HESI Pharmacology Exam
2.) Oral iron supplements are prescribed for a 6-year-old child with iron
deficiency
anemia. The nurse instructs the mother to administer the iron with
which best food
item
?1.
Milk
2.
Water
3. Apple
juice
4. Orange juice correct answers 4. Orange
juice
Rational
e:
Vitamin C increases the absorption of iron by the body. The mother should be
instructed
to administer the medication with a citrus fruit or a juice that is high in
vitamin
may C. Milk
affect absorption of the iron. Water will not assist in absorption.
Orange juice
contains a greater amount of vitamin C than
apple juice.
3.) Salicylic acid is prescribed for a client with a diagnosis of psoriasis.
The nursethe client, knowing that which of the following would indicate the
monitors
presence toxicity
systemic of from this
medication?
1.
Tinnitus
2.
Diarrhea
3.
Constipation
4. Decreased respirations correct answers 1.
Tinnitus
Rational
e:
Salicylic acid is absorbed readily through the skin, and systemic toxicity
(salicylism)
result. Symptoms can include tinnitus, dizziness, hyperpnea, and
psychological
disturbances. Constipation and diarrhea are not associated with
salicylism.
22.) A nurse is caring for a client after thyroidectomy and notes that
calcium
is gluconate
prescribed for the client. The nurse determines that this medication
has been
prescribed
to:
1. Treat thyroid
storm.
2. Prevent cardiac
irritability.
3. Treat hypocalcemic
4. Stimulate the release of parathyroid hormone. correct
tetany.
answers 3. Treat
hypocalcemic
tetany.
Rational
e:
Hypocalcemia can develop after thyroidectomy if the parathyroid glands are
accidentally
removed or injured during surgery. Manifestations develop 1 to 7 days after
surgery.
the clientIf develops numbness and tingling around the mouth, fingertips,
or toes or
muscle spasms or twitching, the health care provider is notified
immediately.
gluconate Calcium
should be kept at the
bedside.
,23.) A client who has been newly diagnosed with diabetes mellitus has been
stabilized
with daily insulin injections. Which information should the nurse teach when
carrying
plans for out
discharge?
1. Keep insulin vials refrigerated at all
times.
2. Rotate the insulin injection sites
systematically.
3. Increase the amount of insulin before unusual
exercise.
4. Monitor the urine acetone level to determine the insulin dosage. correct
answers
Rotate the2.insulin injection sites
systematically.
Rational
e:
Insulin dosages should not be adjusted or increased before unusual exercise.
If acetone
is found in the urine, it may possibly indicate the need for additional insulin.
To minimize
the discomfort associated with insulin injections, the insulin should be
administered
room temperature.at Injection sites should be systematically rotated from
one areaThe
another. to client should be instructed to give injections in one area,
about 1
apart, inchthe whole area has been used and then to change to
until
prevents
another site. dramatic
This changes in daily insulin
absorption.
24.) A nurse is reinforcing teaching for a client regarding how to mix regular
insulin
NPH and in the same syringe. Which of the following actions, if
insulin
performed
client, by the
indicates the need for further
teaching?
1. Withdraws the NPH insulin
first
2. Withdraws the regular
insulin
3. Injectsfirst
air into NPH insulin vial
first
4. Injects an amount of air equal to the desired dose of insulin into the
vial correct
answers 1. Withdraws the NPH
insulin first
Rational
e:
When preparing a mixture of regular insulin with another insulin preparation,
the regular
insulin is drawn into the syringe first. This sequence will avoid
contaminating
regular the vial
insulin with of of another type. Options 2, 3, and 4 identify
insulin
the correct
actions for preparing NPH and regular
insulin.
25.) A home care nurse visits a client recently diagnosed with diabetes
mellitusHumulin
taking who is NPH insulin daily. The client asks the nurse how to store the
unopened
vials of insulin. The nurse tells the
client to: the
1. Freeze
insulin.
2. Refrigerate the
3. Store the insulin in a dark, dry
insulin.
place.
4. Keep the insulin at room temperature. correct answers 2. Refrigerate
the insulin.
Rational
e:
Insulin in unopened vials should be stored under refrigeration until needed.
Vialsbe
not should
frozen. When stored unopened under refrigeration, insulin can be
used up todate
expiration the on the vial. Options 1, 3, and 4 are
incorrect.
27.) Sildenafil (Viagra) is prescribed to treat a client with erectile
dysfunction.
reviews the client's
A nursemedical record and would question the prescription if
which of the
following is noted in the client's
history?
, 1.
Neuralgia
2.
Insomnia
3. Use of
nitroglycerin
4. Use of multivitamins correct answers 3. Use of
nitroglycerin
Rational
e:
Sildenafil (Viagra) enhances the vasodilating effect of nitric oxide in
the corpus of the penis, thus sustaining an erection. Because of the
cavernosum
effect of the it is contraindicated with concurrent use of organic
medication,
nitrates and Sildenafil is not contraindicated with the use of vitamins.
nitroglycerin.
Neuralgiaare
insomnia andside effects of the
medication.
28.) The health care provider (HCP) prescribes exenatide (Byetta) for a
client
1 with type
diabetes mellitus who takes insulin. The nurse knows that which of the
following is the
appropriate
intervention?
1. The medication is administered within 60 minutes before the morning
and evening
meal
.2. The medication is withheld and the HCP is called to question the
prescription for the
clien
t.3. The client is monitored for gastrointestinal side effects after
administration of the
medicatio
n.
4. The insulin is withdrawn from the Penlet into an insulin syringe to
prepare for
administration. correct answers 2. The medication is withheld and the HCP
is called to
question the prescription for the
client.
Rational
e:
Exenatide (Byetta) is an incretin mimetic used for type 2 diabetes mellitus
only. It is not for clients taking insulin. Hence, the nurse should hold the
recommended
medication
and question the HCP regarding this prescription. Although options 1 and 3
are correct about the medication, in this situation the medication
statements
should not be The medication is packaged in prefilled pens ready for
administered.
injection
the need without
for drawing it up into another
syringe.
29.) A client is taking Humulin NPH insulin daily every morning. The nurse
reinforces
instructions for the client and tells the client that the most likely time for a
hypoglycemic
reaction to occur
is:
1. 2 to 4 hours after
administration
2. 4 to 12 hours after
3. 16 to 18 hours after
administration
administration
4. 18 to 24 hours after administration correct answers 2. 4 to 12
hours after
administrati
on
Rational
e:
Humulin NPH is an intermediate-acting insulin. The onset of action is 1.5
hours,
in 4 to it
12peaks
hours, and its duration of action is 24 hours. Hypoglycemic
reactions
likely occur most
during peak
time.
30.) A client with diabetes mellitus visits a health care clinic. The
client's diabetes
mellitus previously had been well controlled with glyburide (DiaBeta) daily,
but recently
2.) Oral iron supplements are prescribed for a 6-year-old child with iron
deficiency
anemia. The nurse instructs the mother to administer the iron with
which best food
item
?1.
Milk
2.
Water
3. Apple
juice
4. Orange juice correct answers 4. Orange
juice
Rational
e:
Vitamin C increases the absorption of iron by the body. The mother should be
instructed
to administer the medication with a citrus fruit or a juice that is high in
vitamin
may C. Milk
affect absorption of the iron. Water will not assist in absorption.
Orange juice
contains a greater amount of vitamin C than
apple juice.
3.) Salicylic acid is prescribed for a client with a diagnosis of psoriasis.
The nursethe client, knowing that which of the following would indicate the
monitors
presence toxicity
systemic of from this
medication?
1.
Tinnitus
2.
Diarrhea
3.
Constipation
4. Decreased respirations correct answers 1.
Tinnitus
Rational
e:
Salicylic acid is absorbed readily through the skin, and systemic toxicity
(salicylism)
result. Symptoms can include tinnitus, dizziness, hyperpnea, and
psychological
disturbances. Constipation and diarrhea are not associated with
salicylism.
22.) A nurse is caring for a client after thyroidectomy and notes that
calcium
is gluconate
prescribed for the client. The nurse determines that this medication
has been
prescribed
to:
1. Treat thyroid
storm.
2. Prevent cardiac
irritability.
3. Treat hypocalcemic
4. Stimulate the release of parathyroid hormone. correct
tetany.
answers 3. Treat
hypocalcemic
tetany.
Rational
e:
Hypocalcemia can develop after thyroidectomy if the parathyroid glands are
accidentally
removed or injured during surgery. Manifestations develop 1 to 7 days after
surgery.
the clientIf develops numbness and tingling around the mouth, fingertips,
or toes or
muscle spasms or twitching, the health care provider is notified
immediately.
gluconate Calcium
should be kept at the
bedside.
,23.) A client who has been newly diagnosed with diabetes mellitus has been
stabilized
with daily insulin injections. Which information should the nurse teach when
carrying
plans for out
discharge?
1. Keep insulin vials refrigerated at all
times.
2. Rotate the insulin injection sites
systematically.
3. Increase the amount of insulin before unusual
exercise.
4. Monitor the urine acetone level to determine the insulin dosage. correct
answers
Rotate the2.insulin injection sites
systematically.
Rational
e:
Insulin dosages should not be adjusted or increased before unusual exercise.
If acetone
is found in the urine, it may possibly indicate the need for additional insulin.
To minimize
the discomfort associated with insulin injections, the insulin should be
administered
room temperature.at Injection sites should be systematically rotated from
one areaThe
another. to client should be instructed to give injections in one area,
about 1
apart, inchthe whole area has been used and then to change to
until
prevents
another site. dramatic
This changes in daily insulin
absorption.
24.) A nurse is reinforcing teaching for a client regarding how to mix regular
insulin
NPH and in the same syringe. Which of the following actions, if
insulin
performed
client, by the
indicates the need for further
teaching?
1. Withdraws the NPH insulin
first
2. Withdraws the regular
insulin
3. Injectsfirst
air into NPH insulin vial
first
4. Injects an amount of air equal to the desired dose of insulin into the
vial correct
answers 1. Withdraws the NPH
insulin first
Rational
e:
When preparing a mixture of regular insulin with another insulin preparation,
the regular
insulin is drawn into the syringe first. This sequence will avoid
contaminating
regular the vial
insulin with of of another type. Options 2, 3, and 4 identify
insulin
the correct
actions for preparing NPH and regular
insulin.
25.) A home care nurse visits a client recently diagnosed with diabetes
mellitusHumulin
taking who is NPH insulin daily. The client asks the nurse how to store the
unopened
vials of insulin. The nurse tells the
client to: the
1. Freeze
insulin.
2. Refrigerate the
3. Store the insulin in a dark, dry
insulin.
place.
4. Keep the insulin at room temperature. correct answers 2. Refrigerate
the insulin.
Rational
e:
Insulin in unopened vials should be stored under refrigeration until needed.
Vialsbe
not should
frozen. When stored unopened under refrigeration, insulin can be
used up todate
expiration the on the vial. Options 1, 3, and 4 are
incorrect.
27.) Sildenafil (Viagra) is prescribed to treat a client with erectile
dysfunction.
reviews the client's
A nursemedical record and would question the prescription if
which of the
following is noted in the client's
history?
, 1.
Neuralgia
2.
Insomnia
3. Use of
nitroglycerin
4. Use of multivitamins correct answers 3. Use of
nitroglycerin
Rational
e:
Sildenafil (Viagra) enhances the vasodilating effect of nitric oxide in
the corpus of the penis, thus sustaining an erection. Because of the
cavernosum
effect of the it is contraindicated with concurrent use of organic
medication,
nitrates and Sildenafil is not contraindicated with the use of vitamins.
nitroglycerin.
Neuralgiaare
insomnia andside effects of the
medication.
28.) The health care provider (HCP) prescribes exenatide (Byetta) for a
client
1 with type
diabetes mellitus who takes insulin. The nurse knows that which of the
following is the
appropriate
intervention?
1. The medication is administered within 60 minutes before the morning
and evening
meal
.2. The medication is withheld and the HCP is called to question the
prescription for the
clien
t.3. The client is monitored for gastrointestinal side effects after
administration of the
medicatio
n.
4. The insulin is withdrawn from the Penlet into an insulin syringe to
prepare for
administration. correct answers 2. The medication is withheld and the HCP
is called to
question the prescription for the
client.
Rational
e:
Exenatide (Byetta) is an incretin mimetic used for type 2 diabetes mellitus
only. It is not for clients taking insulin. Hence, the nurse should hold the
recommended
medication
and question the HCP regarding this prescription. Although options 1 and 3
are correct about the medication, in this situation the medication
statements
should not be The medication is packaged in prefilled pens ready for
administered.
injection
the need without
for drawing it up into another
syringe.
29.) A client is taking Humulin NPH insulin daily every morning. The nurse
reinforces
instructions for the client and tells the client that the most likely time for a
hypoglycemic
reaction to occur
is:
1. 2 to 4 hours after
administration
2. 4 to 12 hours after
3. 16 to 18 hours after
administration
administration
4. 18 to 24 hours after administration correct answers 2. 4 to 12
hours after
administrati
on
Rational
e:
Humulin NPH is an intermediate-acting insulin. The onset of action is 1.5
hours,
in 4 to it
12peaks
hours, and its duration of action is 24 hours. Hypoglycemic
reactions
likely occur most
during peak
time.
30.) A client with diabetes mellitus visits a health care clinic. The
client's diabetes
mellitus previously had been well controlled with glyburide (DiaBeta) daily,
but recently
