2021 HESI Pharmacology Practice Exam With Answers (72 Solved Questions)

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Hesi Pharmacology (ACTUAL) Questions& Answers All answers are Correct GradedA Latest 2021

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1 . A healthcare provider prescribes cephalexin monohydrate (Keflex) for a client with a postoperativeinfection. It is most important for the nurse to assess for what additional drug allergy beforeadministering this prescription?A) Penicillins.B) Aminoglycosides.C) Erythromycins.D) Sulfonamides.A) Penicillins.Cross-allergies exist between penicillins (A) and cephalosporins, such as cephalexin monohydrate(Keflex), so checking for penicillin allergy is a wise precaution before administering this drug.2. Which nursing intervention is most important when caring for a client receiving the antimetabolitecytosine arabinoside (Arc-C) for chemotherapy?A) Hydrate the client with IV fluids before and after infusion.B) Assess the client for numbness and tingling of extremities.C) Inspect the client's oral mucosa for ulcerations.D) Monitor the client's urine pH for increased acidity.C) Inspect the client's oral mucosa for ulcerations.Cytosine arabinoside (Arc-C) affects the rapidly growing cells of the body, therefore stomatitis andmucosal ulcerations are key signs of antimetabolite toxicity (C). (A, B, and D) are not typical interventionsassociated with the administration of antimetabolites.3. When assessing an adolescent who recently overdosed on acetaminophen (Tylenol), it is mostimportant for the nurse to assess for pain in which area of the body?A) Flank.B) Abdomen.C) Chest.D) Head.B) Abdomen.Acetaminophen toxicity can result in liver damage; therefore, it is especially important for the nurse toassess for pain in the right upper quadrant of the abdomen (B), which might indicate liver damage. (A, C,and D) are not areas where pain would be anticipated.Downloaded by: ACEMYWORK | kamun2@yahoo.comDistribution of this document is illegal

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4. An adult client is given a prescription for a scopolamine patch (Transderm Scop) to prevent motionsickness while on a cruise. Which information should the nurse provide to the client?A) Apply the patch at least 4 hours prior to departure.B) Change the patch every other day while on the cruise.C) Place the patch on a hairless area at the base of the skull.D) Drink no more than 2 alcoholic drinks during the cruise.A) Apply the patch at least 4 hours prior to departure.Scopolamine, an anticholinergic agent, is used to prevent motion sickness and has a peak onset in 6hours, so the client should be instructed to apply the patch at least 4 hours before departure (A) on thecruise ship. The duration of the transdermal patch is 72 hours, so (B) is not needed. Scolopamine blocksmuscarinic receptors in the inner ear and to the vomiting center, so the best application site of the patchis behind the ear, not at the base of the skull (C). Anticholinergic medications are CNS depressants, sothe client should be instructed to avoid alcohol (D) while using the patch.5. The nurse is reviewing the use of the patient-controlled analgesia (PCA) pump with a client in theimmediate postoperative period. The client will receive morphine 1 mg IV per hour basal rate with 1 mgIV every 15 minutes per PCA to total 5 mg IV maximally per hour. What assessment has the highestpriority before initiating the PCA pump?A) The expiration date on the morphine syringe in the pump.B) The rate and depth of the client's respirations.C) The type of anesthesia used during the surgical procedure.D) The client's subjective and objective signs of pain.B) The rate and depth of the client's respirations.A life-threatening side effect of intravenous administration of morphine sulfate, an opiate narcotic, isrespiratory depression (B). The PCA pump should be stopped and the healthcare provider notified if theclient's respiratory rate falls below 12 breaths per minute, and the nurse should anticipate adjustmentsin the client's dosage before the PCA pump is restarted. (A, C, and D) provide helpful information, but arenot as high a priority as the assessment described in (B).6. A medication that is classified as a beta-1 agonist is most commonly prescribed for a client with whichcondition?A) Glaucoma.B) Hypertension.C) Heart failure.D) Asthma.Downloaded by: ACEMYWORK | kamun2@yahoo.comDistribution of this document is illegal

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C) Heart failure.Beta-1 agonists improve cardiac output by increasing the heart rate and blood pressure and areindicated in heart failure (C), shock, atrioventricular block dysrhythmias, and cardiac arrest. Glaucoma(A) is managed using adrenergic agents and beta-adrenergic blocking agents. Beta-1 blocking agents areused in the management of hypertension (B). Medications that stimulate beta-2 receptors in the bronchiare effective for bronchoconstriction in respiratory disorders, such as asthma (D).7.A female client with rheumatoid arthritis take ibuprofen (Motrin) 600 mg PO 4 times a day. Toprevent gastrointestinal bleeding, misoprostol (Cytotec) 100 mcg PO is prescribed. Which information ismost important for the nurse to include in client teaching?A) Use contraception during intercourse.B) Ensure the Cytotec is taken on an empty stomach.C) Encourage oral fluid intake to prevent constipation.D) Take Cytotec 30 minutes prior to Motrin.A) Use contraception during intercourse.Cytotec, a synthetic form of a prostaglandin, is classified as pregnancy Category X and can act as anabortifacient, so the client should be instructed to use contraception during intercourse (A) to preventloss of an early pregnancy. (B) is not necessary. A common side effect of Cytotec is diarrhea, soconstipation prevention strategies are usually not needed (C). Cytotec and Motrin should be takentogether (D) to provide protective properties against gastrointestinal bleeding.8. A client with heart failure is prescribed spironolactone (Aldactone). Which information is mostimportant for the nurse to provide to the client 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) Refrain for eating foods high in potassium.Spironolactone (Aldactone), an aldosterone antagonist, is a potassium-sparing diuretic, so a diet high inpotassium 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 of hyperkalemia is more importantwith Aldactone. Restriction of fluids (C) or increasing milk and milk products (D) are not indicated withthis prescription.Downloaded by: ACEMYWORK | kamun2@yahoo.comDistribution of this document is illegal

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9. In evaluating the effects of lactulose (Cephulac), which outcome should indicate that the drug isperforming as intended?A) An increase in urine output.B) Two or three soft stools per day.C) Watery, diarrhea stools.D) Increased serum bilirubin.B) Two or three soft stools per day.Lactulose is administered to reduce blood ammonia by excretion of ammonia through the stool. Two tothree stools a day indicate that lactulose is performing as intended (B). (A) would be expected if thepatient received a diuretic. (C) would indicate an overdose of lactulose and is not expected. Lactulosedoes not affect (D).10. The healthcare provider prescribes naproxen (Naproxen) twice daily for a client with osteoarthritis ofthe hands. The client tells the nurse that the drug does not seem to be effective after three weeks.Which is the best response for the nurse to provide?A) The frequency of the dosing is necessary to increase the effectiveness.B) Therapeutic blood levels of this drug are reached in 4 to 6 weeks.C) Another type of nonsteroidal antiinflammatory drug may be indicated.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 twohours, not (B). Corticosteroids are not indicated for osteoarthritis (D).11.Which instruction(s) should the nurse give to a female client who just received a prescription fororal 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) Increase fluid intake, especially cranberry juice.D) Avoid drinking alcohol while taking this medication.E) Use condoms until treatment is completed.

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F) Ensure that all sexual partners are treated at the same time.Correct selections are (A, D, E, and F). Increased fluid intake and cranberry juice (A) are recommendedfor prevention and treatment of urinary tract infections, which frequently accompany vaginal infections.It is not necessary to taper use of this drug (B) or to check the blood pressure daily (C), as this conditionis not related to hypertension. Flagyl can cause a disulfiram-like reaction if taken in conjunction withingestion of alcohol, so the client should be instructed to avoid alcohol (D). All sexual partners should betreated at the same time (E) and condoms should be used until after treatment is completed to avoidreinfection (F).12. A client receiving albuterol (Proventil) tablets complains of nausea every evening with her 9 p.m.dose. What action should the nurse take to alleviate this side effect?A) Change the time of the dose.B) Hold the 9 p.m. dose.C) Administer the dose with a snack.D) Administer an antiemetic with the dose.C) Administer the dose with a snack.Administering oral doses with food (C) helps minimize GI discomfort. (A) would be appropriate only ifchanging the time of the dose corresponds to meal times while at the same time maintaining anappropriate time interval between doses. (B) would disrupt the dosing schedule, and could result in anontherapeutic serum level of the medication. (D) should not be attempted before other interventions,such as (C), have been proven ineffective in relieving the nausea.13. A client receiving Doxorubicin (Adriamycin) intravenously (IV) complains of pain at the insertion site,and the nurse notes edema at the site. Which intervention is most important for the nurse toimplement?A) Assess for erythema.B) Administer the antidote.C) Apply warm compresses.D) Discontinue the IV fluids.D) Discontinue the IV fluids.Doxorubicin is an antineoplastic agent that causes inflammation, blistering, and necrosis of tissue uponextravasation. First, all IV fluids should be discontinued at the site (D) to prevent further tissue damageby the vesicant. Erythema is one sign of infiltration and should be noted, but edema and pain at theinfusion site require stopping the IV fluids (A). Although an antidote may be available (B), additional

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fluids contribute to the trauma of the subcutaneous tissues. Depending on the type of vesicant, warm orcold compresses (C) may be prescribed after the infusion is discontinued.14. A client with congestive heart failure (CHF) is being discharged with a new prescription for theangiotensin-converting enzyme (ACE) inhibitor captopril (Capoten). The nurse's discharge instructionshould include reporting which problem to the healthcare provider?A) Weight loss.B) Dizziness.C) Muscle cramps.D) Dry mucous membranes.B) Dizziness.Angiotensin-converting enzyme (ACE) inhibitors are used in CHF to reduce afterload by reversingvasoconstriction common in heart failure. This vasodilation can cause hypotension and resultantdizziness (B). (A) is desired if fluid overload is present, and may occur as the result of effectivecombination drug therapy such as diuretics with ACE inhibitors. (C) often indicates hypokalemia in theclient receiving diuretics. Excessive diuretic administration may result in fluid volume deficit, manifestedby symptoms such as (D).15. The nurse is preparing the 0900 dose of losartan (Cozaar), an angiotensin II receptor blocker (ARB),for a client with hypertension and heart failure. The nurse reviews the client's laboratory results andnotes that the client's serum potassium level is 5.9 mEq/L. What action should the nurse take first?A) Withhold the scheduled dose.B) Check the client's apical pulse.C) Notify the healthcare provider.D) Repeat the serum potassium level.A) Withhold the scheduled dose.The nurse should first withhold the scheduled dose of Cozaar (A) because the client is hyperkalemic(normal range 3.5 to 5 mEq/L). Although hypokalemia is usually associated with diuretic therapy in heartfailure, hyperkalemia is associated with several heart failure medications, including ARBs. Becausehyperkalemia may lead to cardiac dysrhythmias, the nurse should check the apical pulse for rate andrhythm (B), and the blood pressure. Before repeating the serum study (D), the nurse should notify thehealthcare provider (C) of the findings.

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16. The nurse is assessing the effectiveness of high dose aspirin therapy for an 88-year-old client witharthritis. The client reports that she can't hear the nurse's questions because her ears are ringing. Whataction should 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 aspirin therapy.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 provider should be notified immediately (C),and the medication discontinued. (A and D) are not needed, and (B) is inaccurate.17. The healthcare provider prescribes digitalis (Digoxin) for a client diagnosed with congestive heartfailure. Which intervention should the nurse implement prior to administering the digoxin?A) Observe respiratory rate and depth.B) Assess the serum potassium level.C) Obtain the client's blood pressure.D) Monitor the serum glucose level.B) Assess the serum potassium level.Hypokalemia (decreased serum potassium) will precipitate digitalis toxicity in persons receiving digoxin(B). (A and C) will not affect the administration of digoxin. (D) should be monitored if he/she is a diabeticand is perhaps receiving insulin.18. A client who has been taking levodopa PO TID to control the symptoms of Parkinson's disease has anew prescription for sustained release levodopa/carbidopa (Sinemet 25/100) PO BID. The client took hislevodopa at 0800. Which instruction should the nurse include in the teaching plan for this client?A) Take the first dose of Sinemet today, as soon as your prescription is filled.B) Since you already took your levodopa, wait until tomorrow to take the Sinemet.C) Take both drugs for the first week, then switch to taking only the Sinemet.D) You can begin taking the Sinemet this evening, but do not take any more levodopa.D) You can begin taking the Sinemet this evening, but do not take any more levodopa.Carbidopa significantly reduces the need for levodopa in clients with Parkinson's disease, so the newprescription should not be started until eight hours after the previous dose of levodopa (D), but can bestarted the same day (B). (A and C) may result in toxicity.

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