2026
HESI Pharmacology Exam Practice 2026:
Comprehensive Test Bank, Clinical Drug
Class Review, and NCLEX-Style
Question Sets
A client is admitted to the hospital for diagnostic testing for possible myasthenia gravis. The
nurse prepares for intravenous administration of edrophonium chloride (Tensilon). What is the
expected outcome for this client following administration of this pharmacologic agent?
A) Progressive difficulty with swallowing
B) Decreased respiratory effort
C) Improvement in generalized fatigue
D) Decreased muscle weakness
Rationale
Edrophonium chloride is a short-acting cholinergic agent used to diagnose myasthenia gravis. It
temporarily improves muscle strength by increasing acetylcholine at the neuromuscular junction
(D). It reverses, rather than worsens, swallowing and respiratory difficulty (A, B). Generalized
fatigue (C) is not the primary manifestation of myasthenia gravis.
Dobutamine (Dobutrex) is an emergency drug most commonly prescribed for a client with which
condition?
A) Shock
B) Asthma
C) Hypotension
D) Heart failure
Rationale
Dobutamine is a beta-1 adrenergic agonist that improves cardiac contractility and output, making
it useful in acute decompensated heart failure (D). Other sympathomimetics are preferred for
shock (A) and asthma (B). It is not used to treat hypotension alone (C).
A client prescribed atorvastatin (Lipitor) one month ago reports muscle pain and weakness in the
legs. Which instruction should the nurse provide?
,2026
A) Increase potassium-rich foods
B) Have serum electrolytes checked at the next visit
C) Make an appointment to see the healthcare provider immediately
D) Follow a low-cholesterol diet
Rationale
Muscle pain and weakness may indicate statin-induced myopathy or rhabdomyolysis, a serious
adverse effect requiring immediate evaluation (C). Electrolyte imbalance is unlikely (A, B). Diet
adherence (D) does not explain the symptoms.
A peak and trough level must be drawn for a client receiving antibiotic therapy. When should the
nurse obtain the trough level?
A) Sixty minutes after the dose
B) Immediately before the next dose
C) With the next blood glucose check
D) Thirty minutes before the next dose
Rationale
Trough levels are drawn just before the next scheduled dose to measure the lowest serum
concentration (B). The other times do not reflect true trough levels.
Which antidiarrheal agent should be used with caution in clients taking high doses of aspirin?
A) Loperamide
B) Probanthine
C) Bismuth subsalicylate
D) Diphenoxylate with atropine
Rationale
Bismuth subsalicylate contains a salicylate, increasing the risk of salicylate toxicity when
combined with aspirin (C). The other medications do not contain salicylates.
An elderly client receiving high-dose aspirin for arthritis reports ringing in her ears. What action
should the nurse take?
A) Refer to an audiologist
B) Reassure the client
C) Notify the healthcare provider immediately
D) Ask the client to remove hearing aids
,2026
Rationale
Tinnitus is an early sign of salicylate toxicity and requires immediate provider notification (C).
Reassurance or referral delays necessary intervention.
A client is experiencing anaphylaxis after an insect sting. Which medication should the nurse
prepare to administer?
A) Dopamine
B) Ephedrine
C) Epinephrine
D) Diphenhydramine
Rationale
Epinephrine is the first-line treatment for anaphylaxis due to its bronchodilation and
vasoconstrictive effects (C). Diphenhydramine treats mild allergic reactions, not acute
anaphylaxis.
A client taking naproxen for osteoarthritis reports no relief after three weeks. What is the best
nursing response?
A) Increase the dosing frequency
B) Explain therapeutic levels take 6 weeks
C) Another NSAID may be more effective
D) Corticosteroids are the next option
Rationale
Response to NSAIDs varies between individuals, so switching medications may be appropriate
(C). Naproxen does not require weeks to become effective (B), and corticosteroids are not first-
line therapy (D).
A category X medication is prescribed for a young adult female. What instruction is most
important?
A) Use a reliable form of birth control
B) Avoid ultraviolet light
C) Refuse the medication if pregnancy is planned
D) Abstain from intercourse
, 2026
Rationale
Category X drugs cause fetal harm, so effective contraception is essential (A). Total abstinence
(D) is not required, and pregnancy planning should be discussed with the provider (C).
A client is prescribed a scopolamine patch for motion sickness. What instruction should the
nurse provide?
A) Apply the patch at least 4 hours before travel
B) Change the patch every other day
C) Apply at the base of the skull
D) Limit alcohol intake
Rationale
Scopolamine requires several hours to reach therapeutic effect, so early application is necessary
(A). The patch lasts 72 hours (B), should be placed behind the ear (C), and alcohol should be
avoided, not limited (D).
A client receives methylprednisolone (Solu-Medrol). Which laboratory value is most likely to
increase?
A) Serum glucose
B) Serum calcium
C) Red blood cells
D) Serum potassium
Rationale
Corticosteroids increase gluconeogenesis, leading to hyperglycemia (A). They may cause
hypocalcemia and hypokalemia, not increases (B, D).
Naloxone (Narcan) is administered for opioid overdose. Which finding indicates effectiveness?
A) Chest pain relief
B) Respiratory rate of 16 breaths/min
C) Seizure cessation
D) Constricted pupils
Rationale
Naloxone reverses opioid-induced respiratory depression, so normalization of respirations
confirms effectiveness (B).
HESI Pharmacology Exam Practice 2026:
Comprehensive Test Bank, Clinical Drug
Class Review, and NCLEX-Style
Question Sets
A client is admitted to the hospital for diagnostic testing for possible myasthenia gravis. The
nurse prepares for intravenous administration of edrophonium chloride (Tensilon). What is the
expected outcome for this client following administration of this pharmacologic agent?
A) Progressive difficulty with swallowing
B) Decreased respiratory effort
C) Improvement in generalized fatigue
D) Decreased muscle weakness
Rationale
Edrophonium chloride is a short-acting cholinergic agent used to diagnose myasthenia gravis. It
temporarily improves muscle strength by increasing acetylcholine at the neuromuscular junction
(D). It reverses, rather than worsens, swallowing and respiratory difficulty (A, B). Generalized
fatigue (C) is not the primary manifestation of myasthenia gravis.
Dobutamine (Dobutrex) is an emergency drug most commonly prescribed for a client with which
condition?
A) Shock
B) Asthma
C) Hypotension
D) Heart failure
Rationale
Dobutamine is a beta-1 adrenergic agonist that improves cardiac contractility and output, making
it useful in acute decompensated heart failure (D). Other sympathomimetics are preferred for
shock (A) and asthma (B). It is not used to treat hypotension alone (C).
A client prescribed atorvastatin (Lipitor) one month ago reports muscle pain and weakness in the
legs. Which instruction should the nurse provide?
,2026
A) Increase potassium-rich foods
B) Have serum electrolytes checked at the next visit
C) Make an appointment to see the healthcare provider immediately
D) Follow a low-cholesterol diet
Rationale
Muscle pain and weakness may indicate statin-induced myopathy or rhabdomyolysis, a serious
adverse effect requiring immediate evaluation (C). Electrolyte imbalance is unlikely (A, B). Diet
adherence (D) does not explain the symptoms.
A peak and trough level must be drawn for a client receiving antibiotic therapy. When should the
nurse obtain the trough level?
A) Sixty minutes after the dose
B) Immediately before the next dose
C) With the next blood glucose check
D) Thirty minutes before the next dose
Rationale
Trough levels are drawn just before the next scheduled dose to measure the lowest serum
concentration (B). The other times do not reflect true trough levels.
Which antidiarrheal agent should be used with caution in clients taking high doses of aspirin?
A) Loperamide
B) Probanthine
C) Bismuth subsalicylate
D) Diphenoxylate with atropine
Rationale
Bismuth subsalicylate contains a salicylate, increasing the risk of salicylate toxicity when
combined with aspirin (C). The other medications do not contain salicylates.
An elderly client receiving high-dose aspirin for arthritis reports ringing in her ears. What action
should the nurse take?
A) Refer to an audiologist
B) Reassure the client
C) Notify the healthcare provider immediately
D) Ask the client to remove hearing aids
,2026
Rationale
Tinnitus is an early sign of salicylate toxicity and requires immediate provider notification (C).
Reassurance or referral delays necessary intervention.
A client is experiencing anaphylaxis after an insect sting. Which medication should the nurse
prepare to administer?
A) Dopamine
B) Ephedrine
C) Epinephrine
D) Diphenhydramine
Rationale
Epinephrine is the first-line treatment for anaphylaxis due to its bronchodilation and
vasoconstrictive effects (C). Diphenhydramine treats mild allergic reactions, not acute
anaphylaxis.
A client taking naproxen for osteoarthritis reports no relief after three weeks. What is the best
nursing response?
A) Increase the dosing frequency
B) Explain therapeutic levels take 6 weeks
C) Another NSAID may be more effective
D) Corticosteroids are the next option
Rationale
Response to NSAIDs varies between individuals, so switching medications may be appropriate
(C). Naproxen does not require weeks to become effective (B), and corticosteroids are not first-
line therapy (D).
A category X medication is prescribed for a young adult female. What instruction is most
important?
A) Use a reliable form of birth control
B) Avoid ultraviolet light
C) Refuse the medication if pregnancy is planned
D) Abstain from intercourse
, 2026
Rationale
Category X drugs cause fetal harm, so effective contraception is essential (A). Total abstinence
(D) is not required, and pregnancy planning should be discussed with the provider (C).
A client is prescribed a scopolamine patch for motion sickness. What instruction should the
nurse provide?
A) Apply the patch at least 4 hours before travel
B) Change the patch every other day
C) Apply at the base of the skull
D) Limit alcohol intake
Rationale
Scopolamine requires several hours to reach therapeutic effect, so early application is necessary
(A). The patch lasts 72 hours (B), should be placed behind the ear (C), and alcohol should be
avoided, not limited (D).
A client receives methylprednisolone (Solu-Medrol). Which laboratory value is most likely to
increase?
A) Serum glucose
B) Serum calcium
C) Red blood cells
D) Serum potassium
Rationale
Corticosteroids increase gluconeogenesis, leading to hyperglycemia (A). They may cause
hypocalcemia and hypokalemia, not increases (B, D).
Naloxone (Narcan) is administered for opioid overdose. Which finding indicates effectiveness?
A) Chest pain relief
B) Respiratory rate of 16 breaths/min
C) Seizure cessation
D) Constricted pupils
Rationale
Naloxone reverses opioid-induced respiratory depression, so normalization of respirations
confirms effectiveness (B).
