Pharmacology HESI Practice Exam
The nurse is caring for a client who has taken atenolol for 2 years. The
healthcare
provider recently changed the medication to enalapril to manage the
client's blood
pressure. Which instruction should the nurse provide the client
regarding the new
medicatio
n?
A. Take the medication at
bedtime.
B. Report presence of increased
bruising.
C. Check pulse before taking
medication.
D. Rise slowly when getting out of bed or chair. correct answers D. Rise
slowly when
getting out of bed or
chair.
Rational: The client's new medication is an angiotensin-converting
enzyme (ACE)
inhibitor, which has the side effect of orthostatic hypotension. Instructing
the client
rise slowlytofrom a sitting or lying down position is important to teach the
client to avoid
dizziness and potentially
falling.
A female client calls the clinic and talks with the nurse to inquire about
a possible
reaction after taking amoxicillin for 5 days. She reports having vaginal
discomfort,
itching, and a white discharge. The nurse should discuss which action with
the client?
A. Discontinue the antibiotic because original symptoms have
subsided.
B. Continue taking medication until finished until the
symptoms
C. subside.
Consult with healthcare provider about another treatment for
thisUse
D. effect.
an over-the-counter (OTC) vaginal wash to flush out the
secretions.
answers C. Consult
correct with healthcare provider about another treatment for
this effect.
Rationale: A superinfection with normal flora yeast may occur during
antibiotic
If therapy.
suspected, the new onset of findings should be reported to the healthcare
provider prescribed
another for treatment to treat the
superinfection.
The nurse is making early morning rounds on a group of clients when a
client begins
exhibiting symptoms of an acute asthma attack. The nurse
administers a
prescription forPRN
a Beta 2 receptor agonist agent. Which client response
should the
expect? nurse
Select all that
apply.
A.
Tachycardia.
B. Increased blood
pressure.
C. Rapid resolution of
wheezing.
D. Improved pulse oximetry
values.
E. Reduce fever airway inflammation. correct answers C. Rapid resolution of
wheezing.
,D. Improved pulse oximetry
values.
Rationale: Beta 2 receptor agonist agents should provide immediate
return
and of airflow
resolve wheezing and improve
oxygenation.
A client prescribed atenolol has a blood pressure of 120/68 mmHg,
displaying a with
bradycardia sinusa rate of 58 beats/minute, and a P-R interval of 0.24.
Which action
should the nurse
take?
A. Lower the head of the bed and assess the client for orthostatic vital
sign
B. changes.
Give the medication as prescribed and continue to monitor
thePrepare
C. client. to administer atropine sulfate IV
push.
D. Hold the prescribed dose and contact the healthcare provider. correct
answers
Give the B.medication as prescribed and continue to monitor
the client.
Rationale: Since the client's blood pressure is within normal limits, and
the
abovepulse
50 isbeats/min with a first degree block, the medication can be
administered.
Atenolol is a beta-blocker that slows the heart rate and lowers the blood
pressure;
drug this
is generally held if the heart rate is less than 50 beats/min or the
client exhibits
dizziness related to
hypotension.
The nurse is preparing the 0900 dose of losartan (Cozaar), an angiotensin
II receptor
blocker (ARB), for a client with hypertension and heart failure. The nurse
reviewslaboratory
client's the results and notes that the client's serum potassium level is
5.9 mEq/L.
Which action should the nurse take
first?
A. Withhold the scheduled
dose.
B. Check the client's apical
pulse.
C. Notify the healthcare
provider.
D. Repeat the serum potassium level. correct answers A. Withhold the
scheduled dose.
Rationale: The nurse should first withhold the scheduled dose of Cozaar
because
client the
is hyperkalemic (normal range 3.5 to 5 mEq/l). Although
hypokalemia
associated is usually
with diuretic therapy in heart failure, hyperkalemia is associated
with several
heart failure medications, including ARBs. Because hyperkalemia may lead
to cardiac
dysrhythmias, the nurse should check the apical pulse for rate and rhythm,
and blood
pressur
e.
Upon admission to the emergency center, an adult client with acute status
asthmaticus
is prescribed this series of medications. In which order should the nurse
administer medications?
prescribed the (Arrange from first
to last.)
Prednisone (Deltasone)
orally.
Albuterol (Proventil)
puffs.
Gentamicin (Garamycin)
IM.
Salmeterol (Serevent Diskus). correct answers 1. Albuterol
(Proventil) puffs.
, 2. Salmeterol (Serevent
Diskus).
3. Prednisone (Deltasone)
orally.
4. Gentamicin (Garamycin)
IM.
Rationale: Status asthmaticus is potentially a life-threatening
respiratorya event,
albuterol, so
beta2 adrenergic agonist and short acting bronchodilator,
should be
administered by inhalation first to provide rapid and deep topical
penetration to relieve
bronchospasms, dilate the bronchioles, and increase oxygenation. In
stepwise
management of persistent asthma, a long-action bronchodilator, such as
salmeterol
(Serevent Diskus), with a 12-hour duration of action should be given next.
Prednisone,
an oral corticosteroid, provides prolonged anti-inflammatory effects and
should
after beclient's
the given respiratory distress begins to resolves. Gentamicin, an
antibiotic,
given deepisIM, which can be painful, and may require repositioning the
client,
be lastso
in should
the
sequence.
An adult client is given a prescription for a scopolamine patch
(Transderm
prevent motion Scop) to
sickness while on a cruise. Which information should the
nurse
to the provide
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
theDrink
D. skull.no more than 2 alcoholic drinks during the cruise. correct answers
A. Apply
patch the 4 hours prior to
at least
departure.
Rationale: Scopolamine, an anticholinergic agent, is used to prevent
motion
and hassickness
a peak onset in 6 hours, so the client should be instructed to apply
the patch
least 4 hoursat before departure on the cruise ship. The duration of the
transdermal
is patch
72 hours. Scolopamine blocks muscarinic receptors in the inner ear
and to thecenter, so the best application site of the patch is
vomiting
behind the ear. medications are CNS depressants, so the client should be
Anticholinergic
instructed
avoid to while using the
alcohol
patch.
A client with giardiasis is taking metronidazole (Flagyl) 2 grams PO. Which
information
should the nurse include in the client's
instruction?
A. Notify the clinic of any changes in the color
of urine.
B. Avoid overexposure to the
sun.
C. Stop the medication after the diarrhea
resolves.
D. Take the medication with food. correct answers D. Take the medication
with food.
Rationale: Flagyl, an amoebicide and antibacterial agent, may cause gastric
distress, so
the client should be instructed to take the medication on a full stomach.
Urine may be
red-brown or dark from taking Flagyl, but this side effect is an expectant
finding and not
necessary to report tot he healthcare
provider.
The nurse is caring for a client who has taken atenolol for 2 years. The
healthcare
provider recently changed the medication to enalapril to manage the
client's blood
pressure. Which instruction should the nurse provide the client
regarding the new
medicatio
n?
A. Take the medication at
bedtime.
B. Report presence of increased
bruising.
C. Check pulse before taking
medication.
D. Rise slowly when getting out of bed or chair. correct answers D. Rise
slowly when
getting out of bed or
chair.
Rational: The client's new medication is an angiotensin-converting
enzyme (ACE)
inhibitor, which has the side effect of orthostatic hypotension. Instructing
the client
rise slowlytofrom a sitting or lying down position is important to teach the
client to avoid
dizziness and potentially
falling.
A female client calls the clinic and talks with the nurse to inquire about
a possible
reaction after taking amoxicillin for 5 days. She reports having vaginal
discomfort,
itching, and a white discharge. The nurse should discuss which action with
the client?
A. Discontinue the antibiotic because original symptoms have
subsided.
B. Continue taking medication until finished until the
symptoms
C. subside.
Consult with healthcare provider about another treatment for
thisUse
D. effect.
an over-the-counter (OTC) vaginal wash to flush out the
secretions.
answers C. Consult
correct with healthcare provider about another treatment for
this effect.
Rationale: A superinfection with normal flora yeast may occur during
antibiotic
If therapy.
suspected, the new onset of findings should be reported to the healthcare
provider prescribed
another for treatment to treat the
superinfection.
The nurse is making early morning rounds on a group of clients when a
client begins
exhibiting symptoms of an acute asthma attack. The nurse
administers a
prescription forPRN
a Beta 2 receptor agonist agent. Which client response
should the
expect? nurse
Select all that
apply.
A.
Tachycardia.
B. Increased blood
pressure.
C. Rapid resolution of
wheezing.
D. Improved pulse oximetry
values.
E. Reduce fever airway inflammation. correct answers C. Rapid resolution of
wheezing.
,D. Improved pulse oximetry
values.
Rationale: Beta 2 receptor agonist agents should provide immediate
return
and of airflow
resolve wheezing and improve
oxygenation.
A client prescribed atenolol has a blood pressure of 120/68 mmHg,
displaying a with
bradycardia sinusa rate of 58 beats/minute, and a P-R interval of 0.24.
Which action
should the nurse
take?
A. Lower the head of the bed and assess the client for orthostatic vital
sign
B. changes.
Give the medication as prescribed and continue to monitor
thePrepare
C. client. to administer atropine sulfate IV
push.
D. Hold the prescribed dose and contact the healthcare provider. correct
answers
Give the B.medication as prescribed and continue to monitor
the client.
Rationale: Since the client's blood pressure is within normal limits, and
the
abovepulse
50 isbeats/min with a first degree block, the medication can be
administered.
Atenolol is a beta-blocker that slows the heart rate and lowers the blood
pressure;
drug this
is generally held if the heart rate is less than 50 beats/min or the
client exhibits
dizziness related to
hypotension.
The nurse is preparing the 0900 dose of losartan (Cozaar), an angiotensin
II receptor
blocker (ARB), for a client with hypertension and heart failure. The nurse
reviewslaboratory
client's the results and notes that the client's serum potassium level is
5.9 mEq/L.
Which action should the nurse take
first?
A. Withhold the scheduled
dose.
B. Check the client's apical
pulse.
C. Notify the healthcare
provider.
D. Repeat the serum potassium level. correct answers A. Withhold the
scheduled dose.
Rationale: The nurse should first withhold the scheduled dose of Cozaar
because
client the
is hyperkalemic (normal range 3.5 to 5 mEq/l). Although
hypokalemia
associated is usually
with diuretic therapy in heart failure, hyperkalemia is associated
with several
heart failure medications, including ARBs. Because hyperkalemia may lead
to cardiac
dysrhythmias, the nurse should check the apical pulse for rate and rhythm,
and blood
pressur
e.
Upon admission to the emergency center, an adult client with acute status
asthmaticus
is prescribed this series of medications. In which order should the nurse
administer medications?
prescribed the (Arrange from first
to last.)
Prednisone (Deltasone)
orally.
Albuterol (Proventil)
puffs.
Gentamicin (Garamycin)
IM.
Salmeterol (Serevent Diskus). correct answers 1. Albuterol
(Proventil) puffs.
, 2. Salmeterol (Serevent
Diskus).
3. Prednisone (Deltasone)
orally.
4. Gentamicin (Garamycin)
IM.
Rationale: Status asthmaticus is potentially a life-threatening
respiratorya event,
albuterol, so
beta2 adrenergic agonist and short acting bronchodilator,
should be
administered by inhalation first to provide rapid and deep topical
penetration to relieve
bronchospasms, dilate the bronchioles, and increase oxygenation. In
stepwise
management of persistent asthma, a long-action bronchodilator, such as
salmeterol
(Serevent Diskus), with a 12-hour duration of action should be given next.
Prednisone,
an oral corticosteroid, provides prolonged anti-inflammatory effects and
should
after beclient's
the given respiratory distress begins to resolves. Gentamicin, an
antibiotic,
given deepisIM, which can be painful, and may require repositioning the
client,
be lastso
in should
the
sequence.
An adult client is given a prescription for a scopolamine patch
(Transderm
prevent motion Scop) to
sickness while on a cruise. Which information should the
nurse
to the provide
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
theDrink
D. skull.no more than 2 alcoholic drinks during the cruise. correct answers
A. Apply
patch the 4 hours prior to
at least
departure.
Rationale: Scopolamine, an anticholinergic agent, is used to prevent
motion
and hassickness
a peak onset in 6 hours, so the client should be instructed to apply
the patch
least 4 hoursat before departure on the cruise ship. The duration of the
transdermal
is patch
72 hours. Scolopamine blocks muscarinic receptors in the inner ear
and to thecenter, so the best application site of the patch is
vomiting
behind the ear. medications are CNS depressants, so the client should be
Anticholinergic
instructed
avoid to while using the
alcohol
patch.
A client with giardiasis is taking metronidazole (Flagyl) 2 grams PO. Which
information
should the nurse include in the client's
instruction?
A. Notify the clinic of any changes in the color
of urine.
B. Avoid overexposure to the
sun.
C. Stop the medication after the diarrhea
resolves.
D. Take the medication with food. correct answers D. Take the medication
with food.
Rationale: Flagyl, an amoebicide and antibacterial agent, may cause gastric
distress, so
the client should be instructed to take the medication on a full stomach.
Urine may be
red-brown or dark from taking Flagyl, but this side effect is an expectant
finding and not
necessary to report tot he healthcare
provider.
