2017 HESI PN Pharmacology Version 2 With Answers (55 Solved Questions)

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Pharmacology 2017HesiPNSpecialty V21) A client is being treated for hyperthyridism with propylthiouracil(PTU). TheLPN/LVNknows that the action of this drug is to:A. decrease the amount of thyroid stimulating hormone circulating inthe blood.B. increase the amount of thyroid-stimulating hormone circulating inthe blood.C. increase the amount of T4 and decrease the amount of T3 producedby the thyroid.D. inhibit synthesis of T3 and T4 by the thyroid gland.D. PTU is an adjunct therapy used to control hyperthyroidism byinhibiting production of thyroid hormones. It is often prescribed in prepfor thyroidectomy or radioactive iodine therapy2) A female client with RA takes ibuprofen (motrin) 600mg PO 4xday.To preven GI bleeding, misoprostol (cytotec) 100mcg PO isprescribed. Which information is most important for the nurse toinclude in client teaching?A. use contraception during intercourseB. ensure the cytotec is taken on an empty stomachC. encourage oral fluid intake to prevent constipationD. take cytotec 30min prior to motrinA. Use contraception during intercourse.Cytotec, a synthetic form of prostaglandin, is classified as pregnancycategory X and can act as an abortifacient, so the client should beinstructed to use contraception during intercourse to prevent loss of earlypregnancy3) Dobutamine (Dobutrex) is an emergency drug most commonlyprescribed for a client with which condition?A) Shock.B) Asthma.C) Hypotension.

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D) Heart failureD. Heart FailureDobutamine is a beta-1 adrenergic agonist that is indicated for short termuse in cardiac decompensation or heart failure (D) related to reducedcardiac contractility due to organic heart disease or cardiac surgicalprocedures. Alpha and beta adrenergic agonists, such as epinephrine anddopamine, are sympathomimetics used in the treatment of shock (A).Other selective beta-2 adrenergic agonists, such as terbutaline andisoproterenol, are indicated in the treatment of asthma (B). Althoughdobutamine improves cardiac output, it is not used to treat hypotension(C).4) Which medications should the nurse caution the client about takingwhile receiving an opioid analgesic?A. Antacids.B. BenzodiasepinesC. AntihypertensivesD. Oral antidiabeticsB. B. BenzodiasepinesRespiratory depression increases with the concurrent use of opioidanalgesics and other cns depressant agents, such as alcohol, barbiturates,and benzodiasepines5)Which client should theLPN/LVNidentify as being at the highestriskfor complications during the use of an opioid analgesic?A. an older client with type 2 diabetesB. A client with chronic rheumatoid arthritisC. A client with a open compound fractureD. A young adult with inflammatory bowel diseaseD. A young adult with inflammatory bowel disease6) Which change in data indicates to the nurse the desired effect of theangiotensin II receptor antagonist valsartan (Diovan) has been achievedA. Dependent edema reduced form +3 to +1B. Serum HDL increased from 35 to 55mg/dlC. PUlse rate reduced from 150 to 90 beats/min

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D.Blood pressure reduced from 160/90 to 130.80D.D. Blood pressure reduced from 160/90 to 130.80angiotensin II receptor antagonist (blocker), prescribed from treatment ofHTN. The desired effect is a decrease in blood pressure.7)A client with heart failure is prescribed spironolactone (Aldactone).Which information is most important for theLPN/LVNto provide to theclient about diet modifications?A) Do not add salt to foods during preparation.B) Refrain for eating foods high in potassium.C) Restrict fluid intake to 1000 ml per day.D) Increase intake of milk and milk products.B.Spironolactone (Aldactone), an aldosterone antagonist, is a potassium-sparing diuretic, so a diet high in potassium should be avoided (B),including potassium salt substitutes, which can lead to hyperkalemia.Although (A) is a common diet modification in heart failure, the risk ofhyperkalemia is more important with Aldactone. Restriction of fluids (C)or increasing milk and milk products (D) are not indicated with thisprescription.8) The nurse is assessing the effectiveness of high dose aspirin therapyfor an 88-year-old client with arthritis. The client reports that she can'thear the nurse's questions because her ears are ringing. What actionshould the nurse implement?A) Refer the client to an audiologist for evaluation of her hearing.B) Advise the client that this is a common side effect of aspirintherapy.C) Notify the healthcare provider of this finding immediately.D) Ask the client to turn off her hearing aid during the exam.C. Notify the healthcare provider of this finding immediately.Tinnitus is an early sign of salicylate toxicity. The healthcare providershould be notified immediately (C), and the medication discontinued. (Aand D) are not needed, and (B) is inaccurate.9) The healthcare provider prescribes naproxen (Naproxen) twice daily

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for a client with osteoarthritis of the hands. The client tells the nursethat the drug does not seem to be effective after three weeks. Which isthe best response for the nurse to provide?A) The frequency of the dosing is necessary to increase theeffectiveness.B) Therapeutic blood levels of this drug are reached in 4 to 6 weeks.C) Another type of nonsteroidal antiinflammatory drug may beindicated.D) Systemic corticosteroids are the next drugs of choice for pain relief.C. Another type of nonsteroidal antiinflammatory drug may be indicated.Individual responses to nonsteroidal antiinflammatory drugs are variable,so (C) is the best response. Naproxen is usually prescribed every 8 hours,so (A) is not indicated. The peak for naproxen is one to two hours, not(B). Corticosteroids are not indicated for osteoarthritis (D).10) An older client with a decreased percentage of lean body mass islikely to receive a prescription that is adjusted based on whichpharmacokinetic process?A) Absorption.B) Metabolism.C) Elimination.D) Distribution.D.A decreased lean body mass in an older adult affects the distribution ofdrugs (D), which affects the pharmacokinetics of drugs. Decreased gastricpH, delayed gastric emptying, decreased splanchnic blood flow,decreased gastrointestinal absorption surface areas and motility affect (A)in the older adult population. Decreased hepatic blood flow, decreasedhepatic mass, and decreased activity of hepatic enzymes affect (B) inolder adults. Decreased renal blood flow, decreased glomerular filtrationrate, decreased tubular secretion, and decreased number of nephronsaffects (C) in an older adult.11)A peak and trough level must be drawn for a client receivingantibiotic therapy. What is the optimum time for theLPN/LVNto obtainthetrough level?A) Sixty minutes after the antibiotic dose is administered.B) Immediately before the next antibiotic dose is given.

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C) When the next blood glucose level is to be checked.D) Thirty minutes before the next antibiotic dose is given.B. Immediately before the next antibiotic dose is given.Trough levels are drawn when the blood level is at its lowest, which istypically just before the next dose is given (B). (A, C, and D) do notdescribe the optimum time for obtaining a trough level of an antibiotic.12) A client with Parkinson's disease is taking carbidopa-levodopa(Sinemet). Which observation by the nurse should indicate that thedesired outcome of the medication is being achieved?A) Decreased blood pressure.B) Lessening of tremors.C) Increased salivation.D) Increased attention span.B.Lessening of tremors.Sinemet increases the amount of levodopa to the CNS (dopamine to thebrain). Increased amounts of dopamine improve the symptoms ofParkinson's, such as involuntary movements, resting tremors (B),shuffling gait, etc. (A) is a side effect of Sinemet. Decreased droolingwould be a desired effect, not (C). Sinemet does not affect (D).13)A client with congestive heart failure (CHF) is being dischargedwith a new prescription for the angiotensin-converting enzyme (ACE)inhibitor captopril (Capoten). TheLPN/LVNdischarge instructionshouldinclude reporting which problem to the healthcare provider?A) Weight loss.B) Dizziness.C) Muscle cramps.D) Dry mucous membranes.B. DizzinessThe client should be prepared to implement measures for constipation (B)which is the most likely persistent side effect related to opioid use.Tolerance to opiate narcotics is common, and the client may experienceless sedation (A) and respiratory depression (D) as analgesic usecontinues. Opioids increase the tone in the urinary bladder sphincter,which causes retention (C) but may subside.

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14)A client is receiving metroprolol (Lopressor SR). What assessmentis most important for theLPN/LVNto obtain?A) Temperature.B) Lung sounds.C) Blood pressure.D) Urinary output.C. Blood pressureIt is most important to monitor the blood pressure (C) of clients takingthis medication because Lopressor is an antianginal, antiarrhythmic,antihypertensive agent. While (A and B) are important data to obtain onany client, they are not as important for a client receiving Lopressor as(C). Intake and output ratios and daily weights should be monitored whiletaking Lopressor to assess for signs and symptoms of congestive heartfailure, but (D) alone does not have the importance of (C).15) A client with coronary artery disease who is taking digoxin(Lanoxin) receives a new prescription for atorvastatin (Lipitor). Twoweeks after initiation of the Lipitor prescription, the nurse assesses theclient. 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 digitalistoxicity. Since Lipitor increases the risk for digitalis toxicity, this findingrequires the most immediate intervention by the nurse (D). (A, B and C)are expected side effects of Lipitor.16) Upon admission to the emergency center, an adult client with acutestatus asthmaticus is prescribed this series of medications. In whichorder should the nurse administer the prescribed medications? (Arrangefrom first to last.)A) Prednisone (Deltasone) orally.B) Gentamicin (Garamycin) IM.C) Albuterol (Proventil) puffs.D) Salmeterol (Serevent Diskus).

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