HESI PHARMACOLOGY
An adult client has prescriptions for morphine sulfate 2.5 mg IV q6h and ketorolac (Toradol) 30 mg IV
q6h. Which action should the nurse implement?
a) Administer both medications according to the prescription.
b) Hold the ketorolac to prevent an antagonistic effect.
c) Hold the morphine to prevent an additive drug interaction.
d) Contact the healthcare provider to clarify the prescription. - ANSWER Rationale: A
Morphine and ketorolac (Toradol) can be administered concurrently, and may produce an additive
analgesic effect, resulting in the ability to reduce the dose of morphine, as seen in this prescription.
Toradol is an anti inflammatory analgesic, and does not have an antagonistic effect with morphine.
The nurse is assessing a client who is experiencing anaphylaxis from an insect sting. Which prescription
should the nurse prepare to administer this client?
a) Dopamine.
b) Ephedrine.
c) Epinephrine.
d) Diphenhydramine. - ANSWER Rationale: C
Epinephrine is an adrenergic agent that stimulates beta receptors to increase cardiac automaticity in
cardiac arrest and relax bronchospasms in anaphylaxis. On the ither hand, dopamine is a vasopressor
used to treat clients with shock. Ephedrine causes peripheral vasoconstriction and is used in the
treatment of nasal congestion. Diphenhydramine is an antihistamine decongestant used in the treatment
of mild allergic reactions and motion sickness. Epinephrine is the medication of choice in treating
anaphylaxis.
Which instruction(s) should the nurse give to a female client who just received a prescription for oral
metronidazole (Flagyl) for treatment of trichomonas vaginalis? (Select all that apply.)
o Increase fluid intake, especially cranberry juice.
o Do not abruptly discontinue the medication, taper use.
o Check blood pressure daily to detect hypertension.
,o Avoid drinking alcohol while taking this medication.
o Use condoms until treatment is completed.
o Ensure that all sexual partners are treated at the same time. - ANSWER Rationale: 1,4,6
Increased fluid intake and cranberry juice are recommended for prevention and treatment of urinary
tract infections, which frequently accompany vaginal infections. It is not necessary to taper use of this
drug or to check the blood pressure daily, as this condition is not related to hypertension. Flagyl can
cause a disulfiram-like reaction if taken in conjunction with ingestion of alcohol, so the client should be
instructed to avoid alcohol. All sexual partners should be treated at the same time and condoms should
be used until after treatment is completed to avoid reinfection.
A client with coronary artery disease who is taking digoxin (Lanoxin) receives a new prescription for
atorvastatin (Lipitor). Two weeks after initiation of the Lipitor prescription, the nurse assesses the client.
Which finding requires the most immediate intervention?
a) Heartburn.
b) Headache.
c) Constipation.
d) Vomiting. - ANSWER Rationale: D
Vomiting, anorexia and abdominal pain are early indications of digitalis toxicity. Since Lipitor increases
the risk for digitalis toxicity, this finding requires the most immediate intervention by the nurse.
While taking a nursing history, the client states, "I am allergic to penicillin." What related allergy to
another type of anti-infective agent should the nurse ask the client about when taking the nursing
history?
a) Aminoglycosides.
b) Cephalosporins.
c) Sulfonamides.
d) Tetracyclines. - ANSWER Rationale: B
, If a client has a history of being allergic to penicillin (PCN); there is appears to be a cross sensitivity
between penicillins and 1st generation cephalosporins. According to research, there appears to be no
cross sensitivity between PCN and 3rd or 4th generation cephalosporins.
A category X drug is prescribed for a young adult female client. Which instruction is most important for
the nurse to teach this client?
a) Use a reliable form of birth control.
b) Avoid exposure to ultra violet light.
c) Refuse this medication if planning pregnancy.
d) Abstain from intercourse while on this drug. - ANSWER Rationale: A
Drugs classified in the category X place a client who is in the first trimester of pregnancy at risk for
teratogenesis, so women in the childbearing years should be counseled to use a reliable form of birth
control during drug therapy. If the client is planning to become pregnant, she should be encouraged to
discuss plans for pregnancy with the healthcare provider, so a safer alternative prescription can be
provided if pregnancy occurs.
A client is receiving methylprednisolone (Solu-Medrol) 40 mg IV daily. The nurse anticipates an increase
in which laboratory value as the result of this medication?
a) Serum glucose.
b) Serum calcium.
c) Red blood cells.
d) Serum potassium. - ANSWER Rationale: A
Solu-Medrol is a corticosteroid with glucocorticoid and mineralocorticoid actions. These effects can lead
to hyperglycemia which is reflected as an increase in the serum glucose value. The client taking Solu-
Medrol is also at risk for hypocalcemia and hypokalemia which result in a decrease in the serum calcium
and serum potassium levels. These medications also alter the some of the body's immune responses by
suppressing the migration of white blood cells decreasing inflammation response.
A client is being treated for osteoporosis with alendronate (Fosamax), and the nurse has completed
discharge teaching regarding medication administration. Which morning schedule would indicate to the
nurse that the client teaching has been effective?
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