PHARMACOLOGY HESI EXAM QUESTIONS
AND CORRECT ANSWERS GRADED A
Which symptoms are serious adverse effects of beta-adrenergic blockers such as
propranolol (Inderal)?
A. Headache, hypertension, and blurred vision.
B. Wheezing, hypotension, and av block.
C. Vomiting, dilated pupils, and papilledema.
D. Tinnitus, muscle weakness, and tachypnea. -
ans__________________________ b. Wheezing, hypotension, and av block.
(b) represents the most serious adverse effects of beta-blocking agents. Av block is
generally associated with bradycardia and results in potentially life-threatening
decreases in cardiac output. Additionally, wheezing secondary to bronchospasm and
hypotension represent life-threatening respiratory and cardiac disorders. (a, c, and d)
are not associated with beta-blockers.
The healthcare provider prescribes naloxone (Narcan) for a client in the emergency
room. Which assessment data would indicate that the naloxone has been effective? The
client's...
A. Statement that the chest pain is better
B) respiratory rate is 16 breaths/minute.
C) seizure activity has stopped temporarily.
D) pupils are constricted bilaterally. -ans__________________________ b.
Naloxone (Narcan) is a narcotic antagonist that reverses the respiratory depression
effects of opiate overdose, so assessment of a normal respiratory rate (b) would indicate
that the respiratory depression has been halted. (a, c, and d) are not related to naloxone
(Narcan) administration.
A client has myxedema, which results from a deficiency of thyroid hormone synthesis in
adults. The nurse knows that which medication should be contraindicated for this
client?
A. Liothyronine (Cytomel) to replace iodine
B. Furosemide (Lasix) for relief of fluid retention
C. Pentobarbital sodium for sleep
D. Nitroglycerin for angina pain -ans__________________________ c. Persons
with myxedema are dangerously hypersensitive to narcotics, barbiturates, and
anesthetics. They do not tolerate liothyronine and usually receive iodine replacement
therapy. These clients are also susceptible to heart problems such as angina for which
nitroglycerine would be indicated and congestive heart failure for which furosemide
would be indicated
A client with osteoarthritis receives a new prescription for celecoxib (Celebrex) orally for
symptom management. The nurse notes the client is allergic to sulfa. Which action is
most important for the nurse to implement prior to administering the first dose?
A) review the client's hemoglobin results.
B) notify the healthcare provider.
,C) inquire about the reaction to sulfa.
D) record the client's vital signs. -ans__________________________ b.
Celebrex contains a sulfur molecule, which can lead to an allergic reaction in individuals
who are sensitive to sulfonamides, so the healthcare provider should be notified of the
client's allergies (b). Although (a, c, and d) are important assessments, it is most
important to notify the healthcare provider for an alternate prescription.
The client with a dysrhythmia is to receive procainamide (pronestyl) in 4 divided doses
over the next 24 hours. What dosing schedule is best for the nurse to implement?
A. Q4h
B. Qid
C. Ac and bedtime
D. Pc and bedtime -ans__________________________ a. Q6h
A client has a continuous iv infusion of dopamine (intropin) and an iv of normal saline
at 50 ml/hour. The nurse notes that the client's urinary output has been 20 ml/hour for
the last two hours. Which intervention should the nurse initiate?
A. Stop the infusion of dopamine
B. Change the normal saline to a keep open rate.
C. Replace the urinary catheter.
D. Notify the healthcare provider of the urinary output. -
ans__________________________ d. Notify the healthcare provider of the
urinary output.
An adult client has prescriptions for morphine sulfate 2.5 mg iv q6h and ketorlac
(Toradol) 30mg iv q6h. Which action should the nurse implement?
A. Administer both medications according to the prescription
B. Hold the ketorolac to prevent an antagonist effect
C. Hold the morphine to prevent an additive drug interaction
D. Contact the healthcare provider to clarify the prescription -
ans__________________________ a. Administer both medications according to
the prescription
Morphine and ketorolac can be administered concurrently and may produce additive
analgesic effect resulting in ability to reduce the dose of morphine, as seen in this
prescription
A client is being treated for hyperthyroidism with propylthiouracil (PTU). The nurse
knows that the action of this drug is to:
A. Decrease the amount of thyroid stimulating hormone circulating in the blood.
B. Increase the amount of thyroid-stimulating hormone circulating in the blood.
C. Increase the amount of t4 and decrease the amount of t3 produced by the thyroid.
D. Inhibit synthesis of t3 and t4 by the thyroid gland. -
ans__________________________ d. PTU is an adjunct therapy used to control
hyperthyroidism by inhibiting production of thyroid hormones. It is often prescribed in
prep for thyroidectomy or radioactive iodine therapy
, A female client with RA takes ibuprofen (Motrin) 600mg po 4xday. To prevent GI
bleeding, misoprostol (Cytotec) 100mcg po is prescribed. Which information is most
important for the nurse to include in client teaching?
A. Use contraception during intercourse
B. Ensure the Cytotec is taken on an empty stomach
C. Encourage oral fluid intake to prevent constipation
D. Take Cytotec 30min prior to Motrin -ans__________________________ a. Use
contraception during intercourse.
Cytotec, a synthetic form of prostaglandin, is classified as pregnancy category x and can
act as an abortifacient, so the client should be instructed to use contraception during
intercourse to prevent loss of early pregnancy
Dobutamine (Dobutrex) is an emergency drug most commonly prescribed for a client
with which condition?
A) shock.
B) asthma.
C) hypotension.
D) heart failure -ans__________________________ d. Heart failure
Dobutamine is a beta-1 adrenergic agonist that is indicated for short term use in cardiac
decompensation or heart failure (d) related to reduced cardiac contractility due to
organic heart disease or cardiac surgical procedures. Alpha- and beta-adrenergic
agonists, such as epinephrine and dopamine, are sympathomimetics used in the
treatment of shock (a). Other selective beta-2 adrenergic agonists, such as terbutaline
and isoproterenol, are indicated in the treatment of asthma (b). Although dobutamine
improves cardiac output, it is not used to treat hypotension (c).
Which medications should the nurse caution the client about taking while receiving an
opioid analgesic?
A. Antacids.
B. Benzodiasepines
C. Antihypertensives
D. Oral antidiabetics -ans__________________________ b. B. Benzodiasepines
Respiratory depression increases with the concurrent use of opioid analgesics and other
CNS depressant agents, such as alcohol, barbiturates, and benzodiasepines
Which client should the nurse identify as being at the highest risk for complications
during the use of an opioid analgesic?
A. An older client with type 2 diabetes
B. A client with chronic rheumatoid arthritis
C. A client with a open compound fracture
D. A young adult with inflammatory bowel disease -
ans__________________________ d. A young adult with inflammatory bowel
disease
Which change in data indicates to the nurse the desired effect of the angiotensin ii
receptor antagonist valsartan (Diovan) has been achieved
A. Dependent edema reduced from +3 to +1
AND CORRECT ANSWERS GRADED A
Which symptoms are serious adverse effects of beta-adrenergic blockers such as
propranolol (Inderal)?
A. Headache, hypertension, and blurred vision.
B. Wheezing, hypotension, and av block.
C. Vomiting, dilated pupils, and papilledema.
D. Tinnitus, muscle weakness, and tachypnea. -
ans__________________________ b. Wheezing, hypotension, and av block.
(b) represents the most serious adverse effects of beta-blocking agents. Av block is
generally associated with bradycardia and results in potentially life-threatening
decreases in cardiac output. Additionally, wheezing secondary to bronchospasm and
hypotension represent life-threatening respiratory and cardiac disorders. (a, c, and d)
are not associated with beta-blockers.
The healthcare provider prescribes naloxone (Narcan) for a client in the emergency
room. Which assessment data would indicate that the naloxone has been effective? The
client's...
A. Statement that the chest pain is better
B) respiratory rate is 16 breaths/minute.
C) seizure activity has stopped temporarily.
D) pupils are constricted bilaterally. -ans__________________________ b.
Naloxone (Narcan) is a narcotic antagonist that reverses the respiratory depression
effects of opiate overdose, so assessment of a normal respiratory rate (b) would indicate
that the respiratory depression has been halted. (a, c, and d) are not related to naloxone
(Narcan) administration.
A client has myxedema, which results from a deficiency of thyroid hormone synthesis in
adults. The nurse knows that which medication should be contraindicated for this
client?
A. Liothyronine (Cytomel) to replace iodine
B. Furosemide (Lasix) for relief of fluid retention
C. Pentobarbital sodium for sleep
D. Nitroglycerin for angina pain -ans__________________________ c. Persons
with myxedema are dangerously hypersensitive to narcotics, barbiturates, and
anesthetics. They do not tolerate liothyronine and usually receive iodine replacement
therapy. These clients are also susceptible to heart problems such as angina for which
nitroglycerine would be indicated and congestive heart failure for which furosemide
would be indicated
A client with osteoarthritis receives a new prescription for celecoxib (Celebrex) orally for
symptom management. The nurse notes the client is allergic to sulfa. Which action is
most important for the nurse to implement prior to administering the first dose?
A) review the client's hemoglobin results.
B) notify the healthcare provider.
,C) inquire about the reaction to sulfa.
D) record the client's vital signs. -ans__________________________ b.
Celebrex contains a sulfur molecule, which can lead to an allergic reaction in individuals
who are sensitive to sulfonamides, so the healthcare provider should be notified of the
client's allergies (b). Although (a, c, and d) are important assessments, it is most
important to notify the healthcare provider for an alternate prescription.
The client with a dysrhythmia is to receive procainamide (pronestyl) in 4 divided doses
over the next 24 hours. What dosing schedule is best for the nurse to implement?
A. Q4h
B. Qid
C. Ac and bedtime
D. Pc and bedtime -ans__________________________ a. Q6h
A client has a continuous iv infusion of dopamine (intropin) and an iv of normal saline
at 50 ml/hour. The nurse notes that the client's urinary output has been 20 ml/hour for
the last two hours. Which intervention should the nurse initiate?
A. Stop the infusion of dopamine
B. Change the normal saline to a keep open rate.
C. Replace the urinary catheter.
D. Notify the healthcare provider of the urinary output. -
ans__________________________ d. Notify the healthcare provider of the
urinary output.
An adult client has prescriptions for morphine sulfate 2.5 mg iv q6h and ketorlac
(Toradol) 30mg iv q6h. Which action should the nurse implement?
A. Administer both medications according to the prescription
B. Hold the ketorolac to prevent an antagonist effect
C. Hold the morphine to prevent an additive drug interaction
D. Contact the healthcare provider to clarify the prescription -
ans__________________________ a. Administer both medications according to
the prescription
Morphine and ketorolac can be administered concurrently and may produce additive
analgesic effect resulting in ability to reduce the dose of morphine, as seen in this
prescription
A client is being treated for hyperthyroidism with propylthiouracil (PTU). The nurse
knows that the action of this drug is to:
A. Decrease the amount of thyroid stimulating hormone circulating in the blood.
B. Increase the amount of thyroid-stimulating hormone circulating in the blood.
C. Increase the amount of t4 and decrease the amount of t3 produced by the thyroid.
D. Inhibit synthesis of t3 and t4 by the thyroid gland. -
ans__________________________ d. PTU is an adjunct therapy used to control
hyperthyroidism by inhibiting production of thyroid hormones. It is often prescribed in
prep for thyroidectomy or radioactive iodine therapy
, A female client with RA takes ibuprofen (Motrin) 600mg po 4xday. To prevent GI
bleeding, misoprostol (Cytotec) 100mcg po is prescribed. Which information is most
important for the nurse to include in client teaching?
A. Use contraception during intercourse
B. Ensure the Cytotec is taken on an empty stomach
C. Encourage oral fluid intake to prevent constipation
D. Take Cytotec 30min prior to Motrin -ans__________________________ a. Use
contraception during intercourse.
Cytotec, a synthetic form of prostaglandin, is classified as pregnancy category x and can
act as an abortifacient, so the client should be instructed to use contraception during
intercourse to prevent loss of early pregnancy
Dobutamine (Dobutrex) is an emergency drug most commonly prescribed for a client
with which condition?
A) shock.
B) asthma.
C) hypotension.
D) heart failure -ans__________________________ d. Heart failure
Dobutamine is a beta-1 adrenergic agonist that is indicated for short term use in cardiac
decompensation or heart failure (d) related to reduced cardiac contractility due to
organic heart disease or cardiac surgical procedures. Alpha- and beta-adrenergic
agonists, such as epinephrine and dopamine, are sympathomimetics used in the
treatment of shock (a). Other selective beta-2 adrenergic agonists, such as terbutaline
and isoproterenol, are indicated in the treatment of asthma (b). Although dobutamine
improves cardiac output, it is not used to treat hypotension (c).
Which medications should the nurse caution the client about taking while receiving an
opioid analgesic?
A. Antacids.
B. Benzodiasepines
C. Antihypertensives
D. Oral antidiabetics -ans__________________________ b. B. Benzodiasepines
Respiratory depression increases with the concurrent use of opioid analgesics and other
CNS depressant agents, such as alcohol, barbiturates, and benzodiasepines
Which client should the nurse identify as being at the highest risk for complications
during the use of an opioid analgesic?
A. An older client with type 2 diabetes
B. A client with chronic rheumatoid arthritis
C. A client with a open compound fracture
D. A young adult with inflammatory bowel disease -
ans__________________________ d. A young adult with inflammatory bowel
disease
Which change in data indicates to the nurse the desired effect of the angiotensin ii
receptor antagonist valsartan (Diovan) has been achieved
A. Dependent edema reduced from +3 to +1
