Pharmacology HESI Test Exam Questions with Accurate
Answers.
An adult client has prescriptions for morphine sulfate 2.5 mg IV q6h and
ketorolac (Toradol) 30 mg IV q6h. Which action should the nurse implement?
a) Administer both medications according to the prescription.
b) Hold the ketorolac to prevent an antagonistic effect.
c) Hold the morphine to prevent an additive drug interaction.
d) Contact the healthcare provider to clarify the prescription. - accurate
answers-Rationale: A
Morphine and ketorolac (Toradol) can be administered concurrently, and may
produce an additive analgesic effect, resulting in the ability to reduce the dose
of morphine, as seen in this prescription. Toradol is an anti inflammatory
analgesic, and does not have an antagonistic effect with morphine.
The nurse is assessing a client who is experiencing anaphylaxis from an insect
sting. Which prescription should the nurse prepare to administer this client?
a) Dopamine.
b) Ephedrine.
c) Epinephrine.
d) Diphenhydramine. - accurate answers-Rationale: C
Epinephrine is an adrenergic agent that stimulates beta receptors to increase
cardiac automaticity in cardiac arrest and relax bronchospasms in
anaphylaxis. On the ither hand, dopamine is a vasopressor used to treat clients
with shock. Ephedrine causes peripheral vasoconstriction and is used in the
treatment of nasal congestion. Diphenhydramine is an antihistamine
decongestant used in the treatment of mild allergic reactions and motion
sickness. Epinephrine is the medication of choice in treating anaphylaxis.
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.)
o Increase fluid intake, especially cranberry juice.
o Do not abruptly discontinue the medication, taper use.
o Check blood pressure daily to detect hypertension.
,o Avoid drinking alcohol while taking this medication.
o Use condoms until treatment is completed.
o Ensure that all sexual partners are treated at the same time. - accurate
answers-Rationale: 1,4,6
Increased fluid intake and cranberry juice 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 or to check the blood
pressure daily, 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. All sexual partners
should be treated at the same time and condoms should be used until after
treatment is completed to avoid reinfection.
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.
d) Vomiting. - accurate answers-Rationale: D
Vomiting, anorexia and abdominal pain are early indications of digitalis
toxicity. Since Lipitor increases the risk for digitalis toxicity, this finding
requires the most immediate intervention by the nurse.
While taking a nursing history, the client states, "I am allergic to penicillin."
What related allergy to another type of anti-infective agent should the nurse
ask the client about when taking the nursing history?
a) Aminoglycosides.
b) Cephalosporins.
c) Sulfonamides.
d) Tetracyclines. - accurate answers-Rationale: B
If a client has a history of being allergic to penicillin (PCN); there is appears to
be a cross sensitivity between penicillins and 1st generation cephalosporins.
, According to research, there appears to be no cross sensitivity between PCN
and 3rd or 4th generation cephalosporins.
A category X drug is prescribed for a young adult female client. Which
instruction is most important for the nurse to teach this client?
a) Use a reliable form of birth control.
b) Avoid exposure to ultra violet light.
c) Refuse this medication if planning pregnancy.
d) Abstain from intercourse while on this drug. - accurate answers-Rationale:
A
Drugs classified in the category X place a client who is in the first trimester of
pregnancy at risk for teratogenesis, so women in the childbearing years
should be counseled to use a reliable form of birth control during drug
therapy. If the client is planning to become pregnant, she should be
encouraged to discuss plans for pregnancy with the healthcare provider, so a
safer alternative prescription can be provided if pregnancy occurs.
A client is receiving methylprednisolone (Solu-Medrol) 40 mg IV daily. The
nurse anticipates an increase in which laboratory value as the result of this
medication?
a) Serum glucose.
b) Serum calcium.
c) Red blood cells.
d) Serum potassium. - accurate answers-Rationale: A
Solu-Medrol is a corticosteroid with glucocorticoid and mineralocorticoid
actions. These effects can lead to hyperglycemia which is reflected as an
increase in the serum glucose value. The client taking Solu-Medrol is also at
risk for hypocalcemia and hypokalemia which result in a decrease in the
serum calcium and serum potassium levels. These medications also alter the
some of the body's immune responses by suppressing the migration of white
blood cells decreasing inflammation response.
A client is being treated for osteoporosis with alendronate (Fosamax), and the
nurse has completed discharge teaching regarding medication administration.
Which morning schedule would indicate to the nurse that the client teaching
has been effective?
Answers.
An adult client has prescriptions for morphine sulfate 2.5 mg IV q6h and
ketorolac (Toradol) 30 mg IV q6h. Which action should the nurse implement?
a) Administer both medications according to the prescription.
b) Hold the ketorolac to prevent an antagonistic effect.
c) Hold the morphine to prevent an additive drug interaction.
d) Contact the healthcare provider to clarify the prescription. - accurate
answers-Rationale: A
Morphine and ketorolac (Toradol) can be administered concurrently, and may
produce an additive analgesic effect, resulting in the ability to reduce the dose
of morphine, as seen in this prescription. Toradol is an anti inflammatory
analgesic, and does not have an antagonistic effect with morphine.
The nurse is assessing a client who is experiencing anaphylaxis from an insect
sting. Which prescription should the nurse prepare to administer this client?
a) Dopamine.
b) Ephedrine.
c) Epinephrine.
d) Diphenhydramine. - accurate answers-Rationale: C
Epinephrine is an adrenergic agent that stimulates beta receptors to increase
cardiac automaticity in cardiac arrest and relax bronchospasms in
anaphylaxis. On the ither hand, dopamine is a vasopressor used to treat clients
with shock. Ephedrine causes peripheral vasoconstriction and is used in the
treatment of nasal congestion. Diphenhydramine is an antihistamine
decongestant used in the treatment of mild allergic reactions and motion
sickness. Epinephrine is the medication of choice in treating anaphylaxis.
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.)
o Increase fluid intake, especially cranberry juice.
o Do not abruptly discontinue the medication, taper use.
o Check blood pressure daily to detect hypertension.
,o Avoid drinking alcohol while taking this medication.
o Use condoms until treatment is completed.
o Ensure that all sexual partners are treated at the same time. - accurate
answers-Rationale: 1,4,6
Increased fluid intake and cranberry juice 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 or to check the blood
pressure daily, 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. All sexual partners
should be treated at the same time and condoms should be used until after
treatment is completed to avoid reinfection.
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.
d) Vomiting. - accurate answers-Rationale: D
Vomiting, anorexia and abdominal pain are early indications of digitalis
toxicity. Since Lipitor increases the risk for digitalis toxicity, this finding
requires the most immediate intervention by the nurse.
While taking a nursing history, the client states, "I am allergic to penicillin."
What related allergy to another type of anti-infective agent should the nurse
ask the client about when taking the nursing history?
a) Aminoglycosides.
b) Cephalosporins.
c) Sulfonamides.
d) Tetracyclines. - accurate answers-Rationale: B
If a client has a history of being allergic to penicillin (PCN); there is appears to
be a cross sensitivity between penicillins and 1st generation cephalosporins.
, According to research, there appears to be no cross sensitivity between PCN
and 3rd or 4th generation cephalosporins.
A category X drug is prescribed for a young adult female client. Which
instruction is most important for the nurse to teach this client?
a) Use a reliable form of birth control.
b) Avoid exposure to ultra violet light.
c) Refuse this medication if planning pregnancy.
d) Abstain from intercourse while on this drug. - accurate answers-Rationale:
A
Drugs classified in the category X place a client who is in the first trimester of
pregnancy at risk for teratogenesis, so women in the childbearing years
should be counseled to use a reliable form of birth control during drug
therapy. If the client is planning to become pregnant, she should be
encouraged to discuss plans for pregnancy with the healthcare provider, so a
safer alternative prescription can be provided if pregnancy occurs.
A client is receiving methylprednisolone (Solu-Medrol) 40 mg IV daily. The
nurse anticipates an increase in which laboratory value as the result of this
medication?
a) Serum glucose.
b) Serum calcium.
c) Red blood cells.
d) Serum potassium. - accurate answers-Rationale: A
Solu-Medrol is a corticosteroid with glucocorticoid and mineralocorticoid
actions. These effects can lead to hyperglycemia which is reflected as an
increase in the serum glucose value. The client taking Solu-Medrol is also at
risk for hypocalcemia and hypokalemia which result in a decrease in the
serum calcium and serum potassium levels. These medications also alter the
some of the body's immune responses by suppressing the migration of white
blood cells decreasing inflammation response.
A client is being treated for osteoporosis with alendronate (Fosamax), and the
nurse has completed discharge teaching regarding medication administration.
Which morning schedule would indicate to the nurse that the client teaching
has been effective?
