2023-2024 HESI Pharmacology Practice Question With Answers (245 Solved Questions)

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HESI Pharmacology Exam PracticeQuestions(245 Terms)with DetailedRationales2023-20241) A nurse is caring for a client with hyperparathyroidism and notes that theclient's serum calcium level is 13 mg/dL. Which medicationshould the nurseprepare to administer as prescribed to the client?1. Calcium chloride2. Calcium gluconate3. Calcitonin (Miacalcin)4. Large doses of vitamin D-Exact Answer:3. Calcitonin (Miacalcin)Rationale:The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is experiencinghypercalcemia. Calcium gluconate and calcium chloride are medications used forthe treatment of tetany, which occurs as a result of acute hypocalcemia. Inhypercalcemia, large doses of vitamin D need to be avoided. Calcitonin, a thyroidhormone, decreases the plasma calcium level by inhibiting bone resorption andlowering the serum calcium concentration.2.) Oral iron supplements are prescribed for a 6-year-old child with iron deficiencyanemia. The nurse instructs the mother to administer the iron with which bestfood item?1. Milk2. Water

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3. Apple juice4. Orange juice-Exact Answer:4. Orange juiceRationale:Vitamin C increases the absorption of iron by the body. The mother should beinstructed to administer the medication with a citrus fruit or a juice that is high invitamin C. Milk may affect absorption of the iron. Water will not assist inabsorption.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 nursemonitors the client, knowing that which of the following would indicate thepresence of systemictoxicity from this medication?1. Tinnitus2. Diarrhea3. Constipation4. Decreased respirations-Exact Answer:1. TinnitusRationale:Salicylic acid is absorbed readily through the skin, and systemic toxicity (salicylism)can result. Symptoms include tinnitus, dizziness, hyperpnea, and psychologicaldisturbances. Constipation and diarrhea are not associated with salicylism.4.) The camp nurse asks the children preparing to swim in the lake if they haveapplied sunscreen. The nurse reminds the children that chemical sunscreens aremost effective when applied:1. Immediately before swimming2. 15 minutes before exposure to the sun

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3. Immediately before exposure to the sun4. At least 30 minutes before exposure to the sun-Exact Answer:4. At least 30minutes before exposure to the sunRationale:Sunscreens are most effective when applied at least 30 minutes before exposureto the sun so that they can penetrate the skin. All sunscreens should be reappliedafter swimming 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 andburning. Which of the following is the most appropriate nursing action?1. Notifying the registered nurse2. Discontinuing the medication3. Informing the client that this is normal4. Applying a thinner film than prescribed to the burn site-Exact Answer:3.Informing the client that this is normalRationale:Mafenide acetate is bacteriostatic for gram-negative and gram-positive organismsand is used to treat burns to reduce bacteria present in avascular tissues. Theclient should be informed that the medication will cause local discomfort andburning and that this is a normal reaction; therefore options1, 2, and 4 areincorrect

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6.) The burn client is receiving treatments of topical mafenide acetate(Sulfamylon) to the site of injury. The nurse monitors the client, knowing thatwhich of the following indicates that a systemic effect has occurred?1.Hyperventilation2.Elevated blood pressure3.Local pain at the burn site4.Local rash at the burn site-Exact Answer:1.HyperventilationRationale:Mafenide acetate is a carbonic anhydrase inhibitor and can suppress renalexcretion of acid, thereby causing acidosis. Clients receiving this treatment shouldbe monitored for signs of an acid-base imbalance (hyperventilation). If this occurs,the medication should be discontinued for 1 to 2 days. Options 3 and 4 describelocal rather than systemic effects. An elevatedblood pressure may be expectedfrom the pain that occurs with a burn injury.7.) Isotretinoin is prescribed for a client with severe acne. Before theadministration of this medication, the nurse anticipates that which laboratory testwill be prescribed?1. Platelet count2. Triglyceride level3. Complete blood count4. White blood cell count-Exact Answer:2. Triglyceride levelRationale:Isotretinoin can elevate triglyceride levels. Blood triglyceride levels should bemeasured before treatment and periodically thereafter until the effect on the

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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 andwould contact the (HCP) if the client is taking which medication?1. Vitamin A2. Digoxin (Lanoxin)3. Furosemide (Lasix)4. Phenytoin (Dilantin)-Exact Answer:1. Vitamin ARationale:Isotretinoin is a metabolite of vitamin A and can produce generalizedintensification of isotretinoin toxicity. Because of the potential for increasedtoxicity, vitamin A supplements should be discontinued before isotretinointherapy. Options 2,3, and 4 are not contraindicated with the use of isotretinoin.9.) The nurse is applying a topical corticosteroid to a client with eczema. The nursewould monitor for the potential for increased systemic absorption of themedication if the medication were being applied to which of the following bodyareas?1. Back2. Axilla3. Soles of the feet4. Palms of the hands-Exact Answer:2. AxillaRationale:

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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 permeabilityis poor (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 medicationprescription, the nurse would suspect that the client is being treated for:1. Acne2. Eczema3. Hair loss4. Herpes simplex-Exact Answer: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 anddecreasing 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-negativebacteria. The nurse is reinforcing information to the client about the medication.Which statement made by the client indicates a lack of understanding about thetreatments?1. "The medication is an antibacterial."2. "The medication will help heal the burn."3. "The medication will permanently stain my skin."

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4. "The medication should be applied directly to the wound."-Exact Answer:3."The medication will permanently stain my skin."Rationale:Silver sulfadiazine (Silvadene) is an antibacterial that has a broad spectrum ofactivity against gram-negative bacteria, gram-positive bacteria, and yeast. It isapplied directly to the wound to assist in healing. It does not stain the skin.12.) A nurse is caring for a client who is receiving an intravenous (IV) infusion of anantineoplastic medication. During the infusion, the client complains of pain at theinsertion site. During an inspection of the site, the nurse notes redness andswelling and that the rate of infusion of the medication has slowed. The nurseshould take which appropriate action?1. Notify the registered nurse.2. Administer pain medication to reduce the discomfort.3. Apply ice and maintain the infusion rate, as prescribed.4. Elevate the extremity of the IV site, and slow the infusion.-Exact Answer:1.Notify the registered nurse.Rationale:When antineoplastic medications (Chemotheraputic Agents) are administered viaIV, great care must be taken to prevent the medication from escaping into thetissues surrounding the injection site, because pain, tissue damage, and necrosiscan result. The nurse monitors for signsof extravasation, such as redness orswelling at the insertion site and a decreased infusion rate. If extravasation occurs,the registered nurse needs to be notified; he or she will then contact the healthcare provider.

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13.) The client with squamous cellcarcinoma of the larynx is receiving bleomycinintravenously. The nurse caring for the client anticipates that which diagnosticstudy will be prescribed?1. Echocardiography2. Electrocardiography3. Cervical radiography4. Pulmonary function studies-Exact Answer:4. Pulmonary function studiesRationale:Bleomycin is an antineoplastic medication (Chemotheraputic Agents) that cancause interstitial pneumonitis, which can progress to pulmonary fibrosis.Pulmonary function studies along with hematological, hepatic, and renal functiontests need to be monitored. The nurse needs to monitor lung sounds for dyspneaand crackles, which indicate pulmonary toxicity. The medication needs to bediscontinued immediately if pulmonary toxicity occurs. Options 1, 2, and 3 areunrelated to the specific use of this medication.14.) The client with acute myelocytic leukemia is being treated with busulfan(Myleran). Which laboratory value would the nurse specifically monitor duringtreatment with this medication?1. Clotting time2. Uric acid level3. Potassium level4. Blood glucose level-Exact Answer:2. Uric acid levelRationale:

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Busulfan (Myleran) can cause an increase in the uric acid level. Hyperuricemia canproduce uric acid nephropathy, renal stones, and acute renal failure. Options 1, 3,and 4 are not specifically related to this medication.15.) The client with small cell lung cancer is being treated with etoposide(VePesid). The nurse who is assisting in caring for the client during itsadministration understands that which side effect is specifically associated withthis medication?1. Alopecia2. Chest pain3. Pulmonary fibrosis4. Orthostatic hypotension-Exact Answer:4. Orthostatic hypotensionRationale:A side effect specific to etoposide is orthostatic hypotension. The client's bloodpressure is monitored during the infusion. Hair loss occurs with nearly all theantineoplastic medications. Chest pain and pulmonary fibrosis are unrelated tothis medication.16.) The clinic nurse is reviewing a teaching plan for the client receiving anantineoplastic medication. When implementing the plan, the nurse tells the client:1. To take aspirin (acetylsalicylic acid) as needed for headache2. Drink beverages containing alcohol in moderate amounts each evening3. Consult with health care providers (HCPs) before receiving immunizations

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4. That it is not necessary to consult HCPs before receiving a flu vaccine at thelocal health fair-Exact Answer:3. Consult with health care providers (HCPs)before receiving immunizationsRationale:Because antineoplastic medications lower the resistance of the body, clients mustbe informed not to receive immunizations without a HCP's approval. Clients alsoneed to avoid contact with individuals who have recently received a live virusvaccine. Clients need to avoid aspirin and aspirin-containing products to minimizethe risk of bleeding, and they need to avoid alcohol to minimize the risk of toxicityand side effects.17.) The client with ovarian cancer is being treated with vincristine (Oncovin). Thenurse monitors the client, knowing that which of the following indicates a sideeffect specific to this medication?1. Diarrhea2. Hair loss3. Chest pain4. Numbness and tingling in the fingers and toes-Exact Answer:4. Numbnessand tingling in the fingers and toesRationale:A side effect specific to vincristine is peripheral neuropathy, which occurs inalmost every client. Peripheral neuropathy can be manifested as numbness andtingling in thefingers and toes. Depression of the Achilles tendon reflex may bethe first clinical sign indicating peripheral neuropathy. Constipation rather thandiarrhea is most likely to occur with this medication, although diarrhea may occur

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occasionally. Hair lossoccurs with nearly all the antineoplastic medications. Chestpain is unrelated to this medication.18.) The nurse is reviewing the history and physical examination of a client whowill be receiving asparaginase (Elspar), an antineoplastic agent. The nurseconsultswith the registered nurse regarding the administration of the medication if whichof the following is documented in the client's history?1. Pancreatitis2. Diabetes mellitus3. Myocardial infarction4. Chronic obstructive pulmonary disease-Exact Answer:1. PancreatitisRationale:Asparaginase (Elspar) is contraindicated if hypersensitivity exists, in pancreatitis,or if the client has a history of pancreatitis. The medication impairs pancreaticfunction and pancreatic function tests should be performed before therapy beginsand when a week or more has elapsed between administration of the doses. Theclient needs to be monitored for signs of pancreatitis, which include nausea,vomiting, and abdominal pain. The conditions noted in options 2, 3, and 4are notcontraindicated with this medication.19.) Tamoxifen is prescribed for the client with metastatic breast carcinoma. Thenurse understands that the primary action of this medication is to:1. Increase DNA and RNA synthesis.2. Promote the biosynthesis of nucleic acids.3. Increase estrogen concentration and estrogen response.

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4. Compete with estradiol for binding to estrogen in tissues containing highconcentrations of receptors.-Exact Answer:4. Compete with estradiol for bindingto estrogen in tissues containing high concentrations of receptors.Rationale:Tamoxifen is an antineoplastic medication that competes with estradiol forbinding to estrogen in tissues containing high concentrations of receptors.Tamoxifen is used to treat metastatic breast carcinoma in women and men.Tamoxifen is also effective in delaying the recurrence ofcancer followingmastectomy. Tamoxifen reduces DNA synthesis and estrogen response.20.) The client with metastatic breast cancer is receiving tamoxifen. The nursespecifically monitors which laboratory value while the client is taking thismedication?1. Glucose level2. Calcium level3. Potassium level4. Prothrombin time-Exact Answer:2. Calcium levelRationale:Tamoxifen may increase calcium, cholesterol, and triglyceride levels. Before theinitiation of therapy, a complete blood count, platelet count,and serum calciumlevels should be assessed. These blood levels, along with cholesterol andtriglyceride levels, should be monitored periodically during therapy. The nurseshould assess for hypercalcemia while the client is taking this medication. Signs ofhypercalcemia include increased urine volume, excessive thirst, nausea, vomiting,constipation, hypotonicity of muscles, and deep bone and flank pain.

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21.) A nurse is assisting with caring for a client with cancer who is receivingcisplatin. Select the adverse effects that the nurse monitors for that are associatedwith this medication. Select all that apply.1. Tinnitus2. Ototoxicity3. Hyperkalemia4. Hypercalcemia5. Nephrotoxicity6. Hypomagnesemia-Exact Answer:1. Tinnitus2. Ototoxicity5. Nephrotoxicity6. HypomagnesemiaRationale:Cisplatin is an alkylating medication. Alkylating medications are cell cycle phase-nonspecific medications that affect the synthesis of DNA by causing the cross-linking of DNA to inhibit cell reproduction. Cisplatin may cause ototoxicity,tinnitus, hypokalemia, hypocalcemia, hypomagnesemia, and nephrotoxicity.Amifostine (Ethyol) may be administered before cisplatin to reduce the potentialfor renal toxicity.22.) A nurse is caring for a client after thyroidectomy andnotes that calciumgluconate is prescribed for the client. The nurse determines that this medicationhas been prescribed to:1. Treat thyroid storm.

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2. Prevent cardiac irritability.3. Treat hypocalcemic tetany.4. Stimulate the release of parathyroid hormone.-Exact Answer:3. Treathypocalcemic tetany.Rationale:Hypocalcemia can develop after thyroidectomy if the parathyroid glands areaccidentally removed or injured during surgery. Manifestations develop 1 to 7daysafter surgery. If the client develops numbness and tingling around the mouth,fingertips, or toes or muscle spasms or twitching, the health care provider isnotified immediately. Calcium gluconate should be kept at the bedside.23.) A client who has beennewly diagnosed with diabetes mellitus has beenstabilized with daily insulin injections. Which information should the nurse teachwhen carrying out plans for 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.-ExactAnswer:2. Rotate the insulin injection sites systematically.Rationale:Insulin dosages should not be adjusted or increased before unusual exercise. Ifacetone is found in the urine, it may possibly indicate the need for additionalinsulin. To minimize the discomfort associated with insulin injections, the insulinshould be administered at room temperature. Injection sites should besystematically rotated from one area to another. The client should be instructed to

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give injections in one area, about 1 inch apart, until the whole area has been usedand then to change to another site. This prevents dramatic changes in daily insulinabsorption.24.) A nurse is reinforcing teaching for a client regarding how to mix regular insulinand NPH insulin in the same syringe. Which of the following actions, if performedby the client, indicates the need for further teaching?1. Withdraws the NPH insulin first2. Withdraws the regular insulin first3. Injects air into NPH insulin vial first4. Injects an amount of air equal to the desired dose of insulin into the vial-ExactAnswer:1. Withdraws the NPH insulin firstRationale:When preparing a mixture of regular insulin with another insulin preparation, theregular insulin is drawn into the syringe first. This sequence will avoidcontaminating the vial of regular insulin with insulin of another type. Options 2, 3,and 4 identifythe correct actions for preparing NPH and regular insulin.25.) A home care nurse visits a client recently diagnosed with diabetes mellituswho is taking Humulin NPH insulin daily. The client asks the nurse how to store theunopened vials of insulin. Thenurse tells the client to:1. Freeze the insulin.2. Refrigerate the insulin.3. Store the insulin in a dark, dry place.

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