HESI Pharmacology: Structured for Success with
Expert-Backed Questions and Solutions from Top-
Tier Universities
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 check:
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, with a loss of appetite - CORRECT ANS- -2. The white
blood cell counts and platelet counts
Rationale:
Infection and pancytopenia are side effects of etanercept (Enbrel). Laboratory studies are
performed before and during drug treatment. The appearance of abnormal white blood cell
counts and abnormal platelet counts can alert the nurse to a potentially life-threatening
infection. Injection site itching is a common occurrence following administration. A
metallic taste with loss of appetite are not common signs of side effects of this medication.
Baclofen (Lioresal) is prescribed for the client with multiple sclerosis. The nurse assists in
planning care, knowing that the primary therapeutic effect of this medication is which of
the following?
1. Increased muscle tone
2. Decreased muscle spasms
3. Increased range of motion
4. Decreased local pain and tenderness - CORRECT ANS- -2. Decreased muscle spasms
Rationale:
Baclofen is a skeletal muscle relaxant and central nervous system depressant and acts at
the spinal cord level to decrease the frequency and amplitude of muscle spasms in clients
with spinal cord injuries or diseases and in clients with multiple sclerosis. Options 1, 3, and
4 are incorrect.
,85.) A nurse is monitoring a client receiving baclofen (Lioresal) for side effects related to the
medication. Which of the following would indicate that the client is experiencing a side
effect?
1. Polyuria
2. Diarrhea
3. Drowsiness
4. Muscular excitability - CORRECT ANS- -3. Drowsiness
Rationale:
Baclofen is a central nervous system (CNS) depressant and frequently causes drowsiness,
dizziness, weakness, and fatigue. It can also cause nausea, constipation, and urinary
retention. Clients should be warned about the possible reactions. Options 1, 2, and 4 are
not side effects.
86.) A nurse is reinforcing discharge instructions to a client receiving baclofen (Lioresal).
Which of the following would the nurse include in the instructions?
1. Restrict fluid intake.
2. Avoid the use of alcohol.
3. Stop the medication if diarrhea occurs.
4. Notify the health care provider if fatigue occurs. - CORRECT ANS- -2. Avoid the use of
alcohol.
Rationale:
Baclofen is a central nervous system (CNS) depressant. The client should be cautioned
against the use of alcohol and other CNS depressants, because baclofen potentiates the
depressant activity of these agents. Constipation rather than diarrhea is an adverse effect
of baclofen. It is not necessary to restrict fluids, but the client should be warned that
urinary retention can occur. Fatigue is related to a CNS effect that is most intense during
the early phase of therapy and diminishes with continued medication use. It is not
necessary that the client notify the health care provider if fatigue occurs.
, 87.) A client with acute muscle spasms has been taking baclofen (Lioresal). The client calls
the clinic nurse because of continuous feelings of weakness and fatigue and asks the nurse
about discontinuing the medication. The nurse should make which appropriate response to
the client?
1. "You should never stop the medication."
2. "It is best that you taper the dose if you intend to stop the medication."
3. "It is okay to stop the medication if you think that you can tolerate the muscle spasms."
4. "Weakness and fatigue commonly occur and will diminish with continued medication
use." - CORRECT ANS- -4. "Weakness and fatigue commonly occur and will diminish with
continued medication use."
Rationale:
The client should be instructed that symptoms such as drowsiness, weakness, and fatigue
are more intense in the early phase of therapy and diminish with continued medication use.
The client should be instructed never to withdraw or stop the medication abruptly, because
abrupt withdrawal can cause visual hallucinations, paranoid ideation, and seizures. It is
best for the nurse to inform the client that these symptoms will subside and encourage the
client to continue the use of the medication.
88.) Dantrolene sodium (Dantrium) is prescribed for a client experiencing flexor spasms,
and the client asks the nurse about the action of the medication. The nurse responds,
knowing that the therapeutic action of this medication is which of the following?
1. Depresses spinal reflexes
2. Acts directly on the skeletal muscle to relieve spasticity
3. Acts within the spinal cord to suppress hyperactive reflexes
4. Acts on the central nervous system (CNS) to suppress spasms - CORRECT ANS- -2. Acts
directly on the skeletal muscle to relieve spasticity
Rationale:
Dantrium acts directly on skeletal muscle to relieve muscle spasticity. The primary action
is the suppression of calcium release from the sarcoplasmic reticulum. This in turn
decreases the ability of the skeletal muscle to contract.
Expert-Backed Questions and Solutions from Top-
Tier Universities
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 check:
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, with a loss of appetite - CORRECT ANS- -2. The white
blood cell counts and platelet counts
Rationale:
Infection and pancytopenia are side effects of etanercept (Enbrel). Laboratory studies are
performed before and during drug treatment. The appearance of abnormal white blood cell
counts and abnormal platelet counts can alert the nurse to a potentially life-threatening
infection. Injection site itching is a common occurrence following administration. A
metallic taste with loss of appetite are not common signs of side effects of this medication.
Baclofen (Lioresal) is prescribed for the client with multiple sclerosis. The nurse assists in
planning care, knowing that the primary therapeutic effect of this medication is which of
the following?
1. Increased muscle tone
2. Decreased muscle spasms
3. Increased range of motion
4. Decreased local pain and tenderness - CORRECT ANS- -2. Decreased muscle spasms
Rationale:
Baclofen is a skeletal muscle relaxant and central nervous system depressant and acts at
the spinal cord level to decrease the frequency and amplitude of muscle spasms in clients
with spinal cord injuries or diseases and in clients with multiple sclerosis. Options 1, 3, and
4 are incorrect.
,85.) A nurse is monitoring a client receiving baclofen (Lioresal) for side effects related to the
medication. Which of the following would indicate that the client is experiencing a side
effect?
1. Polyuria
2. Diarrhea
3. Drowsiness
4. Muscular excitability - CORRECT ANS- -3. Drowsiness
Rationale:
Baclofen is a central nervous system (CNS) depressant and frequently causes drowsiness,
dizziness, weakness, and fatigue. It can also cause nausea, constipation, and urinary
retention. Clients should be warned about the possible reactions. Options 1, 2, and 4 are
not side effects.
86.) A nurse is reinforcing discharge instructions to a client receiving baclofen (Lioresal).
Which of the following would the nurse include in the instructions?
1. Restrict fluid intake.
2. Avoid the use of alcohol.
3. Stop the medication if diarrhea occurs.
4. Notify the health care provider if fatigue occurs. - CORRECT ANS- -2. Avoid the use of
alcohol.
Rationale:
Baclofen is a central nervous system (CNS) depressant. The client should be cautioned
against the use of alcohol and other CNS depressants, because baclofen potentiates the
depressant activity of these agents. Constipation rather than diarrhea is an adverse effect
of baclofen. It is not necessary to restrict fluids, but the client should be warned that
urinary retention can occur. Fatigue is related to a CNS effect that is most intense during
the early phase of therapy and diminishes with continued medication use. It is not
necessary that the client notify the health care provider if fatigue occurs.
, 87.) A client with acute muscle spasms has been taking baclofen (Lioresal). The client calls
the clinic nurse because of continuous feelings of weakness and fatigue and asks the nurse
about discontinuing the medication. The nurse should make which appropriate response to
the client?
1. "You should never stop the medication."
2. "It is best that you taper the dose if you intend to stop the medication."
3. "It is okay to stop the medication if you think that you can tolerate the muscle spasms."
4. "Weakness and fatigue commonly occur and will diminish with continued medication
use." - CORRECT ANS- -4. "Weakness and fatigue commonly occur and will diminish with
continued medication use."
Rationale:
The client should be instructed that symptoms such as drowsiness, weakness, and fatigue
are more intense in the early phase of therapy and diminish with continued medication use.
The client should be instructed never to withdraw or stop the medication abruptly, because
abrupt withdrawal can cause visual hallucinations, paranoid ideation, and seizures. It is
best for the nurse to inform the client that these symptoms will subside and encourage the
client to continue the use of the medication.
88.) Dantrolene sodium (Dantrium) is prescribed for a client experiencing flexor spasms,
and the client asks the nurse about the action of the medication. The nurse responds,
knowing that the therapeutic action of this medication is which of the following?
1. Depresses spinal reflexes
2. Acts directly on the skeletal muscle to relieve spasticity
3. Acts within the spinal cord to suppress hyperactive reflexes
4. Acts on the central nervous system (CNS) to suppress spasms - CORRECT ANS- -2. Acts
directly on the skeletal muscle to relieve spasticity
Rationale:
Dantrium acts directly on skeletal muscle to relieve muscle spasticity. The primary action
is the suppression of calcium release from the sarcoplasmic reticulum. This in turn
decreases the ability of the skeletal muscle to contract.
