Pharmacology HESI Comprehensive Review for the
NCLEX-PN Exam, 6th Edition Study Mode
AThe practical nurse (PN) administered 15 units of NPH insulin
subcutaneously to a client before they consumed their breakfast at 7:30
AM. At what time is the client at an increased risk for a hypoglycemic
reaction?
a. 8:30 to 11:30 AM
b. 3:30 to 7:30 PM
c. 9:30 PM to midnight
d. 1:00 to 5:00 AM
b. 3:30 to 7:30 PM
Rationale:
NPH, an intermediate acting insulin, peaks approximately 8 to 12 hours
after subcutaneous injection. The most likely time for this client to
experience a hypoglycemic reaction is between 3:30 and 7:30 PM.
,A client prescribed glipizide asked why they had to take their insulin
orally. How should the practical nurse respond?
a. "Glipizide is an oral form of insulin and has the same actions and
properties as intermediate insulin."
b. "Glipizide is an oral form of insulin and is distributed, metabolized,
and excreted in the same manner as insulin."
c. "Glipizide is not an oral form of insulin and can be used only when
some beta cell function is present."
d. "Glipizide is not an oral form of insulin, but it is effective for those
who are resistant to injectable insulins."
c. "Glipizide is not an oral form of insulin and can be used only when
some beta cell function is present."
Rationale:
Glipizide is an oral hypoglycemic agent that enhances pancreatic
production of insulin when some beta cell function is present.
,A client has metoprolol prescribed. The nurse should reinforce
instructions that this medication has which potential adverse effect?
a. Anxiety
b. Tachycardia
c. Sexual dysfunction
d. Acute renal failure
c. Sexual dysfunction
Rationale:
The nurse should reinforce education that metoprolol (a beta-blocker)
can cause sexual dysfunction as an adverse effect. It can cause
depression, rather than anxiety. Bradycardia is another potential
adverse reaction. Acute renal failure is not associated with a beta
blocking agent.
A 59-year-old client is prescribed furosemide 40 mg twice a day for the
management of heart failure. The practical nurse (PN) should monitor
the client for the development of which complication?
a. Hypokalemia
b. Hyperchloremia
c. Hypercalcemia
d. Hypophosphatemia
a. Hypokalemia
Rationale:
Furosemide is a loop diuretic. The action of this medication inhibits the
reabsorption of sodium and chloride at the proximal and distal tubule
and in the loop of Henle. This medication potentiates the excretion of
potassium, causing hypokalemia. Hypokalemia can cause cardiac
irregularities.
, The health care provider (HCP) has prescribed a 74-year-old client to
be vaccinated with the influenza vaccine prior to discharge. Which
client condition will make the practical nurse not to vaccinate the client
and consult with the charge nurse?
a. History of congested heart failure
b. History of an allergy to eggs
c. History of pneumococcal vaccination
d. History of end-stage renal disease
b. History of an allergy to eggs
Rationale:
According to the CDC website, the flu vaccination is contraindicated if
a client has a severe allergy to any part of the vaccine. "Most, but not
all, types of flu vaccine contain a small amount of egg protein." The
practical nurse needs not to administer the flu vaccination and consult
with the charge nurse for further guidance.
An adolescent client with a seizure disorder is prescribed the
anticonvulsant medication carbamazepine. The nurse should notify the
health care provider if the client develops which condition?
a. Experiences dry mouth.
b. Experiences dizziness.
c. Develops a sore throat.
d. Develops gingival hyperplasia.
c. Develops a sore throat.
Rationale:
Blood dyscrasias (aplastic anemia, leukopenia, anemia, and
thrombocytopenia) can be an adverse effect of carbamazepine. Flu-
like symptoms, such as pallor, fatigue, sore throat, and fever, are
indications of such dyscrasias.
NCLEX-PN Exam, 6th Edition Study Mode
AThe practical nurse (PN) administered 15 units of NPH insulin
subcutaneously to a client before they consumed their breakfast at 7:30
AM. At what time is the client at an increased risk for a hypoglycemic
reaction?
a. 8:30 to 11:30 AM
b. 3:30 to 7:30 PM
c. 9:30 PM to midnight
d. 1:00 to 5:00 AM
b. 3:30 to 7:30 PM
Rationale:
NPH, an intermediate acting insulin, peaks approximately 8 to 12 hours
after subcutaneous injection. The most likely time for this client to
experience a hypoglycemic reaction is between 3:30 and 7:30 PM.
,A client prescribed glipizide asked why they had to take their insulin
orally. How should the practical nurse respond?
a. "Glipizide is an oral form of insulin and has the same actions and
properties as intermediate insulin."
b. "Glipizide is an oral form of insulin and is distributed, metabolized,
and excreted in the same manner as insulin."
c. "Glipizide is not an oral form of insulin and can be used only when
some beta cell function is present."
d. "Glipizide is not an oral form of insulin, but it is effective for those
who are resistant to injectable insulins."
c. "Glipizide is not an oral form of insulin and can be used only when
some beta cell function is present."
Rationale:
Glipizide is an oral hypoglycemic agent that enhances pancreatic
production of insulin when some beta cell function is present.
,A client has metoprolol prescribed. The nurse should reinforce
instructions that this medication has which potential adverse effect?
a. Anxiety
b. Tachycardia
c. Sexual dysfunction
d. Acute renal failure
c. Sexual dysfunction
Rationale:
The nurse should reinforce education that metoprolol (a beta-blocker)
can cause sexual dysfunction as an adverse effect. It can cause
depression, rather than anxiety. Bradycardia is another potential
adverse reaction. Acute renal failure is not associated with a beta
blocking agent.
A 59-year-old client is prescribed furosemide 40 mg twice a day for the
management of heart failure. The practical nurse (PN) should monitor
the client for the development of which complication?
a. Hypokalemia
b. Hyperchloremia
c. Hypercalcemia
d. Hypophosphatemia
a. Hypokalemia
Rationale:
Furosemide is a loop diuretic. The action of this medication inhibits the
reabsorption of sodium and chloride at the proximal and distal tubule
and in the loop of Henle. This medication potentiates the excretion of
potassium, causing hypokalemia. Hypokalemia can cause cardiac
irregularities.
, The health care provider (HCP) has prescribed a 74-year-old client to
be vaccinated with the influenza vaccine prior to discharge. Which
client condition will make the practical nurse not to vaccinate the client
and consult with the charge nurse?
a. History of congested heart failure
b. History of an allergy to eggs
c. History of pneumococcal vaccination
d. History of end-stage renal disease
b. History of an allergy to eggs
Rationale:
According to the CDC website, the flu vaccination is contraindicated if
a client has a severe allergy to any part of the vaccine. "Most, but not
all, types of flu vaccine contain a small amount of egg protein." The
practical nurse needs not to administer the flu vaccination and consult
with the charge nurse for further guidance.
An adolescent client with a seizure disorder is prescribed the
anticonvulsant medication carbamazepine. The nurse should notify the
health care provider if the client develops which condition?
a. Experiences dry mouth.
b. Experiences dizziness.
c. Develops a sore throat.
d. Develops gingival hyperplasia.
c. Develops a sore throat.
Rationale:
Blood dyscrasias (aplastic anemia, leukopenia, anemia, and
thrombocytopenia) can be an adverse effect of carbamazepine. Flu-
like symptoms, such as pallor, fatigue, sore throat, and fever, are
indications of such dyscrasias.
