HESI PHARMACOLOGY TEST 2023/2024

HESI PHARMACOLOGY TEST 2023/2024 The nurse notes that the hemoglobin level of a client receiving darbepoetin alfa (Aranesp) has increased from 6 to 10 g/dL over the first 2 weeks of treatment. Which action should the nurse take? - CORRECT ANSWER-Notify the health care provider of the change in the client's laboratory values. A rapid increase (more than 1 g/dL in a 2-week period) may lead to... - CORRECT ANSWER-Hypertension A client is receiving pyridostigmine bromide (Mestinon) to control the symptoms of myasthenia gravis. Which client behavior would indicate that the drug therapy is effective? - CORRECT ANSWER-Clear speech--this shows increased muscle strength What is often the first sign of myasthenia gravis? - CORRECT ANSWER-Muscle weakness in the head and neck What are symptoms of ineffective drug management of multiple sclerosis? - CORRECT ANSWER-Ptosis and decreased oral secretions MOA of Metoclopramide HCl (Reglan) - CORRECT ANSWER-Blocks dopamine--risk for EPS Pt education on tetracycline (Vibramycin) - CORRECT ANSWER-Oral contraceptives may not be effective The nurse is preparing to administer amphotericin B (Fungizone) IV to a client. What laboratory data is most important for the nurse to assess before initiating an IV infusion of this medication? - CORRECT ANSWER-Potassium levels---amphotericin B changes cellular permeability. This will allow potassium to leave the cell. Watch for hypokalemia. Important interventions for a pt taking methotrexate for rheumatoid arthritis? - CORRECT ANSWER--Confirm with another nurse that it is not intended as chemo -Assess LFTs -Monitor I&Os -Expected side effect: stomatitis Chemotherapy--daunorubicin HCl (Cerubidine) sign of effective treatment - CORRECT ANSWER-Red urine The health care provider prescribes the anticonvulsant carbamazepine (Tegretol) for an adolescent client with a seizure disorder. The nurse should instruct the client to notify the health care provider if which condition occurs? - CORRECT ANSWER-Develops a sore throat--Blood dyscrasias (aplastic anemia, leukopenia, anemia, and thrombocytopenia) can be an adverse effect of carbamazepine (Tegretol). Flulike symptoms, such as pallor, fatigue, sore throat, and fever, are indications of such dyscrasias. Expected reaction to carbamazepine/tegretol - CORRECT ANSWER-Dizziness and dry mouth Doxorubicin HCl (Adriamycin) - CORRECT ANSWER-Do ECG for risk for cardiotoxicity Adverse effect of too much vitamin C - CORRECT ANSWER-Diarrhea During infusion of Mechlorethamine HCl (nitrogen mustard) and actinomycin (Actinomycin D), what should the nurse do first? - CORRECT ANSWER-Assess for extravasation--they are vesicants Watch for blisters and tissue sloughing Where is the DPT injection done in infants younger than 2 yrs? - CORRECT ANSWERIM--vastus lateralis Indication of venlafaxine (Effexor XR) - CORRECT ANSWER-Depression Fluphenazine (Prolixin) an antipsychotic for schizophrenics is often seen in pts that... - CORRECT ANSWER-Noncompliant with medications Fluphenazine (prolixin) has a rapid onset (1 to 2 hours) and a long duration of action (up to 3 or 4 weeks) Chloramphenicol (Chloromycetin) - CORRECT ANSWER-Risk for irreversible, fatal bone marrow depression The nurse should monitor the client's platelet count The physician has an order for lovenox IV 0.3 mg/ml. What should the nurse do? - CORRECT ANSWER-Question the route of administration. Lovenox is given SC, not IV Haloperidol (Haldol) controls... - CORRECT ANSWER-Tics and vocalizations A pt on haloperiodol (Haldol) reports dizziness when changing from supine to sitting position. What should the first intervention be for the nurse? - CORRECT ANSWERBecause haloperidol (Haldol) causes CNS effects of sedation and decreased thirst, the nurse should assess for signs of dehydration Side effect of linezolid (Zyvox) - CORRECT ANSWER-Severely watery diarrhea A female client with myasthenia gravis is taking a cholinesterase inhibitor and asks the nurse what can be done to remedy her fatigue and difficulty swallowing. What action should the nurse implement? - CORRECT ANSWER-Clients should be taught to recognize signs of overmedication and undermedication so that they can modify the dosage themselves Long-term corticosteroids should be taken at what time of the day? - CORRECT ANSWER-Morning since the drug should be given around the time of the natural release of cortisol--day time. Are steroids best taken on an empty or full stomach? - CORRECT ANSWER-Steroids can cause gastric irritation, so it is best to take it with food A child with cystic fibrosis is receiving ticarcillin disodium (Ticar) for Pseudomonas pneumonia. For which adverse effect should the nurse assess and report promptly to the health care provider? - CORRECT ANSWER-Petichiae What drug is used for conscious sedation? - CORRECT ANSWER-Midalozam (versed) What is the therapeutic range of theophylline (theo-dur) - CORRECT ANSWER-10-20 mcg Caution for toxicity What is important to include in pt education in a patient taking sulfasalazine (Azulfidine)? - CORRECT ANSWER-Increase fluid intake 8 glasses and take after a meal If not enough fluid is taken, sulfa drugs can crystallize urine Which intervention is most important for a nurse to implement prior to administering atropine PO? - CORRECT ANSWER-Determine the presence of 5 to 35 bowel sounds/min. A 26-year-old primigravida client is experiencing increasing discomfort and anxiety during the active phase of labor. She requests something for pain. Which analgesic should the nurse anticipate administering? - CORRECT ANSWER-Butorphanol (Stadol)--is a mixed agonist-antagonist analgesic resulting in good analgesia but with less respiratory depression, nausea, and vomiting compared with opioid agonist analgesics What color is dobutamine? - CORRECT ANSWER-Brown Pseudomonas can change urine to what color? - CORRECT ANSWER-Purple What is a side effect to consider informing the pt on antifungals? - CORRECT ANSWER-Phototoxicity In developing a nursing care plan for a 9-month-old infant with cystic fibrosis, the nurse writes a nursing diagnosis of Alteration in nutrition: less than body requirements, related to inadequate digestion of nutrients. Which intervention would best meet this child's needs? - CORRECT ANSWER-Give pancrelipase (Cotazym-S) capsule mixed with applesauce before each meal. During the initial nursing assessment history, a client tells the nurse that he is taking tetracycline hydrochloride (Sumycin) for urethritis. Which medication taken concurrently with Sumycin could interfere with its absorption? - CORRECT ANSWER-Sucralfate (Carafate) (A) is used to treat duodenal ulcers and will bind with tetracycline hydrochloride (Sumycin), inhibiting this antibiotic's absorption. What is the DOC for status epilepticus? (short-term) - CORRECT ANSWER-Valium A male client with prostatic carcinoma has arrived for his scheduled dose of docetaxel (Taxotere) chemotherapy. What symptom would indicate a need for an immediate response by the nurse prior to implementing another dose of this chemotherapeutic agent? - CORRECT ANSWER-Cough that is new and persistent--fluid retention --> pleural effusion, dyspnea, cardiac tamponade, and abdominal distention Which complication is assessed through frequent laboratory testing of carbamazepine (tegretol)? - CORRECT ANSWER-Myelosuppression A 19-year-old male client who has sustained a severe head injury is intubated and placed on assisted mechanical ventilation. To facilitate optimal ventilation and prevent the client from "fighting" the ventilator, the health care provider administers pancuronium bromide (Pavulon) IV, with adjunctive opioid analgesia. What medication should the nurse maintain at the client's bedside? - CORRECT ANSWER-Neostigmine bromide (Prostigmin) and atropine sulfate (Atropine), both anticholinergic drugs, reverse the respiratory muscle paralysis caused by pancuronium bromide. How do antibiotics work? - CORRECT ANSWER-They block growth of essential components of the bacterial cell by inhibiting/interfering protein synthesis leading to cell death or dysfunction