HESI Pharmacology Practice Exam
A - ANS-After abdominal surgery, a male client is prescribed low molecular weight heparin.
during administration of the medication, the client asks the nurse why he is receiving this
medication. Which is the best response for the nurse to provide.
A. This medication is a blood thinner given to prevent blood clot formation
B. this medication enhances antibiotics to prevent infection
C. This medication dissolves any glots that develop int he legs
D. This abdominal injection assists in the healing of the abdominal wound
A.
Hypokalemia affects myocardial contractility, so (A) places this client at greatest risk for
dysrhythmias that may be unresponsive to drug therapy. Although an imbalance of serum
electrolytes, (B and C), can effect cardiac rhythm, the greatest risk for the client receiving
digoxin is (A). (D) does not cause any interactions related to digoxin therapy for supraventricular
tachycardia (SVT). - ANS-A client is receiving digoxin for the onset of supraventricular
tachycardia (SVT). Which laboratory findings should the nurse identify that places this client at
risk?
A) Hypokalemia.
B) Hyponatremia.
C) Hypercalcemia.
D) Low uric acid levels.
A.
Rash (A) is the most common adverse effect of all penicillins, indicating an allergy to the
medication which could result in anaphylactic shock, a medical emergency. (B, C, and D) are
common side effects of penicillins that should subside after the body adjusts to the medication.
These would not require immediate medical care unless the symptoms persist beyond the first
few days or become extremely severe. - ANS-A client is receiving ampicillin sodium (Omnipen)
for a sinus infection. The nurse should instruct the client to notify the healthcare provider
immediately if which symptom occurs?
A) Rash.
B) Nausea.
C) Headache.
D) Dizziness.
A.
Scopolamine, an anticholinergic agent, is used to prevent motion sickness and has a peak
onset in 6 hours, so the client should be instructed to apply the patch at least 4 hours before
departure (A) on the cruise ship. The duration of the transdermal patch is 72 hours, so (B) is not
needed. Scolopamine blocks muscarinic receptors in the inner ear and to the vomiting center,
so the best application site of the patch is behind the ear, not at the base of the skull (C).
,Anticholinergic medications are CNS depressants, so the client should be instructed to avoid
alcohol (D) while using the patch. - ANS-An adult client is given a prescription for a scopolamine
patch (Transderm Scop) to prevent motion sickness while on a cruise. Which information should
the nurse provide to the client?
A) Apply the patch at least 4 hours prior to departure.
B) Change the patch every other day while on the cruise.
C) Place the patch on a hairless area at the base of the skull.
D) Drink no more than 2 alcoholic drinks during the cruise.
A.
Solu-Medrol is a corticosteroid with glucocorticoid and mineralocorticoid actions. These effects
can lead to hyperglycemia (A), which is reflected as an increase in the serum glucose value.
The client taking Solu-Medrol is at risk for hypocalcemia (B) and hypokalemia (D), which result
in a decrease, not an increase, in the serum calcium and serum potassium levels. This
medication does not adversely affect the RBC count (C). - ANS-A client is receiving
methylprednisolone (Solu-Medrol) 40 mg IV daily. The nurse anticipates an increase in which
laboratory value as the result of this medication?
A) Serum glucose.
B) Serum calcium.
C) Red blood cells.
D) Serum potassium.
A.
The nurse should first withhold the scheduled dose of Cozaar (A) because the client is
hyperkalemic (normal range 3.5 to 5 mEq/L). Although hypokalemia is usually associated with
diuretic therapy in heart failure, hyperkalemia is associated with several heart failure
medications, including ARBs. Because hyperkalemia may lead to cardiac dysrhythmias, the
nurse should check the apical pulse for rate and rhythm (B), and the blood pressure. Before
repeating the serum study (D), the nurse should notify the healthcare provider (C) of the
findings. - ANS-The nurse is preparing the 0900 dose of losartan (Cozaar), an angiotensin II
receptor blocker (ARB), for a client with hypertension and heart failure. The nurse reviews the
client's laboratory results and notes that the client's serum potassium level is 5.9 mEq/L. What
action should the nurse take first?
A) Withhold the scheduled dose.
B) Check the client's apical pulse.
C) Notify the healthcare provider.
D) Repeat the serum potassium level.
A.
Drugs classified in the category X place a client who is in the first trimester of pregnancy at risk
for teratogenesis, so women in the childbearing years should be counseled to use a reliable
form of birth control (A) during drug therapy. (B) is not a specific precaution with Category X
drugs. The client should be encouraged to discuss plans for pregnancy with the healthcare
provider, so a safer alternative prescription (C) can be provided if pregnancy occurs. Although
, the risk of birth defects during pregnancy explains the restriction of these drugs during
pregnancy, (D) is not indicated. - ANS-A category X drug is prescribed for a young adult female
client. Which instruction is most important for the nurse to teach this client?
A) Use a reliable form of birth control.
B) Avoid exposure to ultra violet light.
C) Refuse this medication if planning pregnancy.
D) Abstain from intercourse while on this drug.
A.
The first-pass effect is a pharmacokinetic phenomenon that is related to the drug's metabolism
in the liver. After oral (A) medications are absorbed from the gastrointestinal tract, the drug is
carried directly to the liver via the hepatic portal circulation where hepatic inactivation occurs
and reduces the bioavailability of the drug. Alternative method of administration, such as
sublingual (B), IV (C), and subcutaneous (D) routes, avoid this first-pass effect. - ANS-Which
method of medication administration provides the client with the greatest first-pass effect?
A) Oral.
B) Sublingual.
C) Intravenous.
D) Subcutaneous.
A. - ANS-A client is being treated for osteoporosis with alendronate (fosamax), and the nurse
has completed discharge teaching regarding medication administration. Which morning
schedule would indicated to the nurse that the client teaching has been effective?
A. take medication, go for a30 minutes morning walk, then eat breakfast
B. take med, rest in bed for 30 min., eat breakfast, go for morning walk
C. take medication with breakfast, then take a 30 minute morning walk
D. go for a 30minute morning walk, eat breakfast, then take the med
A. Cross-allergies exist between penicillins and cephalosporines, such as keflex. so checking
for penicillin allergy is a wise precaution - ANS-A healthcare provider prescrives cephalexin
monhydrate (Keflex) for a client with a postoperative infection. It is most important for the nurse
to assess for what additional drug allergy before administering this prescription?
A. Penicillins
B. Aminoglycosides
C. Erythromycins
D.Sulfonamides
A. Cytotec, a synthetic form of prostaglandin, is classified as pregnancy category X and can act
as an abortifacient, so the client should be instructed to use contraception during intercourse to
prevent loss of early pregnancy - ANS-A female client with RA takes ibuprofen (motrin) 600mg
PO 4xday. To preven GI bleeding, misoprostol (cytotec) 100mcg PO is prescribed. Which
information is most important for the nurse to include in client teaching?
A. use contraception during intercourse
B. ensure the cytotec is taken on an empty stomach
A - ANS-After abdominal surgery, a male client is prescribed low molecular weight heparin.
during administration of the medication, the client asks the nurse why he is receiving this
medication. Which is the best response for the nurse to provide.
A. This medication is a blood thinner given to prevent blood clot formation
B. this medication enhances antibiotics to prevent infection
C. This medication dissolves any glots that develop int he legs
D. This abdominal injection assists in the healing of the abdominal wound
A.
Hypokalemia affects myocardial contractility, so (A) places this client at greatest risk for
dysrhythmias that may be unresponsive to drug therapy. Although an imbalance of serum
electrolytes, (B and C), can effect cardiac rhythm, the greatest risk for the client receiving
digoxin is (A). (D) does not cause any interactions related to digoxin therapy for supraventricular
tachycardia (SVT). - ANS-A client is receiving digoxin for the onset of supraventricular
tachycardia (SVT). Which laboratory findings should the nurse identify that places this client at
risk?
A) Hypokalemia.
B) Hyponatremia.
C) Hypercalcemia.
D) Low uric acid levels.
A.
Rash (A) is the most common adverse effect of all penicillins, indicating an allergy to the
medication which could result in anaphylactic shock, a medical emergency. (B, C, and D) are
common side effects of penicillins that should subside after the body adjusts to the medication.
These would not require immediate medical care unless the symptoms persist beyond the first
few days or become extremely severe. - ANS-A client is receiving ampicillin sodium (Omnipen)
for a sinus infection. The nurse should instruct the client to notify the healthcare provider
immediately if which symptom occurs?
A) Rash.
B) Nausea.
C) Headache.
D) Dizziness.
A.
Scopolamine, an anticholinergic agent, is used to prevent motion sickness and has a peak
onset in 6 hours, so the client should be instructed to apply the patch at least 4 hours before
departure (A) on the cruise ship. The duration of the transdermal patch is 72 hours, so (B) is not
needed. Scolopamine blocks muscarinic receptors in the inner ear and to the vomiting center,
so the best application site of the patch is behind the ear, not at the base of the skull (C).
,Anticholinergic medications are CNS depressants, so the client should be instructed to avoid
alcohol (D) while using the patch. - ANS-An adult client is given a prescription for a scopolamine
patch (Transderm Scop) to prevent motion sickness while on a cruise. Which information should
the nurse provide to the client?
A) Apply the patch at least 4 hours prior to departure.
B) Change the patch every other day while on the cruise.
C) Place the patch on a hairless area at the base of the skull.
D) Drink no more than 2 alcoholic drinks during the cruise.
A.
Solu-Medrol is a corticosteroid with glucocorticoid and mineralocorticoid actions. These effects
can lead to hyperglycemia (A), which is reflected as an increase in the serum glucose value.
The client taking Solu-Medrol is at risk for hypocalcemia (B) and hypokalemia (D), which result
in a decrease, not an increase, in the serum calcium and serum potassium levels. This
medication does not adversely affect the RBC count (C). - ANS-A client is receiving
methylprednisolone (Solu-Medrol) 40 mg IV daily. The nurse anticipates an increase in which
laboratory value as the result of this medication?
A) Serum glucose.
B) Serum calcium.
C) Red blood cells.
D) Serum potassium.
A.
The nurse should first withhold the scheduled dose of Cozaar (A) because the client is
hyperkalemic (normal range 3.5 to 5 mEq/L). Although hypokalemia is usually associated with
diuretic therapy in heart failure, hyperkalemia is associated with several heart failure
medications, including ARBs. Because hyperkalemia may lead to cardiac dysrhythmias, the
nurse should check the apical pulse for rate and rhythm (B), and the blood pressure. Before
repeating the serum study (D), the nurse should notify the healthcare provider (C) of the
findings. - ANS-The nurse is preparing the 0900 dose of losartan (Cozaar), an angiotensin II
receptor blocker (ARB), for a client with hypertension and heart failure. The nurse reviews the
client's laboratory results and notes that the client's serum potassium level is 5.9 mEq/L. What
action should the nurse take first?
A) Withhold the scheduled dose.
B) Check the client's apical pulse.
C) Notify the healthcare provider.
D) Repeat the serum potassium level.
A.
Drugs classified in the category X place a client who is in the first trimester of pregnancy at risk
for teratogenesis, so women in the childbearing years should be counseled to use a reliable
form of birth control (A) during drug therapy. (B) is not a specific precaution with Category X
drugs. The client should be encouraged to discuss plans for pregnancy with the healthcare
provider, so a safer alternative prescription (C) can be provided if pregnancy occurs. Although
, the risk of birth defects during pregnancy explains the restriction of these drugs during
pregnancy, (D) is not indicated. - ANS-A category X drug is prescribed for a young adult female
client. Which instruction is most important for the nurse to teach this client?
A) Use a reliable form of birth control.
B) Avoid exposure to ultra violet light.
C) Refuse this medication if planning pregnancy.
D) Abstain from intercourse while on this drug.
A.
The first-pass effect is a pharmacokinetic phenomenon that is related to the drug's metabolism
in the liver. After oral (A) medications are absorbed from the gastrointestinal tract, the drug is
carried directly to the liver via the hepatic portal circulation where hepatic inactivation occurs
and reduces the bioavailability of the drug. Alternative method of administration, such as
sublingual (B), IV (C), and subcutaneous (D) routes, avoid this first-pass effect. - ANS-Which
method of medication administration provides the client with the greatest first-pass effect?
A) Oral.
B) Sublingual.
C) Intravenous.
D) Subcutaneous.
A. - ANS-A client is being treated for osteoporosis with alendronate (fosamax), and the nurse
has completed discharge teaching regarding medication administration. Which morning
schedule would indicated to the nurse that the client teaching has been effective?
A. take medication, go for a30 minutes morning walk, then eat breakfast
B. take med, rest in bed for 30 min., eat breakfast, go for morning walk
C. take medication with breakfast, then take a 30 minute morning walk
D. go for a 30minute morning walk, eat breakfast, then take the med
A. Cross-allergies exist between penicillins and cephalosporines, such as keflex. so checking
for penicillin allergy is a wise precaution - ANS-A healthcare provider prescrives cephalexin
monhydrate (Keflex) for a client with a postoperative infection. It is most important for the nurse
to assess for what additional drug allergy before administering this prescription?
A. Penicillins
B. Aminoglycosides
C. Erythromycins
D.Sulfonamides
A. Cytotec, a synthetic form of prostaglandin, is classified as pregnancy category X and can act
as an abortifacient, so the client should be instructed to use contraception during intercourse to
prevent loss of early pregnancy - ANS-A female client with RA takes ibuprofen (motrin) 600mg
PO 4xday. To preven GI bleeding, misoprostol (cytotec) 100mcg PO is prescribed. Which
information is most important for the nurse to include in client teaching?
A. use contraception during intercourse
B. ensure the cytotec is taken on an empty stomach
