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HESI Pharmacology Exam
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1 of 245
Term
104.) Disulfiram (Antabuse) is prescribed for a client who is seen in
the psychiatric health care clinic. The nurse is collecting data on the
client and is providing instructions regarding the use of this
medication. Which is most important for the nurse to determine
before administration of this medication?
1. A history of hyperthyroidism
2. A history of diabetes insipidus
3. When the last full meal was consumed
4. When the last alcoholic drink was consumed
Give this one a go later!
4. Withhold the medication and call the HCP if the pulse is less than 60 beats per
minute.
Rationale:
An important component of taking this medication is monitoring the pulse rate;
however, it is not necessary for the client to take both the radial and carotid
pulses. It is not necessary for the client to check the blood pressure every
morning and evening because the medication does not directly affect blood
pressure. It is most important for the client to know the guidelines related to
withholding the medication and calling the HCP. The client should not stop
taking a medication.
4. When the last alcoholic drink was consumed
Rationale:
Disulfiram is used as an adjunct treatment for selected clients with chronic
alcoholism who want to remain in a state of enforced sobriety. Clients must
abstain from alcohol intake for at least 12 hours before the initial dose of
the medication is administered. The most important data are to determine
when the last alcoholic drink was consumed. The medication is used with
caution in clients with diabetes mellitus, hypothyroidism, epilepsy, cerebral
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damage, nephritis, and hepatic disease. It is also contraindicated in severe
heart disease, psychosis, or hypersensitivity related to the medication.
2. Take the daily dose at bedtime.
Rationale:
The client taking a single daily dose of theophylline, a xanthine bronchodilator,
should take the medication early in the morning. This enables the client to have
maximal benefit from the medication during daytime activities. In addition, this
medication causes insomnia. The client should take in at least 2 L of fluid per day
to decrease viscosity of secretions. The client should check with the physician
before changing brands of the medication. The client also checks with the HCP
before taking OTC cough, cold, or other respiratory preparations because they
could cause interactive effects, increasing the side effects of theophylline and
causing dysrhythmias.
4. Getting baseline postural blood pressures before administering the
medication and each time the medication is administered
Rationale:
Amitriptyline hydrochloride is a tricyclic antidepressant often used to treat
depression. It causes orthostatic changes and can produce hypotension and
tachycardia. This can be frightening to the client and dangerous because it can
result in dizziness and client falls. The client must be instructed to move slowly
from a lying to a sitting to a standing position to avoid injury if these effects are
experienced. The client may also experience sedation, dry mouth, constipation,
blurred vision, and other anticholinergic effects, but these are transient and will
diminish with time.
Don't know?
2 of 245
Term
178.) Methylergonovine (Methergine) is prescribed for a client with
postpartum hemorrhage caused by uterine atony. Before
administering the medication, the nurse checks which of the
following as the important client parameter?
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1. Temperature
2. Lochial flow
3. Urine output
4. Blood pressure
Give this one a go later!
3. Blood pressure of 198/110 mm Hg
Rationale:
Thrombolytic therapy is contraindicated in a number of preexisting conditions in
which there is a risk of uncontrolled bleeding, similar to the case in anticoagulant
therapy. Thrombolytic therapy also is contraindicated in severe uncontrolled
hypertension because of the risk of cerebral hemorrhage. Therefore the nurse
would report the results of the blood pressure to the registered nurse before
initiating therapy. The findings in options 1, 2, and 4 may be present in the client
with pulmonary embolism.
2. Increase fluid intake to 2000 to 3000 mL daily.
Rationale:
Hemorrhagic cystitis is a toxic effect that can occur with the use of
cyclophosphamide. The client needs to be instructed to drink copious amounts
of fluid during the administration of this medication. Clients also should monitor
urine output for hematuria. The medication should be taken on an empty
stomach, unless gastrointestinal (GI) upset occurs. Hyperkalemia can result from
the use of the medication; therefore the client would not be told to increase
potassium intake. The client would not be instructed to alter sodium intake.
4. Blood pressure
Rationale:
Methylergonovine is an ergot alkaloid used for postpartum hemorrhage. It
stimulates contraction of the uterus and causes arterial vasoconstriction.
Ergot alkaloids are avoided in clients with significant cardiovascular
disease, peripheral disease, hypertension, eclampsia, or preeclampsia.
These conditions are worsened by the vasoconstrictive effects of the ergot
alkaloids. The nurse would check the client's blood pressure before
administering the medication and would follow agency protocols
regarding withholding of the medication. Options 1, 2, and 3 are items that
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1 of 245
Term
104.) Disulfiram (Antabuse) is prescribed for a client who is seen in
the psychiatric health care clinic. The nurse is collecting data on the
client and is providing instructions regarding the use of this
medication. Which is most important for the nurse to determine
before administration of this medication?
1. A history of hyperthyroidism
2. A history of diabetes insipidus
3. When the last full meal was consumed
4. When the last alcoholic drink was consumed
Give this one a go later!
4. Withhold the medication and call the HCP if the pulse is less than 60 beats per
minute.
Rationale:
An important component of taking this medication is monitoring the pulse rate;
however, it is not necessary for the client to take both the radial and carotid
pulses. It is not necessary for the client to check the blood pressure every
morning and evening because the medication does not directly affect blood
pressure. It is most important for the client to know the guidelines related to
withholding the medication and calling the HCP. The client should not stop
taking a medication.
4. When the last alcoholic drink was consumed
Rationale:
Disulfiram is used as an adjunct treatment for selected clients with chronic
alcoholism who want to remain in a state of enforced sobriety. Clients must
abstain from alcohol intake for at least 12 hours before the initial dose of
the medication is administered. The most important data are to determine
when the last alcoholic drink was consumed. The medication is used with
caution in clients with diabetes mellitus, hypothyroidism, epilepsy, cerebral
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damage, nephritis, and hepatic disease. It is also contraindicated in severe
heart disease, psychosis, or hypersensitivity related to the medication.
2. Take the daily dose at bedtime.
Rationale:
The client taking a single daily dose of theophylline, a xanthine bronchodilator,
should take the medication early in the morning. This enables the client to have
maximal benefit from the medication during daytime activities. In addition, this
medication causes insomnia. The client should take in at least 2 L of fluid per day
to decrease viscosity of secretions. The client should check with the physician
before changing brands of the medication. The client also checks with the HCP
before taking OTC cough, cold, or other respiratory preparations because they
could cause interactive effects, increasing the side effects of theophylline and
causing dysrhythmias.
4. Getting baseline postural blood pressures before administering the
medication and each time the medication is administered
Rationale:
Amitriptyline hydrochloride is a tricyclic antidepressant often used to treat
depression. It causes orthostatic changes and can produce hypotension and
tachycardia. This can be frightening to the client and dangerous because it can
result in dizziness and client falls. The client must be instructed to move slowly
from a lying to a sitting to a standing position to avoid injury if these effects are
experienced. The client may also experience sedation, dry mouth, constipation,
blurred vision, and other anticholinergic effects, but these are transient and will
diminish with time.
Don't know?
2 of 245
Term
178.) Methylergonovine (Methergine) is prescribed for a client with
postpartum hemorrhage caused by uterine atony. Before
administering the medication, the nurse checks which of the
following as the important client parameter?
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1. Temperature
2. Lochial flow
3. Urine output
4. Blood pressure
Give this one a go later!
3. Blood pressure of 198/110 mm Hg
Rationale:
Thrombolytic therapy is contraindicated in a number of preexisting conditions in
which there is a risk of uncontrolled bleeding, similar to the case in anticoagulant
therapy. Thrombolytic therapy also is contraindicated in severe uncontrolled
hypertension because of the risk of cerebral hemorrhage. Therefore the nurse
would report the results of the blood pressure to the registered nurse before
initiating therapy. The findings in options 1, 2, and 4 may be present in the client
with pulmonary embolism.
2. Increase fluid intake to 2000 to 3000 mL daily.
Rationale:
Hemorrhagic cystitis is a toxic effect that can occur with the use of
cyclophosphamide. The client needs to be instructed to drink copious amounts
of fluid during the administration of this medication. Clients also should monitor
urine output for hematuria. The medication should be taken on an empty
stomach, unless gastrointestinal (GI) upset occurs. Hyperkalemia can result from
the use of the medication; therefore the client would not be told to increase
potassium intake. The client would not be instructed to alter sodium intake.
4. Blood pressure
Rationale:
Methylergonovine is an ergot alkaloid used for postpartum hemorrhage. It
stimulates contraction of the uterus and causes arterial vasoconstriction.
Ergot alkaloids are avoided in clients with significant cardiovascular
disease, peripheral disease, hypertension, eclampsia, or preeclampsia.
These conditions are worsened by the vasoconstrictive effects of the ergot
alkaloids. The nurse would check the client's blood pressure before
administering the medication and would follow agency protocols
regarding withholding of the medication. Options 1, 2, and 3 are items that
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