HESI Pharmacology 2022 Questions and Answers

A client with giardiasis is taking metronidazole (Flagyl) 2 grams PO. Which information should the nurse include in the client's instruction? - ANSWER-Take the medication with food. A client is receiving metoprolol (Lopressor SR). What assessment is most important for the nurse to obtain? - ANSWER-Blood pressure. A client with a dysrhythmia is to receive procainamide (Pronestyl) in 4 divided doses over the next 24 hours. What dosing schedule is best for the nurse to implement? - ANSWER-q6h. Which instruction(s) should the nurse give to a female client who just received a prescription for oral metronidazole (Flagyl) for treatment of trichomonas vaginalis? (Select all that apply.) - ANSWER-Increase fluid intake, especially cranberry juice. Avoid drinking alcohol while taking this medication. Use condoms until treatment is completed. Ensure that all sexual partners are treated at the same time. 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? - ANSWER-Apply the patch at least 4 hours prior to departure. Which client should the nurse identify as being at highest risk for complications during the use of an opioid analgesic? - ANSWER-A young adult with inflammatory bowel disease. A client who has been prescribed atorvastatin (Lipitor) one month ago calls the triage nurse at the clinic complaining of muscle pain and weakness in his legs. Which statement reflects the correct drug-specific teaching the nurse should provide to this client? - ANSWER-Make an appointment to see the healthcare provider because muscle pain may be an indication of a serious side effect A client is being treated for hyperthyroidism with propylthiouracil (PTU). The nurse knows that the action of this drug is to - ANSWER-inhibit synthesis of T3 and T4 by the thyroid gland. Which change in data indicates to the nurse that the desired effect of the angiotensin II receptor antagonist valsartan (Diovan) has been achieved? - ANSWER-Blood pressure reduced from 160/90 to 130/80. A client has a continuous IV infusion of dopamine (Intropin) and an IV of normal saline at 50 ml/hour. The nurse notes that the client's urinary output has been 20 ml/hour for the last two hours. Which intervention should the nurse initiate? - ANSWER-Notify the healthcare provider of the urinary output. A 43-year-old female client is receiving thyroid replacement hormone following a thyroidectomy. What adverse effects associated with thyroid hormone toxicity should the nurse instruct the client to report promptly to the healthcare provider? - ANSWERTachycardia and chest pain. Following heparin treatment for a pulmonary embolism, a client is being discharged with a prescription for warfarin (Coumadin). In conducting discharge teaching, the nurse advises the client to have which diagnostic test monitored regularly after discharge? - ANSWER-Prothrombin Time (PT/INR). An antacid (Maalox) is prescribed for a client with peptic ulcer disease. The nurse knows that the purpose of this medication is to - ANSWER-maintain a gastric pH of 3.5 or above. Upon admission to the emergency center, an adult client with acute status asthmaticus is prescribed this series of medications. In which order should the nurse administer the prescribed medications? (Arrange from first to last.) 1) Prednisone (Deltasone) orally. 2) Gentamicin (Garamycin) IM. 3) Albuterol (Proventil) puffs. 4) Salmeterol (Serevent Diskus). - ANSWER-Albuterol (Proventil) puffs. Salmeterol (Serevent Diskus). Prednisone (Deltasone) orally. Gentamicin (Garamycin) IM. The nitrate isosorbide dinitrate (Isordil) is prescribed for a client with angina. Which instruction should the nurse include in this client's discharge teaching plan? - ANSWERDo not get up quickly. Always rise slowly. The nurse is assessing the effectiveness of high dose aspirin therapy for an 88-year-old client with arthritis. The client reports that she can't hear the nurse's questions because her ears are ringing. What action should the nurse implement? - ANSWER-Notify the healthcare provider of this finding immediately. A client with congestive heart failure (CHF) is being discharged with a new prescription for the angiotensin-converting enzyme (ACE) inhibitor captopril (Capoten). The nurse's discharge instruction should include reporting which problem to the healthcare provider? - ANSWER-Dizziness. A client receiving Doxorubicin (Adriamycin) intravenously (IV) complains of pain at the insertion site, and the nurse notes edema at the site. Which intervention is most important for the nurse to implement? - ANSWER-Discontinue the IV fluids. 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? - ANSWER-Withhold the scheduled dose. A client who has been taking levodopa PO TID to control the symptoms of Parkinson's disease has a new prescription for sustained release levodopa/carbidopa (Sinemet 25/100) PO BID. The client took his levodopa at 0800. Which instruction should the nurse include in the teaching plan for this client? - ANSWER-You can begin taking the Sinemet this evening, but do not take any more levodopa. The nurse is assessing a client who is experiencing anaphylaxis from an insect sting. Which prescription should the nurse prepare to administer this client? - ANSWEREpinephrine. A client with coronary artery disease who is taking digoxin (Lanoxin) receives a new prescription for atorvastatin (Lipitor). Two weeks after initiation of the Lipitor prescription, the nurse assesses the client. Which finding requires the most immediate intervention? - ANSWER-Vomiting. Which nursing diagnosis is important to include in the plan of care for a client receiving the angiotensin-2 receptor antagonist irbesartan (Avapro)? - ANSWER-Risk for injury. A medication that is classified as a beta-1 agonist is most commonly prescribed for a client with which condition? - ANSWER-Heart failure. A client's dose of isosorbide dinitrate (Imdur) is increased from 40 mg to 60 mg PO daily. When the client reports the onset of a headache prior to the next scheduled dose, which action should the nurse implement? - ANSWER-Administer the 60 mg dose of Imdur and a PRN dose of acetaminophen (Tylenol). A peak and trough level must be drawn for a client receiving antibiotic therapy. What is the optimum time for the nurse to obtain the trough level? - ANSWER-Immediately before the next antibiotic dose is given. 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? - ANSWER-Use contraception during intercourse. The healthcare provider prescribes naloxone (Narcan) for a client in the emergency room. Which assessment data would indicate that the naloxone has been effective? The client's - ANSWER-respiratory rate is 16 breaths/minute. A client is receiving clonidine (Catapres) 0.1 mg/24hr via transdermal patch. Which assessment finding indicates that the desired effect of the medication has been achieved? - ANSWER-Blood pressure has changed from 180/120 to 140/70. Which action is most important for the nurse to implement prior to the administration of the antiarrhythmic drug adenosine (Adenocard)? - ANSWER-Apply continuous cardiac monitoring. Which medications should the nurse caution the client about taking while receiving an opioid analgesic? - ANSWER-Benzodiazepines. Which method of medication administration provides the client with the greatest firstpass effect? - ANSWER-Oral. An adult client has prescriptions for morphine sulfate 2.5 mg IV q6h and ketorolac (Toradol) 30 mg IV q6h. Which action should the nurse implement? - ANSWERAdminister both medications according to the prescription. A client with Parkinson's disease is taking carbidopa-levodopa (Sinemet). Which observation by the nurse should indicate that the desired outcome of the medication is being achieved? - ANSWER-Lessening of tremors. An older client with a decreased percentage of lean body mass is likely to receive a prescription that is adjusted based on which pharmacokinetic process? - ANSWERDistribution. 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? - ANSWER-Serum glucose. While taking a nursing history, the client states, "I am allergic to penicillin." What related allergy to another type of antiinfective agent should the nurse ask the client about when taking the nursing history? - ANSWER-Cephalosporins. The healthcare provider prescribes naproxen (Naproxen) twice daily for a client with osteoarthritis of the hands. The client tells the nurse that the drug does not seem to be effective after three weeks. Which is the best response for the nurse to provide? - ANSWER-Another type of nonsteroidal antiinflammatory drug may be indicated. 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? - ANSWER-Refrain for eating foods high in potassium. 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? - ANSWER-The rate and depth of the client's respirations. In evaluating the effects of lactulose (Cephulac), which outcome should indicate that the drug is performing as intended?A) An increase in urine output. - ANSWER-Two or three soft stools per day. A client asks the nurse if glipizide (Glucotrol) is an oral insulin. Which response should the nurse provide? - ANSWER-"No, it is not an oral insulin and can be used only when some beta cell function is present." After abdominal surgery, a male client is prescribed low molecular weight heparin (LMWH). 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? - ANSWER-This medication is a blood thinner given to prevent blood clot formation. A client is being treated for osteoporosis with alendronate (Fosamax), and the nurse has completed discharge teaching regarding medication administration. Which morning schedule would indicate to the nurse that the client teaching has been effective? - ANSWER-Take medication, go for a 30 minute morning walk, then eat breakfast. A postoperative client has been receiving a continuous IV infusion of meperidine (Demerol) 35 mg/hr for four days. The client has a PRN prescription for Demerol 100 mg PO q3h. The nurse notes that the client has become increasingly restless, irritable and confused, stating that there are bugs all over the walls. What action should the nurse take first? - ANSWER-Decrease the IV infusion rate of the meperidine (Demerol) per protocol. 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? - ANSWERHypokalemia. Which nursing intervention is most important when caring for a client receiving the antimetabolite cytosine arabinoside (Arc-C) for chemotherapy? - ANSWER-Inspect the client's oral mucosa for ulcerations. Which drug is used as a palliative treatment for a client with tumor-induced spinal cord compression? - ANSWER-Dexamethasone (Decadron) A client is admitted to the hospital for diagnostic testing for possible myasthenia gravis. The nurse prepares for intravenous administration of edrophonium chloride (Tensilon). What is the expected outcome for this client following administration of this pharmacologic agent? - ANSWER-Decreased muscle weakness. In teaching a client who had a liver transplant about cyclosporine (Sandimmune), the nurse should encourage the client to report which adverse response to the healthcare provider? - ANSWER-Presence of hand tremors. A client with hyperlipidemia receives a prescription for niacin (Niaspan). Which client teaching is most important for the nurse to provide? - ANSWER-Expected duration of flushing. A category X drug is prescribed for a young adult female client. Which instruction is most important for the nurse to teach this client? - ANSWER-Use a reliable form of birth control. A client is taking hydromorphone (Dilaudid) PO q4h at home. Following surgery, Dilaudid IV q4h PRN and butorphanol tartrate (Stadol) IV q4h PRN are prescribed for pain. The client received a dose of the Dilaudid IV four hours ago, and is again requesting pain medication. What intervention should the nurse implement? - ANSWER-Administer only the Dilaudid q4h PRN for pain. Which antidiarrheal agent should be used with caution in clients taking high dosages of aspirin for arthritis? - ANSWER-Bismuth subsalicylate (Pepto Bismol). A client with osteoarthritis receives a new prescription for celecoxib (Celebrex) orally for symptom management. The nurse notes the client is allergic to sulfa. Which action is most important for the nurse to implement prior to administering the first dose? - ANSWER-Notify the healthcare provider. Which symptoms are serious adverse effects of beta-adrenergic blockers such as propranolol (Inderal)? - ANSWER-Wheezing, hypotension, and AV block. A client is admitted to the coronary care unit with a medical diagnosis of acute myocardial infarction. Which medication prescription decreases both preload and afterload? - ANSWER-Nitroglycerin. Dobutamine (Dobutrex) is an emergency drug most commonly prescribed for a client with which condition? - ANSWER-Heart failure. Following the administration of sublingual nitroglycerin to a client experiencing an acute anginal attack, which assessment finding indicates to the nurse that the desired effect has been achieved? - ANSWER-Client states chest pain is relieved. Which dosing schedule should the nurse teach the client to observe for a controlledrelease oxycodone prescription? - ANSWER-Every 12 hours