increased renal excretion may decrease concentrati
a nurse s preparing to administer eye drops to a c
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HESI PHARMACOLOGY
HESI PHARMACOLOGY
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Pharmacology HESI V2 Preparation
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. - ANSANS: 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.
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 - ANSANS: 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.
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 - ANSANS:B, D, E
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.
,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." - ANSANS: 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.
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. - ANSANS: A
To verify trough levels of a medication, a blood specimen is obtained immediately before the
next dose of medication.
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
D. Safeguarding medications
E. Identifying the client's diagnosis - ANSANS: 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.
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 - ANSANS: 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.
,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 - ANSANS: D
The time and frequency of medication administration is not included and should be clarified
with the provider.
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."
D. "The 'read back' is omitted if this is a one-time prescription." - ANSANS: 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.
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 - ANSANS: 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.
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 - ANSANS: C, E
Pain at the IV site and a palpable, hard mass above the insertion site is a clinical
manifestation of thrombophlebitis.
A tingling sensation below the insertion site is a clinical manifestation of nerve damage.
Tachycardia is a clinical manifestation of fluid volume overload. Cool, pale skin is a clinical
manifestation of infiltration.
A nurse manager is reviewing the facility's policies for IV therapy with the members of his
team. The nurse manager should remind the team that which of the following techniques
helps minimize the risk of catheter embolism?
A. Performing hand hygiene before and after IV insertion
B. Rotating IV sites at least every 72 hr
C. Minimizing tourniquet time
D. Avoiding reinserting the needle into an IV catheter - ANSANS: D
The nurse manager should remind the members to avoid reinserting a needle to an IV
catheter. This action can result in severing the end of the catheter and consequently cause a
catheter embolism.
A nurse is preparing to initiate IV therapy for an older adult client. Which of the following
actions should the nurse take?
A. Use a disposable razor to remove excess hair on the extremity.
B. Select the back of the client's hand to insert the IV catheter.
C. Distend the veins by using a blood pressure cuff.
D. Direct the client to raise his arm above his heart. - ANSANS: C
The nurse should distend the veins using a blood pressure cuff to reduce overfilling of the
vein, which can result in a hematoma.
The nurse should remove excess hair by clipping it with scissors. Shaving with disposable
razors can cause skin damage that lead to infection. In most instances, the nurse inserts the
IV catheter into a distal site, such as the back of the client's hand. However, when inserting
an IV catheter for an older adult, the nurse should use a site on the arm because older
adults typically have fragile veins in the back of their hands. The nurse should direct the
client to hold his arm below the level of his heart to distend the vein.
A nurse is caring for a client receiving dextrose 5% in water IV at 250 mL. Which of the
following findings are an indication of fluid volume overload? (Select all that apply.)
A. Hypotension
B. Bradycardia
C. Shortness of breath
D. Crackles heard in lungs
E. Distended neck veins - ANSANS: C, D, E
Due to an increase in fluid in the cardiovascular system, hypertension and tachycardia are
manifestations of fluid overload.
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