HESI PHARMACOLOGY PRACTICE EXAM
QUESTIONS AND CORRECT ANSWERS WITH
RATIONALES
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. -Answer:-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 is taking hydromorphone (Dilaudid) PO q4h at home. Following
surgery, Dilaudid IV q4h PRN and butorphanol tartrate (Stadol) IV q4h PRN
are prescribed for pain. The client received a dose of the Dilaudid IV four
hours ago, and is again requesting pain medication. What intervention should
the nurse implement?
A) Alternate the two medications q4h PRN for pain.
B) Alternate the two medications q2h PRN for pain.
C) Administer only the Dilaudid q4h PRN for pain.
D) Administer only the Stadol q4h PRN for pain. -Answer:-C.
Dilaudid is an opioid agonist. Stadol is an opioid agonist-antagonist. Use of an
agonist-antagonist for the client who has been receiving opioid agonists may
,result in abrupt withdrawal symptoms, and should be avoided (C). (A, B, and
D) do not reflect good nursing practice.
A 43-year-old female client is receiving thyroid replacement hormone
following a thyroidectomy. What adverse effects associated with thyroid
hormone toxicity should the nurse instruct the client to report promptly to the
healthcare provider?
A) Tinnitus and dizziness.
B) Tachycardia and chest pain.
C) Dry skin and intolerance to cold.
D) Weight gain and increased appetite. -Answer:-B. Thyroid replacement
hormone increases the metabolic rate of all tissues, so common signs and
symptoms of toxicity include tachycardia and chest pain (B). (A, C, and D) do
not indicate a thyroid hormone toxicity.
Which drug is used as a palliative treatment for a client with tumor-induced
spinal cord compression?
A) Morphine Sulfate (Duromorph).
B) Ibuprofen (Advil).
C) Amitriptyline (Amitril).
D) Dexamethasone (Decadron). -Answer:-D.
Dexamethasone (D) is a palliative treatment modality to manage symptoms
related to compression due to tumor growth. Morphine sulphate (A) is an
opioid analgesic used in oncology to manage severe or intractable pain.
Ibuprofen (B), a nonsteroidal antiinflammatory drug (NSAID), provides relief
for mild to moderate pain, suppression of inflammation, and reduction of
fever. Amitriptyline (C), a tricyclic antidepressant, is often prescribed for pain
related to neuropathic origin and provides a reduction in opioid dosage.
, A client is receiving metoprolol (Lopressor SR). What assessment is most
important for the nurse to obtain?
A) Temperature.
B) Lung sounds.
C) Blood pressure.
D) Urinary output. -Answer:-C.
It is most important to monitor the blood pressure (C) of clients taking this
medication because Lopressor is an antianginal, antiarrhythmic,
antihypertensive agent. While (A and B) are important data to obtain on any
client, they are not as important for a client receiving Lopressor as (C). Intake
and output ratios and daily weights should be monitored while taking
Lopressor to assess for signs and symptoms of congestive heart failure, but
(D) alone does not have the importance of (C).
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. -Answer:-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.
QUESTIONS AND CORRECT ANSWERS WITH
RATIONALES
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. -Answer:-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 is taking hydromorphone (Dilaudid) PO q4h at home. Following
surgery, Dilaudid IV q4h PRN and butorphanol tartrate (Stadol) IV q4h PRN
are prescribed for pain. The client received a dose of the Dilaudid IV four
hours ago, and is again requesting pain medication. What intervention should
the nurse implement?
A) Alternate the two medications q4h PRN for pain.
B) Alternate the two medications q2h PRN for pain.
C) Administer only the Dilaudid q4h PRN for pain.
D) Administer only the Stadol q4h PRN for pain. -Answer:-C.
Dilaudid is an opioid agonist. Stadol is an opioid agonist-antagonist. Use of an
agonist-antagonist for the client who has been receiving opioid agonists may
,result in abrupt withdrawal symptoms, and should be avoided (C). (A, B, and
D) do not reflect good nursing practice.
A 43-year-old female client is receiving thyroid replacement hormone
following a thyroidectomy. What adverse effects associated with thyroid
hormone toxicity should the nurse instruct the client to report promptly to the
healthcare provider?
A) Tinnitus and dizziness.
B) Tachycardia and chest pain.
C) Dry skin and intolerance to cold.
D) Weight gain and increased appetite. -Answer:-B. Thyroid replacement
hormone increases the metabolic rate of all tissues, so common signs and
symptoms of toxicity include tachycardia and chest pain (B). (A, C, and D) do
not indicate a thyroid hormone toxicity.
Which drug is used as a palliative treatment for a client with tumor-induced
spinal cord compression?
A) Morphine Sulfate (Duromorph).
B) Ibuprofen (Advil).
C) Amitriptyline (Amitril).
D) Dexamethasone (Decadron). -Answer:-D.
Dexamethasone (D) is a palliative treatment modality to manage symptoms
related to compression due to tumor growth. Morphine sulphate (A) is an
opioid analgesic used in oncology to manage severe or intractable pain.
Ibuprofen (B), a nonsteroidal antiinflammatory drug (NSAID), provides relief
for mild to moderate pain, suppression of inflammation, and reduction of
fever. Amitriptyline (C), a tricyclic antidepressant, is often prescribed for pain
related to neuropathic origin and provides a reduction in opioid dosage.
, A client is receiving metoprolol (Lopressor SR). What assessment is most
important for the nurse to obtain?
A) Temperature.
B) Lung sounds.
C) Blood pressure.
D) Urinary output. -Answer:-C.
It is most important to monitor the blood pressure (C) of clients taking this
medication because Lopressor is an antianginal, antiarrhythmic,
antihypertensive agent. While (A and B) are important data to obtain on any
client, they are not as important for a client receiving Lopressor as (C). Intake
and output ratios and daily weights should be monitored while taking
Lopressor to assess for signs and symptoms of congestive heart failure, but
(D) alone does not have the importance of (C).
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. -Answer:-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.
