2021 HESI PHARMACOLOGY VERSION 1
(100 QUESTIONS AND ANSWERS WITH
RATIONALE)
1) A nurse is caring for a client with hyperparathyroidism and notes that
the client'sserum calcium level is 13 mg/dL. Which medication should
the nurse prepare to administer as prescribed to the client?
1. Calcium chloride
2. Calcium gluconate
3. Calcitonin (Miacalcin)
4. Large doses of vitamin D 3. Calcitonin
(Miacalcin)Rationale:
The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is
experiencing hypercalcemia. Calcium gluconate and calcium chloride
are medications used for the treatment of tetany, which occurs as a
result of acute hypocalcemia. In hypercalcemia, large doses of vitamin
D need to be avoided. Calcitonin, a thyroidhormone, decreases the
plasma calcium level by inhibiting bone resorption and lowering the
serum calcium concentration.
3.) Salicylic acid is prescribed for a client with a diagnosis of psoriasis.
The nurse monitors the client, knowing that which of the following
would indicate the presenceof systemic toxicity from this medication?
1. Tinnitus
2. Diarrhea
3. Constipation
4. Decreased respirations 1.
TinnitusRationale:
,Salicylic acid is absorbed readily through the skin, and systemic
toxicity (salicylism)can result. Symptoms include tinnitus, dizziness,
hyperpnea, and psychological disturbances. Constipation and diarrhea
are not associated with salicylism.
4.) The camp nurse asks the children preparing to swim in the lake if
they have applied sunscreen. The nurse reminds the children that
chemical sunscreens aremost effective when applied:
1. Immediately before swimming
2. 15 minutes before exposure to the sun
3. Immediately before exposure to the sun
4.At least 30 minutes before exposure to the sun 4. At least 30
minutes beforeexposure to the sun
Rationale:
Sunscreens are most effective when applied at least 30 minutes before
exposure to the sun so that they can penetrate the skin. All sunscreens
should be reapplied afterswimming or sweating.
5.) Mafenide acetate (Sulfamylon) is prescribed for the client with a
burn injury. When applying the medication, the client complains of local
discomfort and burning.Which of the following is the most appropriate
nursing action?
1. Notifying the registered nurse
2. Discontinuing the medication
3. Informing the client that this is normal
4. Applying a thinner film than prescribed to the burn site 3.
Informing the clientthat this is normal
Rationale:
Mafenide acetate is bacteriostatic for gram-negative and gram-positive
organisms and is used to treat burns to reduce bacteria present in
avascular tissues. The clientshould be informed that the medication will
cause local discomfort and burning and that this is a normal reaction;
therefore options 1, 2, and 4 are incorrect
6.) The burn client is receiving treatments of topical mafenide acetate
(Sulfamylon)to the site of injury. The nurse monitors the client,
knowing that which of the following indicates that a systemic effect has
occurred?
1.Hyperventilation
,2.Elevated blood
pressure 3.Local pain at
the burn site
4.Local rash at the burn site 1.Hyperventilation
Rationale:
Mafenide acetate is a carbonic anhydrase inhibitor and can suppress
renal excretionof acid, thereby causing acidosis. Clients receiving this
treatment should be monitored for signs of an acid-base imbalance
(hyperventilation). If this occurs, themedication should be discontinued
for 1 to 2 days. Options 3 and 4 describe local rather than systemic
effects. An elevated blood pressure may be expected from the pain that
occurs with a burn injury.
7.) Isotretinoin is prescribed for a client with severe acne. Before the
administrationof this medication, the nurse anticipates that which
laboratory test will be prescribed?
1. Platelet count
2. Triglyceride level
3. Complete blood count
4. White blood cell count 2.
Triglyceride levelRationale:
Isotretinoin can elevate triglyceride levels. Blood triglyceride levels
should be measured before treatment and periodically thereafter until
the effect on the triglycerides has been evaluated. Options 1, 3, and 4 do
not need to be monitoredspecifically during this treatment.
8.) A client with severe acne is seen in the clinic and the health care
provider (HCP) prescribes isotretinoin. The nurse reviews the client's
medication record and would contact the (HCP) if the client is taking
which medication?
1. Vitamin A
2. Digoxin (Lanoxin)
3. Furosemide (Lasix)
4. Phenytoin (Dilantin) 1.
Vitamin ARationale:
Isotretinoin is a metabolite of vitamin A and can produce generalized
intensificationof isotretinoin toxicity. Because of the potential for
, increased toxicity, vitamin A supplements should be discontinued
before isotretinoin therapy. Options 2, 3, and 4are not contraindicated
with the use of isotretinoin.
9.) The nurse is applying a topical corticosteroid to a client with
eczema. The nurse would monitor for the potential for increased
systemic absorption of the medication if the medication were being
applied to which of the following body areas?
1. Back
2. Axilla
3. Soles of the feet
4. Palms of the hands 2.
AxillaRationale:
Topical corticosteroids can be absorbed into the systemic circulation.
Absorption ishigher from regions where the skin is especially
permeable (scalp, axilla, face, eyelids, neck, perineum, genitalia), and
lower from regions in which permeability ispoor (back, palms, soles).
10.) The clinic nurse is performing an admission assessment on a client.
The nursenotes that the client is taking azelaic acid (Azelex). Because
of the medication prescription, the nurse would suspect that the client is
being treated for:
1. Acne
2. Eczema
3. Hair loss
4. Herpes simplex 1.
AcneRationale:
Azelaic acid is a topical medication used to treat mild to moderate
acne. The acidappears to work by suppressing the growth of
Propionibacterium acnes and decreasing the proliferation of
keratinocytes. Options 2, 3, and 4 are incorrect.
11.) The health care provider has prescribed silver sulfadiazine
(Silvadene) for theclient with a partial-thickness burn, which has
cultured positive for gram-negative bacteria. The nurse is reinforcing
information to the client about the medication.Which statement made
by the client indicates a lack of understanding about the treatments?
1. "The medication is an antibacterial."
2. "The medication will help heal theburn."
3. "The medication will permanently stain my skin."
(100 QUESTIONS AND ANSWERS WITH
RATIONALE)
1) A nurse is caring for a client with hyperparathyroidism and notes that
the client'sserum calcium level is 13 mg/dL. Which medication should
the nurse prepare to administer as prescribed to the client?
1. Calcium chloride
2. Calcium gluconate
3. Calcitonin (Miacalcin)
4. Large doses of vitamin D 3. Calcitonin
(Miacalcin)Rationale:
The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is
experiencing hypercalcemia. Calcium gluconate and calcium chloride
are medications used for the treatment of tetany, which occurs as a
result of acute hypocalcemia. In hypercalcemia, large doses of vitamin
D need to be avoided. Calcitonin, a thyroidhormone, decreases the
plasma calcium level by inhibiting bone resorption and lowering the
serum calcium concentration.
3.) Salicylic acid is prescribed for a client with a diagnosis of psoriasis.
The nurse monitors the client, knowing that which of the following
would indicate the presenceof systemic toxicity from this medication?
1. Tinnitus
2. Diarrhea
3. Constipation
4. Decreased respirations 1.
TinnitusRationale:
,Salicylic acid is absorbed readily through the skin, and systemic
toxicity (salicylism)can result. Symptoms include tinnitus, dizziness,
hyperpnea, and psychological disturbances. Constipation and diarrhea
are not associated with salicylism.
4.) The camp nurse asks the children preparing to swim in the lake if
they have applied sunscreen. The nurse reminds the children that
chemical sunscreens aremost effective when applied:
1. Immediately before swimming
2. 15 minutes before exposure to the sun
3. Immediately before exposure to the sun
4.At least 30 minutes before exposure to the sun 4. At least 30
minutes beforeexposure to the sun
Rationale:
Sunscreens are most effective when applied at least 30 minutes before
exposure to the sun so that they can penetrate the skin. All sunscreens
should be reapplied afterswimming or sweating.
5.) Mafenide acetate (Sulfamylon) is prescribed for the client with a
burn injury. When applying the medication, the client complains of local
discomfort and burning.Which of the following is the most appropriate
nursing action?
1. Notifying the registered nurse
2. Discontinuing the medication
3. Informing the client that this is normal
4. Applying a thinner film than prescribed to the burn site 3.
Informing the clientthat this is normal
Rationale:
Mafenide acetate is bacteriostatic for gram-negative and gram-positive
organisms and is used to treat burns to reduce bacteria present in
avascular tissues. The clientshould be informed that the medication will
cause local discomfort and burning and that this is a normal reaction;
therefore options 1, 2, and 4 are incorrect
6.) The burn client is receiving treatments of topical mafenide acetate
(Sulfamylon)to the site of injury. The nurse monitors the client,
knowing that which of the following indicates that a systemic effect has
occurred?
1.Hyperventilation
,2.Elevated blood
pressure 3.Local pain at
the burn site
4.Local rash at the burn site 1.Hyperventilation
Rationale:
Mafenide acetate is a carbonic anhydrase inhibitor and can suppress
renal excretionof acid, thereby causing acidosis. Clients receiving this
treatment should be monitored for signs of an acid-base imbalance
(hyperventilation). If this occurs, themedication should be discontinued
for 1 to 2 days. Options 3 and 4 describe local rather than systemic
effects. An elevated blood pressure may be expected from the pain that
occurs with a burn injury.
7.) Isotretinoin is prescribed for a client with severe acne. Before the
administrationof this medication, the nurse anticipates that which
laboratory test will be prescribed?
1. Platelet count
2. Triglyceride level
3. Complete blood count
4. White blood cell count 2.
Triglyceride levelRationale:
Isotretinoin can elevate triglyceride levels. Blood triglyceride levels
should be measured before treatment and periodically thereafter until
the effect on the triglycerides has been evaluated. Options 1, 3, and 4 do
not need to be monitoredspecifically during this treatment.
8.) A client with severe acne is seen in the clinic and the health care
provider (HCP) prescribes isotretinoin. The nurse reviews the client's
medication record and would contact the (HCP) if the client is taking
which medication?
1. Vitamin A
2. Digoxin (Lanoxin)
3. Furosemide (Lasix)
4. Phenytoin (Dilantin) 1.
Vitamin ARationale:
Isotretinoin is a metabolite of vitamin A and can produce generalized
intensificationof isotretinoin toxicity. Because of the potential for
, increased toxicity, vitamin A supplements should be discontinued
before isotretinoin therapy. Options 2, 3, and 4are not contraindicated
with the use of isotretinoin.
9.) The nurse is applying a topical corticosteroid to a client with
eczema. The nurse would monitor for the potential for increased
systemic absorption of the medication if the medication were being
applied to which of the following body areas?
1. Back
2. Axilla
3. Soles of the feet
4. Palms of the hands 2.
AxillaRationale:
Topical corticosteroids can be absorbed into the systemic circulation.
Absorption ishigher from regions where the skin is especially
permeable (scalp, axilla, face, eyelids, neck, perineum, genitalia), and
lower from regions in which permeability ispoor (back, palms, soles).
10.) The clinic nurse is performing an admission assessment on a client.
The nursenotes that the client is taking azelaic acid (Azelex). Because
of the medication prescription, the nurse would suspect that the client is
being treated for:
1. Acne
2. Eczema
3. Hair loss
4. Herpes simplex 1.
AcneRationale:
Azelaic acid is a topical medication used to treat mild to moderate
acne. The acidappears to work by suppressing the growth of
Propionibacterium acnes and decreasing the proliferation of
keratinocytes. Options 2, 3, and 4 are incorrect.
11.) The health care provider has prescribed silver sulfadiazine
(Silvadene) for theclient with a partial-thickness burn, which has
cultured positive for gram-negative bacteria. The nurse is reinforcing
information to the client about the medication.Which statement made
by the client indicates a lack of understanding about the treatments?
1. "The medication is an antibacterial."
2. "The medication will help heal theburn."
3. "The medication will permanently stain my skin."
