NUR0242 HESI PHARMACOLOGY Exit HESI Q& A 100% CORRECT 2023|2024 UPDATE

• . A healthcare provider prescribes cephalexin monohydrate (Keflex) for a client with a postoperative infection. It is most important for the nurse to assess for what additional drug allergy before administering this prescription? A) Penicillins. B) Aminoglycosides. C) Erythromycins. D) Sulfonamides. A) Penicillins. Cross-allergies exist between penicillins (A) and cephalosporins, such as cephalexin monohydrate (Keflex), so checking for penicillin allergy is a wise precaution before administering this drug.  • Which nursing intervention is most important when caring for a client receiving the antimetabolite cytosine arabinoside (Arc-C) for chemotherapy? A) Hydrate the client with IV fluids before and after infusion. B) Assess the client for numbness and tingling of extremities. C) Inspect the client's oral mucosa for ulcerations. D) Monitor the client's urine pH for increased acidity. C) Inspect the client's oral mucosa for ulcerations. Cytosine arabinoside (Arc-C) affects the rapidly growing cells of the body, therefore stomatitis and mucosal ulcerations are key signs of antimetabolite toxicity (C). (A, B, and D) are not typical interventions associated with the administration of antimetabolites.  • 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? A) Flank. B) Abdomen. C) Chest. D) Head. B) Abdomen. Acetaminophen toxicity can result in liver damage; therefore, it is especially important for the nurse to assess for pain in the right upper quadrant of the abdomen (B), which might indicate liver damage. (A, C, and D) are not areas where pain would be anticipated.  • 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. 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).  • 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? (Select all that apply.) A) Increase fluid intake, especially cranberry juice. B) Do not abruptly discontinue the medication; taper use. C) Check blood pressure daily to detect hypertension. D) Avoid drinking alcohol while taking this medication. E) Use condoms until treatment is completed. F) Ensure that all sexual partners are treated at the same time. A) Increase fluid intake, especially cranberry juice. D) Avoid drinking alcohol while taking this medication. E) Use condoms until treatment is completed. F) Ensure that all sexual partners are treated at the same time. Correct selections are (A, D, E, and F). Increased fluid intake and cranberry juice (A) are recommended for prevention and treatment of urinary tract infections, which frequently accompany vaginal infections. It is not necessary to taper use of this drug (B) or to check the blood pressure daily (C), as this condition is not related to hypertension. Flagyl can cause a disulfiram-like reaction if taken in conjunction with ingestion of alcohol, so the client should be instructed to avoid alcohol (D). All sexual partners should be treated at the same time (E) and condoms should be used until after treatment is completed to avoid reinfection (F).  • A client receiving albuterol (Proventil) tablets complains of nausea every evening with her 9 p.m. dose. What action should the nurse take to alleviate this side effect? A) Change the time of the dose. B) Hold the 9 p.m. dose. C) Administer the dose with a snack. D) Administer an antiemetic with the dose. C) Administer the dose with a snack. Administering oral doses with food (C) helps minimize GI discomfort. (A) would be appropriate only if changing the time of the dose corresponds to meal times while at the same time maintaining an appropriate time interval between doses. (B) would disrupt the dosing schedule, and could result in a nontherapeutic serum level of the medication. (D) should not be attempted before other interventions, such as (C), have been proven ineffective in relieving the nausea.