HESI PHARMACOLOGY PRACTICE EXAM
Following the administration of sublingual nitroglycerin to a client experiencing an acute
anginal attack, which assessment finding indicates to the nurse that the desired effect
has been achieved?
A. Client states chest pain is relieved
B. Client's pulse decreases from 120 to 90
C. Client's systolic blood pressure decreases from 180 to 90
D. Clients SaO2 level increases from 92% to 96% - Answers -A. nitroglycerin reduces
mycocardial oxygen consumption which decreases ischemia and reduces chest pain
A client with hyperlipidemia recieves a prescription for niacin (niaspan). which client
teaching is most important for the nurse to provide
a. expected duration of flushing
b. symptoms of hyperglycemia
c. diets that minimize gi irritation
d. comfort measure for pruritis - Answers -A. flushing of the face and neck, lasting up to
an hour, is a frequent reason for discontinuing niacin. inclusion of this effect in clietn
teaching may promote compliance in taking the med.
When assessing an adolescent who recently overdosed on acetaminophen (tylonel), 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 - Answers -B. acetaminophen toxicisty an result in liver damage; therefore, it is
especially important for the nurse to assess for pain in the right upper quadrant of the
abdomen (which might indicated liver damage)
A client is admitted to the coronary care unit with a medical diagnosis of acute
myocardial infarction. which medication prescription decreases both preload and
afterload
a. nitroglycerin
b. propranolol
c. propranolol
d. captopril - Answers -A. nitroglycerin is a nitrate that causes peripheral vasodilation
and decreases contractility, thereby decreasing both preload and afterload
A client is being treated for hyperthyroidism with propylthiouracil (PTU). The nurse
knows that the action of this drug is to
A. decrease the amount of the thyroid-stimulating hormone circulating in the blood
B. increase the amount of thyroid-stimulating hormone circulating in the blood
C. increase the amount of T4 and decrease the amount of T3 produced by the thyroid
D. inhibit synthesis of T3 and T4 by the thyroid gland - Answers -D. PTU is an adjunct
therapy used to control hyperthyroidism by inhibiting production of thyroid hormones. It
is often prescribed in prep for thyroidectomy or radioactive iodine therapy
,A client has myxedema, which results from a deficiency of thyroid hormone synthesis in
adults. The nurse knows that which medication should be contraindicated for this client?
A. liothyronine (cytomel) to replace iodine
B. Furosemide (Lasix) for relief of fluid retention
C. Pentobarbital sodium for sleep
D. nitroglycerin for angina pain - Answers -C. persons with myxedema are dangerously
hypersensitive to narcotics, barbiturates, and anesthetics. They do not tolerate
liothyronine and usually receive iodine replacement therapy. These clients are also
suceptable to heart problems such as angina for which nitroglycerine would be indicated
and and congestive heart failure for which furosemide would be indicated
A client has a continuous IV infusion of dopamine and an IV of normal saline at
50ml/hour. The nurse noes that the client's urinary output has been 20ml/hour for the
last two hours. Which intervention should the nurse initiate?
A. stop the infusion of dopamine
B. change the normal saline to a keep open rate
C. replace the urinary catheter
D. notify the healthcare provider of the urinary output. - Answers -D.
A healthcare provider prescrives cephalexin monhydrate (Keflex) for a client with a
postoperative infection. It is most important for the nurse to assess for what additional
drug allergy before administering this prescription?
A. Penicillins
B. Aminoglycosides
C. Erythromycins
D.Sulfonamides - Answers -A. Cross-allergies exist between penicillins and
cephalosporines, such as keflex. so checking for penicillin allergy is a wise precaution
Which medications should the nurse caution the client about taking while receiving an
opioid analgesic?
A. Antacids.
B. Benzodiasepines
C. Antihypertensives
D. Oral antidiabetics - Answers -B. respiratory depression increases with the concurrent
use of opioid analgesics and other cns depressant agents, such as alcohol,
barbiturates, and benzodiasepines
Which nursing diagnosis is important to include in the plan of care for a client recieving
the angiotensin II receptor antagonist irbesartan (avapro)?
A. Fluid volume deficit
B.Risk for infection
C. Risk for injury
D. Impaired sleep patterns - Answers -C. Avapro is an antihypertensive agent, which
acts by blocking vasoconstrictor effects at various receptor sites. This can cause
hypotension and dizziness, placing the client at high risk for injury
, A postoperative client has been recieving a continuous IV infusion of meperidine
(demerol) 35mg/hr for four days. The client has a PRN prescription for Demorol 100mg
PO Q3H. The nurse notes that the client has become increasingly restless, irritable and
confused, stating that there are bugs all over the walls. What action should the nurse
take FIRST?
A. Administer a PRN dose of the PO meperidine (demorol)
B. Administer naloxone (narcan) IV per PRN protocol
C. Decrease the IV infusion rate of the demerol per protocol
D. notify the healthcare provider of the clients confusion and hallucinations - Answers -
C. The client is exhibiting symptoms of demerol toxicity, which is consistent with the
large dose of demerol recieved over four days. C. is the most effective action to
immediately decrease the amount of serum demerol.
The client with a dysrhythmia is to receive procainamide (pronestyl) in 4 divided doses
over the next 24 hours. What dosing schedule is best for the nurse to implement?
A. q6h
B. QID
C. AC and bedtime
D. PC and bedtime - Answers -A. q6h
After abdominal surgery, a male client is prescribed low molecular weight heparin.
during administration of the medication, the client asks the nurse why he is receiving
this medication. Which is the best response for the nurse to provide.
A. This medication is a blood thinner given to prevent blood clot formation
B. this medication enhances antibiotics to prevent infection
C. This medication dissolves any glots that develop int he legs
D. This abdominal injection assists in the healing of the abdominal wound - Answers -A
Following heparin treatment for a PE, a client is being discharged with a prescription for
warfarin. In conducting discharge teaching, the nurse advises the client to have which
diagnostic test monitored regularly?
A. Perfusion scan
B. Prothrombin time (PT/INR)
C. Activated Partial thromboplastin (APTT)
D. Serum Coumadin Level (SCL) - Answers -B. When used for a client with PE, the
therapeutic goal for wafarin therapy is a PT 1/5 to 2/5 times greater than the control or
an INR of 2-3. A perfusion might be preformed to monitor lung function but not monthly.
APTT is monitored for Heparin.
A client who has been taking levodopa PO TID to control the symptoms of Parkinsons
disease has a new prescription for sustained release levodopa/carbidopa (sinemet
25/100 PO BID. The client took his levodopa at 0800. Which instruction should the
nurse include in the teaching plan for this client?
A. take the first dose of sinemet today, as soon as your prescription is filld
B. Since you already took your levodopa, wait until tomorrow to take the sinemet
C. Take both drugs for the 1st week, then switch to taking only the sinemet.
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