HESI RN Pharmacology REVIEW 2022/2023 V2 –
65 Questions + Review of important points
PLEASE NOTE: Health care system is continuously
... [Show More] changing, guidelines and recommendation could differ from time to time, the answers of below questions were made up to our best knowledge and elimination of wrong answers – and remember that most of the time there are more than a correct answer but you have to choose the MOST important or priority or what’s within nursing scope of practice. We tried our best to have all answers correct but we do not guarantee that 100%. You must study and review them as well. Good luck!
1. Before administering a laxative to a bedfast client, it is most important for the nurse to perform what assessment?
A. Observe the skin integrity of the client's rectal and sacral areas
B. assess the client strength in moving and turning in the bed
C. evaluate the client's ability to recognize the urge to defecate
D. determine the frequency and consistency of bowel movements
2. A female client with multiple sclerosis reports having less fatigue and improved memory since she began using the herbal supplement, ginkgo biloba. Which information is most important for the nurse to include in the teaching plans for this client?
A. Aspirin and nonsteroidal anti-inflammatory drugs interact with ginkgo
B. nausea and diarrhea can occur when using this supplement
C. anxiety and headaches increased with use of ginkgo
D. ginkgo biloba use should be limited and not taken during pregnancy
3. In explaining the benefits of the combination anti-infective drug code TMP- SMZ (Bactrim) to a client receiving the medication for a urinary tract infection, more rationale to the nurse provide?
A. Each drug could cause damage to the kidneys if taken separately
B. One drug reduces the risk of side effects caused by the drug
C. while one drug provide relief, the other fights the infection
the two drugs work together to reduce resistance of the bacterial
infection of symptoms
D.
4. Client being treated with Haldol for schizophrenia is complaining of jaw tightness and a stiff neck. Which interventions should the nurse implement?
A. give PRN dose of diphenhydramine Benadryl
B. assess client other sensory hallucinations
C. massage neck until muscles begin to relax
D. obtain a 12 lead EKG
5. Which intervention is most important for the nurse implement for a client is receiving Lispro Humalog insulin?
A. Check blood glucose levels every six hours
B. Provide meals at the same time that insulin is given
C. Assess for hypoglycemia between meals
D. Keeping oral liquid or glucose source available
6. Client takes nonsteroidal anti-inflammatory drugs every day for rheumatoid arthritis is being treated for anemia which intervention is most important for the nurse to include any plan of care
A. Observe for gastrointestinal bleeding
B. Monitor liver function test results
C. Protect skin from bruising
D. Offered dietary selections rich in iron
7. A client receives a prescription for theophylline (Theo-Dur) PO to be initiated in the morning after the dose of theophylline IV is complete. The nurse determines that a theophylline level drawn yesterday was 22 mcg/mL.
Based on this information, which action should the nurse implement? A. Hold the theophylline dose and notify the health care provider.
B. Start the client on a half-dose of theophylline PO.
C. The theophylline dose can be initiated as planned.
D. The client is not ready to be weaned from the IV to the PO route
8. The nurse is reviewing a client's laboratory results before a procedure in which a neuromuscular blocking agent is a standing order. Which finding should the nurse report to the health care provider?
A. Hypokalemia
B. Hyponatremia
C. Hypercalcemia
D. Hypomagnesemia
9. The nurse is preparing a child for transport to the operating room for an emergency appendectomy. The anesthesiologist prescribes atropine sulfate (Atropine), IM STAT. What is the primary purpose for administering this drug to the child at this time?
A. Decrease the oral secretions
B. Reduce the child's anxiety
C. Potentiate the opioid effects
D. Prevent possible peritonitis
10. When caring for a client on digoxin (Lanoxin) therapy, the nurse knows to be alert for digoxin (Lanoxin) toxicity. Which finding would predispose this client to developing digoxin toxicity?
A. Low serum sodium level
B. High serum sodium level
C. Low serum potassium level
D. High serum potassium level
11. A client is receiving anti-infective drug therapy for a postoperative infection. Which complaint should alert the nurse to the possibility that the client has contracted a superinfection?
A. "My mouth feels sore"
B. "I have a headache."
C. "My ears feel plugged up."
D. "I feel constipated"
12. During the initial nursing assessment history, a client tells the nurse that he is taking tetracycline hydrochloride (Sumycin) for urethritis. Which medication taken concurrently with Sumycin could interfere with its absorption?
A. Sucralfate (Carafate)
B. Hydrochlorothiazide (Diuril)
C. Acetaminophen (Tylenol)
D. Phenytoin (Dilantin)
13. Following the administration of sublingual nitroglycerin, which assessment finding indicates that the medication was effective?
A. Decrease in level of chest pain
B. Clear bilateral breath sounds
C. Increase in blood pressure
D. Increase in urinary output
14. Alteration of which laboratory finding represents the achievement of a therapeutic goal for heparin administration?
A. Prothrombin time (PT)
B. Fibrin split products
C. Platelet count
D. Partial thromboplastin time (PTT)
15.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?
A. Naloxone hydrochloride (Narcan)
B. Atropine Sulfate
C. Vitamin K
D. Romazicon
16. 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?
A. Antiretroviral medications decrease the efficacy of the TB drugs.
B. Multiple drugs prevent the development of resistant organisms.
C. Duration of the medication regimen is shortened.
D. Potential adverse drug reactions are minimized.
17. Two hours after taking the first dose of penicillin, a client arrives at the emergency department complaining of feeling ill, exhibiting hives, having difficulty breathing, and experiencing hypotension. These findings are consistent with which client response that requires immediate action?
A. Severe acute anaphylactic response
B. Side reaction that should resolve
C. Idiosyncratic reaction
D. Cumulative drug response
18. Which question should the nurse ask a client prior to the initiation of treatment with IV infusions of gentamicin sulfate (Garamycin)?
A. "Are you having difficulty hearing?"
B. "Have you ever been diagnosed with cancer?"
C. "Do you have any type of diabetes mellitus?"
D. "Have you ever had anemia?"
19.A male client who has chronic back pain is on long-term pain medication management and asks the nurse why his pain relief therapy is not as effective as it was 2 months ago. How should the nurse respond?
A. The phenomenon occurs when opiates are used for more than 6 months to relieve pain.
B. Withdrawal occurs if the drug is not tapered slowly while being discontinued.
Pharmacodynamics tolerance requires increased drug levels to
achieve the same effect.
C.
D. A consistent dosage with around-the-clock administration is the most effective.
20. The nurse is providing discharge instructions to a client who has received a prescription for an antibiotic that is hepatotoxic. Which information should the nurse include in the instructions?
A. Avoid ingesting any alcohol or acetaminophen (Tylenol).
B. Schedule a follow-up visit for a liver biopsy in 1 month.
C. Activities that are strenuous should be avoided.
D. Notify the health care provider of any increase in appetite.
21. A client with mild Parkinsonism is started on oral amantadine (Symmetrel). Which statement accurately describes the action of this medication? A. Viral organisms that cause Parkinsonism are eliminated.
B. Acetylcholine in the myoneural junction is enhanced.
C. Dopamine in the central nervous system is increased.
D. Norepinephrine release is reduced within the periphery.
22.A female client who has started long-term corticosteroid therapy tells the nurse that she is careful to take her daily dose at bedtime with a snack of crackers and milk. Which is the best response by the nurse?
Advise the client to take the medication in the morning, rather than
at bedtime.
A.
B. Teach the client that dairy products should not be taken with her medication.
C. Tell the client that absorption is improved when taken on an empty stomach.
D. Affirm that the client has a safe and effective routine for taking the medication.
23. A female client with myasthenia gravis is taking a cholinesterase inhibitor and asks the nurse what can be done to remedy her fatigue and difficulty swallowing. What action should the nurse implement?
A. Explore a plan for development of coping strategies for the symptoms with the client.
B. Explain to the client that the dosage is too high, so she should skip every other dose of medication.
C. Advise the client to contact her health care provider because of the development of tolerance to the medication.
Develop a teaching plan for the client to self-adjust the dose of
medication in response to symptoms
D.
24. A female client is receiving tetracycline (Vibramycin) for acne. Which client teaching should the nurse include?
A. Oral contraceptives may not be effective.
B. Drinking cranberry juice will promote healing.
C. Breast tenderness may occur as a side effect.
D. The urine will turn a red-orange color.
25.A female client with trichomoniasis (Trichomonas vaginalis) receives a prescription for metronidazole (Flagyl). Which instruction is most important for the nurse to include this client's teaching plan? A. Avoid alcohol consumption.
B. Complete the medication regimen.
C. Use a barrier contraceptive method.
D. Treat partner(s) concurrently.
26. A 2-month-old infant is scheduled to receive the first DPT immunization.
What is the preferred injection site to administer this immunization?
A. Dorsal gluteal
B. Vastus lateralis
C. Ventral gluteal
D. Deltoid
27. The nurse is evaluating a client's understanding of the prescribed antilipemic drug lovastatin (Mevacor). Which client statement indicates that further teaching is needed?
A. "My bowel habits should not be affected by this drug."
B. "This medication should be taken once a day only."
C. "I will still need to follow a low-cholesterol diet."
D. "I will take the medication every day before breakfast."
28. An older client who had a colon resection yesterday is receiving a constant dose of hydromorphone (Dilaudid) via a patient-controlled analgesia (PCA) pump. Which assessment finding is most significant and requires that the nurse intervene?
A. The client is drowsy and complains of pruritus.
B. Pupils are 3 mm; PERRLA.
C. The area around the sutures is reddened and swollen.
D. Respirations decrease to 14 breaths/min.
29. A client receives an antihypertensive agent daily. Which action is most important for the nurse to implement prior to administering the medication? A. Verify the expiration date.
B. Obtain the client's blood pressure.
C. Determine the client's history of adverse reactions.
D. Review the client's medical record for a change in drug route.
30. 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?
A. 30-year-old man with a fracture
B. 7-year-old child with an ear infection
C. 75-year-old woman with liver disease
D. 50-year-old man with an upper respiratory tract infection
31. The health care provider has prescribed a low-molecular-weight heparin, enoxaparin (Lovenox) prefilled syringe, 30 mg/0.3 mL IV every 12 hours, for a client following hip replacement. Prior to administering the first dose, which intervention is most important for the nurse to implement? A. Assess the client's IV site for signs of inflammation.
B. Evaluate the client's degree of mobility.
C. Instruct the client regarding medication side effects.
D. Contact the health care provider to clarify the prescription.
32. 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?
A. Ineffective airway clearance
B. Risk for infection
C. Deficient fluid volume
D. Impaired gas exchange
33. The nurse is reviewing prescribed medications with a female client who is preparing for discharge. The client asks the nurse why the oral dose of an opioid analgesic is higher than the IV dose that she received during hospitalization. Which response is best for the nurse to provide?
A. A higher dose of analgesic medication may be needed after discharge.
B. An error in the dose calculation may have occurred when the prescribed dose was converted.
C. The doses should be the same unless the pain is not well controlled.
Oral taken drugs dissolves in the gut its not %100 absorbed unlike
when it is administered as an IV. (that is the concept of the answer
D.
but it is not exactly the same choice).
34. Amoxicillin, 500 mg PO every 8 hours, is prescribed for a client with an infection. The drug is available in a suspension of 125 mg/5 mL. How many milliliters should the nurse administer with each dose?
Answer: 20 mL
= 500 x 5 / 125 = 20
35. Minocycline (Minocin), 50 mg PO every 8 hours, is prescribed for an adolescent girl diagnosed with acne. The nurse discusses self-care with the client while she is taking the medication. Which teaching points should be included in the discussion?
(Select all that apply.)
A. Report vaginal itching or discharge.
B. Take the medication at 0800, 1500, and 2200 hours.
C. Protect skin from natural and artificial ultraviolet light.
D. Avoid driving until response to medication is known.
E. Take with an antacid tablet to prevent nausea.
F. Use a nonhormonal method of contraception if sexually active.
36.The health care provider prescribes carbamazepine (Tegretol) 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 [Show Less]