EXIT HESI _ PHARMACOLOGY || HESI
PHARMACOLOGY EXAM 400+ Q&A
WITH RATIONALE || GUARANTEED A+
A nurse is assessing the therapeutic action of drugs classified as tumor
necrosis factor (TNF) inhibitors. What client response indicates to the
nurse that a drug with this classification is effective?
Continued remission in a client with ovarian cancer
Increased insulin production in a client with diabetes mellitus
Reduction of inflammatory joint pain in a client with rheumatoid
arthritis
Vasodilation of coronary arteries in a client with ischemic heart disease -
ANSWER- Reduction of inflammatory joint pain in a client with
rheumatoid arthritis
,Rationale. TNF is produced mainly by macrophages in synovium;
over time, through various mechanisms, the presence of TNF causes
inflammation of synovium, destruction of bone and cartilage, joint
stiffness, and pain. TNF inhibitors or blockers neutralize TNF,
thereby interrupting the inflammatory cascade; this inhibits the
inflammatory response and other mechanisms, thereby slowing
tissue damage. TNF inhibitors are not prescribed for clients with
ovarian cancer, diabetes mellitus, or ischemic heart disease.
The nurse suspects serotonin syndrome in a client prescribed second-
generation antidepressants for depression. Which assessment findings
observed by the nurse would be beneficial in diagnosing the severity of
the syndrome?
Delirium
Hyperreflexia
Hyperthermia
Muscle spasms
Rhabdomyolysis - ANSWER- Hyperthermia
Rhabdomyolysis
,Rationale. Serotonin syndrome is a potentially hazardous adverse
effect of second-generation antidepressants that are used to treat
depression. Hyperthermia and rhabdomyolysis are symptoms
observed in severe cases of serotonin syndrome. Delirium,
hyperreflexia, and muscle spasms are common symptoms of this
syndrome.
A healthcare provider prescribes enoxaparin 30 mg subcutaneously
daily. Which measure would the nurse take when administering this
medication?
Push over 2 minutes.
Administer in the abdomen.
Rub site after administration.
Remove air pocket from prepackaged syringe before administration. -
ANSWER- Administer in the abdomen.
Rationale. Enoxaparin specifically targets blood clots throughout
the body and carries a lower risk of hemorrhage than that
associated with the drugs heparin and warfarin. Enoxaparin is
administered once a day through a subcutaneous injection site
around the naval. Enoxaparin should be injected into the fatty tissue
, only, which is why the abdomen is the recommended injection site.
Avoid administering in a muscle. Manufacturer recommendations
indicate the air pocket from prepackaged syringes not be removed
before administration. Rubbing the site is contraindicated, as it can
cause bruising. There are no recommendations to push this
subcutaneous medication over 2 minutes.
A client with cirrhosis of the liver and ascites has been taking
chlorothiazide, a thiazide diuretic. Why did the provider add
spironolactone to the client's medication regimen?
To stimulate sodium excretion
To help prevent potassium loss
To increase urine specific gravity
To reduce arterial blood pressure - ANSWER- To help prevent
potassium loss
RATIONALE. Spironolactone is a potassium-sparing diuretic often
used in conjunction with thiazide diuretics. The provider was
prompted to add spironolactone to the chlorothiazide to prevent
potassium loss. Both medications stimulate sodium excretion. Both
medications increase urine specific gravity and reduce arterial blood
pressure.
PHARMACOLOGY EXAM 400+ Q&A
WITH RATIONALE || GUARANTEED A+
A nurse is assessing the therapeutic action of drugs classified as tumor
necrosis factor (TNF) inhibitors. What client response indicates to the
nurse that a drug with this classification is effective?
Continued remission in a client with ovarian cancer
Increased insulin production in a client with diabetes mellitus
Reduction of inflammatory joint pain in a client with rheumatoid
arthritis
Vasodilation of coronary arteries in a client with ischemic heart disease -
ANSWER- Reduction of inflammatory joint pain in a client with
rheumatoid arthritis
,Rationale. TNF is produced mainly by macrophages in synovium;
over time, through various mechanisms, the presence of TNF causes
inflammation of synovium, destruction of bone and cartilage, joint
stiffness, and pain. TNF inhibitors or blockers neutralize TNF,
thereby interrupting the inflammatory cascade; this inhibits the
inflammatory response and other mechanisms, thereby slowing
tissue damage. TNF inhibitors are not prescribed for clients with
ovarian cancer, diabetes mellitus, or ischemic heart disease.
The nurse suspects serotonin syndrome in a client prescribed second-
generation antidepressants for depression. Which assessment findings
observed by the nurse would be beneficial in diagnosing the severity of
the syndrome?
Delirium
Hyperreflexia
Hyperthermia
Muscle spasms
Rhabdomyolysis - ANSWER- Hyperthermia
Rhabdomyolysis
,Rationale. Serotonin syndrome is a potentially hazardous adverse
effect of second-generation antidepressants that are used to treat
depression. Hyperthermia and rhabdomyolysis are symptoms
observed in severe cases of serotonin syndrome. Delirium,
hyperreflexia, and muscle spasms are common symptoms of this
syndrome.
A healthcare provider prescribes enoxaparin 30 mg subcutaneously
daily. Which measure would the nurse take when administering this
medication?
Push over 2 minutes.
Administer in the abdomen.
Rub site after administration.
Remove air pocket from prepackaged syringe before administration. -
ANSWER- Administer in the abdomen.
Rationale. Enoxaparin specifically targets blood clots throughout
the body and carries a lower risk of hemorrhage than that
associated with the drugs heparin and warfarin. Enoxaparin is
administered once a day through a subcutaneous injection site
around the naval. Enoxaparin should be injected into the fatty tissue
, only, which is why the abdomen is the recommended injection site.
Avoid administering in a muscle. Manufacturer recommendations
indicate the air pocket from prepackaged syringes not be removed
before administration. Rubbing the site is contraindicated, as it can
cause bruising. There are no recommendations to push this
subcutaneous medication over 2 minutes.
A client with cirrhosis of the liver and ascites has been taking
chlorothiazide, a thiazide diuretic. Why did the provider add
spironolactone to the client's medication regimen?
To stimulate sodium excretion
To help prevent potassium loss
To increase urine specific gravity
To reduce arterial blood pressure - ANSWER- To help prevent
potassium loss
RATIONALE. Spironolactone is a potassium-sparing diuretic often
used in conjunction with thiazide diuretics. The provider was
prompted to add spironolactone to the chlorothiazide to prevent
potassium loss. Both medications stimulate sodium excretion. Both
medications increase urine specific gravity and reduce arterial blood
pressure.
