PHARMACOLOGY HESI EXIT EXAM TEST
BANKQUESTIONS AND CORRECT ANSWERS WITH
RATIONALES AND DETAILED EXPLANATIONS LATEST
UPDATE
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 - ANS... -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.
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 - ANS... -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.
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 - ANS... -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.
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. - ANS... -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.
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 - ANS... -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
should assess for hypercalcemia while the client is taking this medication. Signs of
hypercalcemia include increased urine volume, excessive thirst, nausea, vomiting,
constipation, hypotonicity of muscles, and deep bone and flank pain.
A nurse is caring for a client with hyperparathyroidism and notes that the client's
serum calcium level is 13 mg/dL. Which medication should the nurse prepare to
administer as prescribed to the client?
1. Calcium chloride
2. Calcium gluconate
3. Calcitonin (Miacalcin)
4. Large doses of vitamin D - ANS... -3. Calcitonin (Miacalcin)
Rationale:
The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is experiencing
hypercalcemia. Calcium gluconate and calcium chloride are medications used for
the treatment of tetany, which occurs as a result of acute hypocalcemia. In
hypercalcemia, large doses of vitamin D need to be avoided. Calcitonin, a thyroid
hormone, decreases the plasma calcium level by inhibiting bone resorption and
lowering the serum calcium concentration.
Oral iron supplements are prescribed for a 6-year-old child with iron deficiency
anemia. The nurse instructs the mother to administer the iron with which best food
item?
1. Milk
2. Water
3. Apple juice
4. Orange juice - ANS... -4. Orange juice
Rationale:
Vitamin C increases the absorption of iron by the body. The mother should be
instructed to administer the medication with a citrus fruit or a juice that is high in
vitamin C. Milk may affect absorption of the iron. Water will not assist in
absorption. Orange juice contains a greater amount of vitamin C than apple juice.
, Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse
monitors the client, 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 - ANS... -1. Tinnitus
Rationale:
Salicylic acid is absorbed readily through the skin, and systemic toxicity
(salicylism) can result. Symptoms include tinnitus, dizziness, hyperpnea, and
psychological disturbances. Constipation and diarrhea are not associated with
salicylism.
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 - ANS... -4. At least 30 minutes
before exposure to the sun
Rationale:
Sunscreens are most effective when applied at least 30 minutes before exposure to
the sun so that they can penetrate the skin. All sunscreens should be reapplied after
swimming or sweating.
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 the 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 - ANS... -3. Informing
the client that this is normal
Rationale:
Mafenide acetate is bacteriostatic for gram-negative and gram-positive organisms
and is used to treat burns to reduce bacteria present in avascular tissues. The client
should be informed that the medication will cause local discomfort and burning
and that this is a normal reaction; therefore options 1, 2, and 4 are incorrect
BANKQUESTIONS AND CORRECT ANSWERS WITH
RATIONALES AND DETAILED EXPLANATIONS LATEST
UPDATE
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 - ANS... -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.
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 - ANS... -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.
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 - ANS... -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.
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. - ANS... -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.
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 - ANS... -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
should assess for hypercalcemia while the client is taking this medication. Signs of
hypercalcemia include increased urine volume, excessive thirst, nausea, vomiting,
constipation, hypotonicity of muscles, and deep bone and flank pain.
A nurse is caring for a client with hyperparathyroidism and notes that the client's
serum calcium level is 13 mg/dL. Which medication should the nurse prepare to
administer as prescribed to the client?
1. Calcium chloride
2. Calcium gluconate
3. Calcitonin (Miacalcin)
4. Large doses of vitamin D - ANS... -3. Calcitonin (Miacalcin)
Rationale:
The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is experiencing
hypercalcemia. Calcium gluconate and calcium chloride are medications used for
the treatment of tetany, which occurs as a result of acute hypocalcemia. In
hypercalcemia, large doses of vitamin D need to be avoided. Calcitonin, a thyroid
hormone, decreases the plasma calcium level by inhibiting bone resorption and
lowering the serum calcium concentration.
Oral iron supplements are prescribed for a 6-year-old child with iron deficiency
anemia. The nurse instructs the mother to administer the iron with which best food
item?
1. Milk
2. Water
3. Apple juice
4. Orange juice - ANS... -4. Orange juice
Rationale:
Vitamin C increases the absorption of iron by the body. The mother should be
instructed to administer the medication with a citrus fruit or a juice that is high in
vitamin C. Milk may affect absorption of the iron. Water will not assist in
absorption. Orange juice contains a greater amount of vitamin C than apple juice.
, Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse
monitors the client, 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 - ANS... -1. Tinnitus
Rationale:
Salicylic acid is absorbed readily through the skin, and systemic toxicity
(salicylism) can result. Symptoms include tinnitus, dizziness, hyperpnea, and
psychological disturbances. Constipation and diarrhea are not associated with
salicylism.
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 - ANS... -4. At least 30 minutes
before exposure to the sun
Rationale:
Sunscreens are most effective when applied at least 30 minutes before exposure to
the sun so that they can penetrate the skin. All sunscreens should be reapplied after
swimming or sweating.
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 the 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 - ANS... -3. Informing
the client that this is normal
Rationale:
Mafenide acetate is bacteriostatic for gram-negative and gram-positive organisms
and is used to treat burns to reduce bacteria present in avascular tissues. The client
should be informed that the medication will cause local discomfort and burning
and that this is a normal reaction; therefore options 1, 2, and 4 are incorrect
