HESI RN Pharmacology Practice Exam.
Which nursing diagnosis is important to include in the plan of care for a client
receiving the angiotensin-2 receptor antagonist irbesartan (Avapro)?
A. Fluid volume deficit.
B. Risk for infection.
C. Risk for injury.
D. Impaired sleep patterns.
C. Risk for injury.
- Avapro is an antihypertensive agent, which acts by blocking vasoconstrictor
effects at various receptor sites. This can cause hypotension and dizziness,
placing the client at high risk for injury.
Which instruction(s) should the nurse give to a female client who just received a
prescription for oral metronidazole (Flagyl) for treatment of trichomonas
vaginalis? (Select all that apply.)
A. Increase fluid intake, especially cranberry juice.
B. Do not abruptly discontinue the medication; taper use.
C. Check blood pressure daily to detect hypertension.
D. Avoid drinking alcohol while taking this medication.
E. Use condoms until treatment is completed.
F. Ensure that all sexual partners are treated at the same time.
( A, D, E, F )
Increased fluid intake and cranberry juice are recommended for prevention and
treatment of urinary tract infections, which frequently accompany vaginal
infections. It is not necessary to taper use of this drug or to check the blood
pressure daily, as this condition is not related to hypertension. Flagyl can cause a
disulfiram-like reaction if taken in conjunction with ingestion of alcohol, so the
client should be instructed to avoid alcohol. All sexual partners should be treated
at the same time and condoms should be used until after treatment is completed
to avoid reinfection.
A client is receiving clonidine (Catapres) 0.1 mg/24hr via transdermal patch.
Which assessment finding indicates that the desired effect of the medication has
been achieved?
A. Client denies recent episodes of angina.
B. Change in peripheral edema from +3 to +1.
C. Client denies recent nausea or vomiting.
D. Blood pressure has changed from 180/120 to 140/70 mmHg.
D. Blood pressure has changed from 180/120 to 140/70 mmHg.
- Catapres acts as a centrally-acting analgesic and antihypertensive agent. A
reduction of the blood pressure to 140/70 mmHg indicates a reduction in
hypertension.
A client with coronary artery disease who is taking digoxin (Lanoxin) receives a
new prescription for atorvastatin (Lipitor). Two weeks after initiation of the Lipitor
prescription, the nurse assesses the client. Which finding requires the most
immediate intervention?
,A. Heartburn.
B. Headache.
C. Constipation.
D. Vomiting.
D. Vomiting.
- Vomiting, anorexia and abdominal pain are early indications of digitalis toxicity.
Since Lipitor increases the risk for digitalis toxicity, this finding requires the most
immediate intervention by the nurse.
A medication that is classified as a beta-1 agonist is most commonly prescribed
for a client with which condition?
A. Glaucoma.
B. Hypertension.
C. Heart failure.
D. Asthma.
C. Heart failure.
- Beta-1 agonists improve cardiac output by increasing the heart rate and blood
pressure and are indicated in heart failure, shock, atrioventricular block
dysrhythmias, and cardiac arrest. In contrast, glaucoma is managed using
adrenergic agents and beta-adrenergic blocking agents. Beta-1 blocking agents
are used in the management of hypertension. Medications that stimulate beta-2
receptors in the bronchi are effective for bronchoconstriction in respiratory
disorders, such as asthma.
The nurse is assessing a client who is experiencing anaphylaxis from an insect
sting. Which prescription should the nurse prepare to administer this client?
A. Dopamine.
B. Ephedrine.
C. Epinephrine.
D. Diphenhydramine.
C. Epinephrine.
- Epinephrine is an adrenergic agent that stimulates beta receptors to increase
cardiac automaticity in cardiac arrest and relax bronchospasms in anaphylaxis.
On the ither hand, dopamine is a vasopressor used to treat clients with shock.
Ephedrine causes peripheral vasoconstriction and is used in the treatment of
nasal congestion. Diphenhydramine is an antihistamine decongestant used in the
treatment of mild allergic reactions and motion sickness. Epinephrine is the
medication of choice in treating anaphylaxis.
Which medications should the nurse caution the client about taking while
receiving an opioid analgesic?
A. Antacids.
B. Benzodiazepines.
C. Antihypertensives.
D. Oral antidiabetics.
B. Benzodiazepines.
- Respiratory depression increases with the concurrent use of opioid analgesics
and other central nervous system depressant agents, such as alcohol,
barbiturates, and benzodiazepines. Antacids and antidiabetic agents do not
, interact with opiates to produce adverse effects. Antihypertensives may cause
morphine-induced hypotension, but should not be withheld without notifying the
healthcare provider.
A client with a dysrhythmia is to receive procainamide (Pronestyl) in 4 divided
doses over the next 24 hours. What dosing schedule is best for the nurse to
implement?
A. q6h.
B. QID.
C. AC and bedtime.
D. PC and bedtime.
A. q6h.
- Pronestyl is a class 1A antidysrhythmic. It should be taken around-the-clock, so
that a stable blood level of the drug can be maintained, thereby decreasing the
possibility of hypotension (an adverse effect) occurring because of too much of
the drug circulating systemically at any particular time of day. Pronestyl may be
given with food if GI distress is a problem.
A client is receiving ampicillin sodium (Omnipen) for a sinus infection. The nurse
should instruct the client to notify the healthcare provider immediately if which
symptom occurs?
A. Rash.
B. Nausea.
C. Headache.
D. Dizziness.
A. Rash.
- Rash is the most common adverse effect of all penicillins, indicating an allergy
to the medication which could result in anaphylactic shock, a medical emergency.
An adult client has prescriptions for morphine sulfate 2.5 mg IV q6h and ketorolac
(Toradol) 30 mg IV q6h. Which action should the nurse implement?
A. Administer both medications according to the prescription.
B. Hold the ketorolac to prevent an antagonistic effect.
C. Hold the morphine to prevent an additive drug interaction.
D. Contact the healthcare provider to clarify the prescription.
A. Administer both medications according to the prescription.
-
Morphine and ketorolac (Toradol) can be administered concurrently, and may
produce an additive analgesic effect, resulting in the ability to reduce the dose of
morphine, as seen in this prescription. Toradol is an antiinflammatory analgesic,
and does not have an antagonistic effect with morphine.
In teaching a client who had a liver transplant about cyclosporine (Sandimmune),
the nurse should encourage the client to report which adverse response to the
healthcare provider?
A. Changes in urine color.
B. Presence of hand tremors.
C. Increasing body hirsutism.
D. Nausea and vomiting.
B. Presence of hand tremors.
Which nursing diagnosis is important to include in the plan of care for a client
receiving the angiotensin-2 receptor antagonist irbesartan (Avapro)?
A. Fluid volume deficit.
B. Risk for infection.
C. Risk for injury.
D. Impaired sleep patterns.
C. Risk for injury.
- Avapro is an antihypertensive agent, which acts by blocking vasoconstrictor
effects at various receptor sites. This can cause hypotension and dizziness,
placing the client at high risk for injury.
Which instruction(s) should the nurse give to a female client who just received a
prescription for oral metronidazole (Flagyl) for treatment of trichomonas
vaginalis? (Select all that apply.)
A. Increase fluid intake, especially cranberry juice.
B. Do not abruptly discontinue the medication; taper use.
C. Check blood pressure daily to detect hypertension.
D. Avoid drinking alcohol while taking this medication.
E. Use condoms until treatment is completed.
F. Ensure that all sexual partners are treated at the same time.
( A, D, E, F )
Increased fluid intake and cranberry juice are recommended for prevention and
treatment of urinary tract infections, which frequently accompany vaginal
infections. It is not necessary to taper use of this drug or to check the blood
pressure daily, as this condition is not related to hypertension. Flagyl can cause a
disulfiram-like reaction if taken in conjunction with ingestion of alcohol, so the
client should be instructed to avoid alcohol. All sexual partners should be treated
at the same time and condoms should be used until after treatment is completed
to avoid reinfection.
A client is receiving clonidine (Catapres) 0.1 mg/24hr via transdermal patch.
Which assessment finding indicates that the desired effect of the medication has
been achieved?
A. Client denies recent episodes of angina.
B. Change in peripheral edema from +3 to +1.
C. Client denies recent nausea or vomiting.
D. Blood pressure has changed from 180/120 to 140/70 mmHg.
D. Blood pressure has changed from 180/120 to 140/70 mmHg.
- Catapres acts as a centrally-acting analgesic and antihypertensive agent. A
reduction of the blood pressure to 140/70 mmHg indicates a reduction in
hypertension.
A client with coronary artery disease who is taking digoxin (Lanoxin) receives a
new prescription for atorvastatin (Lipitor). Two weeks after initiation of the Lipitor
prescription, the nurse assesses the client. Which finding requires the most
immediate intervention?
,A. Heartburn.
B. Headache.
C. Constipation.
D. Vomiting.
D. Vomiting.
- Vomiting, anorexia and abdominal pain are early indications of digitalis toxicity.
Since Lipitor increases the risk for digitalis toxicity, this finding requires the most
immediate intervention by the nurse.
A medication that is classified as a beta-1 agonist is most commonly prescribed
for a client with which condition?
A. Glaucoma.
B. Hypertension.
C. Heart failure.
D. Asthma.
C. Heart failure.
- Beta-1 agonists improve cardiac output by increasing the heart rate and blood
pressure and are indicated in heart failure, shock, atrioventricular block
dysrhythmias, and cardiac arrest. In contrast, glaucoma is managed using
adrenergic agents and beta-adrenergic blocking agents. Beta-1 blocking agents
are used in the management of hypertension. Medications that stimulate beta-2
receptors in the bronchi are effective for bronchoconstriction in respiratory
disorders, such as asthma.
The nurse is assessing a client who is experiencing anaphylaxis from an insect
sting. Which prescription should the nurse prepare to administer this client?
A. Dopamine.
B. Ephedrine.
C. Epinephrine.
D. Diphenhydramine.
C. Epinephrine.
- Epinephrine is an adrenergic agent that stimulates beta receptors to increase
cardiac automaticity in cardiac arrest and relax bronchospasms in anaphylaxis.
On the ither hand, dopamine is a vasopressor used to treat clients with shock.
Ephedrine causes peripheral vasoconstriction and is used in the treatment of
nasal congestion. Diphenhydramine is an antihistamine decongestant used in the
treatment of mild allergic reactions and motion sickness. Epinephrine is the
medication of choice in treating anaphylaxis.
Which medications should the nurse caution the client about taking while
receiving an opioid analgesic?
A. Antacids.
B. Benzodiazepines.
C. Antihypertensives.
D. Oral antidiabetics.
B. Benzodiazepines.
- Respiratory depression increases with the concurrent use of opioid analgesics
and other central nervous system depressant agents, such as alcohol,
barbiturates, and benzodiazepines. Antacids and antidiabetic agents do not
, interact with opiates to produce adverse effects. Antihypertensives may cause
morphine-induced hypotension, but should not be withheld without notifying the
healthcare provider.
A client with a dysrhythmia is to receive procainamide (Pronestyl) in 4 divided
doses over the next 24 hours. What dosing schedule is best for the nurse to
implement?
A. q6h.
B. QID.
C. AC and bedtime.
D. PC and bedtime.
A. q6h.
- Pronestyl is a class 1A antidysrhythmic. It should be taken around-the-clock, so
that a stable blood level of the drug can be maintained, thereby decreasing the
possibility of hypotension (an adverse effect) occurring because of too much of
the drug circulating systemically at any particular time of day. Pronestyl may be
given with food if GI distress is a problem.
A client is receiving ampicillin sodium (Omnipen) for a sinus infection. The nurse
should instruct the client to notify the healthcare provider immediately if which
symptom occurs?
A. Rash.
B. Nausea.
C. Headache.
D. Dizziness.
A. Rash.
- Rash is the most common adverse effect of all penicillins, indicating an allergy
to the medication which could result in anaphylactic shock, a medical emergency.
An adult client has prescriptions for morphine sulfate 2.5 mg IV q6h and ketorolac
(Toradol) 30 mg IV q6h. Which action should the nurse implement?
A. Administer both medications according to the prescription.
B. Hold the ketorolac to prevent an antagonistic effect.
C. Hold the morphine to prevent an additive drug interaction.
D. Contact the healthcare provider to clarify the prescription.
A. Administer both medications according to the prescription.
-
Morphine and ketorolac (Toradol) can be administered concurrently, and may
produce an additive analgesic effect, resulting in the ability to reduce the dose of
morphine, as seen in this prescription. Toradol is an antiinflammatory analgesic,
and does not have an antagonistic effect with morphine.
In teaching a client who had a liver transplant about cyclosporine (Sandimmune),
the nurse should encourage the client to report which adverse response to the
healthcare provider?
A. Changes in urine color.
B. Presence of hand tremors.
C. Increasing body hirsutism.
D. Nausea and vomiting.
B. Presence of hand tremors.
