HESI Pharmacology Exam
Practice Latest update
2024/2025
Cross-allergies exist between penicillins (A) and cephalosporins, such as cephalexin
monohydrate (Keflex), so checking for penicillin allergy is a wise precaution before
administering this drug.
Which nursing intervention is most important when caring for a client receiving the
antimetabolite cytosine arabinoside (Arc-C) for chemotherapy?
A) Hydrate the client with IV fluids before and after infusion.
B) Assess the client for numbness and tingling of extremities.
C) Inspect the client's oral mucosa for ulcerations.
D) Monitor the client's urine pH for increased acidity. - CORRECT ANSWERC) Inspect
the client's oral mucosa for ulcerations.
Cytosine arabinoside (Arc-C) affects the rapidly growing cells of the body, therefore
stomatitis and mucosal ulcerations are key signs of antimetabolite toxicity (C). (A, B,
and D) are not typical interventions associated with the administration of
antimetabolites.
When assessing an adolescent who recently overdosed on acetaminophen (Tylenol), it
is most important for the nurse to assess for pain in which area of the body?
A) Flank.
B) Abdomen.
C) Chest.
D) Head. - CORRECT ANSWERB) Abdomen.
Acetaminophen toxicity can result in liver damage; therefore, it is especially important
for the nurse to assess for pain in the right upper quadrant of the abdomen (B), which
might indicate liver damage. (A, C, and D) are not areas where pain would be
anticipated.
An adult client is given a prescription for a scopolamine patch (Transderm Scop) to
prevent motion sickness while on a cruise. Which information should the nurse provide
to the client?
,A) Apply the patch at least 4 hours prior to departure.
B) Change the patch every other day while on the cruise.
C) Place the patch on a hairless area at the base of the skull.
D) Drink no more than 2 alcoholic drinks during the cruise. - CORRECT ANSWERA)
Apply the patch at least 4 hours prior to departure.
Scopolamine, an anticholinergic agent, is used to prevent motion sickness and has a
peak onset in 6 hours, so the client should be instructed to apply the patch at least 4
hours before departure (A) on the cruise ship. The duration of the transdermal patch is
72 hours, so (B) is not needed. Scolopamine blocks muscarinic receptors in the inner
ear and to the vomiting center, so the best application site of the patch is behind the
ear, not at the base of the skull (C). Anticholinergic medications are CNS depressants,
so the client should be instructed to avoid alcohol (D) while using the patch.
The nurse is reviewing the use of the patient-controlled analgesia (PCA) pump with a
client in the immediate postoperative period. The client will receive morphine 1 mg IV
per hour basal rate with 1 mg IV every 15 minutes per PCA to total 5 mg IV maximally
per hour. What assessment has the highest priority before initiating the PCA pump?
A) The expiration date on the morphine syringe in the pump.
B) The rate and depth of the client's respirations.
C) The type of anesthesia used during the surgical procedure.
D) The client's subjective and objective signs of pain. - CORRECT ANSWERB) The rate
and depth of the client's respirations.
,A female client with rheumatoid arthritis take ibuprofen (Motrin) 600 mg PO 4 times a
day. To prevent gastrointestinal bleeding, misoprostol (Cytotec) 100 mcg PO is
prescribed. Which information is most important for the nurse to include in client
teaching?
A) Use contraception during intercourse.
B) Ensure the Cytotec is taken on an empty stomach.
C) Encourage oral fluid intake to prevent constipation.
D) Take Cytotec 30 minutes prior to Motrin. - CORRECT ANSWERA) Use contraception
during intercourse.
Cytotec, a synthetic form of a prostaglandin, is classified as pregnancy Category X and
can act as an abortifacient, so the client should be instructed to use contraception
during intercourse (A) to prevent loss of an early pregnancy. (B) is not necessary. A
common side effect of Cytotec is diarrhea, so constipation prevention strategies are
usually not needed (C). Cytotec and Motrin should be taken together (D) to provide
protective properties against gastrointestinal bleeding.
A client with heart failure is prescribed spironolactone (Aldactone). Which information is
most important for the nurse to provide to the client about diet modifications?
A) Do not add salt to foods during preparation.
B) Refrain for eating foods high in potassium.
C) Restrict fluid intake to 1000 ml per day.
D) Increase intake of milk and milk products. - CORRECT ANSWERB) Refrain for
eating foods high in potassium.
Spironolactone (Aldactone), an aldosterone antagonist, is a potassium-sparing diuretic,
so a diet high in potassium should be avoided (B), including potassium salt substitutes,
which can lead to hyperkalemia. Although (A) is a common diet modification in heart
failure, the risk of hyperkalemia is more important with Aldactone. Restriction of fluids
(C) or increasing milk and milk products (D) are not indicated with this prescription.
In evaluating the effects of lactulose (Cephulac), which outcome should indicate that the
drug is performing as intended?
A) An increase in urine output.
B) Two or three soft stools per day.
C) Watery, diarrhea stools.
D) Increased serum bilirubin. - CORRECT ANSWERB) Two or three soft stools per day.
Lactulose is administered to reduce blood ammonia by excretion of ammonia through
the stool. Two to three stools a day indicate that lactulose is performing as intended (B).
(A) would be expected if the patient received a diuretic. (C) would indicate an overdose
of lactulose and is not expected. Lactulose does not affect (D).
The healthcare provider prescribes naproxen (Naproxen) twice daily for a client with
osteoarthritis of the hands. The client tells the nurse that the drug does not seem to be
effective after three weeks. Which is the best response for the nurse to provide?
, A) The frequency of the dosing is necessary to increase the effectiveness.
B) Therapeutic blood levels of this drug are reached in 4 to 6 weeks.
C) Another type of nonsteroidal antiinflammatory drug may be indicated.
D) Systemic corticosteroids are the next drugs of choice for pain relief. - CORRECT
ANSWERC) Another type of nonsteroidal antiinflammatory drug may be indicated.
Individual responses to nonsteroidal antiinflammatory drugs are variable, so (C) is the
best response. Naproxen is usually prescribed every 8 hours, so (A) is not indicated.
The peak for naproxen is one to two hours, not (B). Corticosteroids are not indicated for
osteoarthritis (D).
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.)
A) Increase fluid intake, especially cranberry juice.
B) Do not abruptly discontinue the medication; taper use.
C) Check blood pressure daily to detect hypertension.
D) Avoid drinking alcohol while taking this medication.
E) Use condoms until treatment is completed.
F) Ensure that all sexual partners are treated at the same time. - CORRECT
ANSWERA) Increase fluid intake, especially cranberry juice.
D) Avoid drinking alcohol while taking this medication.
E) Use condoms until treatment is completed.
F) Ensure that all sexual partners are treated at the same time.
Correct selections are (A, D, E, and F). Increased fluid intake and cranberry juice (A)
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 (B)
or to check the blood pressure daily (C), 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 (D). All sexual partners
should be treated at the same time (E) and condoms should be used until after
treatment is completed to avoid reinfection (F).
A client receiving albuterol (Proventil) tablets complains of nausea every evening with
her 9 p.m. dose. What action should the nurse take to alleviate this side effect?
A) Change the time of the dose.
B) Hold the 9 p.m. dose.
C) Administer the dose with a snack.
D) Administer an antiemetic with the dose. - CORRECT ANSWERC) Administer the
dose with a snack.
Administering oral doses with food (C) helps minimize GI discomfort. (A) would be
appropriate only if changing the time of the dose corresponds to meal times while at the
same time maintaining an appropriate time interval between doses. (B) would disrupt
the dosing schedule, and could result in a nontherapeutic serum level of the medication.
