Exit hesi- Pharm Study Guides questions
and answers.
A nurse is assessing the therapeutic action of drugs classified as tumor necrosis
factor (TNF) inhibitors. What client response indicates to the nurse that a drug with
this classification is effective?
Continued remission in a client with ovarian cancer
Increased insulin production in a client with diabetes mellitus
Reduction of inflammatory joint pain in a client with rheumatoid arthritis
Vasodilation of coronary arteries in a client with ischemic heart disease - n
Ans ✔
Reduction of inflammatory joint pain in a client with rheumatoid arthritis
TNF is produced mainly by macrophages in synovium; over time, through various
mechanisms, the presence of TNF causes inflammation of synovium, destruction of
bone and cartilage, joint stiffness, and pain. TNF inhibitors or blockers neutralize
TNF, thereby interrupting the inflammatory cascade; this inhibits the inflammatory
response and other mechanisms, thereby slowing tissue damage. TNF inhibitors are
not prescribed for clients with ovarian cancer, diabetes mellitus, or ischemic heart
disease.
Qs
The nurse suspects serotonin syndrome in a client prescribed second-generation
antidepressants for depression. Which assessment findings observed by the nurse
would be beneficial in diagnosing the severity of the syndrome?
Delirium
,Hyperreflexia
Hyperthermia
Muscle spasms
Rhabdomyolysis - n
Ans ✔
Hyperthermia
Rhabdomyolysis
Serotonin syndrome is a potentially hazardous adverse effect of second-generation
antidepressants that are used to treat depression. Hyperthermia and
rhabdomyolysis are symptoms observed in severe cases of serotonin syndrome.
Delirium, hyperreflexia, and muscle spasms are common symptoms of this
syndrome.
Qs
A healthcare provider prescribes enoxaparin 30 mg subcutaneously daily. Which
measure would the nurse take when administering this medication?
Push over 2 minutes.
Administer in the abdomen.
Rub site after administration.
Remove air pocket from prepackaged syringe before administration. - n
Ans ✔
,Administer in the abdomen.
Enoxaparin specifically targets blood clots throughout the body and carries a lower
risk of hemorrhage than that associated with the drugs heparin and warfarin.
Enoxaparin is administered once a day through a subcutaneous injection site
around the naval. Enoxaparin should be injected into the fatty tissue only, which is
why the abdomen is the recommended injection site. Avoid administering in a
muscle. Manufacturer recommendations indicate the air pocket from prepackaged
syringes not be removed before administration. Rubbing the site is contraindicated,
as it can cause bruising. There are no recommendations to push this subcutaneous
medication over 2 minutes.
Qs
A client with cirrhosis of the liver and ascites has been taking chlorothiazide, a
thiazide diuretic. Why did the provider add spironolactone to the client's medication
regimen?
To stimulate sodium excretion
To help prevent potassium loss
To increase urine specific gravity
To reduce arterial blood pressure - n
Ans ✔
To help prevent potassium loss
Spironolactone is a potassium-sparing diuretic often used in conjunction with
thiazide diuretics. The provider was prompted to add spironolactone to the
chlorothiazide to prevent potassium loss. Both medications stimulate sodium
excretion. Both medications increase urine specific gravity and reduce arterial blood
pressure.
Qs
, A client with myasthenia gravis improves and is discharged from the hospital. The
discharge medications include pyridostigmine bromide 10 mg every 6 hours. The
nurse evaluates that the drug regimen is understood when the client makes which
statement?
"I will take the medication on an empty stomach."
"I need to set an alarm so I take the medication on time."
"It will be important to check my heart rate before taking the medication."
"I should monitor for an increase in blood pressure after taking the medication." - n
Ans ✔
"I need to set an alarm so I take the medication on time."
Pyridostigmine is a vital drug that must be taken on time; a missed or late dose can
result in severe respiratory and neuromuscular consequences or even death.
Pyridostigmine should be taken with a small amount of food to prevent gastric
irritation. It is unnecessary to take the pulse rate before taking pyridostigmine.
Pyridostigmine may cause hypotension, not hypertension, which is a sign of
cholinergic crisis.
Qs
A client has been taking 3 mg of risperidone twice a day for the past 8 days. At the
follow-up appointment, the client reports tremors, shortness of breath, a fever, and
sweating. What will the nurse do?
Call 911 and have the client transported to the nearest psychiatric unit.
Take the client's vital signs and arrange for immediate transfer to a hospital.
Check the number of risperidone tablets left in the prescription bottle to see
whether there was an overdose.
and answers.
A nurse is assessing the therapeutic action of drugs classified as tumor necrosis
factor (TNF) inhibitors. What client response indicates to the nurse that a drug with
this classification is effective?
Continued remission in a client with ovarian cancer
Increased insulin production in a client with diabetes mellitus
Reduction of inflammatory joint pain in a client with rheumatoid arthritis
Vasodilation of coronary arteries in a client with ischemic heart disease - n
Ans ✔
Reduction of inflammatory joint pain in a client with rheumatoid arthritis
TNF is produced mainly by macrophages in synovium; over time, through various
mechanisms, the presence of TNF causes inflammation of synovium, destruction of
bone and cartilage, joint stiffness, and pain. TNF inhibitors or blockers neutralize
TNF, thereby interrupting the inflammatory cascade; this inhibits the inflammatory
response and other mechanisms, thereby slowing tissue damage. TNF inhibitors are
not prescribed for clients with ovarian cancer, diabetes mellitus, or ischemic heart
disease.
Qs
The nurse suspects serotonin syndrome in a client prescribed second-generation
antidepressants for depression. Which assessment findings observed by the nurse
would be beneficial in diagnosing the severity of the syndrome?
Delirium
,Hyperreflexia
Hyperthermia
Muscle spasms
Rhabdomyolysis - n
Ans ✔
Hyperthermia
Rhabdomyolysis
Serotonin syndrome is a potentially hazardous adverse effect of second-generation
antidepressants that are used to treat depression. Hyperthermia and
rhabdomyolysis are symptoms observed in severe cases of serotonin syndrome.
Delirium, hyperreflexia, and muscle spasms are common symptoms of this
syndrome.
Qs
A healthcare provider prescribes enoxaparin 30 mg subcutaneously daily. Which
measure would the nurse take when administering this medication?
Push over 2 minutes.
Administer in the abdomen.
Rub site after administration.
Remove air pocket from prepackaged syringe before administration. - n
Ans ✔
,Administer in the abdomen.
Enoxaparin specifically targets blood clots throughout the body and carries a lower
risk of hemorrhage than that associated with the drugs heparin and warfarin.
Enoxaparin is administered once a day through a subcutaneous injection site
around the naval. Enoxaparin should be injected into the fatty tissue only, which is
why the abdomen is the recommended injection site. Avoid administering in a
muscle. Manufacturer recommendations indicate the air pocket from prepackaged
syringes not be removed before administration. Rubbing the site is contraindicated,
as it can cause bruising. There are no recommendations to push this subcutaneous
medication over 2 minutes.
Qs
A client with cirrhosis of the liver and ascites has been taking chlorothiazide, a
thiazide diuretic. Why did the provider add spironolactone to the client's medication
regimen?
To stimulate sodium excretion
To help prevent potassium loss
To increase urine specific gravity
To reduce arterial blood pressure - n
Ans ✔
To help prevent potassium loss
Spironolactone is a potassium-sparing diuretic often used in conjunction with
thiazide diuretics. The provider was prompted to add spironolactone to the
chlorothiazide to prevent potassium loss. Both medications stimulate sodium
excretion. Both medications increase urine specific gravity and reduce arterial blood
pressure.
Qs
, A client with myasthenia gravis improves and is discharged from the hospital. The
discharge medications include pyridostigmine bromide 10 mg every 6 hours. The
nurse evaluates that the drug regimen is understood when the client makes which
statement?
"I will take the medication on an empty stomach."
"I need to set an alarm so I take the medication on time."
"It will be important to check my heart rate before taking the medication."
"I should monitor for an increase in blood pressure after taking the medication." - n
Ans ✔
"I need to set an alarm so I take the medication on time."
Pyridostigmine is a vital drug that must be taken on time; a missed or late dose can
result in severe respiratory and neuromuscular consequences or even death.
Pyridostigmine should be taken with a small amount of food to prevent gastric
irritation. It is unnecessary to take the pulse rate before taking pyridostigmine.
Pyridostigmine may cause hypotension, not hypertension, which is a sign of
cholinergic crisis.
Qs
A client has been taking 3 mg of risperidone twice a day for the past 8 days. At the
follow-up appointment, the client reports tremors, shortness of breath, a fever, and
sweating. What will the nurse do?
Call 911 and have the client transported to the nearest psychiatric unit.
Take the client's vital signs and arrange for immediate transfer to a hospital.
Check the number of risperidone tablets left in the prescription bottle to see
whether there was an overdose.
