Pharmacology HESI V2 Prep with
Complete Solutions
A charge nurse is planning a staff education session to discuss medications appropriate
for the use during the care of a client experiencing alcohol detoxification. Which of the
following should the charge nurse include? (Select all that apply.)
A. Lorazepam
B. Diazepam
C. Disulfiram
D. Naltrexone
E. Acamprosate - ANSWER-ANS: A, B
Lorazepam and diazepam are benzodiazepines used during alcohol detoxification to
decrease anxiety and reduce the risk for seizures.
Disulfiram and naltrexone are administered to assist the client in maintaining abstinence
from alcohol following detoxification. Acamprosate decreases unpleasant effects, such
as anxiety or restlessness, resulting from abstinence.
A client has a new prescription for brimonidine ophthalmic, one drop three times a day.
He tells the nurse he also wears soft contact lenses and wants to know whether he can
put the drops in his eyes with the lenses in place. Which of the following should the
nurse tell this client?
A. "Go ahead and put the drops in your eye with the contact lens in place."
B. "Take the contact lens out of your eye, then instill the eye drop, and immediately
reinsert the contact lens."
C. "Take the contact lens out of your eye, then instill the eye drop, and wait at least 15
minutes before putting the contact lens back in place."
D. "You will need to discontinue the use of contact lenses while using brimonidine eye
drops." - ANSWER-ANS: C
The client can continue to wear his contacts. He should instill the medication and wait at
least 15 mins.
Contact lenses absorb brimonidine.
A client is admitted to undergo a surgical procedure. the nurse should be aware that
which of the following preexisting conditions may be a contraindication for the use of
ketamine as an IV anesthetic for this client?
A. PUD
B. Breast cancer
C. Diabetes mellitus
D. Schizophrenia - ANSWER-ANS: D
Ketamine can produce psychological effects such as hallucinations. Therefore,
schizophrenia can be contraindicated for use of ketamine.
,A client is prescribed long-term use of oral prednisone for treatment of chronic asthma.
the nurse should instruct the client to watch for which of the following?
A. Weight gain and fluid retention
B. Nervousness and insomnia
C. Chest pain and tachycardia
D. Dry mouth and constipation - ANSWER-ANS: A
Weight gain and fluid retention are adverse effects of oral prednisone due to the effect
of sodium and water retention.
Nervousness and insomnia, and angina and tachycardia, are adverse effects of beta
agonists, not glucocorticoids. Dry mouth and constipation are adverse effects of
tiotropium.
A client is prescribed phenobarbital sodium (Luminal) for a seizure disorder. The
medication has a long half-life of 4 days. Based on this half-life, the medication will most
likely be prescribed
A. once a day.
B. twice a day.
C. three times a day.
D. four times a day. - ANSWER-ANS: A
Medication with long half-lives remain at their therapeutic levels between doses for long
periods of time. Therefore, this medication can be administered once a day.
A client taking sucralfate PO for PUD has been started on phenytoin to control seizures.
Which of the following should be included in the client's teaching?
A. Take both of these medications at the same time.
B. Take sucralfate with a glass of milk.
C. Allow a 2-hr interval between these medications.
D. Chew the sucralfate thoroughly before swallowing. - ANSWER-ANS: C
Sucralfate can interfere with absorption of phenytoin, so the client should allow a 2-hr
interval between sucralfate and phenytoin.
Sucralfate should be taken on an empty stomach and swallowed whole.
A client who has increased intracranial pressure is receiving mannitol. Which of the
following findings should the nurse report to the provider?
A. Blood glucose 150 mg/dL
B. Urine output 40 mL/hr
C. Dyspnea
D. Headache - ANSWER-ANS: C
Dyspnea can indicate heart failure, an adverse effect of mannitol.
The urine output is adequate, however, kidney failure is an adverse effect of mannitol
for which the nurse should continue to monitor. A headache is a manifestation of
increased intracranial pressure. Mannitol is given to draw fluid back into the vascular
and extravascular space, which can relieve the headache.
,A nurse educator is reviewing medication dosages and factors that influence medication
metabolism with a group of nurses. Medication dosages may need to be decreased for
which of the following reasons? (Select all that apply.)
A. Increased renal excretion
B. Increased medication-metabolizing enzymes
C. Liver failure
D. Peripheral vascular disease
E. Concurrent use of medication metabolized by the same pathway - ANSWER-ANS: C,
E
Liver failure decreases metabolism and thus increase the concentration of medication.
This may require decreasing the dosage of medication. When two medications are
metabolized in the same way, they may compete for metabolism, thereby increasing the
concentration of one or both medications.
Increased renal excretion may decrease concentration of the medication, requiring
increased dosage. Increased medication-metabolizing enzymes can decrease the
concentration of the medication. The dose might need increased. Peripheral vascular
disease may impair distribution, and more of the medication may be needed.
A nurse in a clinic is caring for a group of clients. The nurse should contact the provider
about a potential contraindication to a medication for which of the following clients?
(Select all that apply.)
A. A client at 8 weeks of gestation who asks for an influenza immunization.
B. A client who takes prednisone and has a possible fungal infection.
C. A client who has chronic liver disease and reports he is taking hydrocodone.
D. A client who has PUD and takes sucralfate and tells the nurse she has started taking
OTC aluminum hydroxide.
E. A client who has a prosthetic heart valve who takes warfarin and reports a suspected
pregnancy. - ANSWER-ANS: B, C, E
Glucocorticoids should not be taken by a client who has possible systemic fungal
infection. Acetaminophen is contraindicated due to toxicity for the client who has a liver
disorder. Warfarin is a Pregnancy Category X medication, which can cause severe birth
defects in a fetus.
The influenza vaccine is recommended for all people older than 6 months of age and is
not contraindicated for pregnant women. There is no contraindication for a client who
has PUD and takes sucralfate and also starts taking OTC aluminum hydroxide. The
nurse should ensure that the client takes medications 3 min apart.
A nurse in a primary care clinic is assessing a client who takes lithium carbonate for the
treatment of bipolar disorder. The nurse should recognize which of the following findings
as a possible indication of toxicity to this medication?
A. Severe hypertension
B. Coarse tremors
C. Constipation
, D. Urinary retention - ANSWER-ANS: B
Severe hypotension, diarrhea, and polyuria are indications of toxicity.
A nurse in a provider's office is instructing a parent how to administer ear drops. Which
of the following instructions should the nurse include? (Select all that apply.)
A. "Place the child on his unaffected side when you are ready to administer the
medication."
B. "Warm the medication by gently rolling it between your hands for a few minutes."
C. "Gently shake the medication that is in suspension form."
D. "Keep the child on his side for 5 minutes after instillation of the ear drops."
E. "Tightly pack the ear with cotton after instillation of ear drops." - ANSWER-ANS: A, B,
C, D
Positioning on unaffected side allows access to affected ear and to promote drainage by
gravity. Administering cold medication can cause dizziness. Gently shaking medication
that is in suspension form to evenly disperse medication.
A nurse in a provider's office is monitoring serum electrolytes for four older adult clients
who take digoxin and furosemide. Which of the following electrolyte values puts a client
at risk for digoxin toxicity?
A. Calcium 9.2 mg/dL
B. Calcium 10.3 mg/dL
C. Potassium 3.4 mEq/L
D. Potassium 4.8 mEq/L - ANSWER-ANS: C
A potassium of 3.4 mEq/L is below the normal range and puts a client at risk for digoxin
toxicity. A low potassium can cause fatal dysrhythmias, especially in older clients who
take digoxin. The nurse should notify the provider who may prescribe a potassium
supplement or a potassium-sparring diuretic.
A nurse in a provider's office is providing instruction to a client who has a new
prescription for lorazepam. The nurse should inform the client that which of the following
are adverse effects of lorazepam? (Select all that apply.)
A. Incoordination
B. Euphoria
C. Pruritus
D. Flatus
E. Amnesia - ANSWER-ANS: A, B, E
Due to CNS depression, incoordination is an adverse effect of lorazepam. Euphoria
may occur as a paradoxical adverse effect of lorazepam. Retrograde amnesia is an
adverse effect.
A nurse in a provider's office is reviewing the health care record of a client who reported
urinary incontinence and asked about a prescription for oxybutynin. The nurse should
recognize that oxybutynin is contraindicated in the presence of which of the following
conditions?
A. Bursitis
Complete Solutions
A charge nurse is planning a staff education session to discuss medications appropriate
for the use during the care of a client experiencing alcohol detoxification. Which of the
following should the charge nurse include? (Select all that apply.)
A. Lorazepam
B. Diazepam
C. Disulfiram
D. Naltrexone
E. Acamprosate - ANSWER-ANS: A, B
Lorazepam and diazepam are benzodiazepines used during alcohol detoxification to
decrease anxiety and reduce the risk for seizures.
Disulfiram and naltrexone are administered to assist the client in maintaining abstinence
from alcohol following detoxification. Acamprosate decreases unpleasant effects, such
as anxiety or restlessness, resulting from abstinence.
A client has a new prescription for brimonidine ophthalmic, one drop three times a day.
He tells the nurse he also wears soft contact lenses and wants to know whether he can
put the drops in his eyes with the lenses in place. Which of the following should the
nurse tell this client?
A. "Go ahead and put the drops in your eye with the contact lens in place."
B. "Take the contact lens out of your eye, then instill the eye drop, and immediately
reinsert the contact lens."
C. "Take the contact lens out of your eye, then instill the eye drop, and wait at least 15
minutes before putting the contact lens back in place."
D. "You will need to discontinue the use of contact lenses while using brimonidine eye
drops." - ANSWER-ANS: C
The client can continue to wear his contacts. He should instill the medication and wait at
least 15 mins.
Contact lenses absorb brimonidine.
A client is admitted to undergo a surgical procedure. the nurse should be aware that
which of the following preexisting conditions may be a contraindication for the use of
ketamine as an IV anesthetic for this client?
A. PUD
B. Breast cancer
C. Diabetes mellitus
D. Schizophrenia - ANSWER-ANS: D
Ketamine can produce psychological effects such as hallucinations. Therefore,
schizophrenia can be contraindicated for use of ketamine.
,A client is prescribed long-term use of oral prednisone for treatment of chronic asthma.
the nurse should instruct the client to watch for which of the following?
A. Weight gain and fluid retention
B. Nervousness and insomnia
C. Chest pain and tachycardia
D. Dry mouth and constipation - ANSWER-ANS: A
Weight gain and fluid retention are adverse effects of oral prednisone due to the effect
of sodium and water retention.
Nervousness and insomnia, and angina and tachycardia, are adverse effects of beta
agonists, not glucocorticoids. Dry mouth and constipation are adverse effects of
tiotropium.
A client is prescribed phenobarbital sodium (Luminal) for a seizure disorder. The
medication has a long half-life of 4 days. Based on this half-life, the medication will most
likely be prescribed
A. once a day.
B. twice a day.
C. three times a day.
D. four times a day. - ANSWER-ANS: A
Medication with long half-lives remain at their therapeutic levels between doses for long
periods of time. Therefore, this medication can be administered once a day.
A client taking sucralfate PO for PUD has been started on phenytoin to control seizures.
Which of the following should be included in the client's teaching?
A. Take both of these medications at the same time.
B. Take sucralfate with a glass of milk.
C. Allow a 2-hr interval between these medications.
D. Chew the sucralfate thoroughly before swallowing. - ANSWER-ANS: C
Sucralfate can interfere with absorption of phenytoin, so the client should allow a 2-hr
interval between sucralfate and phenytoin.
Sucralfate should be taken on an empty stomach and swallowed whole.
A client who has increased intracranial pressure is receiving mannitol. Which of the
following findings should the nurse report to the provider?
A. Blood glucose 150 mg/dL
B. Urine output 40 mL/hr
C. Dyspnea
D. Headache - ANSWER-ANS: C
Dyspnea can indicate heart failure, an adverse effect of mannitol.
The urine output is adequate, however, kidney failure is an adverse effect of mannitol
for which the nurse should continue to monitor. A headache is a manifestation of
increased intracranial pressure. Mannitol is given to draw fluid back into the vascular
and extravascular space, which can relieve the headache.
,A nurse educator is reviewing medication dosages and factors that influence medication
metabolism with a group of nurses. Medication dosages may need to be decreased for
which of the following reasons? (Select all that apply.)
A. Increased renal excretion
B. Increased medication-metabolizing enzymes
C. Liver failure
D. Peripheral vascular disease
E. Concurrent use of medication metabolized by the same pathway - ANSWER-ANS: C,
E
Liver failure decreases metabolism and thus increase the concentration of medication.
This may require decreasing the dosage of medication. When two medications are
metabolized in the same way, they may compete for metabolism, thereby increasing the
concentration of one or both medications.
Increased renal excretion may decrease concentration of the medication, requiring
increased dosage. Increased medication-metabolizing enzymes can decrease the
concentration of the medication. The dose might need increased. Peripheral vascular
disease may impair distribution, and more of the medication may be needed.
A nurse in a clinic is caring for a group of clients. The nurse should contact the provider
about a potential contraindication to a medication for which of the following clients?
(Select all that apply.)
A. A client at 8 weeks of gestation who asks for an influenza immunization.
B. A client who takes prednisone and has a possible fungal infection.
C. A client who has chronic liver disease and reports he is taking hydrocodone.
D. A client who has PUD and takes sucralfate and tells the nurse she has started taking
OTC aluminum hydroxide.
E. A client who has a prosthetic heart valve who takes warfarin and reports a suspected
pregnancy. - ANSWER-ANS: B, C, E
Glucocorticoids should not be taken by a client who has possible systemic fungal
infection. Acetaminophen is contraindicated due to toxicity for the client who has a liver
disorder. Warfarin is a Pregnancy Category X medication, which can cause severe birth
defects in a fetus.
The influenza vaccine is recommended for all people older than 6 months of age and is
not contraindicated for pregnant women. There is no contraindication for a client who
has PUD and takes sucralfate and also starts taking OTC aluminum hydroxide. The
nurse should ensure that the client takes medications 3 min apart.
A nurse in a primary care clinic is assessing a client who takes lithium carbonate for the
treatment of bipolar disorder. The nurse should recognize which of the following findings
as a possible indication of toxicity to this medication?
A. Severe hypertension
B. Coarse tremors
C. Constipation
, D. Urinary retention - ANSWER-ANS: B
Severe hypotension, diarrhea, and polyuria are indications of toxicity.
A nurse in a provider's office is instructing a parent how to administer ear drops. Which
of the following instructions should the nurse include? (Select all that apply.)
A. "Place the child on his unaffected side when you are ready to administer the
medication."
B. "Warm the medication by gently rolling it between your hands for a few minutes."
C. "Gently shake the medication that is in suspension form."
D. "Keep the child on his side for 5 minutes after instillation of the ear drops."
E. "Tightly pack the ear with cotton after instillation of ear drops." - ANSWER-ANS: A, B,
C, D
Positioning on unaffected side allows access to affected ear and to promote drainage by
gravity. Administering cold medication can cause dizziness. Gently shaking medication
that is in suspension form to evenly disperse medication.
A nurse in a provider's office is monitoring serum electrolytes for four older adult clients
who take digoxin and furosemide. Which of the following electrolyte values puts a client
at risk for digoxin toxicity?
A. Calcium 9.2 mg/dL
B. Calcium 10.3 mg/dL
C. Potassium 3.4 mEq/L
D. Potassium 4.8 mEq/L - ANSWER-ANS: C
A potassium of 3.4 mEq/L is below the normal range and puts a client at risk for digoxin
toxicity. A low potassium can cause fatal dysrhythmias, especially in older clients who
take digoxin. The nurse should notify the provider who may prescribe a potassium
supplement or a potassium-sparring diuretic.
A nurse in a provider's office is providing instruction to a client who has a new
prescription for lorazepam. The nurse should inform the client that which of the following
are adverse effects of lorazepam? (Select all that apply.)
A. Incoordination
B. Euphoria
C. Pruritus
D. Flatus
E. Amnesia - ANSWER-ANS: A, B, E
Due to CNS depression, incoordination is an adverse effect of lorazepam. Euphoria
may occur as a paradoxical adverse effect of lorazepam. Retrograde amnesia is an
adverse effect.
A nurse in a provider's office is reviewing the health care record of a client who reported
urinary incontinence and asked about a prescription for oxybutynin. The nurse should
recognize that oxybutynin is contraindicated in the presence of which of the following
conditions?
A. Bursitis
