PHARMACOLOGY HESI PRACTICE EXAM QUESTIONS AND
ANSWERS ALL SOLVED SOLUTION
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. - CORRECT ANSWER 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.
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. - CORRECT ANSWER
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).
,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?
A) Absorption.
B) Metabolism.
C) Elimination.
D) Distribution. - CORRECT ANSWER D.
A decreased lean body mass in an older adult affects the distribution of drugs (D), which affects
the pharmacokinetics of drugs. Decreased gastric pH, delayed gastric emptying, decreased
splanchnic blood flow, decreased gastrointestinal absorption surface areas and motility affect
(A) in the older adult population. Decreased hepatic blood flow, decreased hepatic mass, and
decreased activity of hepatic enzymes affect (B) in older adults. Decreased renal blood flow,
decreased glomerular filtration rate, decreased tubular secretion, and decreased number of
nephrons affects (C) in an older adult.
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?
A) Sixty minutes after the antibiotic dose is administered.
B) Immediately before the next antibiotic dose is given.
C) When the next blood glucose level is to be checked.
D) Thirty minutes before the next antibiotic dose is given. - CORRECT ANSWER B.
Immediately before the next antibiotic dose is given.
Trough levels are drawn when the blood level is at its lowest, which is typically just before the
next dose is given (B). (A, C, and D) do not describe the optimum time for obtaining a trough
level of an antibiotic.
A client with Parkinson's disease is taking carbidopa-levodopa (Sinemet). Which observation by
the nurse should indicate that the desired outcome of the medication is being achieved?
A) Decreased blood pressure.
B) Lessening of tremors.
C) Increased salivation.
D) Increased attention span. - CORRECT ANSWER B. Lessening of tremors.
Sinemet increases the amount of levodopa to the CNS (dopamine to the brain). Increased
amounts of dopamine improve the symptoms of Parkinson's, such as involuntary movements,
, resting tremors (B), shuffling gait, etc. (A) is a side effect of Sinemet. Decreased drooling would
be a desired effect, not (C). Sinemet does not affect (D).
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. - CORRECT ANSWER B. Dizziness
The client should be prepared to implement measures for constipation (B) which is the most
likely persistent side effect related to opioid use. Tolerance to opiate narcotics is common, and
the client may experience less sedation (A) and respiratory depression (D) as analgesic use
continues. Opioids increase the tone in the urinary bladder sphincter, which causes retention
(C) but may subside.
A client is receiving metroprolol (Lopressor SR). What assessment is most important for the
nurse to obtain?
A) Temperature.
B) Lung sounds.
C) Blood pressure.
D) Urinary output. - CORRECT ANSWER C. Blood pressure
It is most important to monitor the blood pressure (C) of clients taking this medication because
Lopressor is an antianginal, antiarrhythmic, antihypertensive agent. While (A and B) are
important data to obtain on any client, they are not as important for a client receiving Lopressor
as (C). Intake and output ratios and daily weights should be monitored while taking Lopressor to
assess for signs and symptoms of congestive heart failure, but (D) alone does not have the
importance of (C).
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?
A) Heartburn.
B) Headache.
C) Constipation.
ANSWERS ALL SOLVED SOLUTION
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. - CORRECT ANSWER 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.
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. - CORRECT ANSWER
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).
,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?
A) Absorption.
B) Metabolism.
C) Elimination.
D) Distribution. - CORRECT ANSWER D.
A decreased lean body mass in an older adult affects the distribution of drugs (D), which affects
the pharmacokinetics of drugs. Decreased gastric pH, delayed gastric emptying, decreased
splanchnic blood flow, decreased gastrointestinal absorption surface areas and motility affect
(A) in the older adult population. Decreased hepatic blood flow, decreased hepatic mass, and
decreased activity of hepatic enzymes affect (B) in older adults. Decreased renal blood flow,
decreased glomerular filtration rate, decreased tubular secretion, and decreased number of
nephrons affects (C) in an older adult.
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?
A) Sixty minutes after the antibiotic dose is administered.
B) Immediately before the next antibiotic dose is given.
C) When the next blood glucose level is to be checked.
D) Thirty minutes before the next antibiotic dose is given. - CORRECT ANSWER B.
Immediately before the next antibiotic dose is given.
Trough levels are drawn when the blood level is at its lowest, which is typically just before the
next dose is given (B). (A, C, and D) do not describe the optimum time for obtaining a trough
level of an antibiotic.
A client with Parkinson's disease is taking carbidopa-levodopa (Sinemet). Which observation by
the nurse should indicate that the desired outcome of the medication is being achieved?
A) Decreased blood pressure.
B) Lessening of tremors.
C) Increased salivation.
D) Increased attention span. - CORRECT ANSWER B. Lessening of tremors.
Sinemet increases the amount of levodopa to the CNS (dopamine to the brain). Increased
amounts of dopamine improve the symptoms of Parkinson's, such as involuntary movements,
, resting tremors (B), shuffling gait, etc. (A) is a side effect of Sinemet. Decreased drooling would
be a desired effect, not (C). Sinemet does not affect (D).
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. - CORRECT ANSWER B. Dizziness
The client should be prepared to implement measures for constipation (B) which is the most
likely persistent side effect related to opioid use. Tolerance to opiate narcotics is common, and
the client may experience less sedation (A) and respiratory depression (D) as analgesic use
continues. Opioids increase the tone in the urinary bladder sphincter, which causes retention
(C) but may subside.
A client is receiving metroprolol (Lopressor SR). What assessment is most important for the
nurse to obtain?
A) Temperature.
B) Lung sounds.
C) Blood pressure.
D) Urinary output. - CORRECT ANSWER C. Blood pressure
It is most important to monitor the blood pressure (C) of clients taking this medication because
Lopressor is an antianginal, antiarrhythmic, antihypertensive agent. While (A and B) are
important data to obtain on any client, they are not as important for a client receiving Lopressor
as (C). Intake and output ratios and daily weights should be monitored while taking Lopressor to
assess for signs and symptoms of congestive heart failure, but (D) alone does not have the
importance of (C).
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?
A) Heartburn.
B) Headache.
C) Constipation.
