HESI Pharmacology Exam 2 (NCLEX PN) – 2 Versions
Complete Test Bank with Practice Questions,
Answers, and Rationales
1.) 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.
2.) 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.
3. Apply ice and maintain the infusion rate, as prescribed.
4. Elevate the extremity of the IV site, and slow the infusion. - ANSWER -1.
Notify the registered nurse.
Rationale:
When antineoplastic medications (Chemotheraputic Agents) are administered via
IV, great care must be taken to prevent the medication from escaping into the
tissues surrounding the injection site, because pain, tissue damage, and necrosis
can result. The nurse monitors for signs of extravasation, such as redness or
swelling at the insertion site and a decreased infusion rate. If extravasation occurs,
the registered nurse needs to be notified; he or she will then contact the health care
provider.
, 3.) The client with squamous cell carcinoma of the larynx is receiving bleomycin
intravenously. The nurse caring for the client anticipates that which diagnostic
study will be prescribed?
1. Echocardiography
2. Electrocardiography
3. Cervical radiography
4. Pulmonary function studies - ANSWER -4. Pulmonary function studies
Rationale:
Bleomycin is an antineoplastic medication (Chemotheraputic Agents) that can
cause interstitial pneumonitis, which can progress to pulmonary fibrosis.
Pulmonary function studies along with hematological, hepatic, and renal function
tests need to be monitored. The nurse needs to monitor lung sounds for dyspnea
and crackles, which indicate pulmonary toxicity. The medication needs to be
discontinued immediately if pulmonary toxicity occurs. Options 1, 2, and 3 are
unrelated to the specific use of this medication.
4.) The client with acute myelocytic leukemia is being treated with busulfan
(Myleran). Which laboratory value would the nurse specifically monitor during
treatment with this medication?
1. Clotting time
2. Uric acid level
3. Potassium level
4. Blood glucose level - ANSWER -2. Uric acid level
Rationale:
Busulfan (Myleran) can cause an increase in the uric acid level. Hyperuricemia can
produce uric acid nephropathy, renal stones, and acute renal failure. Options 1, 3,
and 4 are not specifically related to this medication.
5.) The client with small cell lung cancer is being treated with etoposide
(VePesid). The nurse who is assisting in caring for the client during its
administration understands that which side effect is specifically associated with
this medication?
1. Alopecia
2. Chest pain
3. Pulmonary fibrosis
4. Orthostatic hypotension - ANSWER -4. Orthostatic hypotension
Rationale:
A side effect specific to etoposide is orthostatic hypotension. The client's blood
pressure is monitored during the infusion. Hair loss occurs with nearly all the
,antineoplastic medications. Chest pain and pulmonary fibrosis are unrelated to this
medication.
6.) The clinic nurse is reviewing a teaching plan for the client receiving an
antineoplastic medication. When implementing the plan, the nurse tells the client:
1. To take aspirin (acetylsalicylic acid) as needed for headache
2. Drink beverages containing alcohol in moderate amounts each evening
3. Consult with health care providers (HCPs) before receiving immunizations
4. That it is not necessary to consult HCPs before receiving a flu vaccine at the
local health fair - ANSWER -3. Consult with health care providers (HCPs) before
receiving immunizations
Rationale:
Because antineoplastic medications lower the resistance of the body, clients must
be informed not to receive immunizations without a HCP's approval. Clients also
need to avoid contact with individuals who have recently received a live virus
vaccine. Clients need to avoid aspirin and aspirin-containing products to minimize
the risk of bleeding, and they need to avoid alcohol to minimize the risk of toxicity
and side effects.
17.) The client with ovarian cancer is being treated with vincristine (Oncovin).
The nurse monitors the client, knowing that which of the following indicates a side
effect specific to this medication?
1. Diarrhea
2. Hair loss
3. Chest pain
4. Numbness and tingling in the fingers and toes - ANSWER -4. Numbness and
tingling in the fingers and toes
Rationale:
A side effect specific to vincristine is peripheral neuropathy, which occurs in
almost every client. Peripheral neuropathy can be manifested as numbness and
tingling in the fingers and toes. Depression of the Achilles tendon reflex may be
the first clinical sign indicating peripheral neuropathy. Constipation rather than
diarrhea is most likely to occur with this medication, although diarrhea may occur
occasionally. Hair loss occurs with nearly all the antineoplastic medications. Chest
pain is unrelated to this medication.
18.) The nurse is reviewing the history and physical examination of a client who
will be receiving asparaginase (Elspar), an antineoplastic agent. The nurse consults
with the registered nurse regarding the administration of the medication if which of
the following is documented in the client's history?
, 1. Pancreatitis
2. Diabetes mellitus
3. Myocardial infarction
4. Chronic obstructive pulmonary disease - ANSWER -1. Pancreatitis
Rationale:
Asparaginase (Elspar) is contraindicated if hypersensitivity exists, in pancreatitis,
or if the client has a history of pancreatitis. The medication impairs pancreatic
function and pancreatic function tests should be performed before therapy begins
and when a week or more has elapsed between administration of the doses. The
client needs to be monitored for signs of pancreatitis, which include nausea,
vomiting, and abdominal pain. The conditions noted in options 2, 3, and 4 are not
contraindicated with this medication.
19.) Tamoxifen is prescribed for the client with metastatic breast carcinoma. The
nurse understands that the primary action of this medication is to:
1. Increase DNA and RNA synthesis.
2. Promote the biosynthesis of nucleic acids.
3. Increase estrogen concentration and estrogen response.
4. Compete with estradiol for binding to estrogen in tissues containing high
concentrations of receptors. - ANSWER -4. Compete with estradiol for binding to
estrogen in tissues containing high concentrations of receptors.
Rationale:
Tamoxifen is an antineoplastic medication that competes with estradiol for binding
to estrogen in tissues containing high concentrations of receptors. Tamoxifen is
used to treat metastatic breast carcinoma in women and men. Tamoxifen is also
effective in delaying the recurrence of cancer following mastectomy. Tamoxifen
reduces DNA synthesis and estrogen response.
20.) The client with metastatic breast cancer is receiving tamoxifen. The nurse
specifically monitors which laboratory value while the client is taking this
medication?
1. Glucose level
2. Calcium level
3. Potassium level
4. Prothrombin time - ANSWER -2. Calcium level
Rationale:
Tamoxifen may increase calcium, cholesterol, and triglyceride levels. Before the
initiation of therapy, a complete blood count, platelet count, and serum calcium
levels should be assessed. These blood levels, along with cholesterol and
triglyceride levels, should be monitored periodically during therapy. The nurse
Complete Test Bank with Practice Questions,
Answers, and Rationales
1.) 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.
2.) 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.
3. Apply ice and maintain the infusion rate, as prescribed.
4. Elevate the extremity of the IV site, and slow the infusion. - ANSWER -1.
Notify the registered nurse.
Rationale:
When antineoplastic medications (Chemotheraputic Agents) are administered via
IV, great care must be taken to prevent the medication from escaping into the
tissues surrounding the injection site, because pain, tissue damage, and necrosis
can result. The nurse monitors for signs of extravasation, such as redness or
swelling at the insertion site and a decreased infusion rate. If extravasation occurs,
the registered nurse needs to be notified; he or she will then contact the health care
provider.
, 3.) The client with squamous cell carcinoma of the larynx is receiving bleomycin
intravenously. The nurse caring for the client anticipates that which diagnostic
study will be prescribed?
1. Echocardiography
2. Electrocardiography
3. Cervical radiography
4. Pulmonary function studies - ANSWER -4. Pulmonary function studies
Rationale:
Bleomycin is an antineoplastic medication (Chemotheraputic Agents) that can
cause interstitial pneumonitis, which can progress to pulmonary fibrosis.
Pulmonary function studies along with hematological, hepatic, and renal function
tests need to be monitored. The nurse needs to monitor lung sounds for dyspnea
and crackles, which indicate pulmonary toxicity. The medication needs to be
discontinued immediately if pulmonary toxicity occurs. Options 1, 2, and 3 are
unrelated to the specific use of this medication.
4.) The client with acute myelocytic leukemia is being treated with busulfan
(Myleran). Which laboratory value would the nurse specifically monitor during
treatment with this medication?
1. Clotting time
2. Uric acid level
3. Potassium level
4. Blood glucose level - ANSWER -2. Uric acid level
Rationale:
Busulfan (Myleran) can cause an increase in the uric acid level. Hyperuricemia can
produce uric acid nephropathy, renal stones, and acute renal failure. Options 1, 3,
and 4 are not specifically related to this medication.
5.) The client with small cell lung cancer is being treated with etoposide
(VePesid). The nurse who is assisting in caring for the client during its
administration understands that which side effect is specifically associated with
this medication?
1. Alopecia
2. Chest pain
3. Pulmonary fibrosis
4. Orthostatic hypotension - ANSWER -4. Orthostatic hypotension
Rationale:
A side effect specific to etoposide is orthostatic hypotension. The client's blood
pressure is monitored during the infusion. Hair loss occurs with nearly all the
,antineoplastic medications. Chest pain and pulmonary fibrosis are unrelated to this
medication.
6.) The clinic nurse is reviewing a teaching plan for the client receiving an
antineoplastic medication. When implementing the plan, the nurse tells the client:
1. To take aspirin (acetylsalicylic acid) as needed for headache
2. Drink beverages containing alcohol in moderate amounts each evening
3. Consult with health care providers (HCPs) before receiving immunizations
4. That it is not necessary to consult HCPs before receiving a flu vaccine at the
local health fair - ANSWER -3. Consult with health care providers (HCPs) before
receiving immunizations
Rationale:
Because antineoplastic medications lower the resistance of the body, clients must
be informed not to receive immunizations without a HCP's approval. Clients also
need to avoid contact with individuals who have recently received a live virus
vaccine. Clients need to avoid aspirin and aspirin-containing products to minimize
the risk of bleeding, and they need to avoid alcohol to minimize the risk of toxicity
and side effects.
17.) The client with ovarian cancer is being treated with vincristine (Oncovin).
The nurse monitors the client, knowing that which of the following indicates a side
effect specific to this medication?
1. Diarrhea
2. Hair loss
3. Chest pain
4. Numbness and tingling in the fingers and toes - ANSWER -4. Numbness and
tingling in the fingers and toes
Rationale:
A side effect specific to vincristine is peripheral neuropathy, which occurs in
almost every client. Peripheral neuropathy can be manifested as numbness and
tingling in the fingers and toes. Depression of the Achilles tendon reflex may be
the first clinical sign indicating peripheral neuropathy. Constipation rather than
diarrhea is most likely to occur with this medication, although diarrhea may occur
occasionally. Hair loss occurs with nearly all the antineoplastic medications. Chest
pain is unrelated to this medication.
18.) The nurse is reviewing the history and physical examination of a client who
will be receiving asparaginase (Elspar), an antineoplastic agent. The nurse consults
with the registered nurse regarding the administration of the medication if which of
the following is documented in the client's history?
, 1. Pancreatitis
2. Diabetes mellitus
3. Myocardial infarction
4. Chronic obstructive pulmonary disease - ANSWER -1. Pancreatitis
Rationale:
Asparaginase (Elspar) is contraindicated if hypersensitivity exists, in pancreatitis,
or if the client has a history of pancreatitis. The medication impairs pancreatic
function and pancreatic function tests should be performed before therapy begins
and when a week or more has elapsed between administration of the doses. The
client needs to be monitored for signs of pancreatitis, which include nausea,
vomiting, and abdominal pain. The conditions noted in options 2, 3, and 4 are not
contraindicated with this medication.
19.) Tamoxifen is prescribed for the client with metastatic breast carcinoma. The
nurse understands that the primary action of this medication is to:
1. Increase DNA and RNA synthesis.
2. Promote the biosynthesis of nucleic acids.
3. Increase estrogen concentration and estrogen response.
4. Compete with estradiol for binding to estrogen in tissues containing high
concentrations of receptors. - ANSWER -4. Compete with estradiol for binding to
estrogen in tissues containing high concentrations of receptors.
Rationale:
Tamoxifen is an antineoplastic medication that competes with estradiol for binding
to estrogen in tissues containing high concentrations of receptors. Tamoxifen is
used to treat metastatic breast carcinoma in women and men. Tamoxifen is also
effective in delaying the recurrence of cancer following mastectomy. Tamoxifen
reduces DNA synthesis and estrogen response.
20.) The client with metastatic breast cancer is receiving tamoxifen. The nurse
specifically monitors which laboratory value while the client is taking this
medication?
1. Glucose level
2. Calcium level
3. Potassium level
4. Prothrombin time - ANSWER -2. Calcium level
Rationale:
Tamoxifen may increase calcium, cholesterol, and triglyceride levels. Before the
initiation of therapy, a complete blood count, platelet count, and serum calcium
levels should be assessed. These blood levels, along with cholesterol and
triglyceride levels, should be monitored periodically during therapy. The nurse
