Pharm HESI Practice Exam Latest Update
Pharm HESI Practice Exam Latest Update
A female client calls the clinic and talks with the nurse to inquire about a possible reaction after taking
amoxicillin for 5 days. She reports having vaginal discomfort, itching, and a white discharge. The nurse
should discuss which action with the client?
C. Consult with healthcare provider about another treatment for this effect.
The nurse is making early morning rounds on a group of clients when a client begins exhibiting
symptoms of an acute asthma attack. The nurse administers a PRN prescription for a Beta 2 receptor
agonist agent. Which client response should the nurse expect?
A. Tachycardia.
B. Increased blood pressure.
C. Rapid resolution of wheezing.
D. Improved pulse oximetry values.
E. Reduce fever airway inflammation.
C, D
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A client prescribed atenolol has a blood pressure of 120/68 mmHg, displaying a sinus bradycardia with a
rate of 58 beats/minute, and a P-R interval of 0.24. Which action should the nurse take?
A. Lower the head of the bed and assess the client for orthostatic vital sign changes.
B. Give the medication as prescribed and continue to monitor the client.
C. Prepare to administer atropine sulfate IV push.
D. Hold the prescribed dose and contact the healthcare provider.
The nurse is preparing the 0900 dose of losartan (Cozaar), an angiotensin II receptor blocker (ARB), for a
client with hypertension and heart failure. The nurse reviews the client's laboratory results and notes
that the client's serum potassium level is 5.9 mEq/L. Which action should the nurse take first?
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Upon admission to the emergency center, an adult client with acute status asthmaticus is prescribed this
series of medications. In which order should the nurse administer the prescribed medications? (Arrange
from first to last.)
An adult client is given a prescription for a scopolamine patch (Transderm Scop) to prevent motion
sickness while on a cruise. Which information should the nurse provide to the client?
A client with giardiasis is taking metronidazole (Flagyl) 2 grams PO. Which information should the nurse
include in the client's instruction?
A. Notify the clinic of any changes in the color of urine.
B. Avoid overexposure to the sun.
C. Stop the medication after the diarrhea resolves.
D. Take the medication with food.
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A female client with rheumatoid arthritis takes ibuprofen (Motrin) 600 mg PO 4 times a day. To prevent
gastrointestinal bleeding, misoprostol (Cytotec) 100 mcg PO is prescribed. Which information is most
important for the nurse to include in client teaching?
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A client with osteoarthritis receives a new prescription for celecoxib (Celebrex) orally for symptom
management. The nurse notes the client is allergic to sulfa. Which action is most important for the nurse
to implement prior to administering the first dose?
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A client is admitted to the hospital for a new onset of supraventricular tachycardia (SVT) and is
prescribed digoxin. For which laboratory finding should the nurse notify the healthcare provider
immediately?
A. Potassium level of 3.1 mEq/L.
B. Sodium level of 132 mEq/L.
C. Calcium level of 8.6 mg/dL.
D. Magnesium level of 1.2 mEq/L.
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The nurse is transcribing a new prescription for spironolactone (Aldactone) for a client who receives an
angiotensin-converting enzyme (ACE) inhibitor. Which action should the nurse implement?
The nurse admits a client with tumor-induced spinal cord compression. Which medication should the
nurse anticipate to be prescribed to offer the best palliative treatment for this client?
A. Morphine sulfate.
B. Ibuprofen.
C. Amitriptyline.
D. Dexamethasone.
D. Dexamethasone.
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The nurse is preparing an education session for a client prescribed opioids for intractable cancer pain.
The nurse should include strategies to help prevent which common side effect associated with long-term
use of opioids?
A. Sedation.
B. Constipation.
C. Urinary retention.
D. Respiratory depression.
B. Constipation.
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A client is prescribed controlled-release oxycodone. Which dosing schedule is best for the nurse to teach
the client?
A. As needed.
B. Every 12 hours.
C. Every 24 hours.
D. Every 4 to 6 hours.
B. Every 12 hours.
Which client should the nurse identify as being at highest risk for complications during the use of an
opioid analgesic?
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Which medications should the nurse caution the client about taking while receiving an opioid analgesic?
A. Antacids.
B. Benzodiazepines.
C. Antihypertensives.
D. Oral antidiabetics.
B. Benzodiazepines.
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A. Shock.
B. Asthma.
C. Hypotension.
D. Heart failure.
D. Heart failure.
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A client is experiencing anaphylaxis from an insect sting. Which medication should the nurse administer?
A. Dopamine.
B. Ephedrine.
C. Epinephrine.
D. Diphenhydramine.
C. Epinephrine.
The healthcare provider prescribes a beta-1 agonist medication to be administered. The nurse should
anticipate the medication to be prescribed for a client diagnosed with which condition?
A. Glaucoma.
B. Hypertension.
C. Heart failure.
D. Asthma.
C. Heart failure.
An older client with a decreased percentage of lean body mass is admitted to the hospital. Which
pharmacokinetic process is affected and should be considered in the client's dosing of medication?
A. Absorption.
B. Metabolism.
C. Elimination.
D. Distribution.
D. Distribution.
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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 client being discharged home is prescribed an antibiotic with a dosage three times higher than it was
administered when the client was in the hospital. Which route of administration should the nurse
anticipate will be prescribed for the greatest first-pass effect?
A. Oral.
B. Sublingual.
C. Intravenous.
D. Subcutaneous.
A. Oral.
The healthcare provider prescribes naproxen (Naproxen) twice daily for a client with osteoarthritis of the
hands. The client tells the nurse that the drug does not seem to be effective after three weeks. Which is
the best response for the nurse to provide?
After abdominal surgery, a client is prescribed low molecular weight heparin (LMWH). During
administration of the medication, the client asks the nurse the reason for the medication. Which is the
best response for the nurse to provide the client?
A client with heart failure is prescribed spironolactone (Aldactone). Which information is most important
for the nurse to provide to the client about diet modifications?
A client receiving doxorubicin (Adriamycin) intravenously (IV) complains of pain at the insertion site, and
the nurse notes edema at the site. Which intervention is most important for the nurse to implement?
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A client with acute myocardial infarction is admitted to the coronary care unit. Which medication should
the nurse administer to lessen the workload of the heart by decreasing the cardiac preload and
afterload?
A. Nitroglycerin.
B. Propranolol (Inderal).
C. Morphine.
D. Captopril (Capoten).
A. Nitroglycerin.
Which instruction should the nurse give to a female client who just received a prescription for oral
metronidazole (Flagyl) for treatment of trichomonas vaginalis? (Select all that apply.)
A, D, E, F
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A client with hyperlipidemia receives a prescription for niacin (Niaspan). Which client teaching is most
important for the nurse to provide?
A. Expected duration of flushing.
B. Symptoms of hyperglycemia.
C. Diets that minimize GI irritation.
D. Comfort measures for pruritus.
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The nurse is planning discharge instructions for a client prescribed cyclosporine following a liver
transplant. Which adverse reactions should the nurse instruct the client to report to the healthcare
provider?
A client is taking hydromorphone (Dilaudid) PO every 4 hours at home. Following surgery, Dilaudid IV
every 4 hours PRN and butorphanol tartrate (Stadol) IV every 4 hours PRN are prescribed for pain. The
client received a dose of the Dilaudid IV four hours ago, and is again requesting pain medication. Which
intervention should the nurse implement?
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Which change in data indicates to the nurse that the desired effect of the angiotensin II receptor
antagonist valsartan has been achieved?
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A client with coronary artery disease who is taking digoxin (Lanoxin) receives a new prescription for
atorvastatin (Lipitor). Two weeks after initiation of the Lipitor prescription, the nurse assesses the client.
Which finding requires the most immediate intervention?
A. Heartburn.
B. Headache.
C. Constipation.
D. Vomiting.
D. Vomiting.
The nitrate isosorbide dinitrate is prescribed for a client with angina. Which instruction should the nurse
include in this client's discharge teaching plan?
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The nurse is reviewing admission prescriptions for a client with myxedema. The nurse should clarify with
the healthcare provider which prescription for the client?
The nurse is providing care for a client prescribed propranolol. Which symptoms should the nurse report
to the healthcare provider immediately?
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A client asks the nurse if glipizide (Glucotrol) is an oral insulin. Which response should the nurse provide?
A. "Yes, it is an oral insulin and has the same actions and properties as intermediate insulin."
B. "Yes, it is an oral insulin and is distributed, metabolized, and excreted in the same manner as insulin."
C. "No, it is not an oral insulin and can be used only when some beta cell function is present."
D. "No, it is not an oral insulin, but it is effective for those who are resistant to injectable insulins."
C. "No, it is not an oral insulin and can be used only when some beta cell function is present."
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Which nursing intervention is most important when caring for a client receiving the antimetabolite
cytosine arabinoside (Arc-C) for chemotherapy?
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A client prescribed albuterol tablets reports nausea every evening with the 9:00 p.m. dose. Which action
should the nurse perform to alleviate this side effect?
A peak and trough level is prescribed for a client receiving antibiotic therapy. When should the nurse
should obtain the trough level?
A. Sixty minutes after the antibiotic dose is administered.
B. Immediately before the next antibiotic dose is given.
C. Upon completion of the prescribed antibiotic regime.
D. An hour before the next antibiotic dose is given.
A client is prescribed ampicillin sodium (Omnipen) for a sinus infection. The nurse should instruct the
client to notify the healthcare provider immediately if which symptom occurs?
A. Rash.
B. Nausea.
C. Headache.
D. Dizziness.
A. Rash.
While taking a medical history, the client states, "I am allergic to penicillin." What related allergy to
another type of antiinfective agent should the nurse ask the client about when taking the nursing
history?
A. Aminoglycosides.
B. Cephalosporins.
C. Sulfonamides.
D. Tetracyclines.
B. Cephalosporins.
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A client receives a new prescription for sustained release levodopa/carbidopa PO BID for the treatment
of Parkinson's disease. The client's previous prescription was levodopa PO TID. The client's last dose of
levodopa was at 0800 hr. Which set of instructions should the nurse give to the client?
A. "Take the first dose of levodopa/carbidopa today, as soon as your prescription is filled."
B. "Since you already took your levodopa, wait until tomorrow to take the levodopa/carbidopa."
C. "Take both drugs for the first week, then switch to taking only the levodopa/carbidopa."
D. "You can begin taking the levodopa/carbidopa this evening, but do not take any more levodopa."
D. "You can begin taking the levodopa/carbidopa this evening, but do not take any more levodopa."
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?
The healthcare provider prescribes naloxone (Narcan) for a client in the emergency room. Which
assessment data would indicate that the naloxone has been effective?
A client is prescribed morphine 1 mg IV per hour basal rate with 1 mg IV every 15 minutes per patient-
controlled analgesia (PCA) pump for a total of 5 mg IV maximally per hour. Which nursing action has the
highest priority before initiating the PCA pump?
The nurse is assessing the effectiveness of high dose aspirin therapy for an 88-year-old client with
arthritis. The client reports hearing non-stop ringing in the ears. Which action should the nurse
implement?
Which antidiarrheal agent should be used with caution in clients taking high dosages of aspirin for
arthritis?
A. Loperamide (Imodium).
B. Probanthine (Propantheline).
C. Bismuth subsalicylate (Pepto Bismol).
D. Diphenoxylate hydrochloride with atropine (Lomotil).
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When assessing an adolescent who recently overdosed on acetaminophen (Tylenol), it is most important
for the nurse to assess for pain in which area of the body?
A. Flank.
B. Abdomen.
C. Chest.
D. Head.
B. Abdomen.
A client's dose of isosorbide dinitrate (Imdur) is increased from 40 mg to 60 mg PO daily. When the client
reports the onset of a headache prior to the next scheduled dose, which action should the nurse
implement?
A. Hold the next scheduled dose of Imdur 60 mg and administer a PRN dose of acetaminophen (Tylenol).
B. Administer the 40 mg of Imdur and then contact the healthcare provider.
C. Administer the 60 mg dose of Imdur and a PRN dose of acetaminophen (Tylenol).
D. Do not administer the next dose of Imdur or any acetaminophen until notifying the healthcare
provider.
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An adult client has prescriptions for morphine sulfate 2.5 mg IV every 6 hours and ketorolac (Toradol) 30
mg IV every 6 hours. Which action should the nurse implement?
A client is receiving methylprednisolone 40 mg IV daily. The nurse should monitor which laboratory value
closely?
A. Serum glucose.
B. Serum calcium.
C. Red blood cells.
D. Serum potassium.
A. Serum glucose.
A client is receiving clonidine 0.1 mg/24 hr via transdermal patch. Which assessment finding indicates
the desired effect of the medication has been achieved?
A client who was prescribed atorvastatin (Lipitor) one month ago calls the triage nurse at the clinic
complaining of muscle pain and weakness in his legs. Which statement reflects the correct drug-specific
teaching the nurse should provide to this client?
A. Increase consumption of potassium-rich foods since low potassium levels can cause muscle spasms.
B. Have serum electrolytes checked at the next scheduled appointment to assess hyponatremia, a cause
of cramping.
C. Make an appointment to see the healthcare provider, because muscle pain may be an indication of a
serious side effect.
D. Be sure to consume a low-cholesterol diet while taking the drug to enhance the effectiveness of the
drug.
C. Make an appointment to see the healthcare provider, because muscle pain may be an indication of a
serious side effect.
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Which nursing diagnosis is important to include in the plan of care for a client receiving the angiotensin-
2 receptor antagonist irbesartan (Avapro)?
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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 2 hours. Which
intervention should the nurse initiate?
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Which action is most important for the nurse to implement prior to the administration of the
antiarrhythmic drug adenosine (Adenocard)?
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A client with a dysrhythmia is prescribed procainamide (Pronestyl) in 4 divided doses over the next 24
hours. Which dosing schedule is best for the nurse to implement?
A. Every 6 hours.
B. QID.
C. AC and bedtime.
D. PC and bedtime.
A. Every 6 hours.
The nurse administers a dose of metoprolol for a client. Which assessment is most important for the
nurse to obtain?
A. Temperature.
B. Lung sounds.
C. Blood pressure.
D. Urinary output.
C. Blood pressure.
A client is being treated for osteoporosis with alendronate (Fosamax), and the nurse has completed
discharge teaching regarding medication administration. Which morning schedule would indicate to the
nurse that the client teaching has been effective?
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A postoperative client receiving a continuous IV infusion of meperidine 35 mg/hr for the past four days
has become increasingly restless and irritable, and begins to hallucinate. Which action should the nurse
take first?
A. Perfusion scan.
B. Prothrombin Time (PT).
C. Activated partial thromboplastin (aPTT).
D. Serum Coumadin level (SCL).
A client with Parkinson's disease is taking carbidopa-levodopa (Sinemet). Which observation by the
nurse would indicate that the desired outcome of the medication is being achieved?
B. Lessening of tremors.
A client being treated for hyperthyroidism with propylthiouracil (PTU) asks the nurse how the medication
works. Which is the best response to give the client?
A client with heart failure is being discharged with a new prescription for the angiotensin-converting
enzyme (ACE) inhibitor captopril (Capoten). The nurse's discharge instructions should include reporting
which problem to the healthcare provider?
A. Weight loss.
B. Dizziness.
C. Muscle cramps.
D. Dry mucous membranes.
B. Dizziness.
Following the administration of sublingual nitroglycerin to a client experiencing an acute anginal attack,
which assessment finding indicates to the nurse that the desired effect has been achieved?
The healthcare provider prescribes digitalis (Digoxin) for a client diagnosed with heart failure. Which
intervention should the nurse implement prior to administering the digoxin?
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In evaluating the effects of lactulose (Cephulac), which outcome would indicate that the drug is
performing as intended?
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A client is prescribed aluminum hydroxide for peptic ulcer disease. Which statement by the client
demonstrates an understanding of the action of the medication?