HESI Pharmacology Exam Version 2|Questions and Answers |Aready Rated A| Latest 2022/2023
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Course
HESI (HESI)
Institution
Chamberlain College Of Nursing
HESI Pharmacology|Questions and Answers |Aready Rated A| Latest
2022/2023
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 reporti...
HESI Pharmacology|Questions and Answers |Aready Rated A| Latest
2022/2023
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.
B) Dizziness.
Angiotensin-converting enzyme (ACE) inhibitors are used in CHF to reduce afterload by reversing
vasoconstriction common in heart failure. This vasodilation can cause hypotension and resultant dizziness (B).
(A) is desired if fluid overload is present, and may occur as the result of effective combination drug therapy
such as diuretics with ACE inhibitors. (C) often indicates hypokalemia in the client receiving diuretics. Excessive
diuretic administration may result in fluid volume deficit, manifested by symptoms such as (D).
2. 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?
A) Withhold the scheduled dose.
B) Check the client's apical pulse.
C) Notify the healthcare provider.
D) Repeat the serum potassium level.
A) Withhold the scheduled dose.
The nurse should first withhold the scheduled dose of Cozaar (A) because the client is hyperkalemic (normal
range 3.5 to 5 mEq/L). Although hypokalemia is usually associated with diuretic therapy in heart failure,
hyperkalemia is associated with several heart failure medications, including ARBs. Because hyperkalemia may
lead to cardiac dysrhythmias, the nurse should check the apical pulse for rate and rhythm (B), and the blood
pressure. Before repeating the serum study (D), the nurse should notify the healthcare provider (C) of the
findings.
3. 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?
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.
,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.
4. The healthcare provider prescribes digitalis (Digoxin) for a client diagnosed with congestive heart failure.
Which intervention should the nurse implement prior to administering the digoxin?
A) Observe respiratory rate and depth.
B) Assess the serum potassium level.
C) Obtain the client's blood pressure.
D) Monitor the serum glucose level.
B) Assess the serum potassium level.
Hypokalemia (decreased serum potassium) will precipitate digitalis toxicity in persons receiving digoxin (B). (A
and C) will not affect the administration of digoxin. (D) should be monitored if he/she is a diabetic and is
perhaps receiving insulin.
5. A client who has been taking levodopa PO TID to control the symptoms of Parkinson's disease has a new
prescription for sustained release levodopa/carbidopa (Sinemet 25/100) PO BID. The client took his levodopa
at 0800. Which instruction should the nurse include in the teaching plan for this client?
A) Take the first dose of Sinemet today, as soon as your prescription is filled.
B) Since you already took your levodopa, wait until tomorrow to take the Sinemet.
C) Take both drugs for the first week, then switch to taking only the Sinemet.
D) You can begin taking the Sinemet this evening, but do not take any more levodopa.
D) You can begin taking the Sinemet this evening, but do not take any more levodopa.
Carbidopa significantly reduces the need for levodopa in clients with Parkinson's disease, so the new
prescription should not be started until eight hours after the previous dose of levodopa (D), but can be started
the same day (B). (A and C) may result in toxicity.
6. 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?
A) q6h.
B) QID.
C) AC and bedtime.
D) PC and bedtime.
, A) q6h.
Pronestyl is a class 1A antidysrhythmic. It should be taken around-the-clock (A) so that a stable blood level of
the drug can be maintained, thereby decreasing the possibility of hypotension (an adverse effect) occurring
because of too much of the drug circulating systemically at any particular time of day. (B, C, and D) do not
provide an around-the-clock dosing schedule. Pronestyl may be given with food if GI distress is a problem, but
an around-the-clock schedule should still be maintained.
7. A client is receiving ampicillin sodium (Omnipen) for a sinus infection. The nurse should instruct the client
to notify the healthcare provider immediately if which symptom occurs?
A) Rash.
B) Nausea.
C) Headache.
D) Dizziness.
A) Rash.
Rash (A) is the most common adverse effect of all penicillins, indicating an allergy to the medication which
could result in anaphylactic shock, a medical emergency. (B, C, and D) are common side effects of penicillins
that should subside after the body adjusts to the medication. These would not require immediate medical care
unless the symptoms persist beyond the first few days or become extremely severe.
8. A client is being treated for hyperthyroidism 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.
D) inhibit synthesis of T3 and T4 by the thyroid gland.
PTU is an adjunct therapy used to control hyperthyroidism by inhibiting production of thyroid hormones (D). It
is often prescribed in preparation for thyroidectomy or radioactive iodine therapy. Thyroid-stimulating
hormone (TSH) is produced by the pituitary gland, and PTU does not affect the pituitary (A and B). PTU inhibits
the synthesis of all thyroid hormones--both T3 and T4(C).
9. 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.
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