Nightingale College BSN 315 Exam 1 (pdf) | 2026/2027 | HESI Pharm
V1 Q&A | Pharmacology
1. A client receiving the angiotensin II receptor antagonist irbesartan
(Avapro) is at risk for which nursing diagnosis?
A) Fluid volume deficit
B) Risk for infection
C) Risk for injury
D) Impaired sleep patterns
Correct Answer: Risk for injury
Rationale: Irbesartan is an antihypertensive that blocks vasoconstrictor
effects, which can cause hypotension and dizziness. This places the client at
high risk for injury from falls. While other diagnoses may be relevant, the
primary safety concern is injury related to orthostatic hypotension.
2. The nurse is providing discharge instructions to a client prescribed
gabapentin 300 mg TID for postherpetic neuralgia. Which symptom should
the client be instructed to report?
A) Sexual dysfunction
B) Gastric irritation
C) Rapid weight gain
D) Photosensitivity
Correct Answer: Gastric irritation
Rationale: Gabapentin can cause gastrointestinal side effects, including
gastric irritation. The client should be instructed to report this, as it may
affect tolerability. Sexual dysfunction, rapid weight gain, and photosensitivity
are not commonly associated with gabapentin.
,3. A client with a history of COPD receives a new prescription for an
ipratropium inhaler. The nurse should instruct the client that this medication
works primarily by:
A) Stimulating beta-2 receptors in the lungs
B) Blocking muscarinic receptors to cause bronchodilation
C) Reducing inflammation in the airways
D) Loosening and thinning bronchial secretions
Correct Answer: Blocking muscarinic receptors to cause bronchodilation
Rationale: Ipratropium is an anticholinergic bronchodilator that works by
blocking muscarinic receptors in the airways, leading to bronchodilation. It is
not a beta-agonist, corticosteroid, or mucolytic.
4. A client is scheduled for a spiral CT scan with contrast to evaluate for a
pulmonary embolism. Which preexisting condition should the nurse report to
the healthcare provider before the procedure?
A) Hypertension
B) Diabetes mellitus
C) Renal insufficiency
D) Asthma
Correct Answer: Renal insufficiency
Rationale: Contrast dye used in CT scans can be nephrotoxic. Clients with
preexisting renal insufficiency are at increased risk for contrast-induced
nephropathy. The healthcare provider should be notified so that appropriate
precautions, such as hydration or alternative imaging, can be considered.
,5. A client with acute kidney injury (AKI) is receiving sodium polystyrene
sulfonate. Which laboratory finding indicates the medication has been
effective?
A) Decreased serum potassium
B) Increased serum sodium
C) Decreased serum creatinine
D) Increased serum calcium
Correct Answer: Decreased serum potassium
Rationale: Sodium polystyrene sulfonate is a cation-exchange resin used to
treat hyperkalemia. It works by exchanging sodium for potassium in the
gastrointestinal tract, leading to decreased serum potassium levels.
6. The nurse is preparing to administer a scopolamine patch (Transderm
Scop) to a client for motion sickness. Which instruction should the nurse
provide?
A) Apply the patch at least 4 hours before departure
B) Change the patch every 24 hours
C) Place the patch on a hairless area on the chest
D) Apply the patch immediately before boarding the cruise ship
Correct Answer: Apply the patch at least 4 hours before departure
Rationale: Scopolamine, an anticholinergic, is used to prevent motion
sickness and has a peak onset in 6 hours. The client should be instructed to
apply the patch at least 4 hours before departure to ensure it is effective.
, 7. A client with Paget's disease is started on calcitonin (Calcimar) 500 mcg
subcutaneously daily. What is the priority nursing action during initial
treatment?
A) Assess the injection site for inflammation
B) Evaluate the client's level of pain
C) Monitor the client's alkaline phosphatase levels
D) Observe the client for signs of hypersensitivity
Correct Answer: Observe the client for signs of hypersensitivity
Rationale: Calcitonin is a protein hormone, and hypersensitivity reactions,
including anaphylaxis, can occur. Observing for signs of hypersensitivity is
the priority during initial administration.
8. A male client in the terminal stage of cancer is receiving morphine for
intractable pain. The client awakens, moans in severe pain, and asks for an
increase in dosage. The nurse determines the client's respirations are 10 per
minute. What is the best action?
A) Titrate the morphine dose upward until the client has adequate pain relief
B) Suggest to the family that they can also give the client ibuprofen
C) Hold additional morphine until the client's respirations are at least 16 per
minute
D) Inform the client that an increased dose of morphine increases side
effects without additional pain control
Correct Answer: Titrate the morphine dose upward until the client has
adequate pain relief
Rationale: In a terminally ill client with intractable pain, the goal is adequate
pain relief. A respiratory rate of 10 is acceptable in this context, and the dose
V1 Q&A | Pharmacology
1. A client receiving the angiotensin II receptor antagonist irbesartan
(Avapro) is at risk for which nursing diagnosis?
A) Fluid volume deficit
B) Risk for infection
C) Risk for injury
D) Impaired sleep patterns
Correct Answer: Risk for injury
Rationale: Irbesartan is an antihypertensive that blocks vasoconstrictor
effects, which can cause hypotension and dizziness. This places the client at
high risk for injury from falls. While other diagnoses may be relevant, the
primary safety concern is injury related to orthostatic hypotension.
2. The nurse is providing discharge instructions to a client prescribed
gabapentin 300 mg TID for postherpetic neuralgia. Which symptom should
the client be instructed to report?
A) Sexual dysfunction
B) Gastric irritation
C) Rapid weight gain
D) Photosensitivity
Correct Answer: Gastric irritation
Rationale: Gabapentin can cause gastrointestinal side effects, including
gastric irritation. The client should be instructed to report this, as it may
affect tolerability. Sexual dysfunction, rapid weight gain, and photosensitivity
are not commonly associated with gabapentin.
,3. A client with a history of COPD receives a new prescription for an
ipratropium inhaler. The nurse should instruct the client that this medication
works primarily by:
A) Stimulating beta-2 receptors in the lungs
B) Blocking muscarinic receptors to cause bronchodilation
C) Reducing inflammation in the airways
D) Loosening and thinning bronchial secretions
Correct Answer: Blocking muscarinic receptors to cause bronchodilation
Rationale: Ipratropium is an anticholinergic bronchodilator that works by
blocking muscarinic receptors in the airways, leading to bronchodilation. It is
not a beta-agonist, corticosteroid, or mucolytic.
4. A client is scheduled for a spiral CT scan with contrast to evaluate for a
pulmonary embolism. Which preexisting condition should the nurse report to
the healthcare provider before the procedure?
A) Hypertension
B) Diabetes mellitus
C) Renal insufficiency
D) Asthma
Correct Answer: Renal insufficiency
Rationale: Contrast dye used in CT scans can be nephrotoxic. Clients with
preexisting renal insufficiency are at increased risk for contrast-induced
nephropathy. The healthcare provider should be notified so that appropriate
precautions, such as hydration or alternative imaging, can be considered.
,5. A client with acute kidney injury (AKI) is receiving sodium polystyrene
sulfonate. Which laboratory finding indicates the medication has been
effective?
A) Decreased serum potassium
B) Increased serum sodium
C) Decreased serum creatinine
D) Increased serum calcium
Correct Answer: Decreased serum potassium
Rationale: Sodium polystyrene sulfonate is a cation-exchange resin used to
treat hyperkalemia. It works by exchanging sodium for potassium in the
gastrointestinal tract, leading to decreased serum potassium levels.
6. The nurse is preparing to administer a scopolamine patch (Transderm
Scop) to a client for motion sickness. Which instruction should the nurse
provide?
A) Apply the patch at least 4 hours before departure
B) Change the patch every 24 hours
C) Place the patch on a hairless area on the chest
D) Apply the patch immediately before boarding the cruise ship
Correct Answer: Apply the patch at least 4 hours before departure
Rationale: Scopolamine, an anticholinergic, is used to prevent motion
sickness and has a peak onset in 6 hours. The client should be instructed to
apply the patch at least 4 hours before departure to ensure it is effective.
, 7. A client with Paget's disease is started on calcitonin (Calcimar) 500 mcg
subcutaneously daily. What is the priority nursing action during initial
treatment?
A) Assess the injection site for inflammation
B) Evaluate the client's level of pain
C) Monitor the client's alkaline phosphatase levels
D) Observe the client for signs of hypersensitivity
Correct Answer: Observe the client for signs of hypersensitivity
Rationale: Calcitonin is a protein hormone, and hypersensitivity reactions,
including anaphylaxis, can occur. Observing for signs of hypersensitivity is
the priority during initial administration.
8. A male client in the terminal stage of cancer is receiving morphine for
intractable pain. The client awakens, moans in severe pain, and asks for an
increase in dosage. The nurse determines the client's respirations are 10 per
minute. What is the best action?
A) Titrate the morphine dose upward until the client has adequate pain relief
B) Suggest to the family that they can also give the client ibuprofen
C) Hold additional morphine until the client's respirations are at least 16 per
minute
D) Inform the client that an increased dose of morphine increases side
effects without additional pain control
Correct Answer: Titrate the morphine dose upward until the client has
adequate pain relief
Rationale: In a terminally ill client with intractable pain, the goal is adequate
pain relief. A respiratory rate of 10 is acceptable in this context, and the dose
