HESI PHARM 315 -
2024
1.A client taking atorvastatin develops an increased serum creatine
phospho- kinase (CK) level. The nurse should assess the client for the onset
of which problem?
A. Muscle tenderness.
B. Nausea and vomiting.
C. Excessive bruising.
D. Peripheral edema.: A. Muscle tenderness.
2.An increase in which serum laboratory value indicates to the nurse that a
prescription for atorvastatin is having the desired effect for a client at risk
for coronary artery disease?
A. LDL (Low-density lipoprotein)
B. Triglycerides (Type of fat)
C. HDL (High-density lipoprotein)
D. VLDL (Very low-density lipoprotein): C. HDL (High-density lipoprotein)
3.NGN - Patient Data
History and
Physical:
The client is a 36-year-old female with moderate persistent asthma. She
takes fluticasone/salmeterol 250 mcg/50 mcg 1 inhalation twice daily and
albuterol 90 mcg/inhalation 2 inhalations every 4-6 hours as needed.
Nurses notes:
The client states that she has had more severe asthma symptoms than
usual in the past week. Her forced expiratory volume has been 60-65% even
with multiple doses of albuterol for several days in a row. She came to the
hospital feeling dizzy, lightheaded, and complaining of "heart palpitations".
Upon as- sessment, no wheezes were found. Her oxygen saturation is 99%.
Review H and P, and nurse's note. Identify from the choices below which
condition the client is most likely experiencing, two actions the nurse
should take to address that condition, and two parameters the nurse should
monitor to assess the client's progress.: Potential Condition:
Methemoglobinemia
Actions to Take:
1.Draw blood for a complete blood count
2.Administer methylene blue
, HESI PHARM 315 -
2024
Parameters to Monitor:
1.Methemoglobin level
2.Heart rate and rhythm
4.The nurse provide discharge instructions to a client who has been pre-
scribed gabapentin 300 mg by mouth three times a day for post herpetic
neuralgia. Which symptoms should the nurse tell the client to report to
the healthcare provider?
A. Sexual dysfunction
B. Gastric irritation
C. Rapid weight gain
D. Photosensitivity: B. Gastric irritation
5.A client with chronic lower back pain has been taking non steroidal anti-
in- flammatory (NSAID) drug ibuprofen by mouth twice a day for several
months. Which assessment is most important for the nurse to complete?
A. Assess back pain using numeric scale
B. Palpate volume of pedal pulses
C. Determine presence of abdominal pain
D. Evaluate ongoing sleep patterns: C. Determine presence of abdominal
pain
6.The nurse administers risedrineate to a client with osteoporosis at 0700.
The client asks for a glass of milk to drink with the medication. Which
action should the nurse take?
A. Instruct the client that it is necessary to take nothing but water with
the medication.
B. Assign an unlicensed assistive personnel (UAP) to bring the client a
glass of low fat milk.
C. Withhold the medication until the client's breakfast tray is available on
the unit.
D. Consult with a pharmacist about scheduling the dose one hour after the
client eats.: A. Instruct the client that it is necessary to take nothing but
water with the medication.
7.Which action should the nurse implement to assess the effectiveness
of calcium channel blocker amlodipine?
A. Note the clients serum calcium levels
B. Monitor the clients serum electrolytes
, HESI PHARM 315 -
2024
C. Review the clients intake and output
D. Measure the clients blood pressure: D. Measure the clients blood
pressure
8.A client is receiving tamsulosin an alpha adrenergic - blocking agent for
the management of urinary retention due to benign prostatic hyperplasia
(BPH). Which instruction is most important for the nurse to provide?
A. Use a twice a week dosing schedule
B. Stand and sit up slowly
C. Take the medication early in the day
D. Reduce daily fluid intake: B. Stand and sit up slowly
9.A client with chemotherapy induced nausea receives a prescription
for metoclopramide. Which adverse effect is most important for the
nurse to report?
A. Nausea
B. Involuntary movements
C. Diarrhea
D. Unusual irritability: B. Involuntary movements
10.A client is receiving orlistat as part of a weight management program.
Which ongoing assessment should be included in the plan of care to
deter- mine the effectiveness of the medication?
A. Body mass index
B. Depression screening
C. Daily calorie count
D. Serum protein levels: A. Body mass index
11.Before administering the initial dose of sumatriptan succinate to a
client with a migraine headache, it is most important to determine if the
client's history includes which problem?
A. Type 2 diabetes mellitus
B. Seasonal allergic rhinitis
C. Irritable bowel syndrome
D. Coronary artery disease: D. Coronary artery disease
12.A client receives a prescription for ciprofloxacin 400 mg intravenously
(IV) every 12 hours which is to be infused over an hour. The IV bag contains
ciprofloxacin 400 mg in dextrose 5%in water (D5W) 200 mL. How many mL/hr
should the nurse program the infusion pump to deliver?: 200 mL/hr
, HESI PHARM 315 -
2024
Rationale:
xmL/hr =
200 mL x 400 mg = 80,000 = 200 mL/hr
400 mg 1 hr 400
13.Before administering a laxative to a bed fast client, it is most important
for the nurse to perform which assessment?
A. Determine the frequency and consistency of bowel movements
B. Observe the skin integrity of the clients rectal and sacral areas
C. Assess the clients strength in moving and turning the bed
D. Evaluate the clients ability to recognize the urge to defecate: A.
Determine the frequency and consistency of bowel movements
14.The nurse is caring for a client who takes methotrexate for rheumatoid
arthritis and is now prescribed adalimumab. Which instructions should
the nurse provide the client?
A. Have a chest x-ray prior to your first dose
B. Avoid crowds and people who are sick
C. Obtain routine vaccinations as scheduled
D. Undergo annual eye examinations: A. Have a chest x-ray prior to your fir
dose
15.The nurse is reviewing the history and physical examination of a client
who will be receiving asparaginase (Elspar), an antineoplastic agent. The
nurse consults with the registered nurse regarding the administration of
the medication if which of the following is documented in the client's
history?
A. Pancreatitis
B. Diabetes mellitus
C. Myocardial infarction
D. Chronic obstructive pulmonary disease: A. Pancreatitis
16.Hormone replacement therapy with levothyroxine sodium is prescribed
for a client with hypothyroidism. The nurse should instruct the client to
report which symptom because it indicates that the client is taking too much
of the hormonal agent, levothyroxine?
A. Intolerance to cold
B. Constipation
2024
1.A client taking atorvastatin develops an increased serum creatine
phospho- kinase (CK) level. The nurse should assess the client for the onset
of which problem?
A. Muscle tenderness.
B. Nausea and vomiting.
C. Excessive bruising.
D. Peripheral edema.: A. Muscle tenderness.
2.An increase in which serum laboratory value indicates to the nurse that a
prescription for atorvastatin is having the desired effect for a client at risk
for coronary artery disease?
A. LDL (Low-density lipoprotein)
B. Triglycerides (Type of fat)
C. HDL (High-density lipoprotein)
D. VLDL (Very low-density lipoprotein): C. HDL (High-density lipoprotein)
3.NGN - Patient Data
History and
Physical:
The client is a 36-year-old female with moderate persistent asthma. She
takes fluticasone/salmeterol 250 mcg/50 mcg 1 inhalation twice daily and
albuterol 90 mcg/inhalation 2 inhalations every 4-6 hours as needed.
Nurses notes:
The client states that she has had more severe asthma symptoms than
usual in the past week. Her forced expiratory volume has been 60-65% even
with multiple doses of albuterol for several days in a row. She came to the
hospital feeling dizzy, lightheaded, and complaining of "heart palpitations".
Upon as- sessment, no wheezes were found. Her oxygen saturation is 99%.
Review H and P, and nurse's note. Identify from the choices below which
condition the client is most likely experiencing, two actions the nurse
should take to address that condition, and two parameters the nurse should
monitor to assess the client's progress.: Potential Condition:
Methemoglobinemia
Actions to Take:
1.Draw blood for a complete blood count
2.Administer methylene blue
, HESI PHARM 315 -
2024
Parameters to Monitor:
1.Methemoglobin level
2.Heart rate and rhythm
4.The nurse provide discharge instructions to a client who has been pre-
scribed gabapentin 300 mg by mouth three times a day for post herpetic
neuralgia. Which symptoms should the nurse tell the client to report to
the healthcare provider?
A. Sexual dysfunction
B. Gastric irritation
C. Rapid weight gain
D. Photosensitivity: B. Gastric irritation
5.A client with chronic lower back pain has been taking non steroidal anti-
in- flammatory (NSAID) drug ibuprofen by mouth twice a day for several
months. Which assessment is most important for the nurse to complete?
A. Assess back pain using numeric scale
B. Palpate volume of pedal pulses
C. Determine presence of abdominal pain
D. Evaluate ongoing sleep patterns: C. Determine presence of abdominal
pain
6.The nurse administers risedrineate to a client with osteoporosis at 0700.
The client asks for a glass of milk to drink with the medication. Which
action should the nurse take?
A. Instruct the client that it is necessary to take nothing but water with
the medication.
B. Assign an unlicensed assistive personnel (UAP) to bring the client a
glass of low fat milk.
C. Withhold the medication until the client's breakfast tray is available on
the unit.
D. Consult with a pharmacist about scheduling the dose one hour after the
client eats.: A. Instruct the client that it is necessary to take nothing but
water with the medication.
7.Which action should the nurse implement to assess the effectiveness
of calcium channel blocker amlodipine?
A. Note the clients serum calcium levels
B. Monitor the clients serum electrolytes
, HESI PHARM 315 -
2024
C. Review the clients intake and output
D. Measure the clients blood pressure: D. Measure the clients blood
pressure
8.A client is receiving tamsulosin an alpha adrenergic - blocking agent for
the management of urinary retention due to benign prostatic hyperplasia
(BPH). Which instruction is most important for the nurse to provide?
A. Use a twice a week dosing schedule
B. Stand and sit up slowly
C. Take the medication early in the day
D. Reduce daily fluid intake: B. Stand and sit up slowly
9.A client with chemotherapy induced nausea receives a prescription
for metoclopramide. Which adverse effect is most important for the
nurse to report?
A. Nausea
B. Involuntary movements
C. Diarrhea
D. Unusual irritability: B. Involuntary movements
10.A client is receiving orlistat as part of a weight management program.
Which ongoing assessment should be included in the plan of care to
deter- mine the effectiveness of the medication?
A. Body mass index
B. Depression screening
C. Daily calorie count
D. Serum protein levels: A. Body mass index
11.Before administering the initial dose of sumatriptan succinate to a
client with a migraine headache, it is most important to determine if the
client's history includes which problem?
A. Type 2 diabetes mellitus
B. Seasonal allergic rhinitis
C. Irritable bowel syndrome
D. Coronary artery disease: D. Coronary artery disease
12.A client receives a prescription for ciprofloxacin 400 mg intravenously
(IV) every 12 hours which is to be infused over an hour. The IV bag contains
ciprofloxacin 400 mg in dextrose 5%in water (D5W) 200 mL. How many mL/hr
should the nurse program the infusion pump to deliver?: 200 mL/hr
, HESI PHARM 315 -
2024
Rationale:
xmL/hr =
200 mL x 400 mg = 80,000 = 200 mL/hr
400 mg 1 hr 400
13.Before administering a laxative to a bed fast client, it is most important
for the nurse to perform which assessment?
A. Determine the frequency and consistency of bowel movements
B. Observe the skin integrity of the clients rectal and sacral areas
C. Assess the clients strength in moving and turning the bed
D. Evaluate the clients ability to recognize the urge to defecate: A.
Determine the frequency and consistency of bowel movements
14.The nurse is caring for a client who takes methotrexate for rheumatoid
arthritis and is now prescribed adalimumab. Which instructions should
the nurse provide the client?
A. Have a chest x-ray prior to your first dose
B. Avoid crowds and people who are sick
C. Obtain routine vaccinations as scheduled
D. Undergo annual eye examinations: A. Have a chest x-ray prior to your fir
dose
15.The nurse is reviewing the history and physical examination of a client
who will be receiving asparaginase (Elspar), an antineoplastic agent. The
nurse consults with the registered nurse regarding the administration of
the medication if which of the following is documented in the client's
history?
A. Pancreatitis
B. Diabetes mellitus
C. Myocardial infarction
D. Chronic obstructive pulmonary disease: A. Pancreatitis
16.Hormone replacement therapy with levothyroxine sodium is prescribed
for a client with hypothyroidism. The nurse should instruct the client to
report which symptom because it indicates that the client is taking too much
of the hormonal agent, levothyroxine?
A. Intolerance to cold
B. Constipation
