HESI RN PHARMACOLOGY EXAM VERSION 1 200
QUESTIONS WITH COMPLETE AND VERIFIED
ANSWERS AND RATIONALE/A+ GRADE (NCLEX-RN)
1)/+A/+nurse/+is/+caring/+for/+a/+client/+with/+hyperparathyroidism/+and/+notes/+that/+the/+client's/+serum/+calcium/+le
vel/+is/+13/+mg/dL./+Which/+medication/+should/+the/+nurse/+prepare/+to/+administer/+as/+prescribed/+to/+the/+cli
ent?
1. Calcium/+chloride
2. Calcium/+gluconate
3. Calcitonin/+(Miacalcin)
4. Large/+doses/+of/+vitamin/+D
3./+Calcitonin/+(Miacalcin)/
+Rationale:
The/+normal/+serum/+calcium/+level/+is/+8.6/+to/+10.0/+mg/dL./+This/+client/+is/+experiencing/+hypercalcemia./+Calci
um/+gluconate/+and/+calcium/+chloride/+are/+medications/+used/+for/+the/+treatment/+of/+tetany,/+which/+occur
s/+as/+a/+result/+of/+acute/+hypocalcemia./+In/+hypercalcemia,/+large/+doses/+of/+vitamin/+D/+need/+to/+be/+avoided./+C
alcitonin,/+a/+thyroid/+hormone,/+decreases/+the/+plasma/+calcium/+level/+by/+inhibiting/+bone/+resorption/+and/
+lowering/+the/+serum/+calcium/+concentration.
2.) Oral/+iron/+supplements/+are/+prescribed/+for/+a/+6−year−old/+child/+with/+iron/+deficiency/+anemia./+The/+nu
rse/+instructs/+the/+mother/+to/+administer/+the/+iron/+with/+which/+best/+food/+item?
1. Milk
2. Water
3. Apple/+juice
4. Orange/+juice
4./+Orange/+juice/+Rational
e:
Vitamin/+C/+increases/+the/+absorption/+of/+iron/+by/+the/+body./+The/+mother/+should/+be/+instructed/+to/+adminis
ter/+the/+medication/+with/+a/+citrus/+fruit/+or/+a/+juice/+that/+is/+high/+in/+vitamin/+C./+Milk/+may/+affect/+absorptio
n/+of/+the/+iron./+Water/+will/+not/+assist/+in/+absorption./+Orange/+juice/+contains/+a/+greater/+amount/+of/+vitamin/+C/
+than/+apple/+juice.
3.) Salicylic/+acid/+is/+prescribed/+for/+a/+client/+with/+a/+diagnosis/+of/+psoriasis./+The/+nurse/+monitors/+the/+clie
nt,/+knowing/+that/+which/+of/+the/+following/+would/+indicate/+the/+presence/+of/+systemic/+toxicity/+from
/+this/+medication?
1. Tinnitus
2. Diarrhea
3. Constipation
4. Decreased/+respirations
1. Tinnitus
/+Rationale
:
, HESI RN PHARMACOLOGY EXAM VERSION 1 200
QUESTIONS WITH COMPLETE AND VERIFIED
ANSWERS AND RATIONALE/A+ GRADE (NCLEX-RN)
Salicylic/+acid/+is/+absorbed/+readily/+through/+the/+skin,/+and/+systemic/+toxicity/+(salicylism)/+can/+result./+Sympto
ms/+include/+tinnitus,/+dizziness,/+hyperpnea,/+and/+psychological/+disturbances./+Constipation/+and/+diarrhea/+a
re/+not/+associated/+with/+salicylism.
, HESI RN PHARMACOLOGY EXAM VERSION 1 200
QUESTIONS WITH COMPLETE AND VERIFIED
ANSWERS AND RATIONALE/A+ GRADE (NCLEX-RN)
4.) The/+camp/+nurse/+asks/+the/+children/+preparing/+to/+swim/+in/+the/+lake/+if/+they/+have/+applied/+sunscreen./+
The/+nurse/+reminds/+the/+children/+that/+chemical/+sunscreens/+are/+most/+effective/+when/+applied:
1. Immediately/+before/+swimming
2. 15/+minutes/+before/+exposure/+to/+the/+sun
3. Immediately/+before/+exposure/+to/+the/+sun
4. At/+least/+30/+minutes/+before/+exposure/+to/+the/+sun
4./+At/+least/+30/+minutes/+before/+exposure/+to/+the/+su
n/+Rationale:
Sunscreens/+are/+most/+effective/+when/+applied/+at/+least/+30/+minutes/+before/+exposure/+to/+the/+sun/+so/+that/+th
ey/+can/+penetrate/+the/+skin./+All/+sunscreens/+should/+be/+reapplied/+after/+swimming/+or/+sweating.
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/+th
e/+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
3./+Informing/+the/+client/+that/+this/+is/+normal/+Rationa
le:
Mafenide/+acetate/+is/+bacteriostatic/+for/+gram−negative/+and/+gram−positive/+organisms/+and/+is/+used/+to/+tr
eat/+burns/+to/+reduce/+bacteria/+present/+in/+avascular/+tissues./+The/+client/+should/+be/+informed/+that/+the/+medi
cation/+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/+inju
ry./+The/+nurse/+monitors/+the/+client,/+knowing/+that/+which/+of/+the/+following/+indicates/+that/+a/+systemic/+eff
ect/+has/+occurred?
1. Hyperventilation
2. Elevated/+blood/+pressure
3. Local/+pain/+at/+the/+burn/+site
4. Local/+rash/+at/+the/+burn/+site
1. Hyperventilation
/+Rationale:
Mafenide/+acetate/+is/+a/+carbonic/+anhydrase/+inhibitor/+and/+can/+suppress/+renal/+excretion/+of/+acid,/+there
by/+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/+expe
cted/+from/+the/+pain/+that/+occurs/+with/+a/+burn/+injury.
, HESI RN PHARMACOLOGY EXAM VERSION 1 200
QUESTIONS WITH COMPLETE AND VERIFIED
ANSWERS AND RATIONALE/A+ GRADE (NCLEX-RN)
7.) Isotretinoin/+is/+prescribed/+for/+a/+client/+with/+severe/+acne./+Before/+the/+administration/+of/+this/+medicati
on,/+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
2. Triglyceride/+level
Rationale:
/+
Isotretinoin/+can/+elevate/+triglyceride/+levels./+Blood/+triglyceride/+levels/+should/+be/+measured/+before/+tre
atment/+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/+iso
tretinoin./+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)
1. Vitamin/+A
/+Rationale:
Isotretinoin/+is/+a/+metabolite/+of/+vitamin/+A/+and/+can/+produce/+generalized/+intensification/+of/+isotretin
oin/+toxicity./+Because/+of/+the/+potential/+for/+increased/+toxicity,/+vitamin/+A/+supplements/+should/+be/+discon
tinued/+before/+isotretinoin/+therapy./+Options/+2,/+3,/+and/+4/+are/+not/+contraindicated/+with/+the/+use/+of/+is
otretinoin.
9.) The/+nurse/+is/+applying/+a/+topical/+corticosteroid/+to/+a/+client/+with/+eczema./+The/+nurse/+would/+monito
r/+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
2. Axilla
/+Rational
e:
Topical/+corticosteroids/+can/+be/+absorbed/+into/+the/+systemic/+circulation./+Absorption/+is/+higher/+from/+regio
ns/+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/+clien
t/+is/+taking/+azelaic/+acid/+(Azelex)./+Because/+of/+the/+medication/+prescription,/+the/+nurse/+would/+suspect/+t
QUESTIONS WITH COMPLETE AND VERIFIED
ANSWERS AND RATIONALE/A+ GRADE (NCLEX-RN)
1)/+A/+nurse/+is/+caring/+for/+a/+client/+with/+hyperparathyroidism/+and/+notes/+that/+the/+client's/+serum/+calcium/+le
vel/+is/+13/+mg/dL./+Which/+medication/+should/+the/+nurse/+prepare/+to/+administer/+as/+prescribed/+to/+the/+cli
ent?
1. Calcium/+chloride
2. Calcium/+gluconate
3. Calcitonin/+(Miacalcin)
4. Large/+doses/+of/+vitamin/+D
3./+Calcitonin/+(Miacalcin)/
+Rationale:
The/+normal/+serum/+calcium/+level/+is/+8.6/+to/+10.0/+mg/dL./+This/+client/+is/+experiencing/+hypercalcemia./+Calci
um/+gluconate/+and/+calcium/+chloride/+are/+medications/+used/+for/+the/+treatment/+of/+tetany,/+which/+occur
s/+as/+a/+result/+of/+acute/+hypocalcemia./+In/+hypercalcemia,/+large/+doses/+of/+vitamin/+D/+need/+to/+be/+avoided./+C
alcitonin,/+a/+thyroid/+hormone,/+decreases/+the/+plasma/+calcium/+level/+by/+inhibiting/+bone/+resorption/+and/
+lowering/+the/+serum/+calcium/+concentration.
2.) Oral/+iron/+supplements/+are/+prescribed/+for/+a/+6−year−old/+child/+with/+iron/+deficiency/+anemia./+The/+nu
rse/+instructs/+the/+mother/+to/+administer/+the/+iron/+with/+which/+best/+food/+item?
1. Milk
2. Water
3. Apple/+juice
4. Orange/+juice
4./+Orange/+juice/+Rational
e:
Vitamin/+C/+increases/+the/+absorption/+of/+iron/+by/+the/+body./+The/+mother/+should/+be/+instructed/+to/+adminis
ter/+the/+medication/+with/+a/+citrus/+fruit/+or/+a/+juice/+that/+is/+high/+in/+vitamin/+C./+Milk/+may/+affect/+absorptio
n/+of/+the/+iron./+Water/+will/+not/+assist/+in/+absorption./+Orange/+juice/+contains/+a/+greater/+amount/+of/+vitamin/+C/
+than/+apple/+juice.
3.) Salicylic/+acid/+is/+prescribed/+for/+a/+client/+with/+a/+diagnosis/+of/+psoriasis./+The/+nurse/+monitors/+the/+clie
nt,/+knowing/+that/+which/+of/+the/+following/+would/+indicate/+the/+presence/+of/+systemic/+toxicity/+from
/+this/+medication?
1. Tinnitus
2. Diarrhea
3. Constipation
4. Decreased/+respirations
1. Tinnitus
/+Rationale
:
, HESI RN PHARMACOLOGY EXAM VERSION 1 200
QUESTIONS WITH COMPLETE AND VERIFIED
ANSWERS AND RATIONALE/A+ GRADE (NCLEX-RN)
Salicylic/+acid/+is/+absorbed/+readily/+through/+the/+skin,/+and/+systemic/+toxicity/+(salicylism)/+can/+result./+Sympto
ms/+include/+tinnitus,/+dizziness,/+hyperpnea,/+and/+psychological/+disturbances./+Constipation/+and/+diarrhea/+a
re/+not/+associated/+with/+salicylism.
, HESI RN PHARMACOLOGY EXAM VERSION 1 200
QUESTIONS WITH COMPLETE AND VERIFIED
ANSWERS AND RATIONALE/A+ GRADE (NCLEX-RN)
4.) The/+camp/+nurse/+asks/+the/+children/+preparing/+to/+swim/+in/+the/+lake/+if/+they/+have/+applied/+sunscreen./+
The/+nurse/+reminds/+the/+children/+that/+chemical/+sunscreens/+are/+most/+effective/+when/+applied:
1. Immediately/+before/+swimming
2. 15/+minutes/+before/+exposure/+to/+the/+sun
3. Immediately/+before/+exposure/+to/+the/+sun
4. At/+least/+30/+minutes/+before/+exposure/+to/+the/+sun
4./+At/+least/+30/+minutes/+before/+exposure/+to/+the/+su
n/+Rationale:
Sunscreens/+are/+most/+effective/+when/+applied/+at/+least/+30/+minutes/+before/+exposure/+to/+the/+sun/+so/+that/+th
ey/+can/+penetrate/+the/+skin./+All/+sunscreens/+should/+be/+reapplied/+after/+swimming/+or/+sweating.
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/+th
e/+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
3./+Informing/+the/+client/+that/+this/+is/+normal/+Rationa
le:
Mafenide/+acetate/+is/+bacteriostatic/+for/+gram−negative/+and/+gram−positive/+organisms/+and/+is/+used/+to/+tr
eat/+burns/+to/+reduce/+bacteria/+present/+in/+avascular/+tissues./+The/+client/+should/+be/+informed/+that/+the/+medi
cation/+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/+inju
ry./+The/+nurse/+monitors/+the/+client,/+knowing/+that/+which/+of/+the/+following/+indicates/+that/+a/+systemic/+eff
ect/+has/+occurred?
1. Hyperventilation
2. Elevated/+blood/+pressure
3. Local/+pain/+at/+the/+burn/+site
4. Local/+rash/+at/+the/+burn/+site
1. Hyperventilation
/+Rationale:
Mafenide/+acetate/+is/+a/+carbonic/+anhydrase/+inhibitor/+and/+can/+suppress/+renal/+excretion/+of/+acid,/+there
by/+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/+expe
cted/+from/+the/+pain/+that/+occurs/+with/+a/+burn/+injury.
, HESI RN PHARMACOLOGY EXAM VERSION 1 200
QUESTIONS WITH COMPLETE AND VERIFIED
ANSWERS AND RATIONALE/A+ GRADE (NCLEX-RN)
7.) Isotretinoin/+is/+prescribed/+for/+a/+client/+with/+severe/+acne./+Before/+the/+administration/+of/+this/+medicati
on,/+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
2. Triglyceride/+level
Rationale:
/+
Isotretinoin/+can/+elevate/+triglyceride/+levels./+Blood/+triglyceride/+levels/+should/+be/+measured/+before/+tre
atment/+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/+iso
tretinoin./+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)
1. Vitamin/+A
/+Rationale:
Isotretinoin/+is/+a/+metabolite/+of/+vitamin/+A/+and/+can/+produce/+generalized/+intensification/+of/+isotretin
oin/+toxicity./+Because/+of/+the/+potential/+for/+increased/+toxicity,/+vitamin/+A/+supplements/+should/+be/+discon
tinued/+before/+isotretinoin/+therapy./+Options/+2,/+3,/+and/+4/+are/+not/+contraindicated/+with/+the/+use/+of/+is
otretinoin.
9.) The/+nurse/+is/+applying/+a/+topical/+corticosteroid/+to/+a/+client/+with/+eczema./+The/+nurse/+would/+monito
r/+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
2. Axilla
/+Rational
e:
Topical/+corticosteroids/+can/+be/+absorbed/+into/+the/+systemic/+circulation./+Absorption/+is/+higher/+from/+regio
ns/+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/+clien
t/+is/+taking/+azelaic/+acid/+(Azelex)./+Because/+of/+the/+medication/+prescription,/+the/+nurse/+would/+suspect/+t
