Pharmacology HESI V2 Preparation 2024 Exam Questions and Answers.

A client is prescribed phenobarbital sodium (Luminal) for a seizure disorder. The medication has a long half-life of 4 days. Based on this half-life, the medication will most likely be prescribed A. once a day. B. twice a day. C. three times a day. D. four times a day. Correct answer- ANS: A Medication with long half-lives remain at their therapeutic levels between doses for long periods of time. Therefore, this medication can be administered once a day. A nurse educator is reviewing medication dosages and factors that influence medication metabolism with a group of nurses. Medication dosages may need to be decreased for which of the following reasons? (Select all that apply.) A. Increased renal excretion B. Increased medication-metabolizing enzymes C. Liver failure D. Peripheral vascular disease E. Concurrent use of medication metabolized by the same pathway Correct answer- ANS: C, E Liver failure decreases metabolism and thus increase the concentration of medication. This may require decreasing the dosage of medication. When two medications are metabolized in the same way, they may compete for metabolism, thereby increasing the concentration of one or both medications. Increased renal excretion may decrease concentration of the medication, requiring increased dosage. Increased medication-metabolizing enzymes can decrease the concentration of the medication. The dose might need increased. Peripheral vascular disease may impair distribution, and more of the medication may be needed. A nurse s preparing to administer eye drops to a client. Which of the following are appropriate nursing interventions related to this procedure? (Select all that apply.) A. Using medical aseptic technique B. Asking the client to look up at the ceiling C. Having the client lie in a side-lying position D. Dropping medication into the center of the client's conjunctival sac E. Instructing the client to close the eye gently Correct answer- ANS:B, D, E Pharmacology HESI V2 Preparation 2024 Exam Questions and Answers The medication should be dropped into the center of the conjunctival sac to promote better distribution of the medication. The client should close the eye gently to allow improved distribution of the medication. Surgical aseptic technique is used to administer eye drops. The client should be sitting or in a supine position to facilitate proper administration of eye drops. A nurse is completing discharge teaching to a client who has a new prescription for a transdermal medication. Which of the following statements by the client indicates understanding of the teaching? A. "I will clean the site with an alcohol swab prior to applying the patch." B. "I will rotate the application site weekly." C. "I will apply the patch to an area of skin with no hair." D. "I will place the new patch on the site of the old patch." Correct answer- ANS: C Transdermal medication should be applied to a hairless area of skin to promote absorption of medication. The skin should be washed with soap and water and dried thoroughly before applying a transdermal patch. Application sites should be rotated on a daily basis to prevent skin irritation. A nurse is reviewing a client's health record and notes a new prescription by the provider to verify the trough level of the client's medication. Which of the following actions should the nurse take? A. Have a blood specimen obtained immediately prior to the next dose of medication. B. Verify that the client has been on the medication for 24 hr before ordering a blood specimen. C. Ask the client to provide a urine specimen after the next dose of medication. D. Begin administering the medication, and obtain a blood specimen. Correct answer- ANS: A To verify trough levels of a medication, a blood specimen is obtained immediately before the next dose of medication. A nurse is preparing a client's medication. Which of the following are legal responsibilities of the nurse? (Select all that apply.) A. Maintaining skill competency B. Determining the dosage C. Monitoring for adverse effects D. Safeguarding medications E. Identifying the client's diagnosis Correct answer- ANS: A, C, D Determining medication dosage and identifying a diagnosis is the role/responsibility of the provider. The nurse should be informed about a client's diagnosis. A nurse is reviewing a client's health record and notes a new prescription by the provider for lisinopril (Zestril) 10 mg PO every day. The nurse should recognize this as which of the following types of prescription? A. Single prescription B. Stat prescription C. Routine prescription D. Standing prescription Correct answer- ANS: C A routine prescription identifies a medication that is given on a regular schedule. This medication is administered every day until discontinued. A single prescription is to be given once at a specified time or as soon as possible. A stat prescription is only given once, and it is given immediately. A standing prescription is written for specific circumstances or a specific unit. A nurse is reviewing a new prescription for ondansetron (Zofran) 4 mg PO PRN nausea and vomiting for a client who has hyperemesis gravidarum. The nurse should clarify which of the following parts of the prescription with the provider? A. Name B. Dosage C. Route D. Time Correct answer- ANS: D The time and frequency of medication administration is not included and should be clarified with the provider. A nurse is orienting a newly hired nurse and discussing how to take telephone prescription. Which of the following statements by the newly hired nurse indicates understanding of the discussion? A. "A second nurse enters the prescription into the client's health record." B. "Another nurse should listen to the phone call." C. "The provider can clarify the prescription when he signs the health record." D. "The 'read back' is omitted if this is a one-time prescription." Correct answer- ANS: B The second nurse should listen to a telephone prescription to prevent errors in communication. The nurse who takes the telephone prescription should enter it into the client's health record to prevent errors in translation. The nurse verifies the prescription is complete and accurate at the time it is given by reading it back to the provider. A telephone prescription includes reading back all types of medication prescription. A nurse on a medical unit is admitting a client and completing a preassessment before administration of medications. Which of the following data should the nurse include in the preassessment? (Select all that apply.) A. Use of herbal teas B. Daily fluid intake C. Current health status D. Previous surgical history E. Food allergies Correct answer- ANS: A, C, E Use of herbal product,s which often contains caffeine, should be assessed prior to medication administration because caffeine can affect medication biotransformation. Current health status should be reviewed because new prescriptions can cause alterations in current health status. Food allergies should be included in the preassessment that is completed prior to medication administration to identify any potential interactions. Daily fluid intake and surgical history is important, but it is not part of the presassessment that is completed prior to medication administration. A nurse is assessing a client's IV. Which of the following findings is indicative of phlebitis? (Select all that apply.) A. Tingling sensation below insertion site B. Tachycardia C. Palpable, hard mass above insertion site D. Cool, pale skin E. Pain at site Correct answer- ANS: C, E Pain at the IV site and a palpable, hard mass above the insertion site is a clinical manifestation of thrombophlebitis. A tingling sensation below the insertion site is a clinical manifestation of nerve damage. Tachycardia is a clinical manifestation of fluid volume overload. Cool, pale skin is a clinical manifestation of infiltration. A nurse manager is reviewing the facility's policies for IV therapy with the members of his team. The nurse manager should remind the team that which of the following techniques helps minimize the risk of catheter embolism? A. Performing hand hygiene before and after IV insertion B. Rotating IV sites at least every 72 hr C. Minimizing tourniquet time D. Avoiding reinserting the needle into an IV catheter Correct answer- ANS: D The nurse manager should remind the members to avoid reinserting a needle to an IV catheter. This action can result in severing the end of the catheter and consequently cause a catheter embolism. A nurse is preparing to initiate IV therapy for an older adult client. Which of the following actions should the nurse take? A. Use a disposable razor to remove excess hair on the extremity. B. Select the back of the client's hand to insert the IV catheter. C. Distend the veins by using a blood pressure cuff. D. Direct the client to raise his arm above his heart. Correct answer- ANS: C The nurse should distend the veins using a blood pressure cuff to reduce overfilling of the vein, which can result in a hematoma. The nurse should remove excess hair by clipping it with scissors. Shaving with disposable razors can cause skin damage that lead to infection. In most instances, the nurse inserts the IV catheter into a distal site, such as the back of the client's hand. However, when inserting an IV catheter for an older adult, the nurse should use a site