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HESI Pharmacology Exam Practice Questions and Correct Answers.
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HESI Pharmacology Exam PracticeQuestions and Correct Answers
149.) A client taking fexofenadine (Allegra) is scheduled for allergy skin testing and tells the nurse in the
health care provider's office that a dose was taken this morning. The nurse determines that:
1. The client should reschedule the appointment.
2. A lower dose of allergen will need to be injected.
3. A higher dose of allergen will need to be injected.
4. The client should have the skin test read a day later than usual. - correct answers:1. The client should
reschedule the appointment.
Rationale:
Fexofenadine is an antihistamine, which provides relief of symptoms caused by allergy. Antihistamines
should be discontinued for at least 3 days (72 hours) before allergy skin testing to avoid false-negative
readings. This client should have the appointment rescheduled for 3 days after discontinuing the
medication.
150.) A client complaining of not feeling well is seen in a clinic. The client is taking several medications
for the control of heart disease and hypertension. These medications include a β-blocker, digoxin
(Lanoxin), and a diuretic. A tentative diagnosis of digoxin toxicity is made. Which of the following
assessment data would support this diagnosis?
1. Dyspnea, edema, and palpitations
2. Chest pain, hypotension, and paresthesia
3. Double vision, loss of appetite, and nausea
4. Constipation, dry mouth, and sleep disorder - correct answers:3. Double vision, loss of appetite, and
nausea
Rationale:
Double vision, loss of appetite, and nausea are signs of digoxin toxicity. Additional signs of digoxin
toxicity include bradycardia, difficulty reading, visual alterations such as green and yellow vision or
seeing spots or halos, confusion, vomiting, diarrhea, decreased libido, and impotence.
**gastrointestinal (GI) and visual disturbances occur with digoxin toxicity**
,151.) A client is being treated for acute congestive heart failure with intravenously administered
bumetanide. The vital signs are as follows: blood pressure, 100/60 mm Hg; pulse, 96 beats/min; and
respirations, 24 breaths/min. After the initial dose, which of the following is the priority assessment?
1. Monitoring weight loss
2. Monitoring temperature
3. Monitoring blood pressure
4. Monitoring potassium level - correct answers:3. Monitoring blood pressure
Rationale:
Bumetanide is a loop diuretic. Hypotension is a common side effect associated with the use of this
medication. The other options also require assessment but are not the priority.
**priority ABCs—airway, breathing, and circulation**
152.) Intravenous heparin therapy is prescribed for a client. While implementing this prescription, a
nurse ensures that which of the following medications is available on the nursing unit?
1. Protamine sulfate
2. Potassium chloride
3. Phytonadione (vitamin K )
4. Aminocaproic acid (Amicar) - correct answers:1. Protamine sulfate
Rationale:
The antidote to heparin is protamine sulfate; it should be readily available for use if excessive bleeding or
hemorrhage occurs. Potassium chloride is administered for a potassium deficit. Vitamin K is an antidote
for warfarin sodium. Aminocaproic acid is the antidote for thrombolytic therapy.
153.) A client is diagnosed with pulmonary embolism and is to be treated with streptokinase (Streptase).
A nurse would report which priority data collection finding to the registered nurse before initiating this
therapy?
1. Adventitious breath sounds
2. Temperature of 99.4° F orally
3. Blood pressure of 198/110 mm Hg
4. Respiratory rate of 28 breaths/min - correct answers:3. Blood pressure of 198/110 mm Hg
Rationale:
,Thrombolytic therapy is contraindicated in a number of preexisting conditions in which there is a risk of
uncontrolled bleeding, similar to the case in anticoagulant therapy. Thrombolytic therapy also is
contraindicated in severe uncontrolled hypertension because of the risk of cerebral hemorrhage.
Therefore the nurse would report the results of the blood pressure to the registered nurse before
initiating therapy. The findings in options 1, 2, and 4 may be present in the client with pulmonary
embolism.
154.) A nurse is reinforcing dietary instructions to a client who has been prescribed cyclosporine
(Sandimmune). Which food item would the nurse instruct the client to avoid?
1. Red meats
2. Orange juice
3. Grapefruit juice
4. Green, leafy vegetables - correct answers:3. Grapefruit juice
Rationale:
A compound present in grapefruit juice inhibits metabolism of cyclosporine. As a result, the
consumption of grapefruit juice can raise cyclosporine levels by 50% to 100%, thereby greatly increasing
the risk of toxicity. Grapefruit juice needs to be avoided. Red meats, orange juice, and green leafy
vegetables are acceptable to consume.
155.) Mycophenolate mofetil (CellCept) is prescribed for a client as prophylaxis for organ rejection
following an allogeneic renal transplant. Which of the following instructions does the nurse reinforce
regarding administration of this medication?
1. Administer following meals.
2. Take the medication with a magnesium-type antacid.
3. Open the capsule and mix with food for administration.
4. Contact the health care provider (HCP) if a sore throat occurs. - correct answers:4. Contact the health
care provider (HCP) if a sore throat occurs.
Rationale:
Mycophenolate mofetil should be administered on an empty stomach. The capsules should not be
opened or crushed. The client should contact the HCP if unusual bleeding or bruising, sore throat, mouth
sores, abdominal pain, or fever occurs because these are adverse effects of the medication. Antacids
containing magnesium and aluminum may decrease the absorption of the medication and therefore
should not be taken with the medication. The medication may be given in combination with
corticosteroids and cyclosporine.
**neutropenia can occur with this medication**
, 156.) A nurse is reviewing the laboratory results for a client receiving tacrolimus (Prograf). Which
laboratory result would indicate to the nurse that the client is experiencing an adverse effect of the
medication?
1. Blood glucose of 200 mg/dL
2. Potassium level of 3.8 mEq/L
3. Platelet count of 300,000 cells/mm3
4. White blood cell count of 6000 cells/mm3 - correct answers:1. Blood glucose of 200 mg/dL
Rationale:
A blood glucose level of 200 mg/dL is elevated above the normal range of 70 to 110 mg/dL and suggests
an adverse effect. Other adverse effects include neurotoxicity evidenced by headache, tremor, insomnia;
gastrointestinal (GI) effects such as diarrhea, nausea, and vomiting; hypertension; and hyperkalemia.
157.) A client receiving nitrofurantoin (Macrodantin) calls the health care provider's office complaining of
side effects related to the medication. Which side effect indicates the need to stop treatment with this
medication?
1. Nausea
2. Diarrhea
3. Anorexia
4. Cough and chest pain - correct answers:4. Cough and chest pain
Rationale:
Gastrointestinal (GI) effects are the most frequent adverse reactions to this medication and can be
minimized by administering the medication with milk or meals. Pulmonary reactions, manifested as
dyspnea, chest pain, chills, fever, cough, and the presence of alveolar infiltrates on the x-ray, would
indicate the need to stop the treatment. These symptoms resolve in 2 to 4 days following
discontinuation of this medication.
**Eliminate options 1, 2, and 3 because they are similar GI-related side effects. Also, use the ABCs—
airway, breathing, and circulation**
158.) A client with chronic renal failure is receiving epoetin alfa (Epogen, Procrit). Which laboratory
result would indicate a therapeutic effect of the medication?
1. Hematocrit of 32%
2. Platelet count of 400,000 cells/mm3
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