HESI PHARMACOLOGY FINAL EXAM III SELL
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1. A healthcare provider prescribes cephalexin monohydrate (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. - ANSWER-A) Penicillins.
Cross-allergies exist between penicillins (A) and cephalosporins, such
as cephalexin monohydrate (Keflex), so checking for penicillin allergy
is a wise precaution before administering this drug.
2. Which nursing intervention is most important when caring for a client
receiving the antimetabolite cytosine arabinoside (Arc-C) for
chemotherapy?
A) Hydrate the client with IV fluids before and after infusion.
B) Assess the client for numbness and tingling of extremities.
C) Inspect the client's oral mucosa for ulcerations.
D) Monitor the client's urine pH for increased acidity. - ANSWER-C)
Inspect the client's oral mucosa for ulcerations.
Cytosine arabinoside (Arc-C) affects the rapidly growing cells of the
body, therefore stomatitis and mucosal ulcerations are key signs of
antimetabolite toxicity (C). (A, B, and D) are not typical interventions
associated with the administration of antimetabolites.
3. When assessing an adolescent who recently overdosed on
acetaminophen (Tylenol), it is most important for the nurse to assess
for pain in which area of the body?
A) Flank.
, B) Abdomen.
C) Chest.
D) Head. - ANSWER-B) Abdomen.
Acetaminophen toxicity can result in liver damage; therefore, it is
especially important for the nurse to assess for pain in the right upper
quadrant of the abdomen (B), which might indicate liver damage. (A,
C, and D) are not areas where pain would be anticipated.
4. 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. -
ANSWER-A) Apply the patch at least 4 hours prior to departure.
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.
5. The nurse is reviewing the use of the patient-controlled analgesia
(PCA) pump with a client in the immediate postoperative period. The
client will receive morphine 1 mg IV per hour basal rate with 1 mg IV
every 15 minutes per PCA to total 5 mg IV maximally per hour. What
assessment has the highest priority before initiating the PCA pump?
A) The expiration date on the morphine syringe in the pump.
B) The rate and depth of the client's respirations.
C) The type of anesthesia used during the surgical procedure.
, D) The client's subjective and objective signs of pain. - ANSWER-B)
The rate and depth of the client's respirations.
A life-threatening side effect of intravenous administration of
morphine sulfate, an opiate narcotic, is respiratory depression (B). The
PCA pump should be stopped and the healthcare provider notified if
the client's respiratory rate falls below 12 breaths per minute, and the
nurse should anticipate adjustments in the client's dosage before the
PCA pump is restarted. (A, C, and D) provide helpful information, but
are not as high a priority as the assessment described in (B).
6. A medication that is classified as a beta-1 agonist is most commonly
prescribed for a client with which condition?
A) Glaucoma.
B) Hypertension.
C) Heart failure.
D) Asthma. - ANSWER-C) Heart failure.
Beta-1 agonists improve cardiac output by increasing the heart rate
and blood pressure and are indicated in heart failure (C), shock,
atrioventricular block dysrhythmias, and cardiac arrest. Glaucoma (A)
is managed using adrenergic agents and beta-adrenergic blocking
agents. Beta-1 blocking agents are used in the management of
hypertension (B). Medications that stimulate beta-2 receptors in the
bronchi are effective for bronchoconstriction in respiratory disorders,
such as asthma (D).
7. A female client with rheumatoid arthritis take ibuprofen (Motrin) 600
mg PO 4 times a day. To prevent gastrointestinal bleeding, misoprostol
(Cytotec) 100 mcg 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.
C) Encourage oral fluid intake to prevent constipation.
D) Take Cytotec 30 minutes prior to Motrin. - ANSWER-A) Use
contraception during intercourse.
, Cytotec, a synthetic form of a prostaglandin, is classified as pregnancy
Category X and can act as an abortifacient, so the client should be
instructed to use contraception during intercourse (A) to prevent loss
of an early pregnancy. (B) is not necessary. A common side effect of
Cytotec is diarrhea, so constipation prevention strategies are usually
not needed (C). Cytotec and Motrin should be taken together (D) to
provide protective properties against gastrointestinal bleeding.
8. A client with heart failure is prescribed spironolactone (Aldactone).
Which information is most important for the nurse to provide to the
client about diet modifications?
A) Do not add salt to foods during preparation.
B) Refrain for eating foods high in potassium.
C) Restrict fluid intake to 1000 ml per day.
D) Increase intake of milk and milk products. - ANSWER-B) Refrain
for eating foods high in potassium.
Spironolactone (Aldactone), an aldosterone antagonist, is a potassium-
sparing diuretic, so a diet high in potassium should be avoided (B),
including potassium salt substitutes, which can lead to hyperkalemia.
Although (A) is a common diet modification in heart failure, the risk of
hyperkalemia is more important with Aldactone. Restriction of fluids
(C) or increasing milk and milk products (D) are not indicated with this
prescription.
9. In evaluating the effects of lactulose (Cephulac), which outcome
should indicate that the drug is performing as intended?
A) An increase in urine output.
B) Two or three soft stools per day.
C) Watery, diarrhea stools.
D) Increased serum bilirubin. - ANSWER-B) Two or three soft stools
per day.
MORE
1. A healthcare provider prescribes cephalexin monohydrate (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. - ANSWER-A) Penicillins.
Cross-allergies exist between penicillins (A) and cephalosporins, such
as cephalexin monohydrate (Keflex), so checking for penicillin allergy
is a wise precaution before administering this drug.
2. Which nursing intervention is most important when caring for a client
receiving the antimetabolite cytosine arabinoside (Arc-C) for
chemotherapy?
A) Hydrate the client with IV fluids before and after infusion.
B) Assess the client for numbness and tingling of extremities.
C) Inspect the client's oral mucosa for ulcerations.
D) Monitor the client's urine pH for increased acidity. - ANSWER-C)
Inspect the client's oral mucosa for ulcerations.
Cytosine arabinoside (Arc-C) affects the rapidly growing cells of the
body, therefore stomatitis and mucosal ulcerations are key signs of
antimetabolite toxicity (C). (A, B, and D) are not typical interventions
associated with the administration of antimetabolites.
3. When assessing an adolescent who recently overdosed on
acetaminophen (Tylenol), it is most important for the nurse to assess
for pain in which area of the body?
A) Flank.
, B) Abdomen.
C) Chest.
D) Head. - ANSWER-B) Abdomen.
Acetaminophen toxicity can result in liver damage; therefore, it is
especially important for the nurse to assess for pain in the right upper
quadrant of the abdomen (B), which might indicate liver damage. (A,
C, and D) are not areas where pain would be anticipated.
4. 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. -
ANSWER-A) Apply the patch at least 4 hours prior to departure.
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.
5. The nurse is reviewing the use of the patient-controlled analgesia
(PCA) pump with a client in the immediate postoperative period. The
client will receive morphine 1 mg IV per hour basal rate with 1 mg IV
every 15 minutes per PCA to total 5 mg IV maximally per hour. What
assessment has the highest priority before initiating the PCA pump?
A) The expiration date on the morphine syringe in the pump.
B) The rate and depth of the client's respirations.
C) The type of anesthesia used during the surgical procedure.
, D) The client's subjective and objective signs of pain. - ANSWER-B)
The rate and depth of the client's respirations.
A life-threatening side effect of intravenous administration of
morphine sulfate, an opiate narcotic, is respiratory depression (B). The
PCA pump should be stopped and the healthcare provider notified if
the client's respiratory rate falls below 12 breaths per minute, and the
nurse should anticipate adjustments in the client's dosage before the
PCA pump is restarted. (A, C, and D) provide helpful information, but
are not as high a priority as the assessment described in (B).
6. A medication that is classified as a beta-1 agonist is most commonly
prescribed for a client with which condition?
A) Glaucoma.
B) Hypertension.
C) Heart failure.
D) Asthma. - ANSWER-C) Heart failure.
Beta-1 agonists improve cardiac output by increasing the heart rate
and blood pressure and are indicated in heart failure (C), shock,
atrioventricular block dysrhythmias, and cardiac arrest. Glaucoma (A)
is managed using adrenergic agents and beta-adrenergic blocking
agents. Beta-1 blocking agents are used in the management of
hypertension (B). Medications that stimulate beta-2 receptors in the
bronchi are effective for bronchoconstriction in respiratory disorders,
such as asthma (D).
7. A female client with rheumatoid arthritis take ibuprofen (Motrin) 600
mg PO 4 times a day. To prevent gastrointestinal bleeding, misoprostol
(Cytotec) 100 mcg 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.
C) Encourage oral fluid intake to prevent constipation.
D) Take Cytotec 30 minutes prior to Motrin. - ANSWER-A) Use
contraception during intercourse.
, Cytotec, a synthetic form of a prostaglandin, is classified as pregnancy
Category X and can act as an abortifacient, so the client should be
instructed to use contraception during intercourse (A) to prevent loss
of an early pregnancy. (B) is not necessary. A common side effect of
Cytotec is diarrhea, so constipation prevention strategies are usually
not needed (C). Cytotec and Motrin should be taken together (D) to
provide protective properties against gastrointestinal bleeding.
8. A client with heart failure is prescribed spironolactone (Aldactone).
Which information is most important for the nurse to provide to the
client about diet modifications?
A) Do not add salt to foods during preparation.
B) Refrain for eating foods high in potassium.
C) Restrict fluid intake to 1000 ml per day.
D) Increase intake of milk and milk products. - ANSWER-B) Refrain
for eating foods high in potassium.
Spironolactone (Aldactone), an aldosterone antagonist, is a potassium-
sparing diuretic, so a diet high in potassium should be avoided (B),
including potassium salt substitutes, which can lead to hyperkalemia.
Although (A) is a common diet modification in heart failure, the risk of
hyperkalemia is more important with Aldactone. Restriction of fluids
(C) or increasing milk and milk products (D) are not indicated with this
prescription.
9. In evaluating the effects of lactulose (Cephulac), which outcome
should indicate that the drug is performing as intended?
A) An increase in urine output.
B) Two or three soft stools per day.
C) Watery, diarrhea stools.
D) Increased serum bilirubin. - ANSWER-B) Two or three soft stools
per day.
