HESI Pharmacological Therapies: Certified High-
Standard Exam with Comprehensive Explanations
and Expert Solutions for Academic Success
A client comes to the mental health clinic for a monthly intramuscular 37.5 mg
fluphenazine decanoate injection. Fluphenazine decanoate is available 25 mg/mL. How
many milliliters of solution should the nurse administer? Record your answer using one
decimal place. - CORRECT ANS- -1.5 mL
A nurse is caring for a client who is scheduled to have an abdominal perineal resection for
colorectal cancer. A type and cross match is done because of a concern about blood loss.
The client has type B-negative blood. The blood type that can be used for this client is
1. A positive
2. B negative
3. O negative
4. AB positive - CORRECT ANS- -2. B negative
Rational:
B negative is the same as the client's blood type and is preferred; only in an emergency will
type O-negative blood be given. Irrespective of blood type, Rh-positive blood is
incompatible with the client's blood and will cause hemolysis if it is transfused. Although
O-negative blood can be used in an emergency, it is not the preferred blood type in an
elective situation.
The nurse administers the prescribed vitamin K intramuscularly to a newborn immediately
after birth to:
1. Promote the synthesis of prothrombin
2. Facilitate the growth of intestinal flora
,3. Limit an increase in the serum bilirubin level
4. Decrease the level of calciferol until the kidneys have matured - CORRECT ANS- -1.
Promote the synthesis of prothrombin
Rational: Vitamin K stores are almost absent in the newborn because the intestinal flora
that produce this vitamin are not present; vitamin K is an essential precursor of
prothrombin, which is part of the clotting mechanism. The intestinal flora develop as the
newborn is exposed to extrauterine living conditions. An increased serum bilirubin level
may occur in the newborn because of the rapid breakdown of red blood cells and the
immature liver's inability to conjugate such large amounts; it is not related to vitamin K. A
newborn's kidneys operate at a functional level appropriate to the needs of a healthy
newborn, and kidney maturity and calciferol are not related to vitamin K
After surgery for cancer, a client is to receive chemotherapy. When teaching the client
about the side effects of chemotherapy, the nurse emphasizes that the occurrence of
alopecia is:
1. Usually rare
2. Not permanent
3. Frequently prolonged
4. Sometimes preventable - CORRECT ANS- -2. Not permanent
Rational:
Once the drugs that interfere with cell division are stopped, the hair will grow back;
sometimes the hair will be a different color or texture. Alopecia is a common side effect of
chemotherapy. Hair loss persists while the drugs are being received; once the drugs are
withdrawn, the hair grows back. Although ice caps on the head and rubber bands around
the scalp have been used to try to limit alopecia, they have not been particularly effective.
A client is admitted to the hospital with a diagnosis of acute pancreatitis. The health care
provider's prescriptions include nothing by mouth and total parenteral nutrition (TPN). The
nurse explains that the TPN therapy:
1. Is the easiest method for administering needed nutrition
,2. Is the safest method for meeting the client's nutritional requirements
3. Will satisfy the client's hunger without the discomfort associated with eating
4. Will meet the client's nutritional needs without causing the discomfort precipitated by
eating - CORRECT ANS- -4. Will meet the clients nutritional needs without causing the
discomfort precipitated by eating
Rational:
Providing nutrients by the intravenous route eliminates pancreatic stimulation, therefore
reducing the pain experienced with pancreatitis. TPN is used to meet the client's needs, not
the nurse's needs. TPN creates many safety risks for the client. Hunger can be experienced
with TPN therapy.
The nurse is caring for a client who has just received epidural anesthesia. Which finding
would be of most concern?
<p>The nurse is caring for a client who has just received epidural anesthesia. Which
finding would be of most concern?</p>
Tachycardia
Hypotension
Decreased urine production
Precipitous second stage of labor - CORRECT ANS- -BP
Rationale
lowers the blood pressure, which puts both mother and fetus in jeopardy. Blood pressure,
not the heart rate, is affected first. The client may not have the sensation to void, but the
amount of urine in the bladder does not decrease, because a regional block does not affect
the kidneys. Epidural anesthesia does not shorten the second stage of labor.
, In conjunction with which classification of medication are trihexyphenidyl, biperiden
(Akineton), and benztropine (Cogentin) often prescribed?
1.Anxiolytics
2. Barbiturates
3. Antipsychotics
4. Antidepressants - CORRECT ANS- -3. Antipsychotics
Rationale
Antipsychotics are used to control the extrapyramidal (parkinsonian) symptoms that often
develop as a side effect of antipsychotic therapy. There is no documented use of
anxiolytics with antianxiety agents because they do not have extrapyramidal side effects.
Barbiturates do not have extrapyramidal side effects that respond to these drugs.
Antiparkinsonian drugs usually are not prescribed in conjunction with antidepressants
because antidepressants do not cause parkinsonian symptom
A client with a partial occlusion of the left common carotid artery is to be discharged while
still receiving warfarin (Coumadin). Which clinical adverse effect should the nurse identify
as a reason for the client to seek medical consultation?
1. Presence of blood in urine
2. Increased swelling of the ankles
3. Diminished ability to concentrate
4. Occurrence of transient ischemic attacks - CORRECT ANS- -1. Presence of blood in urine
Rationale
Warfarin causes an increase in the prothrombin time and international normalized ratio
(INR) level, leading to an increased risk for bleeding. Any abnormal or prolonged bleeding
must be reported, because it may indicate an excessive level of the drug. Increased
swelling of the ankles, diminished ability to concentrate, and occurrence of transient
ischemic attacks are not signs of bleeding, the primary concern with warfarin
Standard Exam with Comprehensive Explanations
and Expert Solutions for Academic Success
A client comes to the mental health clinic for a monthly intramuscular 37.5 mg
fluphenazine decanoate injection. Fluphenazine decanoate is available 25 mg/mL. How
many milliliters of solution should the nurse administer? Record your answer using one
decimal place. - CORRECT ANS- -1.5 mL
A nurse is caring for a client who is scheduled to have an abdominal perineal resection for
colorectal cancer. A type and cross match is done because of a concern about blood loss.
The client has type B-negative blood. The blood type that can be used for this client is
1. A positive
2. B negative
3. O negative
4. AB positive - CORRECT ANS- -2. B negative
Rational:
B negative is the same as the client's blood type and is preferred; only in an emergency will
type O-negative blood be given. Irrespective of blood type, Rh-positive blood is
incompatible with the client's blood and will cause hemolysis if it is transfused. Although
O-negative blood can be used in an emergency, it is not the preferred blood type in an
elective situation.
The nurse administers the prescribed vitamin K intramuscularly to a newborn immediately
after birth to:
1. Promote the synthesis of prothrombin
2. Facilitate the growth of intestinal flora
,3. Limit an increase in the serum bilirubin level
4. Decrease the level of calciferol until the kidneys have matured - CORRECT ANS- -1.
Promote the synthesis of prothrombin
Rational: Vitamin K stores are almost absent in the newborn because the intestinal flora
that produce this vitamin are not present; vitamin K is an essential precursor of
prothrombin, which is part of the clotting mechanism. The intestinal flora develop as the
newborn is exposed to extrauterine living conditions. An increased serum bilirubin level
may occur in the newborn because of the rapid breakdown of red blood cells and the
immature liver's inability to conjugate such large amounts; it is not related to vitamin K. A
newborn's kidneys operate at a functional level appropriate to the needs of a healthy
newborn, and kidney maturity and calciferol are not related to vitamin K
After surgery for cancer, a client is to receive chemotherapy. When teaching the client
about the side effects of chemotherapy, the nurse emphasizes that the occurrence of
alopecia is:
1. Usually rare
2. Not permanent
3. Frequently prolonged
4. Sometimes preventable - CORRECT ANS- -2. Not permanent
Rational:
Once the drugs that interfere with cell division are stopped, the hair will grow back;
sometimes the hair will be a different color or texture. Alopecia is a common side effect of
chemotherapy. Hair loss persists while the drugs are being received; once the drugs are
withdrawn, the hair grows back. Although ice caps on the head and rubber bands around
the scalp have been used to try to limit alopecia, they have not been particularly effective.
A client is admitted to the hospital with a diagnosis of acute pancreatitis. The health care
provider's prescriptions include nothing by mouth and total parenteral nutrition (TPN). The
nurse explains that the TPN therapy:
1. Is the easiest method for administering needed nutrition
,2. Is the safest method for meeting the client's nutritional requirements
3. Will satisfy the client's hunger without the discomfort associated with eating
4. Will meet the client's nutritional needs without causing the discomfort precipitated by
eating - CORRECT ANS- -4. Will meet the clients nutritional needs without causing the
discomfort precipitated by eating
Rational:
Providing nutrients by the intravenous route eliminates pancreatic stimulation, therefore
reducing the pain experienced with pancreatitis. TPN is used to meet the client's needs, not
the nurse's needs. TPN creates many safety risks for the client. Hunger can be experienced
with TPN therapy.
The nurse is caring for a client who has just received epidural anesthesia. Which finding
would be of most concern?
<p>The nurse is caring for a client who has just received epidural anesthesia. Which
finding would be of most concern?</p>
Tachycardia
Hypotension
Decreased urine production
Precipitous second stage of labor - CORRECT ANS- -BP
Rationale
lowers the blood pressure, which puts both mother and fetus in jeopardy. Blood pressure,
not the heart rate, is affected first. The client may not have the sensation to void, but the
amount of urine in the bladder does not decrease, because a regional block does not affect
the kidneys. Epidural anesthesia does not shorten the second stage of labor.
, In conjunction with which classification of medication are trihexyphenidyl, biperiden
(Akineton), and benztropine (Cogentin) often prescribed?
1.Anxiolytics
2. Barbiturates
3. Antipsychotics
4. Antidepressants - CORRECT ANS- -3. Antipsychotics
Rationale
Antipsychotics are used to control the extrapyramidal (parkinsonian) symptoms that often
develop as a side effect of antipsychotic therapy. There is no documented use of
anxiolytics with antianxiety agents because they do not have extrapyramidal side effects.
Barbiturates do not have extrapyramidal side effects that respond to these drugs.
Antiparkinsonian drugs usually are not prescribed in conjunction with antidepressants
because antidepressants do not cause parkinsonian symptom
A client with a partial occlusion of the left common carotid artery is to be discharged while
still receiving warfarin (Coumadin). Which clinical adverse effect should the nurse identify
as a reason for the client to seek medical consultation?
1. Presence of blood in urine
2. Increased swelling of the ankles
3. Diminished ability to concentrate
4. Occurrence of transient ischemic attacks - CORRECT ANS- -1. Presence of blood in urine
Rationale
Warfarin causes an increase in the prothrombin time and international normalized ratio
(INR) level, leading to an increased risk for bleeding. Any abnormal or prolonged bleeding
must be reported, because it may indicate an excessive level of the drug. Increased
swelling of the ankles, diminished ability to concentrate, and occurrence of transient
ischemic attacks are not signs of bleeding, the primary concern with warfarin
