1. A client is prescribed phenobarbital sodium (Luminal) for a seizure
disorder. The medication has a long half-life of 4 days. Based on this half-life,
the medication will most likely be prescribed A. once a day.
B. twice a day.
C. three times a day.
D. four times a day.: ANS: A
Medication with long half-lives remain at their therapeutic levels between doses for
long periods of time. Therefore, this medication can be administered once a day.
2. A nurse educator is reviewing medication dosages and factors that
influence medication metabolism with a group of nurses. Medication dosages
may need to be decreased for which of the following reasons? (Select all that
apply.)
A. Increased renal excretion
B. Increased medication-metabolizing enzymes
C. Liver failure
D. Peripheral vascular disease
E. Concurrent use of medication metabolized by the same pathway: ANS: C,
E Liver failure decreases metabolism and thus increase the concentration of
medication. This may require decreasing the dosage of medication. When two
medications are metabolized in the same way, they may compete for
metabolism, thereby increasing the concentration of one or both medications.
Increased renal excretion may decrease concentration of the medication, requiring
increased dosage. Increased medication-metabolizing enzymes can decrease the
concentration of the medication. The dose might need increased. Peripheral
vascular disease may impair distribution, and more of the medication may be
needed.
3. A nurse s preparing to administer eye drops to a client. Which of the
following are appropriate nursing interventions related to this procedure?
(Select all that apply.)
A. Using medical aseptic technique
B. Asking the client to look up at the ceiling
C. Having the client lie in a side-lying position
D. Dropping medication into the center of the client's conjunctival sac
E. Instructing the client to close the eye gently: ANS:B, D, E
, Pharmacology HESI V2 Preparation
The medication should be dropped into the center of the conjunctival sac to promote
better distribution of the medication. The client should close the eye gently to allow
improved distribution of the medication.
Surgical aseptic technique is used to administer eye drops. The client should be
sitting or in a supine position to facilitate proper administration of eye drops.
4. A nurse is completing discharge teaching to a client who has a new
prescription for a transdermal medication. Which of the following
statements by the client indicates understanding of the teaching?
A. "I will clean the site with an alcohol swab prior to applying the patch."
B. "I will rotate the application site weekly."
C. "I will apply the patch to an area of skin with no hair."
D. "I will place the new patch on the site of the old patch.": ANS: C
Transdermal medication should be applied to a hairless area of skin to promote
absorption of medication.
The skin should be washed with soap and water and dried thoroughly before
applying a transdermal patch. Application sites should be rotated on a daily basis
to prevent skin irritation.
5. A nurse is reviewing a client's health record and notes a new prescription
by the provider to verify the trough level of the client's medication. Which of
the following actions should the nurse take?
A. Have a blood specimen obtained immediately prior to the next dose of
medication.
B. Verify that the client has been on the medication for 24 hr before ordering
a blood specimen.
C. Ask the client to provide a urine specimen after the next dose of
medication.
D. Begin administering the medication, and obtain a blood specimen.: ANS: A
To verify trough levels of a medication, a blood specimen is obtained immediately
before the next dose of medication.
6. A nurse is preparing a client's medication. Which of the following are legal
responsibilities of the nurse? (Select all that apply.)
A. Maintaining skill competency
B. Determining the dosage
C. Monitoring for adverse effects
, Pharmacology HESI V2 Preparation
D. Safeguarding medications
E. Identifying the client's diagnosis: ANS: A, C, D
Determining medication dosage and identifying a diagnosis is the
role/responsibility of the provider. The nurse should be informed about a client's
diagnosis.
7. A nurse is reviewing a client's health record and notes a new prescription
by the provider for lisinopril (Zestril) 10 mg PO every day. The nurse should
recognize this as which of the following types of prescription?
A. Single prescription
B. Stat prescription
C. Routine prescription
D. Standing prescription: ANS: C
A routine prescription identifies a medication that is given on a regular schedule.
This medication is administered every day until discontinued.
A single prescription is to be given once at a specified time or as soon as possible.
A stat prescription is only given once, and it is given immediately. A standing
prescription is written for specific circumstances or a specific unit.
8. A nurse is reviewing a new prescription for ondansetron (Zofran) 4 mg PO
PRN nausea and vomiting for a client who has hyperemesis gravidarum. The
nurse should clarify which of the following parts of the prescription with the
provider?
A. Name
B. Dosage
C. Route
D. Time: ANS: D
The time and frequency of medication administration is not included and should be
clarified with the provider.
9. A nurse is orienting a newly hired nurse and discussing how to take
telephone prescription. Which of the following statements by the newly
hired nurse indicates understanding of the discussion?
A. "A second nurse enters the prescription into the client's health record."
B. "Another nurse should listen to the phone call."
C. "The provider can clarify the prescription when he signs the health record."
, Pharmacology HESI V2 Preparation
D. "The 'read back' is omitted if this is a one-time prescription.": ANS: B The
second nurse should listen to a telephone prescription to prevent errors in
communication.
The nurse who takes the telephone prescription should enter it into the client's
health record to prevent errors in translation. The nurse verifies the prescription is
complete and accurate at the time it is given by reading it back to the provider. A
telephone prescription includes reading back all types of medication prescription.
10. A nurse on a medical unit is admitting a client and completing a
preassessment before administration of medications. Which of the following
data should the nurse include in the preassessment? (Select all that apply.)
A. Use of herbal teas
B. Daily fluid intake
C. Current health status
D. Previous surgical history
E. Food allergies: ANS: A, C, E
Use of herbal product,s which often contains caffeine, should be assessed prior to
medication administration because caffeine can affect medication
biotransformation. Current health status should be reviewed because new
prescriptions can cause alterations in current health status. Food allergies should
be included in the preassessment that is completed prior to medication
administration to identify any potential interactions.
Daily fluid intake and surgical history is important, but it is not part of the
presassessment that is completed prior to medication administration.
11. A nurse is assessing a client's IV. Which of the following findings is
indicative of phlebitis? (Select all that apply.) A. Tingling sensation below
insertion site
B. Tachycardia
C. Palpable, hard mass above insertion site
D. Cool, pale skin
E. Pain at site: ANS: C, E
Pain at the IV site and a palpable, hard mass above the insertion site is a clinical
manifestation of thrombophlebitis.
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