do not get up quickly. Always rise slowly.
C. Take the medication with food only.
D. Increase your intake of potassium-rich foods.
B. Do not get up quickly. Always rise slowly.
- An expected side effect of nitrates is orthostatic hypotension and the nurse should address
how to prevent it--by rising slowly.
A client has a continuous IV infusion of dopamine (Intropin) and an IV of normal saline at 50
ml/hour. The nurse notes that the client's urinary output has been 20 ml/hour for the last two
hours. Which intervention should the nurse initiate?
A. Stop the infusion of dopamine.
B. Change the normal saline to a keep open rate.
C. Replace the urinary catheter.
D. Notify the healthcare provider of the urinary output.
D. Notify the healthcare provider of the urinary output.
- The main effect of dopamine is adrenergic stimulation used to increase cardiac output,
which should also result in increased urinary output. A urinary output of less than 20 ml/hour
is oliguria and should be reported to the healthcare provider, so the dose of dopamine can be
adjusted. Depending on the current rate of administration, the dose may need to be increased
or decreased.
,3|Page
A client is being treated for hyperthyroidism with propylthiouracil (PTU). The nurse knows
that the action of this drug is to
A. decrease the amount of thyroid-stimulating hormone circulating in the blood.
B. increase the amount of thyroid-stimulating hormone circulating in the blood.
C. increase the amount of T4 and decrease the amount of T3 produced by the thyroid.
D. inhibit synthesis of T3 and T4 by the thyroid gland.
D. inhibit synthesis of T3 and T4 by the thyroid gland.
- PTU is an adjunct therapy used to control hyperthyroidism by inhibiting production of
thyroid hormones. It is often prescribed in preparation for thyroidectomy or radioactive
iodine therapy.
Which dosing schedule should the nurse teach the client to observe for a controlled-release
oxycodone prescription?
A. As needed.
B. Every 12 hours.
C. Every 24 hours.
D. Every 4 to 6 hours.
B. Every 12 hours.
- A controlled-release oxycodone provides long-acting analgesia to relieve moderate to severe
pain, so a dosing schedule of every 12 hours provides the best around-the-clock pain
management. Controlled-release oxycodone is not prescribed for breakthrough pain on a PRN
or as needed schedule. Using a schedule of every 4 to 6 hours may jeopardize patient safety
due to cumulative effects.
Which drug is used as a palliative treatment for a client with tumor-induced spinal cord
compression?
A. Morphine Sulfate (Duromorph).
B. Ibuprofen (Advil).
C. Amitriptyline (Amitril).
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D. Dexamethasone (Decadron).
D. Dexamethasone (Decadron).
- Dexamethasone is a palliative treatment modality to manage symptoms related to
compression due to tumor growth ( the focus of this question). Morphine sulphate is an
opioid analgesic used in oncology to manage severe or intractable pain. Ibuprofen, a
nonsteroidal antiinflammatory drug (NSAID), provides relief for mild to moderate pain,
suppression of inflammation, and reduction of fever. Amitriptyline, a tricyclic antidepressant,
is often prescribed for pain related to neuropathic origin and provides a reduction in opioid
dosage.
Which nursing intervention is most important when caring for a client receiving the
antimetabolite cytosine arabinoside (Arc-C) for chemotherapy?
A. Hydrate the client with IV fluids before and after infusion.
B. Assess the client for numbness and tingling of extremities.
C. Inspect the client's oral mucosa for ulcerations.
D. Monitor the client's urine pH for increased acidity.
C. Inspect the client's oral mucosa for ulcerations.
- Cytosine arabinoside (Arc-C) affects the rapidly growing cells of the body, therefore
stomatitis and mucosal ulcerations are key signs of antimetabolite toxicity.
A category X drug is prescribed for a young adult female client. Which instruction is most
important for the nurse to teach this client?
A. Use a reliable form of birth control.
B. Avoid exposure to ultra violet light.
C. Refuse this medication if planning pregnancy.
D. Abstain from intercourse while on this drug.
A. Use a reliable form of birth control.
HESI RN ADVANCED PHARMACOLOGY EXAM NEWEST 2025
ACTUAL EXAM COMPLETE 160 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS)
|ALREADY GRADED A+
In teaching a client who had a liver transplant about cyclosporine (Sandimmune), the nurse
should encourage the client to report which adverse response to the healthcare provider?
A. Changes in urine color.
B. Presence of hand tremors.
C. Increasing body hirsutism.
D. Nausea and vomiting.
B. Presence of hand tremors.
- Neurological complications, such as hand tremors, occur in about 50% of clients taking
cyclosporine and should be reported. Although this drug can be nephrotoxic, changes in urine
color typically does not occur. Nausea is a common side effects, but is not usually severe.
Dobutamine (Dobutrex) is an emergency drug most commonly prescribed for a client with
which condition?
A. Shock.
B. Asthma.
C. Hypotension.
D. Heart failure.
D. Heart failure.
- Dobutamine is a beta-1 adrenergic agonist that is indicated for short term use in cardiac
decompensation or heart failure related to reduced cardiac contractility due to organic heart
disease or cardiac surgical procedures. On the other hand, alpha and beta adrenergic agonists,
such as epinephrine and dopamine, are sympathomimetics used in the treatment of shock.
,2|Page
Other selective beta-2 adrenergic agonists, such as terbutaline and isoproterenol, are
indicated in the treatment of asthma. Although dobutamine improves cardiac output, it is not
used to treat hypotension.
The nitrate isosorbide dinitrate (Isordil) is prescribed for a client with angina. Which
instruction should the nurse include in this client's discharge teaching plan?
A. Quit taking the medication if dizziness occurs.
B. Do not get up quickly. Always rise slowly.
C. Take the medication with food only.
D. Increase your intake of potassium-rich foods.
B. Do not get up quickly. Always rise slowly.
- An expected side effect of nitrates is orthostatic hypotension and the nurse should address
how to prevent it--by rising slowly.
A client has a continuous IV infusion of dopamine (Intropin) and an IV of normal saline at 50
ml/hour. The nurse notes that the client's urinary output has been 20 ml/hour for the last two
hours. Which intervention should the nurse initiate?
A. Stop the infusion of dopamine.
B. Change the normal saline to a keep open rate.
C. Replace the urinary catheter.
D. Notify the healthcare provider of the urinary output.
D. Notify the healthcare provider of the urinary output.
- The main effect of dopamine is adrenergic stimulation used to increase cardiac output,
which should also result in increased urinary output. A urinary output of less than 20 ml/hour
is oliguria and should be reported to the healthcare provider, so the dose of dopamine can be
adjusted. Depending on the current rate of administration, the dose may need to be increased
or decreased.
,3|Page
A client is being treated for hyperthyroidism with propylthiouracil (PTU). The nurse knows
that the action of this drug is to
A. decrease the amount of thyroid-stimulating hormone circulating in the blood.
B. increase the amount of thyroid-stimulating hormone circulating in the blood.
C. increase the amount of T4 and decrease the amount of T3 produced by the thyroid.
D. inhibit synthesis of T3 and T4 by the thyroid gland.
D. inhibit synthesis of T3 and T4 by the thyroid gland.
- PTU is an adjunct therapy used to control hyperthyroidism by inhibiting production of
thyroid hormones. It is often prescribed in preparation for thyroidectomy or radioactive
iodine therapy.
Which dosing schedule should the nurse teach the client to observe for a controlled-release
oxycodone prescription?
A. As needed.
B. Every 12 hours.
C. Every 24 hours.
D. Every 4 to 6 hours.
B. Every 12 hours.
- A controlled-release oxycodone provides long-acting analgesia to relieve moderate to severe
pain, so a dosing schedule of every 12 hours provides the best around-the-clock pain
management. Controlled-release oxycodone is not prescribed for breakthrough pain on a PRN
or as needed schedule. Using a schedule of every 4 to 6 hours may jeopardize patient safety
due to cumulative effects.
Which drug is used as a palliative treatment for a client with tumor-induced spinal cord
compression?
A. Morphine Sulfate (Duromorph).
B. Ibuprofen (Advil).
C. Amitriptyline (Amitril).
, 4|Page
D. Dexamethasone (Decadron).
D. Dexamethasone (Decadron).
- Dexamethasone is a palliative treatment modality to manage symptoms related to
compression due to tumor growth ( the focus of this question). Morphine sulphate is an
opioid analgesic used in oncology to manage severe or intractable pain. Ibuprofen, a
nonsteroidal antiinflammatory drug (NSAID), provides relief for mild to moderate pain,
suppression of inflammation, and reduction of fever. Amitriptyline, a tricyclic antidepressant,
is often prescribed for pain related to neuropathic origin and provides a reduction in opioid
dosage.
Which nursing intervention is most important when caring for a client receiving the
antimetabolite cytosine arabinoside (Arc-C) for chemotherapy?
A. Hydrate the client with IV fluids before and after infusion.
B. Assess the client for numbness and tingling of extremities.
C. Inspect the client's oral mucosa for ulcerations.
D. Monitor the client's urine pH for increased acidity.
C. Inspect the client's oral mucosa for ulcerations.
- Cytosine arabinoside (Arc-C) affects the rapidly growing cells of the body, therefore
stomatitis and mucosal ulcerations are key signs of antimetabolite toxicity.
A category X drug is prescribed for a young adult female client. Which instruction is most
important for the nurse to teach this client?
A. Use a reliable form of birth control.
B. Avoid exposure to ultra violet light.
C. Refuse this medication if planning pregnancy.
D. Abstain from intercourse while on this drug.
A. Use a reliable form of birth control.
