PATHO HESI EXIT EXAM/ PRACTICE EXAM QUESTIONS
WITH CORRECT DETAILED ANSWERS/ UPDATED 2024 –
RATED A+
A 5-year-old child is being given dactinomycin and doxorubicin therapy after nephrectomy for Wilms
tumor. What will the nursing care include?
Administering aspirin for pain
Offering citrus juices with meals
Ensuring meticulous oral hygiene
Eliminating spicy foods from the diet - ANSWER - Oral hygiene is essential, especially during the
administration of medications that have a negative effect on the oral mucosa. Although pain may be
present, aspirin is avoided because doxorubicin is also being used, and a side effect of this medication is
thrombocytopenia. Aspirin is contraindicated for children because it is associated with Reye syndrome.
Citrus juice will aggravate stomatitis, which is a common side effect of dactinomycin. Spicy foods may
aggravate the stomatitis that occurs with chemotherapy. However, usually any food that the child
requests is permitted.
A child with acute lymphoid leukemia is started on a chemotherapy protocol that includes prednisone.
What side effect of this medication does the nurse anticipate?
Alopecia
Anorexia
Weight loss
Mood changes - ANSWER - Mood swings may result from steroid therapy. Alopecia does not result from
steroid therapy. An increased appetite, not anorexia, results from steroid therapy. Weight gain, not
weight loss, results from steroid therapy.
Which statement is true regarding antipsychotic drugs?
A. All first- and second-generation antipsychotics are equally effective.
pg. 1
,B. Second-generation antipsychotics pose a risk of extrapyramidal symptoms.
C. First-generation antipsychotics pose a significant risk of metabolic side effects.
D. Clozapine is more effective than other second-generation antipsychotics. - ANSWER - D. Clozapine is
more effective than other second-generation antipsychotics.
Which statement about psychotherapeutic drugs in elderly clients requires correction?
Tricyclic antidepressants may increase anxiety in elderly clients.
Normal dosage of lithium may result in lithium toxicity in elderly clients.
Elderly clients on antipsychotic drugs are susceptible to orthostatic hypotension.
Low serum levels of the drug are reported in elderly clients on psychotherapeutic drugs. - ANSWER - Low
serum levels of the drug are reported in elderly clients on psychotherapeutic drugs.
What is the best drug of choice for treating obsessive-compulsive disorder?
Imipramine
Lithium salts
Amitriptyline
Clomipramine - ANSWER - Clomipramine is a tricyclic antidepressant drug prescribed for treating of
obsessive-compulsive disorder. Childhood enuresis necessitates the administration of imipramine.
Lithium salt is prescribed to treat bipolar disorders. Dysthymias can be treated by the administration of
antidepressant drugs such as amitriptyline.
A client with a history of methamphetamine use is admitted to the medical unit. What clinical
manifestation does the nurse expect when assessing the client?
a. Constricted pupils
b. Intractable diarrhea
c. Increased heart rate
d. Decreased respirations - ANSWER - Methamphetamine is a stimulant that causes the release of
adrenaline, which activates the sympathetic nervous system. The pupils will dilate, not constrict, because
the sympathetic nervous system is activated. Clients withdrawing from opioids, not methamphetamine,
pg. 2
,experience diarrhea. The respirations will be increased, not decreased, because of the activation of the
sympathetic nervous system.
Which monoamine oxidase inhibitor is used to treat Parkinson disease?
1. Selegiline
2. Phenelzine
3. Isocarboxazid
4. Tranylcypromine - ANSWER - Selegiline is a monoamine oxidase-B inhibitor used to treat Parkinson
disease. Phenelzine, isocarboxazid, and tranylcypromine are nonselective inhibitors of both type A and B
used in the treatment of depression.
A client with depression is to be given fluoxetine. What precaution will the nurse consider when
initiating treatment with this drug?
1. It must be given with milk and crackers to prevent hyperacidity and discomfort.
2. Eating cheese or pickled herring or drinking wine may cause a hypertensive crisis.
3. The blood level may not be sufficient to cause noticeable improvement for 2 to 4 weeks.
4. The blood level should be checked weekly for 3 months to monitor for an appropriate level. - ANSWER
- Fluoxetine does not produce an immediate effect; nursing measures must be continued to reduce the
risk for suicide. Consuming milk and crackers to help prevent hyperacidity and discomfort is not
necessary. Avoiding cheese, pickled herring, and wine is a precaution taken with the monoamine oxidase
inhibitors. Weekly blood level checks are not necessary with fluoxetine.
Which type of immune preparation, made from donated blood, contains antibodies that provide passive
immunity?
Toxoid
Killed vaccine
Live attenuated vaccine
Specific Immune Globulin - ANSWER - Specific immune globulins contain a high concentration of
antibodies directed at specific antigens. Toxoid vaccines contain a bacterial toxin that has been changed
to a nontoxic form. Killed vaccines contain killed microbes or isolated microbes. Live attenuated vaccines
are composed of live microbes that have been weakened or rendered completely avirulent.
pg. 3
, Which preparations use toxoids but not live viruses? Select all that apply.
Rotarix
Varivax
M-M-R II
PEDIARIX
DAPTACEL - ANSWER - PEDIARIX consists of diphtheria and tetanus toxoids plus inactivated bacterial
components of pertussis, inactive viral antigen of hepatitis B, and inactivated poliovirus vaccine.
DAPTACEL is a preparation consisting of toxoids plus inactive bacterial and viral components of
diphtheria and tetanus toxoids and acellular pertussis vaccine. Rotarix, Varivax, and M-M-R II are
preparations containing live viruses.
Which condition is contraindicated for St. John's wort herbal therapy?
1. Anxiety
2. Seizures
3. Dementia
4. Pregnancy - ANSWER - Dementia is contraindicated for St. John's wort herbal therapy; this herbal
therapy is used to treat anxiety. Seizures are contraindicated for bupropion therapy. Pregnancy is
contraindicated for ginseng herbal therapy.
A client with schizophrenia is started on a regimen of chlorpromazine. After 10 days a shuffling gait,
tremors, and some rigidity are apparent. Benztropine mesylate 2 mg by mouth daily is prescribed. What
does the nurse remember when administering these medications together?
1. Both medications are cholinesterase inhibitors.
2. Both medications have a cholinergic-blocking action.
3. The antipsychotic effects of chlorpromazine will be decreased.
4. The synergistic effect of these medications will cause drooling. - ANSWER - Both medications block
central acetylcholine receptors. Neither medication inhibits cholinesterase; neostigmine (Prostigmin)
acts in this manner. Although benztropine mesylate can cause mental confusion when given in large
doses, it does not reduce the antipsychotic effect of chlorpromazine. Both medications cause dry mouth.
Which adverse effect is least likely to occur in a client who is prescribed clozapine?
Seizures
Sedation
pg. 4
WITH CORRECT DETAILED ANSWERS/ UPDATED 2024 –
RATED A+
A 5-year-old child is being given dactinomycin and doxorubicin therapy after nephrectomy for Wilms
tumor. What will the nursing care include?
Administering aspirin for pain
Offering citrus juices with meals
Ensuring meticulous oral hygiene
Eliminating spicy foods from the diet - ANSWER - Oral hygiene is essential, especially during the
administration of medications that have a negative effect on the oral mucosa. Although pain may be
present, aspirin is avoided because doxorubicin is also being used, and a side effect of this medication is
thrombocytopenia. Aspirin is contraindicated for children because it is associated with Reye syndrome.
Citrus juice will aggravate stomatitis, which is a common side effect of dactinomycin. Spicy foods may
aggravate the stomatitis that occurs with chemotherapy. However, usually any food that the child
requests is permitted.
A child with acute lymphoid leukemia is started on a chemotherapy protocol that includes prednisone.
What side effect of this medication does the nurse anticipate?
Alopecia
Anorexia
Weight loss
Mood changes - ANSWER - Mood swings may result from steroid therapy. Alopecia does not result from
steroid therapy. An increased appetite, not anorexia, results from steroid therapy. Weight gain, not
weight loss, results from steroid therapy.
Which statement is true regarding antipsychotic drugs?
A. All first- and second-generation antipsychotics are equally effective.
pg. 1
,B. Second-generation antipsychotics pose a risk of extrapyramidal symptoms.
C. First-generation antipsychotics pose a significant risk of metabolic side effects.
D. Clozapine is more effective than other second-generation antipsychotics. - ANSWER - D. Clozapine is
more effective than other second-generation antipsychotics.
Which statement about psychotherapeutic drugs in elderly clients requires correction?
Tricyclic antidepressants may increase anxiety in elderly clients.
Normal dosage of lithium may result in lithium toxicity in elderly clients.
Elderly clients on antipsychotic drugs are susceptible to orthostatic hypotension.
Low serum levels of the drug are reported in elderly clients on psychotherapeutic drugs. - ANSWER - Low
serum levels of the drug are reported in elderly clients on psychotherapeutic drugs.
What is the best drug of choice for treating obsessive-compulsive disorder?
Imipramine
Lithium salts
Amitriptyline
Clomipramine - ANSWER - Clomipramine is a tricyclic antidepressant drug prescribed for treating of
obsessive-compulsive disorder. Childhood enuresis necessitates the administration of imipramine.
Lithium salt is prescribed to treat bipolar disorders. Dysthymias can be treated by the administration of
antidepressant drugs such as amitriptyline.
A client with a history of methamphetamine use is admitted to the medical unit. What clinical
manifestation does the nurse expect when assessing the client?
a. Constricted pupils
b. Intractable diarrhea
c. Increased heart rate
d. Decreased respirations - ANSWER - Methamphetamine is a stimulant that causes the release of
adrenaline, which activates the sympathetic nervous system. The pupils will dilate, not constrict, because
the sympathetic nervous system is activated. Clients withdrawing from opioids, not methamphetamine,
pg. 2
,experience diarrhea. The respirations will be increased, not decreased, because of the activation of the
sympathetic nervous system.
Which monoamine oxidase inhibitor is used to treat Parkinson disease?
1. Selegiline
2. Phenelzine
3. Isocarboxazid
4. Tranylcypromine - ANSWER - Selegiline is a monoamine oxidase-B inhibitor used to treat Parkinson
disease. Phenelzine, isocarboxazid, and tranylcypromine are nonselective inhibitors of both type A and B
used in the treatment of depression.
A client with depression is to be given fluoxetine. What precaution will the nurse consider when
initiating treatment with this drug?
1. It must be given with milk and crackers to prevent hyperacidity and discomfort.
2. Eating cheese or pickled herring or drinking wine may cause a hypertensive crisis.
3. The blood level may not be sufficient to cause noticeable improvement for 2 to 4 weeks.
4. The blood level should be checked weekly for 3 months to monitor for an appropriate level. - ANSWER
- Fluoxetine does not produce an immediate effect; nursing measures must be continued to reduce the
risk for suicide. Consuming milk and crackers to help prevent hyperacidity and discomfort is not
necessary. Avoiding cheese, pickled herring, and wine is a precaution taken with the monoamine oxidase
inhibitors. Weekly blood level checks are not necessary with fluoxetine.
Which type of immune preparation, made from donated blood, contains antibodies that provide passive
immunity?
Toxoid
Killed vaccine
Live attenuated vaccine
Specific Immune Globulin - ANSWER - Specific immune globulins contain a high concentration of
antibodies directed at specific antigens. Toxoid vaccines contain a bacterial toxin that has been changed
to a nontoxic form. Killed vaccines contain killed microbes or isolated microbes. Live attenuated vaccines
are composed of live microbes that have been weakened or rendered completely avirulent.
pg. 3
, Which preparations use toxoids but not live viruses? Select all that apply.
Rotarix
Varivax
M-M-R II
PEDIARIX
DAPTACEL - ANSWER - PEDIARIX consists of diphtheria and tetanus toxoids plus inactivated bacterial
components of pertussis, inactive viral antigen of hepatitis B, and inactivated poliovirus vaccine.
DAPTACEL is a preparation consisting of toxoids plus inactive bacterial and viral components of
diphtheria and tetanus toxoids and acellular pertussis vaccine. Rotarix, Varivax, and M-M-R II are
preparations containing live viruses.
Which condition is contraindicated for St. John's wort herbal therapy?
1. Anxiety
2. Seizures
3. Dementia
4. Pregnancy - ANSWER - Dementia is contraindicated for St. John's wort herbal therapy; this herbal
therapy is used to treat anxiety. Seizures are contraindicated for bupropion therapy. Pregnancy is
contraindicated for ginseng herbal therapy.
A client with schizophrenia is started on a regimen of chlorpromazine. After 10 days a shuffling gait,
tremors, and some rigidity are apparent. Benztropine mesylate 2 mg by mouth daily is prescribed. What
does the nurse remember when administering these medications together?
1. Both medications are cholinesterase inhibitors.
2. Both medications have a cholinergic-blocking action.
3. The antipsychotic effects of chlorpromazine will be decreased.
4. The synergistic effect of these medications will cause drooling. - ANSWER - Both medications block
central acetylcholine receptors. Neither medication inhibits cholinesterase; neostigmine (Prostigmin)
acts in this manner. Although benztropine mesylate can cause mental confusion when given in large
doses, it does not reduce the antipsychotic effect of chlorpromazine. Both medications cause dry mouth.
Which adverse effect is least likely to occur in a client who is prescribed clozapine?
Seizures
Sedation
pg. 4
