Pharmacology HESI Practice
Questions And Answers 2022
which symptoms are serious adverse effects of beta-adrenergic blockers such as
propranolol
... [Show More] (inderal)?
A. Headache, hypertension, and blurred vision.
B. Wheezing, hypotension, and AV block.
C. Vomiting, dilated pupils, and papilledema.
D. Tinnitus, muscle weakness, and tachypnea. - ANS- B. Wheezing, hypotension,
and AV block.
(B) represents the most serious adverse effects of beta-blocking agents. AV block is
generally associated with bradycardia and results in potentially life-threatening
decreases in cardiac output. Additionally, wheezing secondary to bronchospasm and
hypotension represent life-threatening respiratory and cardiac disorders. (A, C, and
D) are not associated with beta-blockers.
The healthcare provider prescribes naloxone (Narcan) for a client in the emergency
room. Which assessment data would indicate that the naloxone has been effective?
The client's...
A. Statement that the chest pain is better
B) respiratory rate is 16 breaths/minute.
C) seizure activity has stopped temporarily.
D) pupils are constricted bilaterally. - ANS- B.
Naloxone (Narcan) is a narcotic antagonist that reverses the respiratory depression
effects of opiate overdose, so assessment of a normal respiratory rate (B) would
indicate that the respiratory depression has been halted. (A, C, and D) are not
related to naloxone (Narcan) administration.
A client has myxedema, which results from a deficiency of thyroid hormone synthesis
in adults. The nurse knows that which medication should be contraindicated for this
client?
A. liothyronine (cytomel) to replace iodine
B. Furosemide (Lasix) for relief of fluid retention
C. Pentobarbital sodium for sleep
D. nitroglycerin for angina pain - ANS- C. persons with myxedema are dangerously
hypersensitive to narcotics, barbiturates, and anesthetics. They do not tolerate
liothyronine and usually receive iodine replacement therapy. These clients are also
suceptable to heart problems such as angina for which nitroglycerine would be
indicated and and congestive heart failure for which furosemide would be indicated
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?
A) Review the client's hemoglobin results.
B) Notify the healthcare provider.
C) Inquire about the reaction to sulfa.
D) Record the client's vital signs. - ANS- B.
Celebrex contains a sulfur molecule, which can lead to an allergic reaction in
individuals who are sensitive to sulfonamides, so the healthcare provider should be
notified of the client's allergies (B). Although (A, C, and D) are important
assessments, it is most important to notify the healthcare provider for an alternate
prescription.
The client with a dysrhythmia is to receive procainamide (pronestyl) in 4 divided
doses over the next 24 hours. What dosing schedule is best for the nurse to
implement?
A. q4h
B. QID
C. AC and bedtime
D. PC and bedtime - ANS- A. q6h
A client has a continous 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 two hours. Which intervention should the nurse initiate?
A. Stop the infusion of dopamine
B. Change the normal saline to a keep open rate.
C. Replace the urinary catheter.
D. Notify the healthcare provider of the urinary output. - ANS- D. Notify the
healthcare provider of the urinary output.
An adult client has prescriptions for morphine sulfate 2.5 mg IV q6h and ketorlac
(toradol) 30mg IV q6h. which action should the nurse implement?
A. administer both medications according to the prescription
B. Hold the ketorolac to prevent an antagonist effect
C. Hold the morphine to prevent an additive drug interaction
D. Contact the healthcare provider to clarify the prescription - ANS- A. Administer
both medications according to the prescription
Morphine and ketorolac can be administered concurrently and may produce additive
analgesic effect resulting in ability to reduce the dose of morphine, as seen in this
prescription
A client is being treated for hyperthyridism with propylthiouracil (PTU). The nurse
knows that the action of this drug is to:
A. decrease the amount of thyroid stimulating hormone circulating in the blood.
B. increase the amount of thyroid-stimulating hormone circulating in the blood.
C. increase the amount of T4 and decrease the amount of T3 produced by the
thyroid.
D. inhibit synthesis of T3 and T4 by the thyroid gland. - ANS- D. PTU is an adjunct
therapy used to control hyperthyroidism by inhibiting production of thyroid hormones.
It is often prescribed in prep for thyroidectomy or radioactive iodine therapy
A female client with RA takes ibuprofen (motrin) 600mg PO 4xday. To preven GI
bleeding, misoprostol (cytotec) 100mcg PO is prescribed. Which information is most
important for the nurse to include in client teaching?
A. use contraception during intercourse
B. ensure the cytotec is taken on an empty stomach
C. encourage oral fluid intake to prevent constipation
D. take cytotec 30min prior to motrin - ANS- A. Use contraception during intercourse.
Cytotec, a synthetic form of prostaglandin, is classified as pregnancy category X and
can act as an abortifacient, so the client should be instructed to use contraception
during intercourse to prevent loss of early pregnancy
Dobutamine (Dobutrex) is an emergency drug most commonly prescribed for a client
with which condition?
A) Shock.
B) Asthma.
C) Hypotension.
D) Heart failure - ANS- D. Heart Failure
Dobutamine is a beta-1 adrenergic agonist that is indicated for short term use in
cardiac decompensation or heart failure (D) related to reduced cardiac contractility
due to organic heart disease or cardiac surgical procedures. Alpha and beta
adrenergic agonists, such as epinephrine and dopamine, are sympathomimetics
used in the treatment of shock (A). Other selective beta-2 adrenergic agonists, such
as terbutaline and isoproterenol, are indicated in the treatment of asthma (B).
Although dobutamine improves cardiac output, it is not used to treat hypotension (C).
Which medications should the nurse caution the client about taking while receiving
an opioid analgesic?
A. Antacids.
B. Benzodiasepines
C. Antihypertensives
D. Oral antidiabetics - ANS- B. B. Benzodiasepines
Respiratory depression increases with the concurrent use of opioid analgesics and
other cns depressant agents, such as alcohol, barbiturates, and benzodiasepines
Which client should the nurse identify as being at the highest risk for complications
during the use of an opioid analgesic?
A. an older client with type 2 diabetes
B. A client with chronic rheumatoid arthritis
C. A client with a open compound fracture
D. A young adult with inflammatory bowel disease - ANS- D. A young adult with
inflammatory bowel disease
Which change in data indicates to the nurse the desired effect of the angiotensin II
receptor antagonist valsartan (Diovan) has been achieved
A. Dependent edema reduced form +3 to +1
B. Serum HDL increased from 35 to 55mg/dl
C. PUlse rate reduced from 150 to 90 beats/min
D. Blood pressure reduced from 160/90 to 130.80 - ANS- D. D. Blood pressure
reduced from 160/90 to 130.80
angiotensin II receptor antagonist (blocker), prescribed from treatment of HTN. The
desired effect is a decrease in blood pressure.
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) Do not add salt to foods during preparation.
B) Refrain for eating foods high in potassium.
C) Restrict fluid intake to 1000 ml per day.
D) Increase intake of milk and milk products. - ANS- B.
Spironolactone (Aldactone), an aldosterone antagonist, is a potassium-sparing
diuretic, so a diet high in potassium should be avoided (B), including potassium salt
substitutes, which can lead to hyperkalemia. Although (A) is a common diet
modification in heart failure, the risk of hyperkalemia is more important with
Aldactone. Restriction of fluids (C) or increasing milk and milk products (D) are not
indicated with this prescription.
The nurse is assessing the effectiveness of high dose aspirin therapy for an 88-yearold client with arthritis. The client reports that she can't hear the nurse's questions
because her ears are ringing. What action should the nurse implement?
A) Refer the client to an audiologist for evaluation of her hearing.
B) Advise the client that this is a common side effect of aspirin therapy.
C) Notify the healthcare provider of this finding immediately.
D) Ask the client to turn off her hearing aid during the exam. - ANS- C. Notify the
healthcare provider of this finding immediately.
Tinnitus is an early sign of salicylate toxicity. The healthcare provider should be
notified immediately (C), and the medication discontinued. (A and D) are not needed,
and (B) is inaccurate.
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?
A) The frequency of the dosing is necessary to increase the effectiveness.
B) Therapeutic blood levels of this drug are reached in 4 to 6 weeks.
C) Another type of nonsteroidal antiinflammatory drug may be indicated.
D) Systemic corticosteroids are the next drugs of choice for pain relief. - ANS- C.
Another type of nonsteroidal antiinflammatory drug may be indicated.
Individual responses to nonsteroidal antiinflammatory drugs are variable, so (C) is
the best response. Naproxen is usually prescribed every 8 hours, so (A) is not
indicated. The peak for naproxen is one to two hours, not (B). Corticosteroids are not
indicated for osteoarthritis (D).
An older client with a decreased percentage of lean body mass is likely to receive a
prescription that is adjusted based on which pharmacokinetic process?
A) Absorption.
B) Metabolism.
C) Elimination.
D) Distribution. - ANS- D.
A decreased lean body mass in an older adult affects the distribution of drugs (D),
which affects the pharmacokinetics of drugs. Decreased gastric pH, delayed gastric
emptying, decreased splanchnic blood flow, decreased gastrointestinal absorption
surface areas and motility affect (A) in the older adult population. Decreased hepatic
blood flow, decreased hepatic mass, and decreased activity of hepatic enzymes
affect (B) in older adults. Decreased renal blood flow, decreased glomerular filtration
rate, decreased tubular secretion, and decreased number of nephrons affects (C) in
an older adult.
A peak and trough level must be drawn for a client receiving antibiotic therapy. What
is the optimum time for the nurse to obtain the trough level?
A) Sixty minutes after the antibiotic dose is administered.
B) Immediately before the next antibiotic dose is given.
C) When the next blood glucose level is to be checked.
D) Thirty minutes before the next antibiotic dose is given. - ANS- B. Immediately
before the next antibiotic dose is given.
Trough levels are drawn when the blood level is at its lowest, which is typically just
before the next dose is given (B). (A, C, and D) do not describe the optimum time for
obtaining a trough level of an antibiotic.
A client with Parkinson's disease is taking carbidopa-levodopa (Sinemet). Which
observation by the nurse should indicate that the desired outcome of the medication
is being achieved?
A) Decreased blood pressure.
B) Lessening of tremors.
C) Increased salivation.
D) Increased attention span. - ANS- B. Lessening of tremors.
Sinemet increases the amount of levodopa to the CNS (dopamine to the brain).
Increased amounts of dopamine improve the symptoms of Parkinson's, such as
involuntary movements, resting tremors (B), shuffling gait, etc. (A) is a side effect of
Sinemet. Decreased drooling would be a desired effect, not (C). Sinemet does not
affect (D).
A client with congestive heart failure (CHF) is being discharged with a new
prescription for the angiotensin-converting enzyme (ACE) inhibitor captopril
(Capoten). The nurse's discharge instruction should include reporting which problem
to the healthcare provider?
A) Weight loss.
B) Dizziness.
C) Muscle cramps.
D) Dry mucous membranes. - ANS- B. Dizziness
The client should be prepared to implement measures for constipation (B) which is
the most likely persistent side effect related to opioid use. Tolerance to opiate
narcotics is common, and the client may experience less sedation (A) and
respiratory depression (D) as analgesic use continues. Opioids increase the tone in
the urinary bladder sphincter, which causes retention (C) but may subside.
A client is receiving metroprolol (Lopressor SR). What assessment is most important
for the nurse to obtain?
A) Temperature.
B) Lung sounds.
C) Blood pressure.
D) Urinary output. - ANS- C. Blood pressure
It is most important to monitor the blood pressure (C) of clients taking this medication
because Lopressor is an antianginal, antiarrhythmic, antihypertensive agent. While
(A and B) are important data to obtain on any client, they are not as important for a
client receiving Lopressor as (C). Intake and output ratios and daily weights should
be monitored while taking Lopressor to assess for signs and symptoms of congestive
heart failure, but (D) alone does not have the importance of (C).
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