HESI Pharmacology: Guaranteed Academic
Improvement with Premier Exam Questions,
Thorough Explanations, and Correct Responses
The client has been on treatment for rheumatoid arthritis for 3 weeks. During the
administration of etanercept (Enbrel), it is most important for the nurse to assess:
1. The injection site for itching and edema
2. The white blood cell counts and platelet counts
3. Whether the client is experiencing fatigue and joint pain
4. A metallic taste in the mouth and a loss of appetite - CORRECT ANS- -2. The white blood
cell counts and platelet counts
Rationale:
Infection and pancytopenia are adverse effects of etanercept (Enbrel). Laboratory studies
are performed before and during treatment. The appearance of abnormal white blood cell
counts and abnormal platelet counts can alert the nurse to a potential life-threatening
infection. Injection site itching is a common occurrence following administration of the
medication. In early treatment, residual fatigue and joint pain may still be apparent. A
metallic taste and loss of appetite are not common signs of side effects of this medication.
166.) Alendronate (Fosamax) is prescribed for a client with osteoporosis. The client taking
this medication is instructed to:
1. Take the medication at bedtime.
2. Take the medication in the morning with breakfast.
3. Lie down for 30 minutes after taking the medication.
4. Take the medication with a full glass of water after rising in the morning. - CORRECT
ANS- -4. Take the medication with a full glass of water after rising in the morning.
Rationale:
Precautions need to be taken with administration of alendronate to prevent gastrointestinal
side effects (especially esophageal irritation) and to increase absorption of the medication.
The medication needs to be taken with a full glass of water after rising in the morning. The
,client should not eat or drink anything for 30 minutes following administration and should
not lie down after taking the medication.
167.) A nurse prepares to reinforce instructions to a client who is taking allopurinol
(Zyloprim). The nurse plans to include which of the following in the instructions?
1. Instruct the client to drink 3000 mL of fluid per day.
2. Instruct the client to take the medication on an empty stomach.
3. Inform the client that the effect of the medication will occur immediately.
4. Instruct the client that, if swelling of the lips occurs, this is a normal expected response.
- CORRECT ANS- -1. Instruct the client to drink 3000 mL of fluid per day.
Rationale:
Allopurinol (Zyloprim) is an antigout medication used to decrease uric acid levels. Clients
taking allopurinol are encouraged to drink 3000 mL of fluid a day. A full therapeutic effect
may take 1 week or longer. Allopurinol is to be given with or immediately following meals or
milk to prevent gastrointestinal irritation. If the client develops a rash, irritation of the eyes,
or swelling of the lips or mouth, he or she should contact the health care provider because
this may indicate hypersensitivity.
168.) Colcrys (colchicine) is prescribed for a client with a diagnosis of gout. The nurse
reviews the client's medical history in the health record, knowing that the medication
would be contraindicated in which disorder?
1. Myxedema
2. Renal failure
3. Hypothyroidism
4. Diabetes mellitus - CORRECT ANS- -2. Renal failure
Rationale:
Colchicine is contraindicated in clients with severe gastrointestinal, renal, hepatic or
cardiac disorders, or with blood dyscrasias. Clients with impaired renal function may
exhibit myopathy and neuropathy manifested as generalized weakness. This medication
, should be used with caution in clients with impaired hepatic function, older clients, and
debilitated clients.
**Note that options 1, 3, and 4 are all endocrine-related disorders:
Myxedema=Hypothyroidism**
169.) Insulin glargine (Lantus) is prescribed for a client with diabetes mellitus. The nurse
tells the client that it is best to take the insulin:
1. 1 hour after each meal
2. Once daily, at the same time each day
3. 15 minutes before breakfast, lunch, and dinner
4. Before each meal, on the basis of the blood glucose level - CORRECT ANS- -2. Once
daily, at the same time each day
Rationale:
Insulin glargine is a long-acting recombinant DNA human insulin used to treat type 1 and
type 2 diabetes mellitus. It has a 24-hour duration of action and is administered once a day,
at the same time each day.
170.) Atenolol hydrochloride (Tenormin) is prescribed for a hospitalized client. The nurse
should perform which of the following as a priority action before administering the
medication?
1. Listen to the client's lung sounds.
2. Check the client's blood pressure.
3. Check the recent electrolyte levels.
4. Assess the client for muscle weakness. - CORRECT ANS- -2. Check the client's blood
pressure.
Rationale:
Atenolol hydrochloride is a beta-blocker used to treat hypertension. Therefore the priority
nursing action before administration of the medication is to check the client's blood
pressure. The nurse also checks the client's apical heart rate. If the systolic blood pressure
is below 90 mm Hg or the apical pulse is 60 beats per minute or lower, the medication is
Improvement with Premier Exam Questions,
Thorough Explanations, and Correct Responses
The client has been on treatment for rheumatoid arthritis for 3 weeks. During the
administration of etanercept (Enbrel), it is most important for the nurse to assess:
1. The injection site for itching and edema
2. The white blood cell counts and platelet counts
3. Whether the client is experiencing fatigue and joint pain
4. A metallic taste in the mouth and a loss of appetite - CORRECT ANS- -2. The white blood
cell counts and platelet counts
Rationale:
Infection and pancytopenia are adverse effects of etanercept (Enbrel). Laboratory studies
are performed before and during treatment. The appearance of abnormal white blood cell
counts and abnormal platelet counts can alert the nurse to a potential life-threatening
infection. Injection site itching is a common occurrence following administration of the
medication. In early treatment, residual fatigue and joint pain may still be apparent. A
metallic taste and loss of appetite are not common signs of side effects of this medication.
166.) Alendronate (Fosamax) is prescribed for a client with osteoporosis. The client taking
this medication is instructed to:
1. Take the medication at bedtime.
2. Take the medication in the morning with breakfast.
3. Lie down for 30 minutes after taking the medication.
4. Take the medication with a full glass of water after rising in the morning. - CORRECT
ANS- -4. Take the medication with a full glass of water after rising in the morning.
Rationale:
Precautions need to be taken with administration of alendronate to prevent gastrointestinal
side effects (especially esophageal irritation) and to increase absorption of the medication.
The medication needs to be taken with a full glass of water after rising in the morning. The
,client should not eat or drink anything for 30 minutes following administration and should
not lie down after taking the medication.
167.) A nurse prepares to reinforce instructions to a client who is taking allopurinol
(Zyloprim). The nurse plans to include which of the following in the instructions?
1. Instruct the client to drink 3000 mL of fluid per day.
2. Instruct the client to take the medication on an empty stomach.
3. Inform the client that the effect of the medication will occur immediately.
4. Instruct the client that, if swelling of the lips occurs, this is a normal expected response.
- CORRECT ANS- -1. Instruct the client to drink 3000 mL of fluid per day.
Rationale:
Allopurinol (Zyloprim) is an antigout medication used to decrease uric acid levels. Clients
taking allopurinol are encouraged to drink 3000 mL of fluid a day. A full therapeutic effect
may take 1 week or longer. Allopurinol is to be given with or immediately following meals or
milk to prevent gastrointestinal irritation. If the client develops a rash, irritation of the eyes,
or swelling of the lips or mouth, he or she should contact the health care provider because
this may indicate hypersensitivity.
168.) Colcrys (colchicine) is prescribed for a client with a diagnosis of gout. The nurse
reviews the client's medical history in the health record, knowing that the medication
would be contraindicated in which disorder?
1. Myxedema
2. Renal failure
3. Hypothyroidism
4. Diabetes mellitus - CORRECT ANS- -2. Renal failure
Rationale:
Colchicine is contraindicated in clients with severe gastrointestinal, renal, hepatic or
cardiac disorders, or with blood dyscrasias. Clients with impaired renal function may
exhibit myopathy and neuropathy manifested as generalized weakness. This medication
, should be used with caution in clients with impaired hepatic function, older clients, and
debilitated clients.
**Note that options 1, 3, and 4 are all endocrine-related disorders:
Myxedema=Hypothyroidism**
169.) Insulin glargine (Lantus) is prescribed for a client with diabetes mellitus. The nurse
tells the client that it is best to take the insulin:
1. 1 hour after each meal
2. Once daily, at the same time each day
3. 15 minutes before breakfast, lunch, and dinner
4. Before each meal, on the basis of the blood glucose level - CORRECT ANS- -2. Once
daily, at the same time each day
Rationale:
Insulin glargine is a long-acting recombinant DNA human insulin used to treat type 1 and
type 2 diabetes mellitus. It has a 24-hour duration of action and is administered once a day,
at the same time each day.
170.) Atenolol hydrochloride (Tenormin) is prescribed for a hospitalized client. The nurse
should perform which of the following as a priority action before administering the
medication?
1. Listen to the client's lung sounds.
2. Check the client's blood pressure.
3. Check the recent electrolyte levels.
4. Assess the client for muscle weakness. - CORRECT ANS- -2. Check the client's blood
pressure.
Rationale:
Atenolol hydrochloride is a beta-blocker used to treat hypertension. Therefore the priority
nursing action before administration of the medication is to check the client's blood
pressure. The nurse also checks the client's apical heart rate. If the systolic blood pressure
is below 90 mm Hg or the apical pulse is 60 beats per minute or lower, the medication is
