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Pharmacology version 4 HESI Exam
Test Bank (4 Versions) with
Verified Answers and Rationales
(100% Correct) | RN HESI
Pharmacology with NGN Latest
The health care provider prescribes Myelosuppression
carbamazepine for a child whose tonic- Rationale: Myelosuppression isthe highest priority
clonic seizures have been poorly complication that can potentially affect clients managed
with controlled. The nurse informs the mother carbamazepine therapy. The client requires close
monitoring that the child must have blood tests every for this condition by weekly laboratory
testing. Hepatic week. The mother asks why so many blood function may be altered, but this
complication does not have tests are necessary. Which complication is as great a potential for
occurrence as Myelosupression assessed through frequent laboratory
testing that the nurse should explain to this
mother?
A client is prescribed a cholinesterase Improves nerve impulse transmission
inhibitor, and a family member asks the
nurse how this medication works. Which Rationale: Cholinesterase inhibitors work to increase the
pharmacophysiologic explanation should availability of acetylcholine at cholinergic synapses,
which the nurse use to describe this class of drug? aids in neuronal transmission and assists in memory
formation.
,A client is ordered 22 mg of gentamicin by 2.2 mL
IM injection. The drug is available in 20 mg/2 Rationale: (22 mg/20 mg) × (x mL/2 mL) = 22x = 40 x = 2.2 mL
mL. How many milliliters should be
administered?
In addition to nitrate therapy, a client is Hypotension
receiving nifedipine, 10 mg PO every 6 Rationale: Nifedipine reduces peripheral vascular resistance
hours. The nurse should plan to observe for and nitrates produce vasodilation,so concurrent use of
which common side effect of this treatment nitrates with nifedipine can cause hypotension with the initial
regimen? administration of these agents.
Which response best supports the Psychological response to inert medication
observations that the nurse identifies in a
client who is experiencing a placebo effect? Rationale: The placebo effect is a response in the client that is
caused by the psychological impact of taking an inert drug
that has no biochemical properties. A placebo effect can be
therapeutic, negative, or ineffective but provides no cure or
benefit to the client's progress. The placebo effect may evoke
behavioral changes but does not affect neurochemical
psychotropic changes. Malingering and drug seeking are
behaviors that a client exhibits to obtain treatment for
nonexistent disorders or obtain prescription medications.
A 42-year-old client is admitted to the Sodium bicarbonate
emergency department after taking an Rationale: Sodium bicarbonate is an effective treatment for
an overdose of amitriptyline in a suicide overdose of tricyclic antidepressantssuch as amitriptyline
to attempt. Which drug should the nurse plan reverse QRS prolongation.
to administer to reverse the cardiac and
central nervous system effects of
amitriptyline?
A 67-year-old client is discharged from the Take and record radial pulse rate
daily. hospital with a prescription for digoxin, 0.25
mg daily. Which instruction should the nurse Rationale: Monitoring pulse rate is very important when
taking include in this client's discharge teaching digoxin. The client should be further instructed to
report pulse plan? rates <60 or >110 beats/min and to withhold the dosage until
consulting with the health care provider in such a case.
Vision change is an indication of drug toxicity, and the client
should be instructed to report this immediately.
A 55-year-old client was diagnosed with Fluphenazine decanoate
schizophrenia 5 years earlier. Numerous Rationale: Fluphenazine, an antipsychotic drug that can be
hospitalizations have occurred since the given IM, has a rapid onset (1 to 2 hours) and a long
duration diagnosis because of noncompliance with of action (up to 3 or 4 weeks), so it would be
the drug of
the prescribed medication regimen. Which choice for a noncompliant psychotic client.
Chlorpromazine drug might work best for this particular HCl is an antipsychotic drug used to treat
schizophrenia and is client? usually administered PO (IM doses are short-acting). The client
must be compliant in taking this drug for it to be effective.
Lithium carbonate is most effective with manic and
depressive bipolar affective disorders. Diazepam is an anti-
anxiety drug and would not be effective for a psychotic
disorder.
, A client is being discharged with a Drink at least eight glasses of fluid a
day prescription for sulfasalazine to treat
ulcerative colitis. Which instruction should Rationale: Adequate hydration is important for all sulfa
drugs the nurse provide to this client prior to because they can crystallize in the urine. If possible,
the drug discharge? should be taken after eating to provide longer intestinal
transit
time. Maintaining good oral hygiene is important for other
medications, such as phenytoin, because of the incidence of
gingival hyperplasia, Discontinue use of the drug gradually is
important for steroid administration.
Amoxicillin, 500 mg PO every 8 hours, is 20 mL
prescribed for a client with an infection. The Rationale: 500 mg/x mL = 125 mg/5 mL 125x = 2500 x = 20 mL
drug is available in a suspension of 125 mg/5
mL. How many milliliters should the nurse
administer with each dose?
A client with acute lymphocytic leukemia Reduction or elimination of nausea and
vomiting isto begin chemotherapy today. The health Rationale: Ondansetron is a type
3 receptor (5-HT3)
care provider's prescription specifies that antagonist that isrecognized for improved control of
acute ondansetron is to be administered IV 30 nausea and vomiting associated with
chemotherapy. 5-HT3 minutes prior to the infusion of cisplatin.antagonists are most effective when
administered IV prior to What is the rationale for administering the induction of the chemotherapeutic
agent(s).
Zofran prior to the chemotherapy
induction?
A client with chronic gouty arthritis is talking Uric acid level
allopurinol, 100 mg PO daily. Which Rationale: The primary therapeutic outcome associated
with laboratory serum level should the nurse allopurinol therapy is reduced serum uric acid
levels with a report to the health care provider to lower frequency of acute gouty attacks, so uric
acid level determine the therapeutic outcome? should be reported to the health care provider
The nurse is reviewing prescribed Oral forms of drugs must pass through the liver first,
where medications with a female client who is more of the dose is metabolized.
preparing for discharge. The client asks the Rationale: Oral doses of medication are usually larger
than nurse why the oral dose of an opioid parenteral dosesto compensate for the first-pass effect in
the analgesic is higher than the IV dose that she liver after oral administration, which metabolizes
more of the received during hospitalization. Which drug's dose before affecting its therapeutic
response. response is best for the nurse to provide? Although recommended dose ranges for
adultsshould be
individualized, a client's pain should be controlled at
discharge.
The nurse performs a client assessment Administer the prescribed dose as scheduled.
prior to the administration of a prescribed Rationale: A carotid bruit reflects the degree of blood vessel
dose of dipyridamole and aspirin PO. The turbulence, which is typically the result of atherosclerosis.
nurse notes that the client's carotid bruit is Aspirin is prescribed to reduce platelet aggregation and
louder than previously assessed. Which should be administered to this client, who is at high risk for
action should the nurse implement? thrombus occlusion.
A client experiencing dysrhythmias is given Diarrhea
quinidine, 300 mg PO every 6 hours. The Rationale: The most common side effects associated
with nurse plans to observe this client for which quinidine therapy are gastrointestinal complaints,
such as common side effect associated with the use diarrhea.
of this medication?
Pharmacology version 4 HESI Exam
Test Bank (4 Versions) with
Verified Answers and Rationales
(100% Correct) | RN HESI
Pharmacology with NGN Latest
The health care provider prescribes Myelosuppression
carbamazepine for a child whose tonic- Rationale: Myelosuppression isthe highest priority
clonic seizures have been poorly complication that can potentially affect clients managed
with controlled. The nurse informs the mother carbamazepine therapy. The client requires close
monitoring that the child must have blood tests every for this condition by weekly laboratory
testing. Hepatic week. The mother asks why so many blood function may be altered, but this
complication does not have tests are necessary. Which complication is as great a potential for
occurrence as Myelosupression assessed through frequent laboratory
testing that the nurse should explain to this
mother?
A client is prescribed a cholinesterase Improves nerve impulse transmission
inhibitor, and a family member asks the
nurse how this medication works. Which Rationale: Cholinesterase inhibitors work to increase the
pharmacophysiologic explanation should availability of acetylcholine at cholinergic synapses,
which the nurse use to describe this class of drug? aids in neuronal transmission and assists in memory
formation.
,A client is ordered 22 mg of gentamicin by 2.2 mL
IM injection. The drug is available in 20 mg/2 Rationale: (22 mg/20 mg) × (x mL/2 mL) = 22x = 40 x = 2.2 mL
mL. How many milliliters should be
administered?
In addition to nitrate therapy, a client is Hypotension
receiving nifedipine, 10 mg PO every 6 Rationale: Nifedipine reduces peripheral vascular resistance
hours. The nurse should plan to observe for and nitrates produce vasodilation,so concurrent use of
which common side effect of this treatment nitrates with nifedipine can cause hypotension with the initial
regimen? administration of these agents.
Which response best supports the Psychological response to inert medication
observations that the nurse identifies in a
client who is experiencing a placebo effect? Rationale: The placebo effect is a response in the client that is
caused by the psychological impact of taking an inert drug
that has no biochemical properties. A placebo effect can be
therapeutic, negative, or ineffective but provides no cure or
benefit to the client's progress. The placebo effect may evoke
behavioral changes but does not affect neurochemical
psychotropic changes. Malingering and drug seeking are
behaviors that a client exhibits to obtain treatment for
nonexistent disorders or obtain prescription medications.
A 42-year-old client is admitted to the Sodium bicarbonate
emergency department after taking an Rationale: Sodium bicarbonate is an effective treatment for
an overdose of amitriptyline in a suicide overdose of tricyclic antidepressantssuch as amitriptyline
to attempt. Which drug should the nurse plan reverse QRS prolongation.
to administer to reverse the cardiac and
central nervous system effects of
amitriptyline?
A 67-year-old client is discharged from the Take and record radial pulse rate
daily. hospital with a prescription for digoxin, 0.25
mg daily. Which instruction should the nurse Rationale: Monitoring pulse rate is very important when
taking include in this client's discharge teaching digoxin. The client should be further instructed to
report pulse plan? rates <60 or >110 beats/min and to withhold the dosage until
consulting with the health care provider in such a case.
Vision change is an indication of drug toxicity, and the client
should be instructed to report this immediately.
A 55-year-old client was diagnosed with Fluphenazine decanoate
schizophrenia 5 years earlier. Numerous Rationale: Fluphenazine, an antipsychotic drug that can be
hospitalizations have occurred since the given IM, has a rapid onset (1 to 2 hours) and a long
duration diagnosis because of noncompliance with of action (up to 3 or 4 weeks), so it would be
the drug of
the prescribed medication regimen. Which choice for a noncompliant psychotic client.
Chlorpromazine drug might work best for this particular HCl is an antipsychotic drug used to treat
schizophrenia and is client? usually administered PO (IM doses are short-acting). The client
must be compliant in taking this drug for it to be effective.
Lithium carbonate is most effective with manic and
depressive bipolar affective disorders. Diazepam is an anti-
anxiety drug and would not be effective for a psychotic
disorder.
, A client is being discharged with a Drink at least eight glasses of fluid a
day prescription for sulfasalazine to treat
ulcerative colitis. Which instruction should Rationale: Adequate hydration is important for all sulfa
drugs the nurse provide to this client prior to because they can crystallize in the urine. If possible,
the drug discharge? should be taken after eating to provide longer intestinal
transit
time. Maintaining good oral hygiene is important for other
medications, such as phenytoin, because of the incidence of
gingival hyperplasia, Discontinue use of the drug gradually is
important for steroid administration.
Amoxicillin, 500 mg PO every 8 hours, is 20 mL
prescribed for a client with an infection. The Rationale: 500 mg/x mL = 125 mg/5 mL 125x = 2500 x = 20 mL
drug is available in a suspension of 125 mg/5
mL. How many milliliters should the nurse
administer with each dose?
A client with acute lymphocytic leukemia Reduction or elimination of nausea and
vomiting isto begin chemotherapy today. The health Rationale: Ondansetron is a type
3 receptor (5-HT3)
care provider's prescription specifies that antagonist that isrecognized for improved control of
acute ondansetron is to be administered IV 30 nausea and vomiting associated with
chemotherapy. 5-HT3 minutes prior to the infusion of cisplatin.antagonists are most effective when
administered IV prior to What is the rationale for administering the induction of the chemotherapeutic
agent(s).
Zofran prior to the chemotherapy
induction?
A client with chronic gouty arthritis is talking Uric acid level
allopurinol, 100 mg PO daily. Which Rationale: The primary therapeutic outcome associated
with laboratory serum level should the nurse allopurinol therapy is reduced serum uric acid
levels with a report to the health care provider to lower frequency of acute gouty attacks, so uric
acid level determine the therapeutic outcome? should be reported to the health care provider
The nurse is reviewing prescribed Oral forms of drugs must pass through the liver first,
where medications with a female client who is more of the dose is metabolized.
preparing for discharge. The client asks the Rationale: Oral doses of medication are usually larger
than nurse why the oral dose of an opioid parenteral dosesto compensate for the first-pass effect in
the analgesic is higher than the IV dose that she liver after oral administration, which metabolizes
more of the received during hospitalization. Which drug's dose before affecting its therapeutic
response. response is best for the nurse to provide? Although recommended dose ranges for
adultsshould be
individualized, a client's pain should be controlled at
discharge.
The nurse performs a client assessment Administer the prescribed dose as scheduled.
prior to the administration of a prescribed Rationale: A carotid bruit reflects the degree of blood vessel
dose of dipyridamole and aspirin PO. The turbulence, which is typically the result of atherosclerosis.
nurse notes that the client's carotid bruit is Aspirin is prescribed to reduce platelet aggregation and
louder than previously assessed. Which should be administered to this client, who is at high risk for
action should the nurse implement? thrombus occlusion.
A client experiencing dysrhythmias is given Diarrhea
quinidine, 300 mg PO every 6 hours. The Rationale: The most common side effects associated
with nurse plans to observe this client for which quinidine therapy are gastrointestinal complaints,
such as common side effect associated with the use diarrhea.
of this medication?
