PHARMACOLOGY HESI ACTUAL EXAM QUESTIONS 2024 (55 Q&A)

1. A male client who has been taking a high dose of a nonsteroidal anti-inflammatory drug (NSAID) comes to the clinic complaining of gastric pain and blood in his stool. The healthcare provider discontinues the NSAIDs and prescribes esomeprazole. Which information should the client include in the nurse’s teaching plan? A. Once pain subsides, NSAID therapy can be continued B. Resume a diet that consists of milk, cream, and bland foods C. Notify the healthcare provider of the passage of black stool D. Call the clinic if diarrhea or headache occur when taking esomeprazole Answer: C. Notify the healthcare provider of the passage of black stool 2. When administering zolpidem to an older client, which computer documentation indicates that the desired outcome has been achieved? A. Sleeps soundly through the night B. Decreased episodes of incontinence C. Exhibits fewer emotional outburst D. Improved ability to concentrate Answer: A. Sleeps soundly through the night 3. A male client with a fungal infection of the toenail reports to the nurse that he has been applying an over-the-counter triple antibiotic ointment to the infection daily for two weeks without any improvement. Which action should the nurse take? A. Instruct the client to obtain a prescription for oral terbinafine B. Suggest that the client use the ointment twice a day to be more effective C. Reassure that the treatment of fungus-infected toenails often takes several months D. Advise the client to obtain a prescription-strength formulation of the ointment Answer: A. Instruct the client to obtain a prescription for oral terbinafine 4. A client with a nasogastric tube (NGT) has a prescription for sucralfate. The liquid form of the medication is not currently available in the pharmacy and tablets have been delivered to the medication dispensing system. Which action should the nurse include when administering the medication? A. Crush the tablet and mix it with water separately from other medications B. Crush the tablet and mix it with other crushed tablets diluted in water C. Withhold the medication until a liquid form is available on the nursing unit D. Crush the tablet and mix it with other liquid medications for administration Answer: A. Crush the tablet and mix it with water separately from other medications 5. A client with chronic asthma receives a prescription for montelukast, a leukotriene modifier. Which statement by the client indicates to the nurse that medication teaching was effective? A. I should take this medication only when I am having an asthma attack B. I will take the tablet every evening to control my asthma C. This medication will stop an asthma attack immediately D. I will not need to use my inhalers twice a day when I start this medication Answer: B. I will take the tablet every evening to control my asthma 6. The nurse is planning to administer the antiulcer GI agent sucralfate to a client with peptic ulcer disease. Which action should the nurse include in this client’s plan of care? A. Assess for secondary Candida infection B. Administer sucralfate once a day, preferably at bedtime C. Give sucralfate on an empty stomach D. Monitor for electrolyte imbalance Answer: C. Give sucralfate once a day, preferably at bedtime lOMoAR cPSD| 7. A client with anemia secondary to chronic kidney disease (CKD) started a prescription for epoetin alfa two months ago. Which client finding best indicates that the medication is effective? A. Reports of increased energy levels and decreased fatigue B. Takes concurrent iron therapy without adverse effects C. Food diary shows increased consumption of iron-rich foods D. Hemoglobin level increased to 12 grams/dL (120 mmol/L) Answer: D. Hemoglobin level increased to 12 grams/dL (120 mmol/L) 8. The healthcare provider prescribes propylthiouracil (PTU) and Lugol’s solution, a strong idoine solution, for a client with hyperthyroidism. How should the nurse schedule the administration of these medications? A. Administer iodine one hour before PTU B. Offer both drugs together with a meal C. Schedule both medications at bedtime D. Give parental dose once every 24 hours Answer: B. Offer both drugs together with a meal 9. Twenty minutes after the nurse starts a secondary IV infusion of cefepime 2 grams using an infusion pump to deliver the dose in one hour, the client reports feeling nauseated. Which action should the nurse implement? A. Continue the infusion and administer a PRN antiemetic prescription B. Stop the medication infusion and notify the healthcare provider of the adverse effect C. Reassure the client that the nausea us not related to the IV infusion D. Increase the rate of the infusion to complete the dose of the medication more rapidly Answer: A. Continue the infusion and administer a PRN antiemetic prescription 10. A client with diabetic peripheral neuropathy, who has been taking pregabalin for 2 weeks reports diminished foot pain. The nurse notes that there is no improvement in the healing of several toe ulcerations. Which action should the nurse take? A. Review the plan of care for strategies used to manage the foot ulcerations B. Reassure the client that diabetic foot ulcers take several months to heal C. Explain that the medication dosage will probably need to be increased D. Withhold the next dose of the drug until the healthcare provider is notified Answer: A. Review the plan of care for strategies used to manage the foot ulcerations 11. A client with type 2 diabetes mellitus who takes glimepiride by mouth daily calls the nurse to report a recent onset of nausea, vomiting and diarrhea. Which response should the nurse provide? A. Increases oral fluid intake until these symptoms subside. B. Use insulin sliding scale until symptoms are resolved C. Schedule a visit for evaluation by the healthcare provider D. Return to the clinic for laboratory test for an infection Answer: A. Increases oral fluid intake until these symptoms subside. 12. The healthcare provider increases a client’s prescription for glipizide 5mg to glipizide 7.5 mg by mouth every 12 hours. The medication is available in 5 mg scored tablets. How many tablets should the nurse administer with each dose? Answer: 1.5 13. The nurse is administering the muscle relaxant baclofen PO to a client diagnosed with multiple sclerosis. Which interventions should the nurse implement? A. Advise the client to move slowly and cautiously when rising and walking B. Ensure the client knows to stop baclofen before using other antispasmodics C. Monitor intake and output every 8 hours D. Evaluate muscle strength every 4 hours Answer: D. Evaluate muscle strength every 4 hours lOMoAR cPSD| 14. The nurse retrieves hydromorphone 4 mg/ml from the Pyxis Medstation, an automated dispensing system, for a client who is receiving hydromorphone 3 mg IM every 8 hours PRN severe pain. How many mL should the nurse administer to the client? (Round to the nearest tenth) Answer: 0.8 15. When conducting a drug education about an oral prescription for cyclosporine, which juice should the nurse instruct the client to avoid because it can increase the serum cyclosporine levels? A. Apple B. Grape C. Grapefruit D. Orange Answer: C. Grapefruit 16. A patient with hepatic encephalopathy is receiving lactulose. Which assessment provides the nurse with the best information to evaluate the client’s therapeutic response to the drug? A. Serum electrolyte and ammonia B. Stool color and character C. Fingerstick glucose D. Serum Hepatic enzymes Answer: B. Stool color and character 17. A client is recieving morphine sulfate via a PCA pump postoperatively. Which assessment finding should prompt the nurse to administer a prescribed PRN dose of naloxone? A. Respiratory rate of 7 breaths/minute B. Pulse oximeter reading of 89% on room air C. Expresses that they cannot get enough air to breathe D. Intercostal retractions and bilateral wheezing on auscultation Answer: A. Respiratory rate of 7 breaths/minute 18. The nurse is providing instructions about a client’s new medications. how should the nurse explain the purpose of probenecid, a uricosuric drug? A. Promotes excretion of uric acid in the urine B. Increases the strength of the urine stream C. Prevents the formation of kidney stones D. Decreases pain and burning during urination Answer: A. Promotes excretion of uric acid in the urine 19. A female client who has trichomoniasis vaginitis receives a prescription for metronidazole. Which instruction should the nurse provide this client? A. Urine may turn an orange color B. Report any difficulty with hearing C. Male partners must also be treated D. Take the medication only when symptomatic Answer: C. Male partners must also be treated 20. After receiving five doses of filgrastim the nurse notes that the client’s white blood cell count has increased from 2500/mm (2.5* 10/LSI) to 5,000/mm(5* 10/LSI). What action should the nurse implement? A. Assess the client’s vital signs B. Implement neutropenic precautions C. Review the client’s culture and sensitivity reports D. Inform the client that the medication has been effective Answer: B. Implement neutropenic precautions lOMoAR cPSD| 21. The nurse is preparing a discharge teaching plan for a client who is taking ciprofloxacin hydrochloride (Cipro) tablets, which were prescribed because of suspected anthrax exposure. Which instructions should be included in the teaching plan? (Select all that apply) A. Increase fluid intake while taking the medication B. Crush and mix the tablets with pudding if you have trouble swallowing the tablets C. Use NSAIDs to relieve mild joint aches and pains caused by the medication D. Report any tendon pain or swelling to the HCP immediately E. Limit exposure to sunlight and avoid tanning beds Answers: A, D, and E 22. A client with chronic lower back pain has been taking the non-steroidal anti-inflammatory drug (NSAID) ibuprofen, by mouth twice a day for several months. Which assessment is most important for the nurse to complete? A. Assess back pain using numeric scale B. Palpate volume of pedal pulses C. Determine presence of abdominal pain D. Evaluate ongoing sleep patterns Answer: C. Determine presence of abdominal pain 23. A 48 year-old male client tells the nurse that he obtained sildenafil without a prescription over the internet and asks the nurse if it is safe to take. In addition to advising the client to obtain medical evaluation. It is important that the nurse immediately determine if he takes what other type of medication? A. Anticoagulants, such as warfarin B. Statins, such as atorvastatin C. Nitrates, such as nitroglycerine D. Analgesics, such as acetaminophen Answer: C. Nitrates, such as nitroglycerine 24. A client recently diagnosed with early stage Alzheimer's disease receives a prescription for donepezil, an acetylcholinesterase inhibitor. Which content should the nurse include in the client medication teaching? A. Discuss the fact that Aricept may slow the progression of the disease over the next year. B. Instruct the client to get monthly liver function studies to assess for liver failure C. Encourage the client to avoid foods high in Vitamin K, such as green leafy vegetables D. Explain that the psychiatrist has prescribed the maximum dose and will decrease it gradually Answer: A. Discuss the fact that Aricept may slow the progression of the disease over the next year 25. The nurse is planning care for a client with major depression who is receiving a new prescription for duloxetine. Which information is most important for the nurse to obtain? A. Liver function laboratory results B. Family history of mental illness C. Recent use of other antidepressants D. Weight change in the last month Answer: A. Liver function laboratory results 26. The nurse is preparing a client with COPD and a chronic productive cough for discharged home. Which prescribed medication should the nurse review with the client to manage this symptom A. Tiotropium B. Salmeterol C. Prednisone D. Guaifenesin Answer: D. Guaifenesin