HESI Pharmacology Exam Questions & Answers Version 1 2023 Update
A nurse is caring for a client with hyperparathyroidism and notes that the client's serum calcium level is 13 mg/dL. Which medication should the nurse prepare to administer as prescribed to the client?
Calcitonin (Miacalcin...
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HESI Pharmacology Exam Questions & Answers Version 1
2023 Update
A nurse is caring for a client with hyperparathyroidism and notes that the client's serum calcium level is 13
mg/dL. Which medication should the nurse prepare to administer as prescribed to the client?
Calcitonin (Miacalcin)
Rationale:
The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is experiencing hypercalcemia. Calcium
gluconate and calcium chloride are medications used for the treatment of tetany, which occurs as a result of
acute hypocalcemia. In hypercalcemia, large doses of vitamin D need to be avoided. Calcitonin, a thyroid
hormone, decreases the plasma calcium level by inhibiting bone resorption and lowering the serum calcium
concentration.
Oral iron supplements are prescribed for a 6-year-old child with iron deficiency anemia. The nurse instructs the
mother to administer the iron with which best food item?
Orange juice
Rationale:
Vitamin C increases the absorption of iron by the body. The mother should be instructed to administer the
medication with a citrus fruit or a juice that is high in vitamin C. Milk may affect absorption of the iron. Water
will not assist in absorption. Orange juice contains a greater amount of vitamin C than apple juice.
Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse monitors the client, knowing that
which of the following would indicate the presence of systemic toxicity from this medication?
1. Tinnitus
Rationale:
Salicylic acid is absorbed readily through the skin, and systemic toxicity (salicylism) can result. Symptoms
include tinnitus, dizziness, hyperpnea, and psychological disturbances. Constipation and diarrhea are not
associated with salicylism.
The camp nurse asks the children preparing to swim in the lake if they have applied sunscreen. The nurse
reminds the children that chemical sunscreens are most effective when applied:
4. At least 30 minutes before exposure to the
sun Rationale:
Sunscreens are most effective when applied at least 30 minutes before exposure to the sun so that they can
penetrate the skin. All sunscreens should be reapplied after swimming or sweating.
Mafenide acetate (Sulfamylon) is prescribed for the client with a burn injury. When applying the
medication, the client complains of local discomfort and burning. Which of the following is the most
appropriate nursing action?
3. Informing the client that this is normal
Rationale:
Mafenide acetate is bacteriostatic for gram-negative and gram-positive organisms and is used to treat burns to
reduce bacteria present in avascular tissues. The client should be informed that the medication will cause
local discomfort and burning and that this is a normal reaction; therefore options 1, 2, and 4 are incorrect
The burn client is receiving treatments of topical mafenide acetate (Sulfamylon) to the site of injury. The nurse
monitors the client, knowing that which of the following indicates that a systemic effect has occurred?
,Hyperventilation
Rationale:
Mafenide acetate is a carbonic anhydrase inhibitor and can suppress renal excretion of acid, thereby causing
acidosis. Clients receiving this treatment should be monitored for signs of an acid-base imbalance
(hyperventilation). If this occurs, the medication should be discontinued for 1 to 2 days.
, Isotretinoin is prescribed for a client with severe acne. Before the administration of this medication, the nurse
anticipates that which laboratory test will be prescribed?
Triglyceride level
Rationale:
Isotretinoin can elevate triglyceride levels. Blood triglyceride levels should be measured before treatment and
periodically thereafter until the effect on the triglycerides has been evaluated. Options 1, 3, and 4 do not need to
be monitored specifically during this treatment.
A client with severe acne is seen in the clinic and the health care provider (HCP) prescribes isotretinoin. The
nurse reviews the client's medication record and would contact the (HCP) if the client is taking which
medication?
Vitamin A
Rationale:
Isotretinoin is a metabolite of vitamin A and can produce generalized intensification of isotretinoin toxicity.
Because of the potential for increased toxicity, vitamin A supplements should be discontinued before
isotretinoin therapy.
The nurse is applying a topical corticosteroid to a client with eczema. The nurse would monitor for the potential
for increased systemic absorption of the medication if the medication were being applied to which of the
following body areas?
Axilla
Rationale:
Topical corticosteroids can be absorbed into the systemic circulation. Absorption is higher from regions where
the skin is especially permeable (scalp, axilla, face, eyelids, neck, perineum, genitalia), and lower from regions
in which permeability is poor (back, palms, soles).
The clinic nurse is performing an admission assessment on a client. The nurse notes that the client is taking
azelaic acid (Azelex). Because of the medication prescription, the nurse would suspect that the client is being
treated for:
Acne
Rationale:
Azelaic acid is a topical medication used to treat mild to moderate acne. The acid appears to work by
suppressing the growth of Propionibacterium acnes and decreasing the proliferation of keratinocytes.
The health care provider has prescribed silver sulfadiazine (Silvadene) for the client with a partial-thickness
burn, which has cultured positive for gram-negative bacteria. The nurse is reinforcing information to the client
about the medication. Which statement made by the client indicates a lack of understanding about the
treatments?
"The medication will permanently stain my skin."
Rationale:
Silver sulfadiazine (Silvadene) is an antibacterial that has a broad spectrum of activity against gram-negative
bacteria, gram-positive bacteria, and yeast. It is applied directly to the wound to assist in healing. It does not
stain the skin.
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