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HESI PHARMACOLOGY EXAM PRACTICE WITH CORRECT ANSWERS 2026, Exams of Nursing

Stanford UniversityNursing

HESI PHARMACOLOGY EXAM PRACTICE WITH CORRECT ANSWERS 2026 149.) A client taking fexofenadine (Allegra) is scheduled for allergy skin testing and tells the nurse in the health care provider's office that a dose was taken this morning. The nurse determines that: 1. The client should reschedule the appointment. 2. A lower dose of allergen will need to be injected. 3. A higher dose of allergen will need to be injected. 4. The client should have the skin test read a day later than usual. ( correct answers ) 1. The client should

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HESI PHARMACOLOGY EXAM
PRACTICE WITH CORRECT
ANSWERS 2026
149.) A client taking fexofenadine (Allegra) is scheduled for allergy skin
testing and tells the nurse in the health care provider's office that a dose was
taken this morning. The nurse determines that:
1. The client should reschedule the appointment.
2. A lower dose of allergen will need to be injected.
3. A higher dose of allergen will need to be injected.
4. The client should have the skin test read a day later than usual.
( correct answers ) 1. The client should reschedule the appointment.
Rationale:
Fexofenadine is an antihistamine, which provides relief of symptoms caused
by allergy. Antihistamines should be discontinued for at least 3 days (72
hours) before allergy skin testing to avoid false-negative readings. This client
should have the appointment rescheduled for 3 days after discontinuing the
medication.
150.) A client complaining of not feeling well is seen in a clinic. The client is
taking several medications for the control of heart disease and hypertension.
These medications include a β-blocker, digoxin (Lanoxin), and a diuretic. A
tentative diagnosis of digoxin toxicity is made. Which of the following
assessment data would support this diagnosis?
1. Dyspnea, edema, and palpitations
2. Chest pain, hypotension, and paresthesia
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HESI PHARMACOLOGY EXAM

PRACTICE WITH CORRECT

ANSWERS 2026

149.) A client taking fexofenadine (Allegra) is scheduled for allergy skin testing and tells the nurse in the health care provider's office that a dose was taken this morning. The nurse determines that:

  1. The client should reschedule the appointment.
  2. A lower dose of allergen will need to be injected.
  3. A higher dose of allergen will need to be injected.
  4. The client should have the skin test read a day later than usual. ( correct answers ) 1. The client should reschedule the appointment. Rationale: Fexofenadine is an antihistamine, which provides relief of symptoms caused by allergy. Antihistamines should be discontinued for at least 3 days ( hours) before allergy skin testing to avoid false-negative readings. This client should have the appointment rescheduled for 3 days after discontinuing the medication. 150.) A client complaining of not feeling well is seen in a clinic. The client is taking several medications for the control of heart disease and hypertension. These medications include a β-blocker, digoxin (Lanoxin), and a diuretic. A tentative diagnosis of digoxin toxicity is made. Which of the following assessment data would support this diagnosis?
  5. Dyspnea, edema, and palpitations
  6. Chest pain, hypotension, and paresthesia
  1. Double vision, loss of appetite, and nausea
  2. Constipation, dry mouth, and sleep disorder ( correct answers ) 3. Double vision, loss of appetite, and nausea Rationale: Double vision, loss of appetite, and nausea are signs of digoxin toxicity. Additional signs of digoxin toxicity include bradycardia, difficulty reading, visual alterations such as green and yellow vision or seeing spots or halos, confusion, vomiting, diarrhea, decreased libido, and impotence. gastrointestinal (GI) and visual disturbances occur with digoxin toxicity 151.) A client is being treated for acute congestive heart failure with intravenously administered bumetanide. The vital signs are as follows: blood pressure, 100/60 mm Hg; pulse, 96 beats/min; and respirations, 24 breaths/min. After the initial dose, which of the following is the priority assessment?
  3. Monitoring weight loss
  4. Monitoring temperature
  5. Monitoring blood pressure
  6. Monitoring potassium level ( correct answers ) 3. Monitoring blood pressure Rationale: Bumetanide is a loop diuretic. Hypotension is a common side effect associated with the use of this medication. The other options also require assessment but are not the priority. priority ABCs—airway, breathing, and circulation 152.) Intravenous heparin therapy is prescribed for a client. While implementing this prescription, a nurse ensures that which of the following medications is available on the nursing unit?
  7. Protamine sulfate
  8. Potassium chloride
  9. Phytonadione (vitamin K )

A compound present in grapefruit juice inhibits metabolism of cyclosporine. As a result, the consumption of grapefruit juice can raise cyclosporine levels by 50% to 100%, thereby greatly increasing the risk of toxicity. Grapefruit juice needs to be avoided. Red meats, orange juice, and green leafy vegetables are acceptable to consume. 155.) Mycophenolate mofetil (CellCept) is prescribed for a client as prophylaxis for organ rejection following an allogeneic renal transplant. Which of the following instructions does the nurse reinforce regarding administration of this medication?

  1. Administer following meals.
  2. Take the medication with a magnesium-type antacid.
  3. Open the capsule and mix with food for administration.
  4. Contact the health care provider (HCP) if a sore throat occurs. ( correct answers ) 4. Contact the health care provider (HCP) if a sore throat occurs. Rationale: Mycophenolate mofetil should be administered on an empty stomach. The capsules should not be opened or crushed. The client should contact the HCP if unusual bleeding or bruising, sore throat, mouth sores, abdominal pain, or fever occurs because these are adverse effects of the medication. Antacids containing magnesium and aluminum may decrease the absorption of the medication and therefore should not be taken with the medication. The medication may be given in combination with corticosteroids and cyclosporine. neutropenia can occur with this medication 156.) A nurse is reviewing the laboratory results for a client receiving tacrolimus (Prograf). Which laboratory result would indicate to the nurse that the client is experiencing an adverse effect of the medication?
  5. Blood glucose of 200 mg/dL
  6. Potassium level of 3.8 mEq/L
  7. Platelet count of 300,000 cells/mm
  8. White blood cell count of 6000 cells/mm3 ( correct answers ) 1. Blood glucose of 200 mg/dL

Rationale: A blood glucose level of 200 mg/dL is elevated above the normal range of 70 to 110 mg/dL and suggests an adverse effect. Other adverse effects include neurotoxicity evidenced by headache, tremor, insomnia; gastrointestinal (GI) effects such as diarrhea, nausea, and vomiting; hypertension; and hyperkalemia. 157.) A client receiving nitrofurantoin (Macrodantin) calls the health care provider's office complaining of side effects related to the medication. Which side effect indicates the need to stop treatment with this medication?

  1. Nausea
  2. Diarrhea
  3. Anorexia
  4. Cough and chest pain ( correct answers ) 4. Cough and chest pain Rationale: Gastrointestinal (GI) effects are the most frequent adverse reactions to this medication and can be minimized by administering the medication with milk or meals. Pulmonary reactions, manifested as dyspnea, chest pain, chills, fever, cough, and the presence of alveolar infiltrates on the x-ray, would indicate the need to stop the treatment. These symptoms resolve in 2 to 4 days following discontinuation of this medication. Eliminate options 1, 2, and 3 because they are similar GI-related side effects. Also, use the ABCs— airway, breathing, and circulation 158.) A client with chronic renal failure is receiving epoetin alfa (Epogen, Procrit). Which laboratory result would indicate a therapeutic effect of the medication?
  5. Hematocrit of 32%
  6. Platelet count of 400,000 cells/mm
  7. White blood cell count of 6000 cells/mm
  8. Blood urea nitrogen (BUN) level of 15 mg/dL ( correct answers ) 1. Hematocrit of 32% Rationale:

161.) A nurse is caring for a client with severe back pain, and codeine sulfate has been prescribed for the client. Which of the following would the nurse include in the plan of care while the client is taking this medication?

  1. Restrict fluid intake.
  2. Monitor bowel activity.
  3. Monitor for hypertension.
  4. Monitor peripheral pulses. ( correct answers ) 2. Monitor bowel activity. Rationale: While the client is taking codeine sulfate, an opioid analgesic, the nurse would monitor vital signs and monitor for hypotension. The nurse should also increase fluid intake, palpate the bladder for urinary retention, auscultate bowel sounds, and monitor the pattern of daily bowel activity and stool consistency (codeine can cause constipation). The nurse should monitor respiratory status and initiate breathing and coughing exercises. In addition, the nurse monitors the effectiveness of the pain medication. 162.) Carbamazepine (Tegretol) is prescribed for a client with a diagnosis of psychomotor seizures. The nurse reviews the client's health history, knowing that this medication is contraindicated if which of the following disorders is present?
  5. Headaches
  6. Liver disease
  7. Hypothyroidism
  8. Diabetes mellitus ( correct answers ) 2. Liver disease Rationale: Carbamazepine (Tegretol) is contraindicated in liver disease, and liver function tests are routinely prescribed for baseline purposes and are monitored during therapy. It is also contraindicated if the client has a history of blood dyscrasias. It is not contraindicated in the conditions noted in the incorrect options. 163.) A client with trigeminal neuralgia tells the nurse that acetaminophen (Tylenol) is taken on a frequent daily basis for relief of generalized

discomfort. The nurse reviews the client's laboratory results and determines that which of the following indicates toxicity associated with the medication?

  1. Sodium of 140 mEq/L
  2. Prothrombin time of 12 seconds
  3. Platelet count of 400,000 cells/mm
  4. A direct bilirubin level of 2 mg/dL ( correct answers ) 4. A direct bilirubin level of 2 mg/dL Rationale: In adults, overdose of acetaminophen (Tylenol) causes liver damage. Option 4 is an indicator of liver function and is the only option that indicates an abnormal laboratory value. The normal direct bilirubin is 0 to 0.4 mg/dL. The normal platelet count is 150,000 to 400,000 cells/mm3. The normal prothrombin time is 10 to 13 seconds. The normal sodium level is 135 to 145 mEq/L. 164.) A client receives a prescription for methocarbamol (Robaxin), and the nurse reinforces instructions to the client regarding the medication. Which client statement would indicate a need for further instructions?
  5. "My urine may turn brown or green."
  6. "This medication is prescribed to help relieve my muscle spasms."
  7. "If my vision becomes blurred, I don't need to be concerned about it."
  8. "I need to call my doctor if I experience nasal congestion from this medication." ( correct answers ) 3. "If my vision becomes blurred, I don't need to be concerned about it." Rationale: The client needs to be told that the urine may turn brown, black, or green. Other adverse effects include blurred vision, nasal congestion, urticaria, and rash. The client needs to be instructed that, if these adverse effects occur, the health care provider needs to be notified. The medication is used to relieve muscle spasms. 165.) The client has been on treatment for rheumatoid arthritis for 3 weeks. During the administration of etanercept (Enbrel), it is most important for the nurse to assess:
  1. Instruct the client to drink 3000 mL of fluid per day.
  2. Instruct the client to take the medication on an empty stomach.
  3. Inform the client that the effect of the medication will occur immediately.
  4. Instruct the client that, if swelling of the lips occurs, this is a normal expected response. ( correct answers ) 1. Instruct the client to drink 3000 mL of fluid per day. Rationale: Allopurinol (Zyloprim) is an antigout medication used to decrease uric acid levels. Clients taking allopurinol are encouraged to drink 3000 mL of fluid a day. A full therapeutic effect may take 1 week or longer. Allopurinol is to be given with or immediately following meals or milk to prevent gastrointestinal irritation. If the client develops a rash, irritation of the eyes, or swelling of the lips or mouth, he or she should contact the health care provider because this may indicate hypersensitivity. 168.) Colcrys (colchicine) is prescribed for a client with a diagnosis of gout. The nurse reviews the client's medical history in the health record, knowing that the medication would be contraindicated in which disorder?
  5. Myxedema
  6. Renal failure
  7. Hypothyroidism
  8. Diabetes mellitus ( correct answers ) 2. Renal failure Rationale: Colchicine is contraindicated in clients with severe gastrointestinal, renal, hepatic or cardiac disorders, or with blood dyscrasias. Clients with impaired renal function may exhibit myopathy and neuropathy manifested as generalized weakness. This medication should be used with caution in clients with impaired hepatic function, older clients, and debilitated clients. Note that options 1, 3, and 4 are all endocrine-related disorders: Myxedema=Hypothyroidism 169.) Insulin glargine (Lantus) is prescribed for a client with diabetes mellitus. The nurse tells the client that it is best to take the insulin:
  1. 1 hour after each meal
  2. Once daily, at the same time each day
  3. 15 minutes before breakfast, lunch, and dinner
  4. Before each meal, on the basis of the blood glucose level ( correct answers ) 2. Once daily, at the same time each day Rationale: Insulin glargine is a long-acting recombinant DNA human insulin used to treat type 1 and type 2 diabetes mellitus. It has a 24-hour duration of action and is administered once a day, at the same time each day. 170.) Atenolol hydrochloride (Tenormin) is prescribed for a hospitalized client. The nurse should perform which of the following as a priority action before administering the medication?
  5. Listen to the client's lung sounds.
  6. Check the client's blood pressure.
  7. Check the recent electrolyte levels.
  8. Assess the client for muscle weakness. ( correct answers ) 2. Check the client's blood pressure. Rationale: Atenolol hydrochloride is a beta-blocker used to treat hypertension. Therefore the priority nursing action before administration of the medication is to check the client's blood pressure. The nurse also checks the client's apical heart rate. If the systolic blood pressure is below 90 mm Hg or the apical pulse is 60 beats per minute or lower, the medication is withheld and the registered nurse and/or health care provider is notified. The nurse would check baseline renal and liver function tests. The medication may cause weakness, and the nurse would assist the client with activities if weakness occurs. Beta-blockers have "-lol" at the end of the medication name 171.) A nurse is preparing to administer furosemide (Lasix) to a client with a diagnosis of heart failure. The most important laboratory test result for the nurse to check before administering this medication is:
  1. "Are you experiencing heartburn?" ( correct answers ) 1. "Do you have any joint pain?" Rationale: Leflunomide is an immunosuppressive agent and has an anti-inflammatory action. The medication provides symptomatic relief of rheumatoid arthritis. Diarrhea can occur as a side effect of the medication. The other options are unrelated to medication effectiveness. 174.) A client with portosystemic encephalopathy is receiving oral lactulose (Chronulac) daily. The nurse assesses which of the following to determine medication effectiveness?
  2. Lung sounds
  3. Blood pressure
  4. Blood ammonia level
  5. Serum potassium level ( correct answers ) 3. Blood ammonia level Rationale: Lactulose is a hyperosmotic laxative and ammonia detoxicant. It is used to prevent or treat portosystemic encephalopathy, including hepatic precoma and coma. It also is used to treat constipation. The medication retains ammonia in the colon (decreases the blood ammonia concentration), producing an osmotic effect. It promotes increased peristalsis and bowel evacuation, expelling ammonia from the colon. 175.) A nurse notes that a client is receiving lamivudine (Epivir). The nurse determines that this medication has been prescribed to treat which of the following?
  6. Pancreatitis
  7. Pharyngitis
  8. Tonic-clonic seizures
  9. Human immunodeficiency virus (HIV) infection ( correct answers ) 4. Human immunodeficiency virus (HIV) infection Rationale:

Lamivudine is a nucleoside reverse transcriptase inhibitor and antiviral medication. It slows HIV replication and reduces the progression of HIV infection. It also is used to treat chronic hepatitis B and is used for prophylaxis in health care workers at risk of acquiring HIV after occupational exposure to the virus. Note the letters "-vir" in the trade name for this medication 176.) A nurse notes that a client is taking lansoprazole (Prevacid). On data collection, the nurse asks which question to determine medication effectiveness?

  1. "Has your appetite increased?"
  2. "Are you experiencing any heartburn?"
  3. "Do you have any problems with vision?"
  4. "Do you experience any leg pain when walking?" ( correct answers ) 2. "Are you experiencing any heartburn?" Rationale: Lansoprazole is a gastric acid pump inhibitor used to treat gastric and duodenal ulcers, erosive esophagitis, and hypersecretory conditions. It also is used to treat gastroesophageal reflux disease (GERD). It is not used to treat visual problems, problems with appetite, or leg pain. NOTE: "-zole" refers to gastric acid pump inhibitors 177.) A nurse is assisting in caring for a pregnant client who is receiving intravenous magnesium sulfate for the management of preeclampsia and notes that the client's deep tendon reflexes are absent. On the basis of this data, the nurse reports the finding and makes which determination?
  5. The magnesium sulfate is effective.
  6. The infusion rate needs to be increased.
  7. The client is experiencing cerebral edema.
  8. The client is experiencing magnesium toxicity. ( correct answers ) 4. The client is experiencing magnesium toxicity. Rationale:
  1. "I need to call the health care provider (HCP) if my urine volume decreases or my urine becomes cloudy." ( correct answers ) 1. "I need to obtain a yearly influenza vaccine." Rationale: Cyclosporine is an immunosuppressant medication. Because of the medication's effects, the client should not receive any vaccinations without first consulting the HCP. The client should report decreased urine output or cloudy urine, which could indicate kidney rejection or infection, respectively. The client must be able to self-monitor blood pressure to check for the side effect of hypertension. The client needs meticulous oral care and dental cleaning every 3 months to help prevent gingival hyperplasia. 180.) A health care provider (HCP) writes a prescription for digoxin (Lanoxin), 0.25 mg daily. The nurse teaches the client about the medication and tells the client that it is important to:
  2. Count the radial and carotid pulses every morning.
  3. Check the blood pressure every morning and evening.
  4. Stop taking the medication if the pulse is higher than 100 beats per minute.
  5. Withhold the medication and call the HCP if the pulse is less than 60 beats per minute. ( correct answers ) 4. Withhold the medication and call the HCP if the pulse is less than 60 beats per minute. Rationale: An important component of taking this medication is monitoring the pulse rate; however, it is not necessary for the client to take both the radial and carotid pulses. It is not necessary for the client to check the blood pressure every morning and evening because the medication does not directly affect blood pressure. It is most important for the client to know the guidelines related to withholding the medication and calling the HCP. The client should not stop taking a medication. 181.) A client is taking ticlopidine hydrochloride (Ticlid). The nurse tells the client to avoid which of the following while taking this medication?
  6. Vitamin C
  7. Vitamin D
  1. Acetaminophen (Tylenol)
  2. Acetylsalicylic acid (aspirin) ( correct answers ) 4. Acetylsalicylic acid (aspirin) Rationale: Ticlopidine hydrochloride is a platelet aggregation inhibitor. It is used to decrease the risk of thrombotic strokes in clients with precursor symptoms. Because it is an antiplatelet agent, other medications that precipitate or aggravate bleeding should be avoided during its use. Therefore, aspirin or any aspirin-containing product should be avoided. 182.) A client with angina pectoris is experiencing chest pain that radiates down the left arm. The nurse administers a sublingual nitroglycerin tablet to the client. The client's pain is unrelieved, and the nurse determines that the client needs another nitroglycerin tablet. Which of the following vital signs is most important for the nurse to check before administering the medication?
  3. Temperature
  4. Respirations
  5. Blood pressure
  6. Radial pulse rate ( correct answers ) Rationale: Nitroglycerin acts directly on the smooth muscle of the blood vessels, causing relaxation and dilation. As a result, hypotension can occur. The nurse would check the client's blood pressure before administering the second nitroglycerin tablet. Although the respirations and apical pulse may be checked, these vital signs are not affected as a result of this medication. The temperature also is not associated with the administration of this medication. 183.) A client who received a kidney transplant is taking azathioprine (Imuran), and the nurse provides instructions about the medication. Which statement by the client indicates a need for further instructions?
  7. "I need to watch for signs of infection."
  8. "I need to discontinue the medication after 14 days of use."
  9. "I can take the medication with meals to minimize nausea."

Rationale: Chamomile has a mild sedative effect and acts as an antispasmodic and anti- inflammatory. Peppermint oil acts as an antispasmodic and is used for irritable bowel syndrome. Topical aloe promotes wound healing. Aloe taken orally acts as a laxative. Kava has an anxiolytic, sedative, and analgesic effect. Ginger is effective in relieving nausea. 186.) A nurse prepares to administer sodium polystyrene sulfonate (Kayexalate) to a client. Before administering the medication, the nurse reviews the action of the medication and understands that it:

  1. Releases bicarbonate in exchange for primarily sodium ions
  2. Releases sodium ions in exchange for primarily potassium ions
  3. Releases potassium ions in exchange for primarily sodium ions
  4. Releases sodium ions in exchange for primarily bicarbonate ions ( correct answers ) 2. Releases sodium ions in exchange for primarily potassium ions Rationale: Sodium polystyrene sulfonate is a cation exchange resin used in the treatment of hyperkalemia. The resin either passes through the intestine or is retained in the colon. It releases sodium ions in exchange for primarily potassium ions. The therapeutic effect occurs 2 to 12 hours after oral administration and longer after rectal administration. 187.) A clinic nurse prepares to administer an MMR (measles, mumps, rubella) vaccine to a child. How is this vaccine best administered?
  5. Intramuscularly in the deltoid muscle
  6. Subcutaneously in the gluteal muscle
  7. Subcutaneously in the outer aspect of the upper arm
  8. Intramuscularly in the anterolateral aspect of the thigh ( correct answers ) 3. Subcutaneously in the outer aspect of the upper arm Rationale:

The MMR vaccine is administered subcutaneously in the outer aspect of the upper arm. The gluteal muscle is most often used for intramuscular injections. The MMR vaccine is not administered by the intramuscular route. 188.) The nurse should anticipate that the most likely medication to be prescribed prophylactically for a child with spina bifida (myelomeningocele) who has a neurogenic bladder would be:

  1. Prednisone
  2. Sulfisoxazole
  3. Furosemide (Lasix)
  4. Intravenous immune globulin (IVIG) ( correct answers ) 2. Sulfisoxazole Rationale: A neurogenic bladder prevents the bladder from completely emptying because of the decrease in muscle tone. The most likely medication to be prescribed to prevent urinary tract infection would be an antibiotic. A common prescribed medication is sulfisoxazole. Prednisone relieves allergic reactions and inflammation rather than preventing infection. Furosemide promotes diuresis and decreases edema caused by congestive heart failure. IVIG assists with antibody production in immunocompromised clients. 189.) Prostaglandin E1 is prescribed for a child with transposition of the great arteries. The mother of the child asks the nurse why the child needs the medication. The nurse tells the mother that the medication:
  5. Prevents hypercyanotic (blue or tet) spells
  6. Maintains an adequate hormone level
  7. Maintains the position of the great arteries
  8. Provides adequate oxygen saturation and maintains cardiac output ( correct answers ) 4. Provides adequate oxygen saturation and maintains cardiac output Rationale: A child with transposition of the great arteries may receive prostaglandin E temporarily to increase blood mixing if systemic and pulmonary mixing are inadequate to maintain adequate cardiac output. Options 1, 2, and 3 are incorrect. In addition, hypercyanotic spells occur in tetralogy of Fallot.