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Hesi medical surgical 1 version1 55 questions and answers 100 % latest
September 2023


1) 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?

1. Calcium chloride

2. Calcium gluconate

3. Calcitonin (Miacalcin)

4. Large doses of vitamin D 3. 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.

10.) 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:

1. Acne

2. Eczema

3. Hair loss

4. Herpes simplex 1. 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.
Options 2, 3, and 4 are incorrect.

100.) Saquinavir (Invirase) is prescribed for the client who is human immunodeficiency virus
seropositive. The nurse reinforces medication instructions and tells the client to:

1. Avoid sun exposure.

2. Eat low-calorie foods.

3. Eat foods that are low in fat.

,Hesi medical surgical 1 version1 55 questions and answers 100 % latest
September 2023


4. Take the medication on an empty stomach. 1. Avoid sun exposure.

Rationale:

Saquinavir (Invirase) is an antiretroviral (protease inhibitor) used with other antiretroviral medications
to manage human immunodeficiency virus infection. Saquinavir is administered with meals and is best
absorbed if the client consumes high-calorie, high-fat meals. Saquinavir can cause photosensitivity, and
the nurse should instruct the client to avoid sun exposure.

101.) Ketoconazole is prescribed for a client with a diagnosis of candidiasis. Select the interventions that
the nurse includes when administering this medication. Select all that apply.

1. Restrict fluid intake.

2. Instruct the client to avoid alcohol.

3. Monitor hepatic and liver function studies.

4. Administer the medication with an antacid.

5. Instruct the client to avoid exposure to the sun.

6. Administer the medication on an empty stomach. 2. Instruct the client to avoid alcohol.

3. Monitor hepatic and liver function studies.

5. Instruct the client to avoid exposure to the sun.

Rationale:

Ketoconazole is an antifungal medication. It is administered with food (not on an empty stomach) and
antacids are avoided for 2 hours after taking the medication to ensure absorption. The medication is
hepatotoxic and the nurse monitors liver function studies. The client is instructed to avoid exposure to
the sun because the medication increases photosensitivity. The client is also instructed to avoid alcohol.
There is no reason for the client to restrict fluid intake. In fact, this could be harmful to the client.

102.) A client with human immunodeficiency virus is taking nevirapine (Viramune). The nurse should
monitor for which adverse effects of the medication? Select all that apply.

1. Rash

2. Hepatotoxicity

3. Hyperglycemia

,Hesi medical surgical 1 version1 55 questions and answers 100 % latest
September 2023


4. Peripheral neuropathy

5. Reduced bone mineral density 1. Rash

2. Hepatotoxicity

Rationale:

Nevirapine (Viramune) is a non-nucleoside reverse transcriptase inhibitors (NRTI) that is used to treat
HIV infection. It is used in combination with other antiretroviral medications to treat HIV. Adverse
effects include rash, Stevens-Johnson syndrome, hepatitis, and increased transaminase levels.
Hyperglycemia, peripheral neuropathy, and reduced bone density are not adverse effects of this
medication.

103.) A nurse is caring for a hospitalized client who has been taking clozapine (Clozaril) for the treatment
of a schizophrenic disorder. Which laboratory study prescribed for the client will the nurse specifically
review to monitor for an adverse effect associated with the use of this medication?

1. Platelet count

2. Cholesterol level

3. White blood cell count

4. Blood urea nitrogen level 3. White blood cell count

Rationale:

Hematological reactions can occur in the client taking clozapine and include agranulocytosis and mild
leukopenia. The white blood cell count should be checked before initiating treatment and should be
monitored closely during the use of this medication. The client should also be monitored for signs
indicating agranulocytosis, which may include sore throat, malaise, and fever. Options 1, 2, and 4 are
unrelated to this medication.

104.) Disulfiram (Antabuse) is prescribed for a client who is seen in the psychiatric health care clinic. The
nurse is collecting data on the client and is providing instructions regarding the use of this medication.
Which is most important for the nurse to determine before administration of this medication?

1. A history of hyperthyroidism

2. A history of diabetes insipidus

3. When the last full meal was consumed

4. When the last alcoholic drink was consumed 4. When the last alcoholic drink was consumed

, Hesi medical surgical 1 version1 55 questions and answers 100 % latest
September 2023


Rationale:

Disulfiram is used as an adjunct treatment for selected clients with chronic alcoholism who want to
remain in a state of enforced sobriety. Clients must abstain from alcohol intake for at least 12 hours
before the initial dose of the medication is administered. The most important data are to determine
when the last alcoholic drink was consumed. The medication is used with caution in clients with
diabetes mellitus, hypothyroidism, epilepsy, cerebral damage, nephritis, and hepatic disease. It is also
contraindicated in severe heart disease, psychosis, or hypersensitivity related to the medication.

105.) A nurse is collecting data from a client and the client's spouse reports that the client is taking
donepezil hydrochloride (Aricept). Which disorder would the nurse suspect that this client may have
based on the use of this medication?

1. Dementia

2. Schizophrenia

3. Seizure disorder

4. Obsessive-compulsive disorder 1. Dementia

Rationale:

Donepezil hydrochloride is a cholinergic agent used in the treatment of mild to moderate dementia of
the Alzheimer type. It enhances cholinergic functions by increasing the concentration of acetylcholine. It
slows the progression of Alzheimer's disease. Options 2, 3, and 4 are incorrect.

106.) Fluoxetine (Prozac) is prescribed for the client. The nurse reinforces instructions to the client
regarding the administration of the medication. Which statement by the client indicates an
understanding about administration of the medication?

1. "I should take the medication with my evening meal."

2. "I should take the medication at noon with an antacid."

3. "I should take the medication in the morning when I first arise."

4. "I should take the medication right before bedtime with a snack." 3. "I should take the medication
in the morning when I first arise."

Rationale:

Fluoxetine hydrochloride is administered in the early morning without consideration to meals.

**Eliminate options 1, 2, and 4 because they are comparable or alike and indicate taking the medication

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