FINAL PHARM HESI 2022/2023
A male client asks the nurse why condoms should not be lubricated with the spermicide
nonoxynol-9. Which response is best
... [Show More] for the nurse to provide? - ANS- Nonoxynol-9
provides no protection from STDs and has been linked to the transmission of HIV.
The nurse is assessing a stuporous client in the emergency department who is
suspected of overdosing with opioids. Which agent should the nurse prepare to
administer if the client becomes comatose? - ANS- Naloxone hydrochloride (Narcan)
A primigravida at 34 weeks of gestation is admitted to labor and delivery in preterm
labor. She is started on a terbutaline sulfate (Brethine) continuous IV infusion via pump.
This therapy is ineffective, and the baby is delivered vaginally. For which complication
should the nurse monitor in this infant during the first few hours after delivery? - ANSHypoglycemia
A client with metastatic cancer reports severe continuous pain. Which route of
administration should the nurse use to provide the most effective continuous analgesia?
- ANS- Transdermal
A client who is hypertensive receives a prescription for hydrochlorothiazide (HCTZ).
When teaching about the side effects of this drug, which symptoms are most important
for the nurse to instruct the client to report? - ANS- Fatigue and muscle weakness
Prior to administering a scheduled dose of digoxin (Lanoxin), the nurse reviews the
client's current serum digoxin level, which is 1.3 ng/dL. Which action should the nurse
implement? - ANS- Give the dose of digoxin if the client's heart rate is within a safe
range.
A client who is receiving chlorpromazine HCl (Thorazine) to control his psychotic
behavior also has a prescription for benztropine (Cogentin). When teaching the client
and/or significant others about these medications, what should the nurse explain about
the use of benztropine (Cogentin) in the treatment plan for this client? - ANS- The
benztropine (Cogentin) is used to control extrapyramidal symptoms.
The nurse is preparing a plan of care for a client receiving the glucocorticoid
methylprednisolone (Solu-Medrol). Which nursing diagnosis reflects a problem related
to this medication that should be included in the care plan? - ANS- Risk for infection
A client being treated for an acute myocardial infarction is to receive the tissue
plasminogen activator alteplase (Activase). The nurse would be correct in providing
which explanation to the client regarding the purpose of this drug? - ANS- This drug is a
clot buster that dissolves clots within a coronary artery.
A lidocaine IV infusion at 4 mg/min via infusion pump is prescribed for a client having
premature ventricular contractions (PVCs). The available premixed infusion contains 2
mg/mL of D5W. How many milliliters per hour should the nurse program the pump to
deliver to this client? - ANS- 120
A client who is HIV-positive is receiving epoetin alfa (Epogen) for the management of
anemia secondary to zidovudine (AZT) therapy. Which laboratory finding is most
important for the nurse to report to the health care provider? - ANS- Hematocrit (HCT)
of 58%
A client is ordered 22 mg of gentamicin by IM injection. The drug is available in 20 mg/2
mL. How many mL should be administered? - ANS- 2.2 mL
The charge nurse is reviewing the admission history and physical data for four clients
newly admitted to the unit. Which client is at greatest risk for adverse reactions to
medications? - ANS- 75-year-old woman with liver disease
During therapy with isoniazid (INH), it is most important for the nurse to monitor which
laboratory value closely? - ANS- Liver enzyme levels
A client receives an antihypertensive agent daily. Which action is most important for the
nurse to implement prior to administering the medication? - ANS- Obtain the client's
blood pressure.
The nurse is preparing a teaching plan for a client who has received a new prescription
for levothyroxine sodium (Synthroid). Which instruction should be included? - ANS-
"Take your pulse daily, and if it exceeds 100 beats/min, contact the health care
provider."
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? - ANS- Midazolam (Versed) IV
Which physiologic mechanism explains a drug's increased metabolism that is triggered
by a disease process? - ANS- Pharmacokinetics
A 42-year-old client is admitted to the emergency department after taking an overdose
of amitriptyline (Elavil) in a suicide attempt. Which drug should the nurse plan to
administer to reverse the cardiac and central nervous system effects of amitriptyline
(Elavil)? - ANS- Sodium bicarbonate
A 55-year-old client was diagnosed with schizophrenia 5 years earlier. Numerous
hospitalizations have occurred since the diagnosis because of noncompliance with the
prescribed medication regimen. Which drug might work best for this particular client? -
ANS- Fluphenazine decanoate (Prolixin decanoate)
The apical heart rate of an infant receiving digoxin (Lanoxin) for congestive heart failure
is 80 beats/min. Which intervention should the nurse implement first? - ANS- Obtain a
serum digoxin level.
The nurse performs a client assessment prior to the administration of a prescribed dose
of dipyridamole and aspirin (Aggrenox) PO. The nurse notes that the client's carotid
bruit is louder than previously assessed. Which action should the nurse implement? -
ANS- Administer the prescribed dose of Aggrenox as scheduled.
A client who arrives in the postanesthesia care unit (PACU) after surgery is not awake
from general anesthesia. Which action should the nurse implement first? - ANS- Review
the medication administration record (MAR).
A client receives pancuronium (Pavulon), a long-acting, nondepolarizing neuromuscular
blocker, during surgical anesthesia. Which client situation should alert the nurse to
evaluate the client for a prolonged muscle relaxation response to this medication? -
ANS- Renal insufficiency
The nurse is preparing to administer a secondary infusion of a dobutamine solution to a
client. The nurse notes that the solution is brown in color. Which action should the nurse
implement? - ANS- Administer the drug if the solution's reconstitution time is less than
24 hours.
A client is prescribed a cholinesterase inhibitor, and a family member asks the nurse
how this medication works. Which pharmacophysiologic explanation should the nurse
use to describe this class of drug? - ANS- Improves nerve impulse transmission
Following the administration of sublingual nitroglycerin, which assessment finding
indicates that the medication was effective? - ANS- Decrease in level of chest pain
Which instruction should the nurse include in the teaching plan for a client who is
receiving phenytoin (Dilantin) for seizure control? - ANS- Brush and floss teeth daily.
Which instructions should the nurse provide to an adolescent female client who is
initiating treatment with isotretinoin (Accutane) for acne vulgaris? (Select all that apply.)
- ANS- A. "Notify the health care provider immediately if you think you are pregnant."
E. "If you begin crying more than usual and feel sad, stop the drug and call the health
care provider."
F. "Before, during, and after therapy, two effective forms of birth control must be used at
the same time."
A client with chronic gouty arthritis is talking allopurinol (Zyloprim), 100 mg PO daily.
Which laboratory serum level should the nurse report to the health care provider to
determine the therapeutic outcome? - ANS- Uric acid level
The health care provider prescribes ipratropium (Atrovent) for a client. An allergic
reaction to which other medication would cause the nurse to question the prescription
for Atrovent? - ANS- Atropine sulfate (Atropine)
A chemotherapeutic regimen with doxorubicin HCl (Adriamycin) is being planned for a
client recently diagnosed with cancer. What diagnostic test results should the nurse
review prior to initiating this treatment? - ANS- Electrocardiogram (ECG)
A client with metastatic cancer who has been receiving fentanyl (Duragesic) for several
weeks reports to the nurse that the medication is not effectively controlling the pain.
Which intervention should the nurse initiate? - ANS- Notify the health care provider of
the need to increase the dose.
Which intervention is most important for a nurse to implement prior to administering
atropine PO? - ANS- Determine the presence of 5 to 35 bowel sounds/min.
A client with HIV who was recently diagnosed with tuberculosis (TB) asks the nurse,
"Why do I need to take all of these medications for TB?" What information should the
nurse provide? - ANS- Multiple drugs prevent the development of resistant organisms.
A client is experiencing an adverse effect of the gastrointestinal stimulant
metoclopramide HCl (Reglan). Which assessment finding would require immediate
intervention by the nurse? - ANS- Demonstrates Parkinson's-like symptoms, such as
cogwheel rigidity
Dopamine (Intropin) is administered to a client who is hypotensive. Which finding should
the nurse identify as a therapeutic response? - ANS- Increase in urine output
A 4-year-old child is receiving chemotherapy for acute lymphocytic leukemia. Which
laboratory result should the nurse examine to assess the child's risk for infection? -
ANS- Neutrophil count
Which assessment datum indicates to the nurse that a dose of granisetron (Kytril)
administered IV prior to chemotherapy has had the desired effect? - ANS- Client denies
nausea
The nurse is scheduling a client's antibiotic peak and trough levels with the laboratory
personnel. What is the best schedule for drawing the trough level? - ANS- Instruct the
laboratory to draw the trough immediately before the next scheduled dose.
A client who is HIV-positive is receiving combination therapy with the antiviral
medication zidovudine (Retrovir). Which instruction should the nurse include in this
client's teaching plan? - ANS- Return to the clinic every 2 weeks for blood counts. CONTINUES... [Show Less]