PHARMACOLOGY HESI ACTUAL EXAM LATEST VERSION 2023 80
QUESTION AND CORRECT DETAILED ANSWERS WITH RATIONALES
.RATED A GRADE
Upon admission to the emergency center, an adult client with acute
status asthmaticus is prescribed this series of medications. In which
order should the nurse administer the prescribed medications? (Arrange
from first to last.) - ANSWER-Albuterol (Proventil) puffs.
Salmeterol (Serevent Diskus).
Prednisone (Deltasone) orally.
Gentamicin (Garamycin) IM.
RATIONALES ;Status asthmaticus is potentially a life-threatening
respiratory event, so albuterol, a beta2 adrenergic agonist and short
acting bronchodilator, should be administered by inhalation first to
provide rapid and deep topical penetration to relieve bronchospasms,
dilate the bronchioles, and increase oxygenation. In stepwise
management of persistent asthma, a long-action bronchodilator, such
as salmeterol (Serevent Diskus), with a 12-hour duration of action should
be given next. Prednisone, an oral corticosteroid, provides prolonged
anti-inflammatory effects and should be given after the client's
respiratory distress begins to resolves. Gentamicin, an antibiotic, is given
deep IM, which can be painful, and may require repositioning the client,
so should be last in the sequence.
,An adult client is given a prescription for a scopolamine patch
(Transderm Scop) to prevent motion sickness while on a cruise. Which
information should the nurse provide to the client? - ANSWER-Apply the
patch at least 4 hours prior to departure. Correct
Change the patch every other day while on the cruise.
Place the patch on a hairless area at the base of the skull.
Drink no more than 2 alcoholic drinks during the cruise.
RATIONALES ;Scopolamine, an anticholinergic agent, is used to prevent
motion sickness and has a peak onset in 6 hours, so the client should be
instructed to apply the patch at least 4 hours before departure on the
cruise ship. The duration of the transdermal patch is 72 hours.
Scolopamine blocks muscarinic receptors in the inner ear and to the
vomiting center, so the best application site of the patch is behind the
ear. Anticholinergic medications are CNS depressants, so the client
should be instructed to avoid alcohol while using the patch.
A client with giardiasis is taking metronidazole (Flagyl) 2 grams PO.
Which information should the nurse include in the client's instruction? -
ANSWER-Notify the clinic of any changes in the color of urine.
Avoid overexposure to the sun.
Stop the medication after the diarrhea resolves.
,Take the medication with food. Correct
RATIONALES ;Flagyl, an amoebicide and antibacterial agent, may cause
gastric distress, so the client should be instructed to take the medication
on a full stomach. Urine may be red-brown or dark from taking Flagyl, but
this side effect is an expectant finding and not necessary to report tot he
healthcare provider.
A female client with rheumatoid arthritis takes ibuprofen (Motrin) 600 mg
PO 4 times a day. To prevent gastrointestinal bleeding, misoprostol
(Cytotec) 100 mcg PO is prescribed. Which information is most
important for the nurse to include in client teaching? - ANSWER-Use
contraception during intercourse. Correct
Ensure the Cytotec is taken on an empty stomach.
Encourage oral fluid intake to prevent constipation.
Take Cytotec 30 minutes prior to Motrin.
Rationales ;Cytotec, a synthetic form of a prostaglandin, is classified as
pregnancy Category X and can act as an abortifacient, so the client
should be instructed to use contraception during intercourse to prevent
loss of an early pregnancy. A common side effect of Cytotec is diarrhea,
so constipation prevention strategies are usually not needed. Cytotec
, and Motrin should be taken together to provide protective properties
against gastrointestinal bleeding.
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? - ANSWER-Review the
client's hemoglobin results.
Notify the healthcare provider. Correct
Inquire about the reaction to sulfa.
Record the client's vital signs.
Rationales ;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.
A client is admitted to the hospital for a new onset of supraventricular
tachycardia (SVT) and is prescribed digoxin. For which laboratory finding
should the nurse notify the healthcare provider immediately? - ANSWER-
Potassium level of 3.1 mEq/L. Correct
Sodium level of 132 mEq/L.
QUESTION AND CORRECT DETAILED ANSWERS WITH RATIONALES
.RATED A GRADE
Upon admission to the emergency center, an adult client with acute
status asthmaticus is prescribed this series of medications. In which
order should the nurse administer the prescribed medications? (Arrange
from first to last.) - ANSWER-Albuterol (Proventil) puffs.
Salmeterol (Serevent Diskus).
Prednisone (Deltasone) orally.
Gentamicin (Garamycin) IM.
RATIONALES ;Status asthmaticus is potentially a life-threatening
respiratory event, so albuterol, a beta2 adrenergic agonist and short
acting bronchodilator, should be administered by inhalation first to
provide rapid and deep topical penetration to relieve bronchospasms,
dilate the bronchioles, and increase oxygenation. In stepwise
management of persistent asthma, a long-action bronchodilator, such
as salmeterol (Serevent Diskus), with a 12-hour duration of action should
be given next. Prednisone, an oral corticosteroid, provides prolonged
anti-inflammatory effects and should be given after the client's
respiratory distress begins to resolves. Gentamicin, an antibiotic, is given
deep IM, which can be painful, and may require repositioning the client,
so should be last in the sequence.
,An adult client is given a prescription for a scopolamine patch
(Transderm Scop) to prevent motion sickness while on a cruise. Which
information should the nurse provide to the client? - ANSWER-Apply the
patch at least 4 hours prior to departure. Correct
Change the patch every other day while on the cruise.
Place the patch on a hairless area at the base of the skull.
Drink no more than 2 alcoholic drinks during the cruise.
RATIONALES ;Scopolamine, an anticholinergic agent, is used to prevent
motion sickness and has a peak onset in 6 hours, so the client should be
instructed to apply the patch at least 4 hours before departure on the
cruise ship. The duration of the transdermal patch is 72 hours.
Scolopamine blocks muscarinic receptors in the inner ear and to the
vomiting center, so the best application site of the patch is behind the
ear. Anticholinergic medications are CNS depressants, so the client
should be instructed to avoid alcohol while using the patch.
A client with giardiasis is taking metronidazole (Flagyl) 2 grams PO.
Which information should the nurse include in the client's instruction? -
ANSWER-Notify the clinic of any changes in the color of urine.
Avoid overexposure to the sun.
Stop the medication after the diarrhea resolves.
,Take the medication with food. Correct
RATIONALES ;Flagyl, an amoebicide and antibacterial agent, may cause
gastric distress, so the client should be instructed to take the medication
on a full stomach. Urine may be red-brown or dark from taking Flagyl, but
this side effect is an expectant finding and not necessary to report tot he
healthcare provider.
A female client with rheumatoid arthritis takes ibuprofen (Motrin) 600 mg
PO 4 times a day. To prevent gastrointestinal bleeding, misoprostol
(Cytotec) 100 mcg PO is prescribed. Which information is most
important for the nurse to include in client teaching? - ANSWER-Use
contraception during intercourse. Correct
Ensure the Cytotec is taken on an empty stomach.
Encourage oral fluid intake to prevent constipation.
Take Cytotec 30 minutes prior to Motrin.
Rationales ;Cytotec, a synthetic form of a prostaglandin, is classified as
pregnancy Category X and can act as an abortifacient, so the client
should be instructed to use contraception during intercourse to prevent
loss of an early pregnancy. A common side effect of Cytotec is diarrhea,
so constipation prevention strategies are usually not needed. Cytotec
, and Motrin should be taken together to provide protective properties
against gastrointestinal bleeding.
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? - ANSWER-Review the
client's hemoglobin results.
Notify the healthcare provider. Correct
Inquire about the reaction to sulfa.
Record the client's vital signs.
Rationales ;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.
A client is admitted to the hospital for a new onset of supraventricular
tachycardia (SVT) and is prescribed digoxin. For which laboratory finding
should the nurse notify the healthcare provider immediately? - ANSWER-
Potassium level of 3.1 mEq/L. Correct
Sodium level of 132 mEq/L.
