HESI PHARMACOLOGY – EXAMINATION GUIDE 2026
COMPREHENSIVE HIGH-YIELD NURSING PHARMACOLOGY: DRUG
CLASSIFICATIONS, MECHANISMS OF ACTION, SAFE ADMINISTRATION, ADVERSE
EFFECTS, AND CLINICAL APPLICATIONS
MEDICATION PRACTICE AND PATIENT CARE DECISION-MAKING
SPRING SEMESTER EXAM [2025/2026]
A 19-year-old male client who has sustained a severe head injury is intubated and placed on
assisted mechanical ventilation. To facilitate optimal ventilation and prevent the client from
"fighting" the ventilator, the health care provider administers pancuronium bromide IV, with
adjunctive opioid analgesia. What medication should be immediately accessible for a potential
complication with this drug?
A. Dantrolene sodium
B. Neostigmine bromide
C. Succinylcholine bromide
D. Epinephrine
B. Neostigmine bromide
Neostigmine bromide and atropine sulfate, both anticholinergic drugs, reverse the respiratory
muscle paralysis caused by pancuronium bromide. Options A, C, and D are not antagonists to
pancuronium bromide and would not be helpful in reversing the effects of the drug compared
with the use of anticholinergics.
1
Page
, A client with viral influenza is receiving vitamin C, 1000 mg PO daily, and acetaminophen elixir,
650 mg PO every 4 hours PRN. The nurse calls the health care provider to report that the client
has developed diarrhea. Which change in prescriptions should the nurse anticipate?
A. Change the acetaminophen to ibuprofen.
B. Change the elixir to an injectable route.
C. Decrease the dose of vitamin C.
D. Begin treatment with an antibiotic.
C. Decrease the dose of vitamin C.
When providing nursing care for a client receiving pyridostigmine bromide for myasthenia
gravis, which nursing intervention has the highest priority?
A. Monitor the client frequently for urinary retention.
B. Assess respiratory status and breath sounds often.
C. Monitor blood pressure each shift to screen for hypertension.
D. Administer most medications after meals to decrease gastrointestinal irritation.
B. Assess respiratory status and breath sounds often.
A client with a dislocated shoulder is being prepared for a closed manual reduction using
conscious sedation. Which medication should the nurse explain as a sedative used during the
procedure?
A.Inhaled nitrous oxide
2
B.Midazolam IV
Page
, C.Ketamine IM
D.Fentanyl and droperidol IM
B. Midazolam IV
A client is being discharged with a prescription for sulfasalazine to treat ulcerative colitis. Which
instruction should the nurse provide to this client prior to discharge?
A. Maintain good oral hygiene.
B. Take the medication 30 minutes before a meal.
C. Discontinue use of the drug gradually.
D. Drink at least eight glasses of fluid a day.
D. Drink at least eight glasses of fluid a day.
The health care provider prescribes carbamazepine for a child whose tonic-clonic seizures have
been poorly controlled. The nurse informs the mother that the child must have blood tests
every week. The mother asks why so many blood tests are necessary. Which complication is
assessed through frequent laboratory testing that the nurse should explain to this mother?
A. Nephrotoxicity
B. Ototoxicity
C. Myelosuppression
D.Hepatotoxicity
C. Myelosuppression
3
Page
, Myelosuppression is the highest priority complication that can potentially affect clients
managed with carbamazepine therapy. The client requires close monitoring for this condition by
weekly laboratory testing. Hepatic function may be altered, but this complication does not have
as great a potential for occurrence as option C. Options A and B are not typical complications of
carbamazepine therapy.
When developing a written nursing care plan for a client receiving chemotherapy for treatment
of cancer, the nurse writes, "Assess each voiding for hematuria." The administration of which
type of chemotherapeutic agent would prompt the nurse to add this intervention?
A. Vincristine
B. Bleomycin sulfate
C. Chlorambucil
D. Cyclophosphamide
D. Cyclophosphamide
Hemorrhagic cystitis is the characteristic adverse reaction of cyclophosphamide. Administration
of options A, B, and C does not typically cause hemorrhagic cystitis.
A client is receiving oral griseofulvin for a persistent tinea corporis infection. Which response by
the client indicates an accurate understanding of the drug teaching conducted by the nurse?
A. "I'll wear sunscreen whenever I mow the lawn."
B. "This is the worse bacterial infection I've ever had."
C. "I will need to take the medication for 7 days."
4
D. "My urine will probably turn brown due to this drug."
Page
COMPREHENSIVE HIGH-YIELD NURSING PHARMACOLOGY: DRUG
CLASSIFICATIONS, MECHANISMS OF ACTION, SAFE ADMINISTRATION, ADVERSE
EFFECTS, AND CLINICAL APPLICATIONS
MEDICATION PRACTICE AND PATIENT CARE DECISION-MAKING
SPRING SEMESTER EXAM [2025/2026]
A 19-year-old male client who has sustained a severe head injury is intubated and placed on
assisted mechanical ventilation. To facilitate optimal ventilation and prevent the client from
"fighting" the ventilator, the health care provider administers pancuronium bromide IV, with
adjunctive opioid analgesia. What medication should be immediately accessible for a potential
complication with this drug?
A. Dantrolene sodium
B. Neostigmine bromide
C. Succinylcholine bromide
D. Epinephrine
B. Neostigmine bromide
Neostigmine bromide and atropine sulfate, both anticholinergic drugs, reverse the respiratory
muscle paralysis caused by pancuronium bromide. Options A, C, and D are not antagonists to
pancuronium bromide and would not be helpful in reversing the effects of the drug compared
with the use of anticholinergics.
1
Page
, A client with viral influenza is receiving vitamin C, 1000 mg PO daily, and acetaminophen elixir,
650 mg PO every 4 hours PRN. The nurse calls the health care provider to report that the client
has developed diarrhea. Which change in prescriptions should the nurse anticipate?
A. Change the acetaminophen to ibuprofen.
B. Change the elixir to an injectable route.
C. Decrease the dose of vitamin C.
D. Begin treatment with an antibiotic.
C. Decrease the dose of vitamin C.
When providing nursing care for a client receiving pyridostigmine bromide for myasthenia
gravis, which nursing intervention has the highest priority?
A. Monitor the client frequently for urinary retention.
B. Assess respiratory status and breath sounds often.
C. Monitor blood pressure each shift to screen for hypertension.
D. Administer most medications after meals to decrease gastrointestinal irritation.
B. Assess respiratory status and breath sounds often.
A client with a dislocated shoulder is being prepared for a closed manual reduction using
conscious sedation. Which medication should the nurse explain as a sedative used during the
procedure?
A.Inhaled nitrous oxide
2
B.Midazolam IV
Page
, C.Ketamine IM
D.Fentanyl and droperidol IM
B. Midazolam IV
A client is being discharged with a prescription for sulfasalazine to treat ulcerative colitis. Which
instruction should the nurse provide to this client prior to discharge?
A. Maintain good oral hygiene.
B. Take the medication 30 minutes before a meal.
C. Discontinue use of the drug gradually.
D. Drink at least eight glasses of fluid a day.
D. Drink at least eight glasses of fluid a day.
The health care provider prescribes carbamazepine for a child whose tonic-clonic seizures have
been poorly controlled. The nurse informs the mother that the child must have blood tests
every week. The mother asks why so many blood tests are necessary. Which complication is
assessed through frequent laboratory testing that the nurse should explain to this mother?
A. Nephrotoxicity
B. Ototoxicity
C. Myelosuppression
D.Hepatotoxicity
C. Myelosuppression
3
Page
, Myelosuppression is the highest priority complication that can potentially affect clients
managed with carbamazepine therapy. The client requires close monitoring for this condition by
weekly laboratory testing. Hepatic function may be altered, but this complication does not have
as great a potential for occurrence as option C. Options A and B are not typical complications of
carbamazepine therapy.
When developing a written nursing care plan for a client receiving chemotherapy for treatment
of cancer, the nurse writes, "Assess each voiding for hematuria." The administration of which
type of chemotherapeutic agent would prompt the nurse to add this intervention?
A. Vincristine
B. Bleomycin sulfate
C. Chlorambucil
D. Cyclophosphamide
D. Cyclophosphamide
Hemorrhagic cystitis is the characteristic adverse reaction of cyclophosphamide. Administration
of options A, B, and C does not typically cause hemorrhagic cystitis.
A client is receiving oral griseofulvin for a persistent tinea corporis infection. Which response by
the client indicates an accurate understanding of the drug teaching conducted by the nurse?
A. "I'll wear sunscreen whenever I mow the lawn."
B. "This is the worse bacterial infection I've ever had."
C. "I will need to take the medication for 7 days."
4
D. "My urine will probably turn brown due to this drug."
Page
