HESI PHARMACOLOGY EXAM PRACTICE EXAM
2[NCLEX PN] WITH QUESTIONS AND WELL
VERIFIED ANSWERS [GRADED A+}
5.) Mafenide acetate (Sulfamylon) is prescribed for the client with a burn
injury. When applying the medication, the client complains of local
discomfort and burning. Which of the following is the most appropriate
nursing action?
1. Notifying the registered nurse
2. Discontinuing the medication
3. Informing the client that this is normal
4. Applying a thinner film than prescribed to the burn site -
ANSWER✔✔-3. Informing the client that this is normal
Rationale:
Mafenide acetate is bacteriostatic for gram-negative and gram-positive
organisms and is used to treat burns to reduce bacteria present in
avascular tissues. The client should be informed that the medication will
cause local discomfort and burning and that this is a normal reaction;
therefore options 1, 2, and 4 are incorrect
6.) The burn client is receiving treatments of topical mafenide acetate
(Sulfamylon) to the site of injury. The nurse monitors the client, knowing
that which of the following indicates that a systemic effect has occurred?
1.Hyperventilation
2.Elevated blood pressure
3.Local pain at the burn site
,4.Local rash at the burn site - ANSWER✔✔-1.Hyperventilation
Rationale:
Mafenide acetate is a carbonic anhydrase inhibitor and can suppress renal
excretion of acid, thereby causing acidosis. Clients receiving this treatment
should be monitored for signs of an acid-base imbalance (hyperventilation).
If this occurs, the medication should be discontinued for 1 to 2 days.
Options 3 and 4 describe local rather than systemic effects. An elevated
blood pressure may be expected from the pain that occurs with a burn
injury.
7.) Isotretinoin is prescribed for a client with severe acne. Before the
administration of this medication, the nurse anticipates that which
laboratory test will be prescribed?
1. Platelet count
2. Triglyceride level
3. Complete blood count
4. White blood cell count - ANSWER✔✔-2. Triglyceride level
Rationale:
Isotretinoin can elevate triglyceride levels. Blood triglyceride levels should
be measured before treatment and periodically thereafter until the effect on
the triglycerides has been evaluated. Options 1, 3, and 4 do not need to be
monitored specifically during this treatment.
8.) A client with severe acne is seen in the clinic and the health care
provider (HCP) prescribes isotretinoin. The nurse reviews the client's
medication record and would contact the (HCP) if the client is taking which
medication?
1. Vitamin A
2. Digoxin (Lanoxin)
3. Furosemide (Lasix)
,4. Phenytoin (Dilantin) - ANSWER✔✔-1. Vitamin A
Rationale:
Isotretinoin is a metabolite of vitamin A and can produce generalized
intensification of isotretinoin toxicity. Because of the potential for increased
toxicity, vitamin A supplements should be discontinued before isotretinoin
therapy. Options 2, 3, and 4 are not contraindicated with the use of
isotretinoin.
9.) The nurse is applying a topical corticosteroid to a client with eczema.
The nurse would monitor for the potential for increased systemic absorption
of the medication if the medication were being applied to which of the
following body areas?
1. Back
2. Axilla
3. Soles of the feet
4. Palms of the hands - ANSWER✔✔-2. Axilla
Rationale:
Topical corticosteroids can be absorbed into the systemic circulation.
Absorption is higher from regions where the skin is especially permeable
(scalp, axilla, face, eyelids, neck, perineum, genitalia), and lower from
regions in which permeability is poor (back, palms, soles).
10.) The clinic nurse is performing an admission assessment on a client.
The nurse notes that the client is taking azelaic acid (Azelex). Because of
the medication prescription, the nurse would suspect that the client is being
treated for:
1. Acne
2. Eczema
3. Hair loss
, 4. Herpes simplex - ANSWER✔✔-1. Acne
Rationale:
Azelaic acid is a topical medication used to treat mild to moderate acne.
The acid appears to work by suppressing the growth of Propionibacterium
acnes and decreasing the proliferation of keratinocytes. Options 2, 3, and 4
are incorrect.
11.) The health care provider has prescribed silver sulfadiazine (Silvadene)
for the client with a partial-thickness burn, which has cultured positive for
gram-negative bacteria. The nurse is reinforcing information to the client
about the medication. Which statement made by the client indicates a lack
of understanding about the treatments?
1. "The medication is an antibacterial."
2. "The medication will help heal the burn."
3. "The medication will permanently stain my skin."
4. "The medication should be applied directly to the wound." -
ANSWER✔✔-3. "The medication will permanently stain my skin."
Rationale:
Silver sulfadiazine (Silvadene) is an antibacterial that has a broad spectrum
of activity against gram-negative bacteria, gram-positive bacteria, and
yeast. It is applied directly to the wound to assist in healing. It does not
stain the skin.
12.) A nurse is caring for a client who is receiving an intravenous (IV)
infusion of an antineoplastic medication. During the infusion, the client
complains of pain at the insertion site. During an inspection of the site, the
nurse notes redness and swelling and that the rate of infusion of the
medication has slowed. The nurse should take which appropriate action?
1. Notify the registered nurse.
2. Administer pain medication to reduce the discomfort.
2[NCLEX PN] WITH QUESTIONS AND WELL
VERIFIED ANSWERS [GRADED A+}
5.) Mafenide acetate (Sulfamylon) is prescribed for the client with a burn
injury. When applying the medication, the client complains of local
discomfort and burning. Which of the following is the most appropriate
nursing action?
1. Notifying the registered nurse
2. Discontinuing the medication
3. Informing the client that this is normal
4. Applying a thinner film than prescribed to the burn site -
ANSWER✔✔-3. Informing the client that this is normal
Rationale:
Mafenide acetate is bacteriostatic for gram-negative and gram-positive
organisms and is used to treat burns to reduce bacteria present in
avascular tissues. The client should be informed that the medication will
cause local discomfort and burning and that this is a normal reaction;
therefore options 1, 2, and 4 are incorrect
6.) The burn client is receiving treatments of topical mafenide acetate
(Sulfamylon) to the site of injury. The nurse monitors the client, knowing
that which of the following indicates that a systemic effect has occurred?
1.Hyperventilation
2.Elevated blood pressure
3.Local pain at the burn site
,4.Local rash at the burn site - ANSWER✔✔-1.Hyperventilation
Rationale:
Mafenide acetate is a carbonic anhydrase inhibitor and can suppress renal
excretion of acid, thereby causing acidosis. Clients receiving this treatment
should be monitored for signs of an acid-base imbalance (hyperventilation).
If this occurs, the medication should be discontinued for 1 to 2 days.
Options 3 and 4 describe local rather than systemic effects. An elevated
blood pressure may be expected from the pain that occurs with a burn
injury.
7.) Isotretinoin is prescribed for a client with severe acne. Before the
administration of this medication, the nurse anticipates that which
laboratory test will be prescribed?
1. Platelet count
2. Triglyceride level
3. Complete blood count
4. White blood cell count - ANSWER✔✔-2. Triglyceride level
Rationale:
Isotretinoin can elevate triglyceride levels. Blood triglyceride levels should
be measured before treatment and periodically thereafter until the effect on
the triglycerides has been evaluated. Options 1, 3, and 4 do not need to be
monitored specifically during this treatment.
8.) A client with severe acne is seen in the clinic and the health care
provider (HCP) prescribes isotretinoin. The nurse reviews the client's
medication record and would contact the (HCP) if the client is taking which
medication?
1. Vitamin A
2. Digoxin (Lanoxin)
3. Furosemide (Lasix)
,4. Phenytoin (Dilantin) - ANSWER✔✔-1. Vitamin A
Rationale:
Isotretinoin is a metabolite of vitamin A and can produce generalized
intensification of isotretinoin toxicity. Because of the potential for increased
toxicity, vitamin A supplements should be discontinued before isotretinoin
therapy. Options 2, 3, and 4 are not contraindicated with the use of
isotretinoin.
9.) The nurse is applying a topical corticosteroid to a client with eczema.
The nurse would monitor for the potential for increased systemic absorption
of the medication if the medication were being applied to which of the
following body areas?
1. Back
2. Axilla
3. Soles of the feet
4. Palms of the hands - ANSWER✔✔-2. Axilla
Rationale:
Topical corticosteroids can be absorbed into the systemic circulation.
Absorption is higher from regions where the skin is especially permeable
(scalp, axilla, face, eyelids, neck, perineum, genitalia), and lower from
regions in which permeability is poor (back, palms, soles).
10.) The clinic nurse is performing an admission assessment on a client.
The nurse notes that the client is taking azelaic acid (Azelex). Because of
the medication prescription, the nurse would suspect that the client is being
treated for:
1. Acne
2. Eczema
3. Hair loss
, 4. Herpes simplex - ANSWER✔✔-1. Acne
Rationale:
Azelaic acid is a topical medication used to treat mild to moderate acne.
The acid appears to work by suppressing the growth of Propionibacterium
acnes and decreasing the proliferation of keratinocytes. Options 2, 3, and 4
are incorrect.
11.) The health care provider has prescribed silver sulfadiazine (Silvadene)
for the client with a partial-thickness burn, which has cultured positive for
gram-negative bacteria. The nurse is reinforcing information to the client
about the medication. Which statement made by the client indicates a lack
of understanding about the treatments?
1. "The medication is an antibacterial."
2. "The medication will help heal the burn."
3. "The medication will permanently stain my skin."
4. "The medication should be applied directly to the wound." -
ANSWER✔✔-3. "The medication will permanently stain my skin."
Rationale:
Silver sulfadiazine (Silvadene) is an antibacterial that has a broad spectrum
of activity against gram-negative bacteria, gram-positive bacteria, and
yeast. It is applied directly to the wound to assist in healing. It does not
stain the skin.
12.) A nurse is caring for a client who is receiving an intravenous (IV)
infusion of an antineoplastic medication. During the infusion, the client
complains of pain at the insertion site. During an inspection of the site, the
nurse notes redness and swelling and that the rate of infusion of the
medication has slowed. The nurse should take which appropriate action?
1. Notify the registered nurse.
2. Administer pain medication to reduce the discomfort.
