HESI Pharmacology Exam QUESTIONS AND ANSWERS

HESI Pharmacology Exam QUESTIONS AND ANSWERS 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. 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. 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. 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. 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. B) The rate and depth of the client's respirations. A client with mild parkinsonism is started on oral amantadine (Symmetrel). What statement accurately describes the action of this medication? dopamine in central nervous system is increased A 52-year-old client is admitted to the hospital for possible duodenal ulcers. The healthcare provider prescribes ranitidine hydrochloride (Zantac) 150 mg BID PO. Which data would indicate that this medication is effective? Within 4 hours after meals, the client denies having pain. A 78-year-old client with congestive heart failure receives the cardiac glycoside digoxin (Lanoxin) 0.25 mg PO daily. Which observation by the nurse indicates that the medication has been effective? Clear breath sounds anteriorly and posteriorly Minocycline (Minocin) 50 mg every 8 hours is prescribed for an adolescent girl diagnosed with acne. The nurse discusses self-care with the client while she is taking the medication. Which teaching points should be included in the discussion? (Select all that apply.) Report vaginal itching or discharge. Use a nonhormonal method of contraception if sexually active. The nurse is assessing a stuporous client in the emergency department who is suspected of overdosing with opioids. Which agent should the nurse prepare to administer if the client becomes comatose? Naloxone hydrochloride (Narcan) The healthcare provider prescribes captopril (Capoten) 37.5 mg. The medication is available in 25 mg tablets. What should the nurse administer? 1½ tablets A client who is HIV positive is receiving epoetin (Epogen) for management of anemia secondary to zidovudine (AZT) therapy. Which laboratory finding is most important for the nurse to report to the healthcare provider? Hematocrit (HCT) of 58% Una mujer de 42 años se presenta en el departamento de emergencias después de ser violada. El AGACNP la examina y se da cuenta de que el esposo de la paciente es el violador. La paciente no quiere presentar cargos y quiere regresar a casa con su esposo. La acción inicial de AGACNP debe ser: A. Denuncie el asalto físico a la policía. B. Haga que la paciente firme una autorización para irse a casa con su esposo. C. Consultar a la psiquiatría para una retención psicológica D. Brindar asesoramiento a la paciente sobre sus opciones. Pregunta 22 M. R. es una mujer de 52 años que se queja de dolor abdominal significativo, que califica de 8 a 9 en una escala de 1 a 10. El dolor ha estado sucediendo durante unas horas, y ella teme que no desaparezca por sí solo. Ella niega cualquier náusea o vómito, y no puede recordar con precisión cuándo ocurrió su última evacuación intestinal; Probablemente fue hace unos días. Ella informa que ella está "siempre" estreñida. En el examen físico, ella tiene taquicardia pero por lo demás tiene signos vitales normales; su abdomen es tensamente rígido, pero no se aprecian puntos sensibles a la palpación. Todo el abdomen percusiona como timpánico: no hay opacidad distintiva sobre los cuadrantes superiores. Los ruidos intestinales están presentes pero son hipoactivos e intermitentes. Hay dolor de rebote a la palpación. La AGACNP sospecha: El AGACNP sabe que al evaluar a un paciente con sospecha de pielonefritis aguda, ¿cuál de las siguientes no es una característica común? A. Pyuria B. fiebre C. ternura CVA D. hematuria macroscópica Pregunta 3: Un paciente es diagnosticado con asma. La enfermera de atención primaria (NP) prescribe un corticosteroide inhalado y un medicamento Durante las visitas de rutina para mujeres sexualmente activas de 21 a 29 años que reportan más de 1 pareja sexual en los últimos 6 meses, todas las siguientes son pruebas de detección apropiadas, excepto: Opciones de preguntas: Pregunta 60 Una mujer de 42 años se presenta en el departamento de emergencias después de ser violada. El AGACNP la examina y se da cuenta de que el esposo de la paciente es el violador. La paciente no quiere presentar cargos y quiere regresar a casa con su esposo. La acción inicial de AGACNP debe ser: A. Denuncie el asalto físico a la policía. B. Haga que la paciente firme una autorización para irse a casa con su esposo. C. Consultar a la psiquiatría para una retención psicológica D. Brindar asesoramiento a la paciente sobre sus opciones. Pregunta 22 M. R. es una mujer de 52 años que se queja de dolor abdominal significativo, que califica de 8 a 9 en una escala de 1 a 10. El dolor ha estado sucediendo durante unas horas, y ella teme que no desaparezca por sí solo. Ella niega cualquier náusea o vómito, y no puede recordar con precisión cuándo ocurrió su última evacuación intestinal; Probablemente fue hace unos días. Ella informa que ella está "siempre" estreñida. En el examen físico, ella tiene taquicardia pero por lo demás tiene signos vitales normales; su abdomen es tensamente rígido, pero no se aprecian puntos sensibles a la palpación. Todo el abdomen percusiona como timpánico: no hay opacidad distintiva sobre los cuadrantes superiores. Los ruidos intestinales están presentes pero son hipoactivos e intermitentes. Hay dolor de rebote a la palpación. La AGACNP sospecha: A. tomarse durante la mañana de la cirugía D. La metformina debe mantenerse si el nivel de azúcar en la mañana es 200 mg / dL; todos los demás medicamentos, excepto warfarina, pueden administrarse el día de la cirugía Pregunta 38 1) 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 1. Calcium gluconate 2. Calcitonin (Miacalcin) 3. Large doses of vitamin D 4. 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. 2.) 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 1. Water 2. Apple juice 3. Orange juice 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. 3.) 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 1. Diarrhea 2. Constipation 3. Decreased respirations 4. 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. 4.) 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 1. 15 minutes before exposure to the sun 2. Immediately before exposure to the sun 3. At least 30 minutes before exposure to the sun 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. 5.) 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 1. Discontinuing the medication 2. Informing the client that this is normal 3. Applying a thinner film than prescribed to the burn site 4. 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 6.) The burn client is receiving treatments of topical mafenide acetate (Sulfamylon) to the site of injury. The nurse monitors the client, knowing that which of the following indicates that a systemic effect has occurred? 1.Hyperventilation 2.Elevated blood pressure 3. Local pain at the burn site 4. Local rash at the burn site 1.Hyperventilation Rationale: Mafenide acetate is a carbonic anhydrase inhibitor and can suppress renal excretion of acid, thereby causing acidosis. Clients receiving this treatment should be monitored for signs of an acid-base imbalance (hyperventilation). If this occurs, the medication should be discontinued for 1 to 2 days. Options 3 and 4 describe local rather than systemic effects. An elevated blood pressure may be expected from the pain that occurs with a burn injury. 7.) Isotretinoin is prescribed for a client with severe acne. Before the administration of this medication, the nurse anticipates that which laboratory test will be prescribed? 1. Platelet count 1. Triglyceride level 2. Complete blood count 3. White blood cell count 4. 2. Triglyceride level Rationale: Isotretinoin can elevate triglyceride levels. Blood triglyceride levels should be measured before treatment and periodically thereafter until the effect on the triglycerides has been evaluated. Options 1, 3, and 4 do not need to be monitored specifically during this treatment. 8.) A client with severe acne is seen in the clinic and the health care provider (HCP) prescribes isotretinoin. The nurse reviews the client's medication record and would contact the (HCP) if the client is taking which medication? 1. Vitamin A 1. Digoxin (Lanoxin) 2. Furosemide (Lasix) 3. Phenytoin (Dilantin)1. Vitamin A Rationale: Isotretinoin is a metabolite of vitamin A and can produce generalized intensification of isotretinoin toxicity. Because of the potential for increased toxicity, vitamin A supplements should be discontinued before isotretinoin therapy. Options 2, 3, and 4 are not contraindicated with the use of isotretinoin. Novello es un paciente masculino de 81 años que presenta dolor abdominal tipo calambre en el hipogastro y una vaga historia en cuanto a su última evacuación intestinal normal. El examen físico revela distensión y sonidos intestinales agudos. El paciente dice que nunca antes ha tenido este tipo de problema y niega cualquier historial de cirugía abdominal. Las radiografías abdominales revelan un patrón de cuadro de distensión colónica. La AGACNP considera: A. Un laxante estimulante para aliviar el contenido intestinal. B Pregunta 39 Jane S. es una paciente de 35 años que se encuentra a las 30 semanas de gestación. La siguen regularmente para recibir atención prenatal y siempre ha estado sana; ella solo tuvo una visita al consultorio y le dijeron que todo estaba bien. Esta noche se presenta a la sala de emergencias quejándose de un dolor significativo en la parte superior del abdomen. Sus signos vitales revelan una Pregunta 23 C. V. es un paciente varón afroamericano de 70 años que se presenta para consulta quirúrgica. Su historia incluye 4 meses de hipertensión severa que ha respondido mal a la medicación. También se queja de fuertes dolores de cabeza intermitentes, palpitaciones y una vaga sensación de ansiedad con temblores. Una orina de 24 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. 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. 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. 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. A) Apply the patch at least 4 hours prior to departure.