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HESI:Pharmacology
Evolve Practice
| Question | Answer |
|---|---|
| Which instruction(s) should the nurse give to a female client who just received a prescription for oral metronidazole (Flagyl) for treatment of trichomonas vaginalis? SATA Increase fluid intake, especially cranberry juice. Do not abruptly discontinue the medication; taper use. Check blood pressure daily to detect hypertension. Avoid drinking alcohol while taking this medication. Use condoms until treatment is completed. Ensure that all sexual partners are treated at the same time. | Increase fluid intake, especially cranberry juice. Avoid drinking alcohol while taking this medication. Use condoms until treatment is completed. Ensure that all sexual partners are treated at the same time. |
| A P asks the nurse if glipizide (Glucotrol) is an oral insulin. Which response should the N provide? "Yes, it is an oral insulin and has the same actions and properties as intermediate insulin." "Yes, it is an oral insulin and is distributed, metabolized, and excreted in the same manner as insulin." "No, it is not an oral insulin and can be used only when some beta cell function is present." "No, it is not an oral insulin, but it is effective for those who are resistant to injectable insulins." | "No, it is not an oral insulin and can be used only when some beta cell function is present." |
| A 43-year-old female client is receiving thyroid replacement hormone following a thyroidectomy. What adverse effects associated with thyroid hormone toxicity should the nurse instruct the client to report promptly to the healthcare provider? Tinnitus and dizziness. Tachycardia and chest pain. Dry skin and intolerance to cold. Weight gain and increased appetite. | Tachycardia and chest pain. |
| 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? Review the client's hemoglobin results. Notify the healthcare provider. Inquire about the reaction to sulfa. Record the client's vital signs. | Notify 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. What action should the nurse take first? Withhold the scheduled dose. Check the client's apical pulse. Notify the healthcare provider. Repeat the serum potassium level. | Withhold the scheduled dose. |
| Which medications should the nurse caution the client about taking while receiving an opioid analgesic? Antacids. Benzodiazepines. Antihypertensives. Oral antidiabetics. | Benzodiazepines. |
| Which antidiarrheal agent should be used with caution in clients taking high dosages of aspirin for arthritis? Loperamide (Imodium). Probanthine (Propantheline). Bismuth subsalicylate (Pepto Bismol). Diphenoxylate hydrochloride with atropine (Lomotil). | Bismuth subsalicylate (Pepto Bismol). |
| A client with hyperlipidemia receives a prescription for niacin (Niaspan). Which client teaching is most important for the nurse to provide? Expected duration of flushing. Symptoms of hyperglycemia. Diets that minimize GI irritation. Comfort measures for pruritis. | Expected duration of flushing. |
| In teaching a client who had a liver transplant about cyclosporine (Sandimmune), the nurse should encourage the client to report which adverse response to the healthcare provider? Changes in urine color. Presence of hand tremors. Increasing body hirsutism. Nausea and vomiting. | Presence of hand tremors. |
| The N is reviewing the use of the PCA pump with a P in the immediate postoperative period. The P will receive morphine 1 mg IV per hr basal rate with 1 mg IV every 15 min per PCA to total 5 mg IV maximally per hour. What assessment has the highest priority before initiating the PCA pump? The expiration date on the morphine syringe in the pump. The rate and depth of the client's respirations. The type of anesthesia used during the surgical procedure. The client's subjective and objective signs of pain. | The rate and depth of the client's respirations. |
| A client is receiving clonidine (Catapres) 0.1 mg/24hr via transdermal patch. Which assessment finding indicates that the desired effect of the medication has been achieved? Client denies recent episodes of angina. Change in peripheral edema from +3 to +1. Client denies recent nausea or vomiting. Blood pressure has changed from 180/120 to 140/70 mmHg. | Blood pressure has changed from 180/120 to 140/70 mmHg. |
| A client's dose of isosorbide dinitrate (Imdur) is increased from 40 mg to 60 mg PO daily. The client reports a headache before the next dose. What should the nurse do? Hold the Imdur dose and give PRN acetaminophen (Tylenol). Administer 40 mg Imdur, then contact the provider. Give the 60 mg Imdur dose with PRN acetaminophen. Withhold Imdur and acetaminophen until notifying the provider. | Administer the 60 mg dose of Imdur and a PRN dose of acetaminophen. |
| 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? Do not add salt to foods during preparation. Refrain for eating foods high in potassium. Restrict fluid intake to 1000 ml per day. Increase intake of milk and milk products. | Refrain for eating foods high in potassium. |
| A client on levodopa TID for Parkinson's symptoms now has a prescription for Sinemet (levodopa/carbidopa) BID. They took their last levodopa dose at 0800. What should the nurse advise? "Take the first Sinemet dose today once filled." "Wait until tomorrow to start Sinemet." "Take both drugs for one week, then switch to Sinemet only." "Start Sinemet this evening, but don’t take more levodopa." | "You can begin taking the Sinemet this evening, but do not take any more levodopa." |
| 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? Assess for erythema. Administer the antidote. Apply warm compresses. Discontinue the IV fluids. | Discontinue the IV fluids. |
| 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? Client states chest pain is relieved. Client's pulse decreases from 120 to 90. Client's systolic blood pressure decreases from 180 to 90. Client's SaO2 level increases from 92% to 96%. | Client states chest pain is relieved. |
| The nitrate isosorbide dinitrate (Isordil) is prescribed for a client with angina. Which instruction should the nurse include in this client's discharge teaching plan? Quit taking the medication if dizziness occurs. Do not get up quickly. Always rise slowly. Take the medication with food only. Increase your intake of potassium-rich foods. | Do not get up quickly. Always rise slowly. |
| The nurse is assessing the effectiveness of high dose aspirin therapy for an 88-year-old 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? Refer the client to an audiologist for evaluation of her hearing. Advise the client that this is a common side effect of aspirin therapy. Notify the healthcare provider of this finding immediately. Ask the client to turn off her hearing aid during the exam. | Notify the healthcare provider of this finding immediately. |
| The nurse is teaching a client with cancer about opioid management for intractable pain and tolerance related side effects. The nurse should prepare the client for which side effect that is most likely to persist during long-term use of opioids? Sedation. Constipation. Urinary retention. Respiratory depression. | Constipation. |
| Which client should the nurse identify as being at highest risk for complications during the use of an opioid analgesic? An older client with Type 2 diabetes mellitus. A client with chronic rheumatoid arthritis. A client with a open compound fracture. A young adult with inflammatory bowel disease. | A young adult with inflammatory bowel disease. |
| 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? Flank. Abdomen. Chest. Head. | Abdomen. |
| An antacid (Maalox) is prescribed for a client with peptic ulcer disease. The nurse knows that the purpose of this medication is to decrease production of gastric secretions. produce an adherent barrier over the ulcer. maintain a gastric pH of 3.5 or above. decrease gastric motor activity. | maintain a gastric pH of 3.5 or above. |
| A client with osteoarthritis of the hands reports that naproxen twice daily hasn’t been effective after three weeks. What is the best response from the nurse? "Increasing dosing frequency will improve effectiveness." "Therapeutic levels are reached in 4 to 6 weeks." "Another NSAID may be more suitable." "Systemic corticosteroids are the next choice for pain relief." | Another type of nonsteroidal antiinflammatory drug may be indicated. |
| A client is receiving digoxin for the onset of supraventricular tachycardia (SVT). Which laboratory finding should the nurse identify that places this client at risk? Hypokalemia. Hyponatremia. Hypercalcemia. Low uric acid levels. | Hypokalemia. |
| A client with heart failure (HF) 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? Weight loss. Dizziness. Muscle cramps. Dry mucous membranes. | Dizziness. |
| Dobutamine (Dobutrex) is an emergency drug most commonly prescribed for a client with which condition? Shock. Asthma. Hypotension. Heart failure. | Heart failure. |
| The nurse is assessing a client who is experiencing anaphylaxis from an insect sting. Which prescription should the nurse prepare to administer this client? Dopamine. Ephedrine. Epinephrine. Diphenhydramine. | Epinephrine. |
| A female client with rheumatoid arthritis take 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? Use contraception during intercourse. Ensure the Cytotec is taken on an empty stomach. Encourage oral fluid intake to prevent constipation. Take Cytotec 30 minutes prior to Motrin. | Use contraception during intercourse. |
| A P is taking hydromorphone (Dilaudid) PO q4h at home. Following surgery, Dilaudid IV q4h PRN and butorphanol tartrate (Stadol) IV q4h PRN are prescribed for pain. The P received a dose of the Dilaudid IV four hours ago, and is again requesting pain medication. What intervention should the N implement? Alternate the two medications q4h PRN for pain. Alternate the two medications q2h PRN for pain. Administer only the Dilaudid q4h PRN for pain. Administer only the Stadol q4h PRN for pain. | Administer only the Dilaudid q4h PRN for pain. |
| A 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? q6h. QID. AC and bedtime. PC and bedtime. | q6h. |
| Which action is most important for the nurse to implement prior to the administration of the antiarrhythmic drug adenosine (Adenocard)? Assess pupillary response to light. Instruct the client that facial flushing may occur. Apply continuous cardiac monitoring. Request that family members leave the room. | Apply continuous cardiac monitoring. |
| A client on atorvastatin (Lipitor) reports muscle pain and leg weakness. What should the nurse advise? Increase potassium-rich foods to reduce muscle spasms. Check electrolytes for possible hyponatremia at next appointment. See the provider, as muscle pain may indicate a serious side effect. Follow a low-cholesterol diet to enhance drug effectiveness. | See the provider, as muscle pain may indicate a serious side effect. |
| While taking a nursing 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? Aminoglycosides. Cephalosporins. Sulfonamides. Tetracyclines. | Cephalosporins. |
| 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? Review the client's hemoglobin results. Notify the healthcare provider. Inquire about the reaction to sulfa. Record the client's vital signs. | Notify the healthcare provider. |
| Following heparin treatment for a pulmonary embolism, a client is being discharged with a prescription for warfarin (Coumadin). In conducting discharge teaching, the nurse advises the client to have which diagnostic test monitored regularly after discharge? Perfusion scan. Prothrombin Time (PT/INR). Activated partial thromboplastin (APTT). Serum Coumadin level (SCL). | Prothrombin Time (PT/INR). |
| 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? Heartburn. Headache. Constipation. Vomiting. | Vomiting. |
| A category X drug is prescribed for a young adult female client. Which instruction is most important for the nurse to teach this client? Use a reliable form of birth control. Avoid exposure to ultra violet light. Refuse this medication if planning pregnancy. Abstain from intercourse while on this drug. | Use a reliable form of birth control. |
| 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 two hours. Which intervention should the nurse initiate? Stop the infusion of dopamine. Change the normal saline to a keep open rate. Replace the urinary catheter. Notify the healthcare provider of the urinary output. | Notify the healthcare provider of the urinary output. |
| 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? Sixty minutes after the antibiotic dose is administered. Immediately before the next antibiotic dose is given. When the next blood glucose level is to be checked. Thirty minutes before the next antibiotic dose is given. | Immediately before the next antibiotic dose is given. |
| A medication that is classified as a beta-1 agonist is most commonly prescribed for a client with which condition? Glaucoma. Hypertension. Heart failure. Asthma. | Heart failure. |
| A P asks the N if glipizide (Glucotrol) is an oral insulin. Which response should the nurse provide? "Yes, it is an oral insulin and has the same actions and properties as intermediate insulin." "Yes, it is an oral insulin and is distributed, metabolized, and excreted in the same manner as insulin." "No, it is not an oral insulin and can be used only when some beta cell function is present." "No, it is not an oral insulin, but it is effective for those who are resistant to injectable insulins." | "No, it is not an oral insulin and can be used only when some beta cell function is present." |
| A postoperative client on a continuous IV infusion of meperidine (Demerol) for four days shows restlessness, irritability, and hallucinations. What should the nurse do first? Give a PRN dose of PO meperidine. Administer naloxone (Narcan) IV as per PRN protocol. Decrease the meperidine IV rate per protocol. Notify the provider about the client’s confusion and hallucinations. | Decrease the meperidine IV rate per protocol. |
| 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? Absorption. Metabolism. Elimination. Distribution. | Distribution. |
| 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? Verify both prescriptions with the healthcare provider. Report the medication interactions to the nurse manager. Hold the ACE inhibitor and give the new prescription. Transcribe and send the prescription to the pharmacy. | Verify both prescriptions with the healthcare provider. |
| 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? Apply the patch at least 4 hours prior to departure. Change the patch every other day while on the cruise. Place the patch on a hairless area at the base of the skull. Drink no more than 2 alcoholic drinks during the cruise. | Apply the patch at least 4 hours prior to departure. |
| Which nursing intervention is most important when caring for a client receiving the antimetabolite cytosine arabinoside (Arc-C) for chemotherapy? Hydrate the client with IV fluids before and after infusion. Assess the client for numbness and tingling of extremities. Inspect the client's oral mucosa for ulcerations. Monitor the client's urine pH for increased acidity. | Inspect the client's oral mucosa for ulcerations. |
| A client is admitted to the coronary care unit with a medical diagnosis of acute myocardial infarction. Which medication prescription decreases both preload and afterload? Nitroglycerin. Propranolol (Inderal). Morphine. Captopril (Capoten). | Nitroglycerin. |
| 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 statement that the chest pain is better. respiratory rate is 16 breaths/minute. seizure activity has stopped temporarily. pupils are constricted bilaterally. | respiratory rate is 16 breaths/minute. |
| 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.) | Albuterol (Proventil) puffs. Salmeterol (Serevent Diskus). Prednisone (Deltasone) orally. Gentamicin (Garamycin) IM. |
| Which dosing schedule should the nurse teach the client to observe for a controlled-release oxycodone prescription? As needed. Every 12 hours. Every 24 hours. Every 4 to 6 hours. | Every 12 hours. |
| After abdominal surgery, a male client is prescribed low molecular weight heparin (LMWH). During administration of the medication, the client asks the nurse why he is receiving this medication. Which is the best response for the nurse to provide? This med is a blood thinner given to prevent blood clot formation. This med enhances antibiotics to prevent infection. This med dissolves any clots that develop in the legs. This abdominal injection assists in the healing of the abdominal wound. | This med is a blood thinner given to prevent blood clot formation. |
| Which method of medication administration provides the client with the greatest first-pass effect? Oral. Sublingual. Intravenous. Subcutaneous. | Oral. |
| A P asks the N if glipizide (Glucotrol) is an oral insulin. Which response should the N provide? "Yes, it is an oral insulin and has the same actions and properties as intermediate insulin." "Yes, it is an oral insulin and is distributed, metabolized, and excreted in the same manner as insulin." "No, it is not an oral insulin and can be used only when some beta cell function is present." "No, it is not an oral insulin, but it is effective for those who are resistant to injectable insulins." | "No, it is not an oral insulin and can be used only when some beta cell function is present." |
| Which drug is used as a palliative treatment for a client with tumor-induced spinal cord compression? Morphine Sulfate (Duromorph). Ibuprofen (Advil). Amitriptyline (Amitril). Dexamethasone (Decadron). | Dexamethasone (Decadron). |
| A client on hydromorphone (Dilaudid) IV q4h PRN for post-op pain requests medication four hours after the last dose. What should the nurse do? Alternate Dilaudid and Stadol q4h PRN. Alternate Dilaudid and Stadol q2h PRN. Give only Dilaudid q4h PRN. Give only Stadol q4h PRN. | Give only Dilaudid q4h PRN. |
| The healthcare provider prescribes digitalis (Digoxin) for a client diagnosed with heart failure. Which intervention should the nurse implement prior to administering the digoxin? Observe respiratory rate and depth. Assess the serum potassium level. Obtain the client's blood pressure. Monitor the serum glucose level. | Assess the serum potassium level. |
| A P is being treated for osteoporosis with alendronate (Fosamax), and the N has completed discharge teaching regarding med administration. Which morning schedule would indicate to the N that the client teaching has been effective? Take med , go for a 30 minute morning walk, then eat breakfast. Take med , rest in bed for 30 minutes, eat breakfast, go for morning walk. Take med with breakfast, then take a 30 minute morning walk Go for a 30 minute morning walk, eat breakfast, then take medication. | Take med , go for a 30 minute morning walk, then eat breakfast. |
| A client is being treated for hyperthyroidism with propylthiouracil (PTU). The nurse knows that the action of this drug is to decrease the amount of thyroid-stimulating hormone circulating in the blood. increase the amount of thyroid-stimulating hormone circulating in the blood. increase the amount of T4 and decrease the amount of T3 produced by the thyroid. inhibit synthesis of T3 and T4 by the thyroid gland. | inhibit synthesis of T3 and T4 by the thyroid gland. |
| Which change in data indicates to the nurse that the desired effect of the angiotensin II receptor antagonist valsartan (Diovan) has been achieved? Dependent edema reduced from +3 to +1. Serum HDL increased from 35 to 55 mg/dl. Pulse rate reduced from 150 to 90 beats/minute. Blood pressure reduced from 160/90 to 130/80. | Blood pressure reduced from 160/90 to 130/80. |
| Which symptoms are serious adverse effects of beta-adrenergic blockers such as propranolol (Inderal)? Headache, hypertension, and blurred vision. Wheezing, hypotension, and AV block. Vomiting, dilated pupils, and papilledema. Tinnitus, muscle weakness, and tachypnea. | Wheezing, hypotension, and AV block. |
| Which nursing diagnosis is important to include in the plan of care for a client receiving the angiotensin-2 receptor antagonist irbesartan (Avapro)? Fluid volume deficit. Risk for infection. Risk for injury. Impaired sleep patterns. | Risk for injury. |
| An adult client has prescriptions for morphine sulfate 2.5 mg IV q6h and ketorolac (Toradol) 30 mg IV q6h. Which action should the nurse implement? Administer both medications according to the prescription. Hold the ketorolac to prevent an antagonistic effect. Hold the morphine to prevent an additive drug interaction. Contact the healthcare provider to clarify the prescription. | Administer both medications according to the prescription. |
| A client is receiving metoprolol (Lopressor SR, Nu-Metop). What assessment is most important for the nurse to obtain? Temperature. Lung sounds. Blood pressure. Urinary output. | Blood pressure. |
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PRO Teacher
garrisonjr84