Pharmacology Hesi Practice 2
A client receives a prescription for esomeprazole (Nexium) for heartburn. Which finding in the
client's history should the nurse report to the healthcare provider before administering the
prescription?
Eats spicy food three times a week.
History of deep vein thrombosis.
Drinks 2 alcoholic beverages on weekends.
Family history of diabetes mellitus. ------- ✔ CORRECT ANSWER ✓✓History of deep vein
thrombosis.
A male client who is in the terminal stage of cancer is cared for at home by his family and
receives a prescription for morphine at a rate to control intractable pain. When the hospice
nurse visits, the client awakens, moans in severe pain, and asks for an increase in the morphine
dosage. After determining the client's respirations are 10 per minute, what is the best action for
the nurse to implement?
Titrate the morphine dose upward until the client has adequate pain relief.
Suggest to the family that they can also give the client ibuprofen, a non-narcotic analgesic.
Hold additional morphine until the client's respirations are at least 16 per minute.
Inform the client that an increased dose of morphine increases side effects without additional
pain control. ------- ✔ CORRECT ANSWER ✓✓Titrate the morphine dose upward until the client
has adequate pain relief.
A client with Paget's disease is started on calcitonin (Calcimar) 500 mcg subcutaneously daily.
During the initial treatment, what is the priority nursing action?
,Assess the injection site for inflammation.
Evaluate the client's level of pain.
Monitor the client's alkaline phosphatase levels.
Observe the client for signs of hypersensitivity. ------- ✔ CORRECT ANSWER ✓✓Observe the
client for signs of hypersensitivity.
A client is taking cyclosporine for renal allograft rejection prevention. After 9 months of drug
therapy, the nurse reviews laboratory data and notes that the blood urea nitrogen level is 36
mg/dl. What additional finding should the nurse identify?
Hypotension.
White blood cell count 10,000.
Creatinine 28 mg/dl.
Anaphylactic reaction. ------- ✔ CORRECT ANSWER ✓✓Creatinine 28 mg/dl.
The nurse receives a unit of blood from the blood bank for a postoperative client who is
currently in the X-ray department. What action should the nurse implement?
Return the blood to the blood bank for refrigeration within 30 minutes.
Hang the blood transfusion as soon as the client returns to the unit.
Store the blood bag in the nursing unit's refrigerator until the client returns.
Take the unit of blood to the X-ray department to initiate the transfusion. ------- ✔ CORRECT
ANSWER ✓✓Return the blood to the blood bank for refrigeration within 30 minutes.
Which side effects should the nurse monitor for a client who is receiving dexamethasone
(Decadron) following neurosurgery? (Select all that apply.)
Select all that apply
, Mood swings.
Decreased appetite.
Increased weight gain.
Serum glucose level of 65 mg/dl.
Delayed incisional wound healing.
Serum hemoglobin level of 9 mg/dl. ------- ✔ CORRECT ANSWER ✓✓Mood swings.
Increased weight gain.
Delayed incisional wound healing.
Serum hemoglobin level of 9 mg/dl.
A client is taking danazol (Danocrine) for endometriosis and calls the clinic nurse to complain of
a dark, swollen, and painful leg. What instructions should the nurse provide the client?
Wear support stockings.
Elevate both legs and apply heat.
Proceed to the closest emergency room.
Walk for 20 to 30 minutes to reduce muscle cramps. ------- ✔ CORRECT ANSWER ✓✓Proceed to
the closest emergency room.
A client asks the nurse to explain the meaning of a narrow therapeutic index of a medication.
What information should the nurse use to answer the question?
The onset of action for the medication occurs very quickly.
A small margin exists between safe and toxic plasma levels.
Bioavailability is significantly reduced by the first-pass effect.
Minimum dosage is needed for the medication to be effective. ------- ✔ CORRECT ANSWER ✓✓A
small margin exists between safe and toxic plasma levels.
A client receives a prescription for esomeprazole (Nexium) for heartburn. Which finding in the
client's history should the nurse report to the healthcare provider before administering the
prescription?
Eats spicy food three times a week.
History of deep vein thrombosis.
Drinks 2 alcoholic beverages on weekends.
Family history of diabetes mellitus. ------- ✔ CORRECT ANSWER ✓✓History of deep vein
thrombosis.
A male client who is in the terminal stage of cancer is cared for at home by his family and
receives a prescription for morphine at a rate to control intractable pain. When the hospice
nurse visits, the client awakens, moans in severe pain, and asks for an increase in the morphine
dosage. After determining the client's respirations are 10 per minute, what is the best action for
the nurse to implement?
Titrate the morphine dose upward until the client has adequate pain relief.
Suggest to the family that they can also give the client ibuprofen, a non-narcotic analgesic.
Hold additional morphine until the client's respirations are at least 16 per minute.
Inform the client that an increased dose of morphine increases side effects without additional
pain control. ------- ✔ CORRECT ANSWER ✓✓Titrate the morphine dose upward until the client
has adequate pain relief.
A client with Paget's disease is started on calcitonin (Calcimar) 500 mcg subcutaneously daily.
During the initial treatment, what is the priority nursing action?
,Assess the injection site for inflammation.
Evaluate the client's level of pain.
Monitor the client's alkaline phosphatase levels.
Observe the client for signs of hypersensitivity. ------- ✔ CORRECT ANSWER ✓✓Observe the
client for signs of hypersensitivity.
A client is taking cyclosporine for renal allograft rejection prevention. After 9 months of drug
therapy, the nurse reviews laboratory data and notes that the blood urea nitrogen level is 36
mg/dl. What additional finding should the nurse identify?
Hypotension.
White blood cell count 10,000.
Creatinine 28 mg/dl.
Anaphylactic reaction. ------- ✔ CORRECT ANSWER ✓✓Creatinine 28 mg/dl.
The nurse receives a unit of blood from the blood bank for a postoperative client who is
currently in the X-ray department. What action should the nurse implement?
Return the blood to the blood bank for refrigeration within 30 minutes.
Hang the blood transfusion as soon as the client returns to the unit.
Store the blood bag in the nursing unit's refrigerator until the client returns.
Take the unit of blood to the X-ray department to initiate the transfusion. ------- ✔ CORRECT
ANSWER ✓✓Return the blood to the blood bank for refrigeration within 30 minutes.
Which side effects should the nurse monitor for a client who is receiving dexamethasone
(Decadron) following neurosurgery? (Select all that apply.)
Select all that apply
, Mood swings.
Decreased appetite.
Increased weight gain.
Serum glucose level of 65 mg/dl.
Delayed incisional wound healing.
Serum hemoglobin level of 9 mg/dl. ------- ✔ CORRECT ANSWER ✓✓Mood swings.
Increased weight gain.
Delayed incisional wound healing.
Serum hemoglobin level of 9 mg/dl.
A client is taking danazol (Danocrine) for endometriosis and calls the clinic nurse to complain of
a dark, swollen, and painful leg. What instructions should the nurse provide the client?
Wear support stockings.
Elevate both legs and apply heat.
Proceed to the closest emergency room.
Walk for 20 to 30 minutes to reduce muscle cramps. ------- ✔ CORRECT ANSWER ✓✓Proceed to
the closest emergency room.
A client asks the nurse to explain the meaning of a narrow therapeutic index of a medication.
What information should the nurse use to answer the question?
The onset of action for the medication occurs very quickly.
A small margin exists between safe and toxic plasma levels.
Bioavailability is significantly reduced by the first-pass effect.
Minimum dosage is needed for the medication to be effective. ------- ✔ CORRECT ANSWER ✓✓A
small margin exists between safe and toxic plasma levels.
