HESI Pharmacology Exam Practice
p p p
1)pApnursepispcaringpforpapclientpwithphyperparathyroidismpandpnotespthatpthepclient'spserumpcalciumpleve
lpisp13pmg/dL.pWhichpmedicationpshouldpthepnursepprepareptopadministerpaspprescribedptopthepclient?
1. Calciumpchloride
2. Calciumpgluconate
3. Calcitoninp(Miacalcin)
4. LargepdosespofpvitaminpDp-
3.pCalcitoninp(Miacalcin)pRationale:
p
Thepnormalpserumpcalciumplevelpisp8.6ptop10.0pmg/dL.pThispclientpispexperiencingphypercalcemia.pCalcium
pgluconatepandpcalciumpchlorideparepmedicationspusedpforptheptreatmentpofptetany,pwhichpoccurspaspapre
sultpofpacutephypocalcemia.pInphypercalcemia,plargepdosespofpvitaminpDpneedptopbepavoided.pCalcitonin,pap
thyroidphormone,pdecreasespthepplasmapcalciumplevelpbypinhibitingpbonepresorptionpandploweringpthepse
rumpcalciumpconcentration.
2.)pOralpironpsupplementsparepprescribedpforpap6-year-
oldpchildpwithpironpdeficiencypanemia.pThepnursepinstructspthepmotherptopadministerpthepironpwithpwhi
chpbestpfoodpitem?
1. Milk
2. Water
3. Applepjuice
4. Orangepjuicep-
4.pOrangepjuicepRationale:
p
VitaminpCpincreasespthepabsorptionpofpironpbypthepbody.pThepmotherpshouldpbepinstructedptopadministerp
thepmedicationpwithpapcitruspfruitporpapjuicepthatpisphighpinpvitaminpC.pMilkpmaypaffectpabsorptionpofpthepir
on.pWaterpwillpnotpassistpinpabsorption.pOrangepjuicepcontainspapgreaterpamountpofpvitaminpCpthanpapplepj
uice.
,3.)pSalicylicpacidpispprescribedpforpapclientpwithpapdiagnosispofppsoriasis.pThepnursepmonitorspthepclient,pknowi
ngpthatpwhichpofpthepfollowingpwouldpindicateptheppresencepofpsystemicptoxicitypfrompthispmedication?
1. Tinnitus
2. Diarrhea
3. Constipation
4. Decreasedprespirationsp-
1.pTinnituspRationale:
p
Salicylicpacidpispabsorbedpreadilypthroughpthepskin,pandpsystemicptoxicityp(salicylism)pcanpresult.pSymptom
spincludeptinnitus,pdizziness,phyperpnea,pandppsychologicalpdisturbances.pConstipationpandpdiarrheaparepn
otpassociatedpwithpsalicylism.
4.)pThepcamppnursepaskspthepchildrenppreparingptopswimpinptheplakepifptheyphavepappliedpsunscreen.pTh
epnursepremindspthepchildrenpthatpchemicalpsunscreensparepmostpeffectivepwhenpapplied:
1. Immediatelypbeforepswimming
2. 15pminutespbeforepexposureptopthepsun
3. Immediatelypbeforepexposureptopthepsun
4. Atpleastp30pminutespbeforepexposureptopthepsunp-
4.pAtpleastp30pminutespbeforepexposureptopthepsunpRationale:
p
Sunscreensparepmostpeffectivepwhenpappliedpatpleastp30pminutespbeforepexposureptopthepsunpsopthatptheypc
anppenetratepthepskin.pAllpsunscreenspshouldpbepreappliedpafterpswimmingporpsweating.
5.)pMafenidepacetatep(Sulfamylon)pispprescribedpforpthepclientpwithpapburnpinjury.pWhenpapplyingpthe
pmedication,pthepclientpcomplainspofplocalpdiscomfortpandpburning.pWhichpofpthepfollowingpispthepmo
stpappropriatepnursingpaction?
1. Notifyingpthepregisteredpnurse
2. Discontinuingpthepmedication
3. Informingpthepclientpthatpthispispnormal
4. Applyingpapthinnerpfilmpthanpprescribedptopthepburnpsitep-p3.pInformingpthepclientpthatpthispispnormal
,Rationale:
Mafenidepacetatepispbacteriostaticpforpgram-negativepandpgram-
positiveporganismspandpispusedptoptreatpburnsptopreducepbacteriappresentpinpavascularptissues.pThepclientp
shouldpbepinformedpthatpthepmedicationpwillpcauseplocalpdiscomfortpandpburningpandpthatpthispispapnormal
preaction;pthereforepoptionsp1,p2,pandp4parepincorrect
6.)pThepburnpclientpispreceivingptreatmentspofptopicalpmafenidepacetatep(Sulfamylon)ptopthepsitepofpinjury
.pThepnursepmonitorspthepclient,pknowingpthatpwhichpofpthepfollowingpindicatespthatpapsystemicpeffectphas
poccurred?
1.Hyperventilationp2.Elevat
edpbloodppressurep3.Localpp
ainpatpthepburnpsite
4.Localprashpatpthepburnpsitep-
1.HyperventilationpRationale:
p
Mafenidepacetatepispapcarbonicpanhydrasepinhibitorpandpcanpsuppressprenalpexcretionpofpacid,pthereb
ypcausingpacidosis.pClientspreceivingpthisptreatmentpshouldpbepmonitoredpforpsignspofpanpacid-
basepimbalancep(hyperventilation).pIfpthispoccurs,pthepmedicationpshouldpbepdiscontinuedpforp1ptop2pd
ays.pOptionsp3pandp4pdescribeplocalpratherpthanpsystemicpeffects.pAnpelevatedpbloodppressurepmaypbep
expectedpfromptheppainpthatpoccurspwithpapburnpinjury.
7.)pIsotretinoinpispprescribedpforpapclientpwithpseverepacne.pBeforepthepadministrationpofpthispmedication
,pthepnursepanticipatespthatpwhichplaboratoryptestpwillpbepprescribed?
1. Plateletpcount
2. Triglycerideplevel
3. Completepbloodpcount
4. Whitepbloodpcellpcountp-
2.pTriglycerideplevelpRationale:
p
Isotretinoinpcanpelevateptriglycerideplevels.pBloodptriglycerideplevelspshouldpbepmeasuredpbeforeptreatme
ntpandpperiodicallypthereafterpuntilpthepeffectponptheptriglyceridesphaspbeenpevaluated.pOptionsp1,p3,pandp
4pdopnotpneedptopbepmonitoredpspecificallypduringpthisptreatment.
, 8.)pApclientpwithpseverepacnepispseenpinpthepclinicpandpthephealthpcarepproviderp(HCP)pprescribespisotretino
in.pThepnursepreviewspthepclient'spmedicationprecordpandpwouldpcontactpthep(HCP)pifpthepclientpisptakingpw
hichpmedication?
1. VitaminpA
2. Digoxinp(Lanoxin)
3. Furosemidep(Lasix)
4. Phenytoinp(Dilantin)p-
1.pVitaminpApRationale:
p
IsotretinoinpispapmetabolitepofpvitaminpApandpcanpproducepgeneralizedpintensificationpofpisotretinoinpto
xicity.pBecausepofptheppotentialpforpincreasedptoxicity,pvitaminpApsupplementspshouldpbepdiscontinuedpb
eforepisotretinoinptherapy.pOptionsp2,p3,pandp4parepnotpcontraindicatedpwithpthepusepofpisotretinoin.
9.)pThepnursepispapplyingpaptopicalpcorticosteroidptopapclientpwithpeczema.pThepnursepwouldpmonitorpforp
theppotentialpforpincreasedpsystemicpabsorptionpofpthepmedicationpifpthepmedicationpwerepbeingpapplie
dptopwhichpofpthepfollowingpbodypareas?
1. Back
2. Axilla
3. Solespofpthepfeet
4. Palmspofpthephandsp-
2.pAxillapRationale:
p
Topicalpcorticosteroidspcanpbepabsorbedpintopthepsystemicpcirculation.pAbsorptionpisphigherpfrompregion
spwherepthepskinpispespeciallyppermeablep(scalp,paxilla,pface,peyelids,pneck,pperineum,pgenitalia),pandplow
erpfrompregionspinpwhichppermeabilitypisppoorp(back,ppalms,psoles).
10.)pThepclinicpnursepispperformingpanpadmissionpassessmentponpapclient.pThepnursepnotespthatpthepclientpi
sptakingpazelaicpacidp(Azelex).pBecausepofpthepmedicationpprescription,pthepnursepwouldpsuspectpthatpthepc
lientpispbeingptreatedpfor:
1. Acne
p p p
1)pApnursepispcaringpforpapclientpwithphyperparathyroidismpandpnotespthatpthepclient'spserumpcalciumpleve
lpisp13pmg/dL.pWhichpmedicationpshouldpthepnursepprepareptopadministerpaspprescribedptopthepclient?
1. Calciumpchloride
2. Calciumpgluconate
3. Calcitoninp(Miacalcin)
4. LargepdosespofpvitaminpDp-
3.pCalcitoninp(Miacalcin)pRationale:
p
Thepnormalpserumpcalciumplevelpisp8.6ptop10.0pmg/dL.pThispclientpispexperiencingphypercalcemia.pCalcium
pgluconatepandpcalciumpchlorideparepmedicationspusedpforptheptreatmentpofptetany,pwhichpoccurspaspapre
sultpofpacutephypocalcemia.pInphypercalcemia,plargepdosespofpvitaminpDpneedptopbepavoided.pCalcitonin,pap
thyroidphormone,pdecreasespthepplasmapcalciumplevelpbypinhibitingpbonepresorptionpandploweringpthepse
rumpcalciumpconcentration.
2.)pOralpironpsupplementsparepprescribedpforpap6-year-
oldpchildpwithpironpdeficiencypanemia.pThepnursepinstructspthepmotherptopadministerpthepironpwithpwhi
chpbestpfoodpitem?
1. Milk
2. Water
3. Applepjuice
4. Orangepjuicep-
4.pOrangepjuicepRationale:
p
VitaminpCpincreasespthepabsorptionpofpironpbypthepbody.pThepmotherpshouldpbepinstructedptopadministerp
thepmedicationpwithpapcitruspfruitporpapjuicepthatpisphighpinpvitaminpC.pMilkpmaypaffectpabsorptionpofpthepir
on.pWaterpwillpnotpassistpinpabsorption.pOrangepjuicepcontainspapgreaterpamountpofpvitaminpCpthanpapplepj
uice.
,3.)pSalicylicpacidpispprescribedpforpapclientpwithpapdiagnosispofppsoriasis.pThepnursepmonitorspthepclient,pknowi
ngpthatpwhichpofpthepfollowingpwouldpindicateptheppresencepofpsystemicptoxicitypfrompthispmedication?
1. Tinnitus
2. Diarrhea
3. Constipation
4. Decreasedprespirationsp-
1.pTinnituspRationale:
p
Salicylicpacidpispabsorbedpreadilypthroughpthepskin,pandpsystemicptoxicityp(salicylism)pcanpresult.pSymptom
spincludeptinnitus,pdizziness,phyperpnea,pandppsychologicalpdisturbances.pConstipationpandpdiarrheaparepn
otpassociatedpwithpsalicylism.
4.)pThepcamppnursepaskspthepchildrenppreparingptopswimpinptheplakepifptheyphavepappliedpsunscreen.pTh
epnursepremindspthepchildrenpthatpchemicalpsunscreensparepmostpeffectivepwhenpapplied:
1. Immediatelypbeforepswimming
2. 15pminutespbeforepexposureptopthepsun
3. Immediatelypbeforepexposureptopthepsun
4. Atpleastp30pminutespbeforepexposureptopthepsunp-
4.pAtpleastp30pminutespbeforepexposureptopthepsunpRationale:
p
Sunscreensparepmostpeffectivepwhenpappliedpatpleastp30pminutespbeforepexposureptopthepsunpsopthatptheypc
anppenetratepthepskin.pAllpsunscreenspshouldpbepreappliedpafterpswimmingporpsweating.
5.)pMafenidepacetatep(Sulfamylon)pispprescribedpforpthepclientpwithpapburnpinjury.pWhenpapplyingpthe
pmedication,pthepclientpcomplainspofplocalpdiscomfortpandpburning.pWhichpofpthepfollowingpispthepmo
stpappropriatepnursingpaction?
1. Notifyingpthepregisteredpnurse
2. Discontinuingpthepmedication
3. Informingpthepclientpthatpthispispnormal
4. Applyingpapthinnerpfilmpthanpprescribedptopthepburnpsitep-p3.pInformingpthepclientpthatpthispispnormal
,Rationale:
Mafenidepacetatepispbacteriostaticpforpgram-negativepandpgram-
positiveporganismspandpispusedptoptreatpburnsptopreducepbacteriappresentpinpavascularptissues.pThepclientp
shouldpbepinformedpthatpthepmedicationpwillpcauseplocalpdiscomfortpandpburningpandpthatpthispispapnormal
preaction;pthereforepoptionsp1,p2,pandp4parepincorrect
6.)pThepburnpclientpispreceivingptreatmentspofptopicalpmafenidepacetatep(Sulfamylon)ptopthepsitepofpinjury
.pThepnursepmonitorspthepclient,pknowingpthatpwhichpofpthepfollowingpindicatespthatpapsystemicpeffectphas
poccurred?
1.Hyperventilationp2.Elevat
edpbloodppressurep3.Localpp
ainpatpthepburnpsite
4.Localprashpatpthepburnpsitep-
1.HyperventilationpRationale:
p
Mafenidepacetatepispapcarbonicpanhydrasepinhibitorpandpcanpsuppressprenalpexcretionpofpacid,pthereb
ypcausingpacidosis.pClientspreceivingpthisptreatmentpshouldpbepmonitoredpforpsignspofpanpacid-
basepimbalancep(hyperventilation).pIfpthispoccurs,pthepmedicationpshouldpbepdiscontinuedpforp1ptop2pd
ays.pOptionsp3pandp4pdescribeplocalpratherpthanpsystemicpeffects.pAnpelevatedpbloodppressurepmaypbep
expectedpfromptheppainpthatpoccurspwithpapburnpinjury.
7.)pIsotretinoinpispprescribedpforpapclientpwithpseverepacne.pBeforepthepadministrationpofpthispmedication
,pthepnursepanticipatespthatpwhichplaboratoryptestpwillpbepprescribed?
1. Plateletpcount
2. Triglycerideplevel
3. Completepbloodpcount
4. Whitepbloodpcellpcountp-
2.pTriglycerideplevelpRationale:
p
Isotretinoinpcanpelevateptriglycerideplevels.pBloodptriglycerideplevelspshouldpbepmeasuredpbeforeptreatme
ntpandpperiodicallypthereafterpuntilpthepeffectponptheptriglyceridesphaspbeenpevaluated.pOptionsp1,p3,pandp
4pdopnotpneedptopbepmonitoredpspecificallypduringpthisptreatment.
, 8.)pApclientpwithpseverepacnepispseenpinpthepclinicpandpthephealthpcarepproviderp(HCP)pprescribespisotretino
in.pThepnursepreviewspthepclient'spmedicationprecordpandpwouldpcontactpthep(HCP)pifpthepclientpisptakingpw
hichpmedication?
1. VitaminpA
2. Digoxinp(Lanoxin)
3. Furosemidep(Lasix)
4. Phenytoinp(Dilantin)p-
1.pVitaminpApRationale:
p
IsotretinoinpispapmetabolitepofpvitaminpApandpcanpproducepgeneralizedpintensificationpofpisotretinoinpto
xicity.pBecausepofptheppotentialpforpincreasedptoxicity,pvitaminpApsupplementspshouldpbepdiscontinuedpb
eforepisotretinoinptherapy.pOptionsp2,p3,pandp4parepnotpcontraindicatedpwithpthepusepofpisotretinoin.
9.)pThepnursepispapplyingpaptopicalpcorticosteroidptopapclientpwithpeczema.pThepnursepwouldpmonitorpforp
theppotentialpforpincreasedpsystemicpabsorptionpofpthepmedicationpifpthepmedicationpwerepbeingpapplie
dptopwhichpofpthepfollowingpbodypareas?
1. Back
2. Axilla
3. Solespofpthepfeet
4. Palmspofpthephandsp-
2.pAxillapRationale:
p
Topicalpcorticosteroidspcanpbepabsorbedpintopthepsystemicpcirculation.pAbsorptionpisphigherpfrompregion
spwherepthepskinpispespeciallyppermeablep(scalp,paxilla,pface,peyelids,pneck,pperineum,pgenitalia),pandplow
erpfrompregionspinpwhichppermeabilitypisppoorp(back,ppalms,psoles).
10.)pThepclinicpnursepispperformingpanpadmissionpassessmentponpapclient.pThepnursepnotespthatpthepclientpi
sptakingpazelaicpacidp(Azelex).pBecausepofpthepmedicationpprescription,pthepnursepwouldpsuspectpthatpthepc
lientpispbeingptreatedpfor:
1. Acne
