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PHARM HESI EXAM QUESTIONS AND ANSWERS

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Publié le 8 août 2024
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PHARM HESI EXAM QUESTIONS AND ANSWERS
Which action is most important for the nurse to implement prior to the administration of
the antiarrhythmic drug adenosine (Adenocard)?

-Assess pupillary response to light.
-Instruct the client that facial flushing may occur.
-Apply continuous cardiac monitoring.
-Request that family members leave the room. - answer- -Apply continuous cardiac
monitoring.

A client's dose of isosorbide dinitrate (Imdur) is increased from 40 mg to 60 mg PO
daily. When the client reports the onset of a headache prior to the next scheduled dose,
which action should the nurse implement?

-Hold the next scheduled dose of Imdur 60 mg and administer a PRN dose of
acetaminophen (Tylenol).
-Administer the 40 mg of Imdur and then contact the healthcare provider.
-Administer the 60 mg dose of Imdur and a PRN dose of acetaminophen (Tylenol).
-Do not administer the next dose of Imdur or any acetaminophen until notifying the
healthcare provider. - answer- -Administer the 60 mg dose of Imdur and a PRN dose of
acetaminophen (Tylenol).

Imdur is a nitrate which causes vasodilation. This vasodilation can result in headaches,
which can generally be controlled with acetaminophen until the client develops a
tolerance to this adverse effect.

A client being treated for hyperthyroidism with propylthiouracil (PTU) asks the nurse
how the medication works. Which is the best response to give the client?

-It decreases the amount of thyroid-stimulating hormone circulating in the blood.
-It increases the amount of thyroid-stimulating hormone circulating in the blood.
-It enhances the amount of T4 and diminishes the amount of T3 produced by the
thyroid.
-It inhibits the synthesis of T3 and T4 by the thyroid gland. - answer- -It inhibits the
synthesis of T3 and T4 by the thyroid gland.

Propylthiouracil (PTU) is an adjunct therapy used to control hyperthyroidism by
inhibiting the production of thyroid hormones. It is often prescribed in preparation for
thyroidectomy or radioactive iodine therapy.

A client with Parkinson's disease is taking carbidopa-levodopa (Sinemet). Which
observation by the nurse would indicate that the desired outcome of the medication is
being achieved?

-Decreased blood pressure.

,-Lessening of tremors.
-Increased salivation.
-Increased attention span. - answer- -Lessening of tremors

Sinemet increases the amount of levodopa to the CNS (dopamine to the brain).
Increased amounts of dopamine improve the symptoms of Parkinson's, such as
involuntary movements, resting tremors, shuffling gait, etc. Decreased drooling would
be a desired effect, not increased salivation.

A client receives a new prescription for sustained release levodopa/carbidopa PO BID
for the treatment of Parkinson's disease. The client's previous prescription was
levodopa PO TID. The client's last dose of levodopa was at 0800 hr. Which set of
instructions should the nurse give to the client?

-"Take the first dose of levodopa/carbidopa today, as soon as your prescription is filled."
-"Since you already took your levodopa, wait until tomorrow to take the
levodopa/carbidopa."
-"Take both drugs for the first week, then switch to taking only the levodopa/carbidopa."
-"You can begin taking the levodopa/carbidopa this evening, but do not take any more
levodopa." - answer- -"You can begin taking the levodopa/carbidopa this evening, but
do not take any more levodopa."

Carbidopa combined with the levodopa significantly reduces the need for levodopa in
clients with Parkinson's disease, so the new prescription should not be started until
eight hours after the previous dose of levodopa, but can be started the same day.

While taking a medical history, the client states, "I am allergic to penicillin." What related
allergy to another type of antiinfective agent should the nurse ask the client about when
taking the nursing history?

-Aminoglycosides.
-Cephalosporins.
-Sulfonamides.
-Tetracyclines. - answer- -Cephalosporins.

According to research, there appears to be a cross sensitivity between penicillins and
first generation cephalosporins; however, research shows there is no evidence of cross
sensitivity between PCN and third or fourth generation cephalosporins.

An older client with a decreased percentage of lean body mass is admitted to the
hospital. Which pharmacokinetic process is affected and should be considered in the
client's dosing of medication?

-Absorption.
-Metabolism.
-Elimination.

, -has Distribution - answer- Distribution

Adenosine (Adenocard) is an antiarrhythmic drug used to restore a normal sinus rhythm
in clients with rapid supraventricular tachycardia. The client's heart rate should be
monitored continuously (C) for the onset of additional arrhythmias while receiving
adenosine. (A and B) are valuable nursing interventions, but are of less importance than
monitoring for potentially fatal arrhythmias. Family members may be asked to leave the
room because of the potential for an emergency situation (D), however, this is also of
less priority than (C).

A peak and trough level is prescribed for a client receiving antibiotic therapy. When
should the nurse should obtain the trough level?

-Sixty minutes after the antibiotic dose is administered.
-Immediately before the next antibiotic dose is given.
-Upon completion of the prescribed antibiotic regime.
-An hour before the next antibiotic dose is give - answer- -Immediately before the next
antibiotic dose is given.

Trough levels are drawn when the blood level is at its lowest, which is typically just
before the next dose is given.

A decreased lean body mass in an older adult affects the distribution of drugs, which
affects the pharmacokinetics of drug and how the medication is distributed throughout
the body.

A client is receiving clonidine (Catapres) 0.1 mg/24hr via transdermal patch. Which
assessment finding indicates that the desired effect of the medication has been
achieved?

-Client denies recent episodes of angina.
-Change in peripheral edema from +3 to +1.
-Client denies recent nausea or vomiting.
-Blood pressure has changed from 180/120 to 140/70. - answer- -Blood pressure has
changed from 180/120 to 140/70.

Catapres acts as a centrally-acting analgesic and antihypertensive agent. (D) indicates
a reduction in hypertension. Catapres does not affect (A, B, or C), so these findings do
not indicate desired outcomes of Catapres.

A postoperative client receiving a continuous IV infusion of meperidine 35 mg/hr for the
past four days has become increasingly restless and irritable, and begins to hallucinate.
Which action should the nurse take first?

-Administer a PRN dose of the PO lithium.

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