Free HESI Pharmacology practice for HESI Pharmacology Practice Exam (HESI RN). Answer 47 nursing exam-style questions with rationales, exam mode, and progress t
A client taking ethambutol (Myambutol) understands the instructions provided by the nurse if the client states that he or she will immediately report:
Select the best answer.
Explanation:
The correct answer is B: Problems with visual acuity. Ethambutol is known to cause optic neuritis, leading to a decrease in visual acuity and color discrimination. Therefore, any visual changes should be reported promptly to prevent further complications. Choices A, C, and D are incorrect because ethambutol does not typically cause impaired sense of hearing, gastrointestinal side effects, or orange-red discoloration of body secretions. It is crucial for clients taking ethambutol to be aware of potential visual disturbances and report them promptly to healthcare providers.
A client with angina pectoris is experiencing chest pain that radiates down the left arm. The nurse administers a sublingual nitroglycerin tablet to the client. The client's pain is unrelieved, and the nurse determines that the client needs another nitroglycerin tablet. Which of the following vital signs is most important for the nurse to check before administering the medication?
Select the best answer.
Explanation:
The correct answer is checking the client's blood pressure (C) before administering another nitroglycerin tablet. Nitroglycerin can cause hypotension, and monitoring blood pressure is crucial to prevent a sudden drop in blood pressure, especially when giving another dose of nitroglycerin.
A client with coronary artery disease complains of substernal chest pain. After checking the client's heart rate and blood pressure, a nurse administers nitroglycerin, 0.4 mg, sublingually. After 5 minutes, the client states, 'My chest still hurts.' Select the appropriate actions that the nurse should take.
Select the best answer.
Explanation:
The correct action for the nurse to take in this situation is to contact the registered nurse. When a client with coronary artery disease experiences chest pain and does not achieve relief after the initial administration of nitroglycerin, it is crucial to inform the registered nurse promptly. Following the usual guideline for nitroglycerin administration, the nurse may administer a second tablet after assessing the client's pain level. The nurse should continue to assess the client's pain and monitor vital signs before each dose administration. Calling a code blue is not warranted at this point, as the client's condition does not indicate an immediate life-threatening emergency. Contacting the client's family is not necessary unless requested by the client.
During an admission assessment, a client informs the nurse that they take propylthiouracil (PTU) daily. Based on this information, the nurse suspects that the client has a history of:
Select the best answer.
Explanation:
Propylthiouracil (PTU) is a medication commonly used to treat hyperthyroidism, including Graves' disease, which is characterized by an overactive thyroid gland. The client mentioning the daily use of PTU indicates that they likely have a history of Graves' disease, as this medication helps manage the condition by reducing the production of thyroid hormones. Therefore, the correct answer is B: Graves' disease. Choice A, Myxedema, is incorrect as it refers to a condition of severe hypothyroidism, the opposite of hyperthyroidism. Choices C and D, Addison's disease and Cushing's syndrome, respectively, are unrelated to the use of PTU or hyperthyroidism, making them incorrect choices.
The client with squamous cell carcinoma of the larynx is receiving bleomycin intravenously. The nurse caring for the client anticipates that which diagnostic study will be prescribed?
Select the best answer.
Explanation:
Bleomycin, when administered intravenously, can lead to interstitial pneumonitis and potentially progress to pulmonary fibrosis. Therefore, pulmonary function studies are essential to monitor lung function and detect any early signs of pulmonary toxicity. Other tests, such as regular pulmonary assessments, should also be conducted to ensure the safety and well-being of the client.
A client presenting with complaints of not feeling well is seen in a clinic. The client is taking several medications for the control of heart disease and hypertension, including a beta-blocker, digoxin (Lanoxin), and a diuretic. A tentative diagnosis of digoxin toxicity is made. Which of the following assessment data would support this diagnosis?
Select the best answer.
Explanation:
The correct answer is C. Double vision, loss of appetite, and nausea are classic signs of digoxin toxicity. Other signs may include bradycardia, visual disturbances, and confusion. These symptoms are indicators that the client may be experiencing adverse effects due to elevated levels of digoxin in the system, requiring immediate medical attention to prevent serious complications.
A client is receiving sulfisoxazole. Which of the following should be included in the list of instructions?
Select the best answer.
Explanation:
When a client is taking sulfisoxazole, it is important to maintain a high fluid intake. Each dose of sulfisoxazole should be taken with a full glass of water, as the medication is more soluble in alkaline urine. Restricting fluid intake is not recommended as it can lead to inadequate hydration. Dark brown urine may be a side effect of some forms of sulfisoxazole but does not necessarily warrant immediate notification of the healthcare provider unless accompanied by other concerning symptoms. Decreasing the dosage when symptoms improve is not advised as it may lead to treatment failure or the development of resistance.
A client who received a kidney transplant is taking azathioprine (Imuran), and the nurse provides instructions about the medication. Which statement by the client indicates a need for further instructions?
Select the best answer.
Explanation:
Azathioprine is an immunosuppressant taken for life. Discontinuing the medication after 14 days is incorrect.
The healthcare provider should anticipate that the most likely medication to be prescribed prophylactically for a child with spina bifida (myelomeningocele) who has a neurogenic bladder would be:
Select the best answer.
Explanation:
Children with spina bifida, especially those with a neurogenic bladder, are at an increased risk of urinary tract infections. Sulfisoxazole, an antibiotic, is commonly prescribed prophylactically to prevent UTIs in this population. Prednisone (Choice A) is a corticosteroid and is not typically used for prophylaxis in this scenario. Furosemide (Lasix) (Choice C) is a diuretic used to treat fluid retention and hypertension, not for preventing UTIs. Intravenous immune globulin (IVIG) (Choice D) is used to boost the immune system, not for UTI prophylaxis in this case.
A client has been started on long-term therapy with rifampin (Rifadin). A nurse teaches the client that the medication:
Select the best answer.
Explanation:
Rifampin causes orange-red discoloration of body secretions, including sweat, tears, urine, and feces. It can also permanently stain soft contact lenses. It is essential to take rifampin exactly as directed and not discontinue it without consulting the healthcare provider.
A client is being taught about the use of nitroglycerin (Nitrostat) for angina. Which statement by the client indicates a need for further teaching?
Select the best answer.
Explanation:
The correct administration of nitroglycerin for angina is to take up to three tablets, 5 minutes apart. If the chest pain persists after the third tablet, emergency medical services should be called. Taking more than three tablets or reducing the time interval between doses may lead to hypotension and indicates a need for further teaching.
A client with hyperlipidemia is prescribed atorvastatin (Lipitor). Which instruction should the nurse include in the teaching plan?
Select the best answer.
Explanation:
The correct instruction for the nurse to include in the teaching plan is to advise the client to avoid consuming grapefruit juice. Grapefruit juice can increase the risk of atorvastatin (Lipitor) toxicity by inhibiting its metabolism. Atorvastatin is typically taken in the evening as cholesterol synthesis occurs at night. Increasing dairy intake is not specifically recommended for atorvastatin therapy, and the medication can be taken with or without food.
A healthcare provider has written a prescription for ranitidine (Zantac), once daily. When should the nurse schedule the medication?
Select the best answer.
Explanation:
The correct answer is A: At bedtime. Ranitidine should be scheduled at bedtime because it provides a prolonged effect and offers the greatest protection of the gastric mucosa. Administering it at this time helps in managing nocturnal acid breakthrough and providing relief during the night.
A client is receiving vancomycin (Vancocin). Which of the following is the most important action for the nurse to take?
Select the best answer.
Explanation:
The most important action for the nurse to take when a client is receiving vancomycin is to monitor for signs of nephrotoxicity. Vancomycin can cause kidney damage, so monitoring kidney function and signs of nephrotoxicity are crucial to prevent harm. While monitoring for ototoxicity and ensuring adequate hydration are important nursing actions, they are not as critical as preventing nephrotoxicity when administering vancomycin.
A client who had a kidney transplant is receiving therapy with cyclosporine (Sandimmune). Which statement by the client indicates a need for further instruction?
Select the best answer.
Explanation:
The correct answer is A. Cyclosporine is an immunosuppressant that can reduce the effectiveness of vaccines. Clients should avoid vaccinations without consulting their health care provider to prevent potential complications or reduced efficacy of the vaccines.
A nurse preparing a client for surgery reviews the client's medication record. The client is to be nothing per mouth (NPO) after midnight. Which of the following medications, if noted on the client's record, should the nurse question?
Select the best answer.
Explanation:
Prednisone is a corticosteroid that can cause adrenal atrophy, reducing the body's ability to withstand stress. During surgery, the dosage may need to be adjusted due to its impact on the body's stress response. Choices A, B, and C are not typically contraindicated before surgery and do not have the same potential impact on the body's stress response.
The client has been taking omeprazole (Prilosec) for 4 weeks. The ambulatory care nurse evaluates that the client is receiving the optimal intended effect of the medication if the client reports the absence of which symptom?
Select the best answer.
Explanation:
Omeprazole, a proton pump inhibitor, is used as an antiulcer agent to reduce gastric acid secretion. The optimal intended effect of omeprazole is the relief of pain and discomfort associated with gastric irritation, commonly referred to as heartburn. Therefore, the absence of heartburn indicates that the medication is working effectively in managing the client's gastric condition.
A client is prescribed phenytoin (Dilantin) for seizure control. Which statement by the client indicates an understanding of the medication?
Select the best answer.
Explanation:
The correct statement is 'I should brush and floss my teeth regularly.' Phenytoin (Dilantin) can cause gingival hyperplasia, so maintaining good oral hygiene is essential. Taking the medication with antacids can affect its absorption, so it should not be done. It is crucial not to stop taking the medication abruptly, even if seizures are controlled. There is no specific requirement to avoid milk while taking phenytoin (Dilantin).
Glimepiride (Amaryl) is prescribed for a client with diabetes mellitus. A healthcare provider reinforces instructions for the client and advises them to avoid which of the following while taking this medication?
Select the best answer.
Explanation:
Alcohol should be avoided when taking glimepiride (Amaryl) because it can cause a disulfiram-like reaction and enhance the hypoglycemic effects of the medication. Consuming alcohol with glimepiride can lead to symptoms such as flushing, palpitations, nausea, and vomiting. Therefore, it is crucial for individuals on glimepiride therapy to steer clear of alcohol to prevent adverse reactions and maintain optimal medication efficacy.
Oxybutynin chloride (Ditropan XL) is prescribed for a client with neurogenic bladder. Which sign would indicate a possible toxic effect related to this medication?
Select the best answer.
Explanation:
Signs of toxicity related to oxybutynin chloride (Ditropan XL) include central nervous system excitation, such as nervousness, restlessness, hallucinations, and irritability. Other signs of toxicity may include hypotension or hypertension, confusion, tachycardia, a flushed or red face, and signs of respiratory depression. Restlessness is a sign of central nervous system excitation, which can indicate a possible toxic effect of this medication.
Why is prostaglandin E1 prescribed for a child with transposition of the great arteries?
Select the best answer.
Explanation:
Prostaglandin E1 is prescribed for a child with transposition of the great arteries to increase blood mixing, which helps maintain adequate oxygen saturation and cardiac output. This medication does not prevent hypercyanotic spells, maintain hormone levels, or influence the position of the great arteries.
Meperidine hydrochloride (Demerol) is prescribed for a client with pain. Which of the following would the nurse monitor for as a side effect of this medication?
Select the best answer.
Explanation:
Meperidine hydrochloride (Demerol) is an opioid analgesic that can cause various side effects. Common side effects include respiratory depression, orthostatic hypotension, tachycardia, drowsiness, constipation, and urinary retention. Diarrhea is not a common side effect of Meperidine hydrochloride. Bradycardia and hypertension are not typically associated with this medication. Therefore, the nurse should monitor for urinary retention as a potential side effect of Meperidine hydrochloride.
A client is taking lansoprazole (Prevacid) for the chronic management of Zollinger-Ellison syndrome. The nurse advises the client to take which of the following products if needed for a headache?
Select the best answer.
Explanation:
Acetaminophen is the preferred choice for pain relief in individuals taking lansoprazole for Zollinger-Ellison syndrome due to its lower risk of stomach irritation compared to NSAIDs like ibuprofen and aspirin. Naproxen, ibuprofen, and aspirin are NSAIDs that can increase the risk of stomach irritation and bleeding, which is why they are not recommended for individuals with Zollinger-Ellison syndrome who are already on lansoprazole to reduce stomach acid production.
The healthcare provider is reviewing the history and physical examination of a client who will be receiving asparaginase (Elspar), an antineoplastic agent. The healthcare provider consults with the registered nurse regarding the administration of the medication if which of the following is documented in the client's history?
Select the best answer.
Explanation:
Asparaginase is contraindicated in clients with a history of pancreatitis due to the risk of impairing pancreatic function and causing complications. Therefore, the healthcare provider should consult with the registered nurse to assess the client's history of pancreatitis before administering asparaginase.
A client is receiving desmopressin acetate (DDAVP), and a healthcare provider is monitoring for adverse effects. Which of the following indicates the presence of an adverse effect?
Select the best answer.
Explanation:
Drowsiness can be a sign of water intoxication or hyponatremia, which are potential adverse effects of desmopressin acetate (DDAVP). It is crucial to monitor for this symptom and promptly address it to prevent complications.
A client is prescribed metronidazole (Flagyl) for a trichomoniasis infection. Which of the following should the nurse include in the teaching plan?
Select the best answer.
Explanation:
The correct answer is A. Metronidazole (Flagyl) can cause a disulfiram-like reaction when taken with alcohol, resulting in severe nausea, vomiting, and headache. Therefore, the client should be advised to avoid alcohol while taking this medication to prevent adverse effects. Avoiding alcohol is crucial to prevent these reactions and ensure the effectiveness of the treatment. The other options are not directly related to the specific medication or the condition being treated.
A client has a prescription for albuterol (Proventil HFA) (two puffs) and beclomethasone dipropionate (Qvar) (nasal inhalation, two puffs) by metered-dose inhaler. The medications are to be administered by the nurse by giving the:
Select the best answer.
Explanation:
Albuterol, as a bronchodilator, should be administered first to help open up the airways, followed by beclomethasone dipropionate to reduce inflammation in the airways. This sequence ensures optimal therapeutic effects of the medications.
A client with hypertension is prescribed losartan (Cozaar). Which instruction should the nurse include in the teaching plan?
Select the best answer.
Explanation:
The correct instruction for a client prescribed losartan (Cozaar) is to report any swelling of the lips or face. Losartan can cause angioedema, which is a serious side effect that requires immediate medical attention. Clients do not need to avoid potassium-rich foods unless specifically instructed by their healthcare provider. Taking the medication with grapefruit juice is not recommended as it can interact with certain medications. Additionally, monitoring blood pressure regularly is important, but it should not be limited to a weekly basis; blood pressure should be monitored as per the healthcare provider's recommendation.
After administering acetylcysteine (Mucomyst), 20% solution diluted in 0.9% normal saline by nebulizer, the nurse should have which item available for potential use?
Select the best answer.
Explanation:
Acetylcysteine is administered via inhalation as a mucolytic. It helps liquefy secretions, making it easier for the client to clear them. However, in some cases, the increased volume of liquefied secretions may be challenging for the client to manage, leading to the potential need for suction equipment to assist in clearing the airway. Therefore, the nurse should have suction equipment available after administering acetylcysteine to address any issues related to excessive secretions.
Sildenafil (Viagra) is prescribed to treat a client with erectile dysfunction. A nurse reviews the client's medical record and would question the prescription if which of the following is noted in the client's history?
Select the best answer.
Explanation:
The correct answer is C. Sildenafil (Viagra) enhances the vasodilating effect of nitric oxide and is contraindicated with the concurrent use of organic nitrates and nitroglycerin. Using nitroglycerin together with Viagra can lead to severe hypotension and cardiovascular collapse, making it unsafe to combine both medications.
A postoperative client has received a dose of naloxone hydrochloride for respiratory depression shortly after transfer to the nursing unit from the postanesthesia care unit. After administration of the medication, the nurse checks the client for:
Select the best answer.
Explanation:
Naloxone hydrochloride is an antidote to opioids and may be administered to postoperative clients to address respiratory depression. This medication can also reverse the effects of analgesics, potentially leading to a sudden increase in pain. Therefore, the nurse must assess the client for any unexpected rise in pain levels after naloxone administration. Choices A, B, and D are incorrect because pupillary changes, scattered lung wheezes, and sudden episodes of diarrhea are not typically associated with naloxone administration for respiratory depression.
A client is prescribed calcium gluconate after thyroidectomy. The medication is most likely prescribed to:
Select the best answer.
Explanation:
After a thyroidectomy, the parathyroid glands can be inadvertently removed or damaged, leading to a decrease in calcium levels and potentially causing hypocalcemic tetany. Calcium gluconate is given to supplement calcium levels and prevent or treat hypocalcemia-related symptoms, such as muscle spasms and tetany.
A child is hospitalized with a diagnosis of lead poisoning. The healthcare provider assisting in caring for the child would prepare to assist in administering which of the following medications?
Select the best answer.
Explanation:
Dimercaprol (BAL in Oil) is a chelating agent indicated for lead poisoning. It works by binding to lead and facilitating its removal from the body. Activated charcoal is used for certain types of poisoning by adsorbing toxins, while sodium bicarbonate can be used to treat acidosis. Syrup of ipecac is no longer recommended for poison treatment due to potential risks.
A client with type 2 diabetes mellitus is prescribed glipizide (Glucotrol). Which instruction should the nurse include in the teaching plan?
Select the best answer.
Explanation:
The correct instruction the nurse should include in the teaching plan for a client prescribed glipizide (Glucotrol) is to monitor for signs of hypoglycemia. Glipizide stimulates insulin release from the pancreas, which can lead to hypoglycemia. It is usually taken before a meal, not necessarily on an empty stomach. Alcohol consumption should be avoided to prevent interactions with the medication. Taking the medication before bedtime is not the typical recommendation.
Atenolol hydrochloride (Tenormin) is prescribed for a hospitalized client. The nurse should perform which of the following as a priority action before administering the medication?
Select the best answer.
Explanation:
Atenolol hydrochloride is a beta-blocker used to treat hypertension. Checking the client's blood pressure is crucial before administration.
A healthcare professional prepares to reinforce instructions to a client who is taking allopurinol (Zyloprim). The healthcare professional plans to include which of the following in the instructions?
Select the best answer.
Explanation:
Allopurinol is an antigout medication that works by reducing the production of uric acid in the body. To prevent kidney stones and promote the excretion of uric acid, increased fluid intake is essential. Instructing the client to drink 3000 mL of fluid per day helps to reduce the risk of kidney stones and assists in the elimination of uric acid, thereby enhancing the effectiveness of allopurinol therapy.
The healthcare provider is applying a topical corticosteroid to a client with eczema. The healthcare provider should monitor for the potential of increased systemic absorption of the medication if the medication were being applied to which of the following body areas?
Select the best answer.
Explanation:
The axilla has thinner skin, making it more permeable to topical medications. Areas with thinner skin, like the axilla, allow for higher systemic absorption of topical corticosteroids.
A client is prescribed warfarin (Coumadin) for atrial fibrillation. Which statement by the client indicates a need for further teaching?
Select the best answer.
Explanation:
Clients taking warfarin (Coumadin) should avoid aspirin unless prescribed by their healthcare provider, as it can increase the risk of bleeding. The other statements are correct and do not indicate a need for further teaching. Taking aspirin along with warfarin can potentiate the anticoagulant effects of warfarin, leading to an increased risk of bleeding complications.
A client is being cared for by a nurse due to severe back pain, and codeine sulfate has been prescribed. Which of the following should the nurse include in the plan of care while the client is taking this medication?
Select the best answer.
Explanation:
When a client is prescribed codeine sulfate, it is essential to monitor bowel activity because this medication can lead to constipation. Therefore, monitoring bowel function is crucial to prevent or manage any potential gastrointestinal issues that may arise.
The client with small cell lung cancer is being treated with etoposide (VePesid). The nurse assisting in caring for the client during its administration understands that which side effect is specifically associated with this medication?
Select the best answer.
Explanation:
The correct answer is 'D: Orthostatic hypotension.' Etoposide is associated with orthostatic hypotension, a sudden drop in blood pressure that can occur when transitioning from lying down to standing up. It is important for the nurse to monitor the client's blood pressure during the infusion to detect and manage this potential side effect.
A home health care nurse is visiting a client with elevated triglyceride levels and a serum cholesterol level of 398 mg/dL. The client is taking cholestyramine (Questran). Which of the following statements, if made by the client, indicates the need for further education?
Select the best answer.
Explanation:
Nicotinic acid, even an over-the-counter form, should be avoided because it may lead to liver abnormalities. All lipid-lowering medications also can cause liver abnormalities, so a combination of nicotinic acid and cholestyramine resin is to be avoided. Constipation and bloating are the two most common side effects. Walking and the reduction of fats in the diet are therapeutic measures to reduce cholesterol and triglyceride levels.
Desmopressin acetate (DDAVP) is prescribed for the treatment of diabetes insipidus. The nurse monitors the client after medication administration for which therapeutic response?
Select the best answer.
Explanation:
Desmopressin promotes renal conservation of water by increasing the permeability of kidney collecting ducts to water, resulting in decreased urinary output. Therefore, the therapeutic response expected after administering desmopressin for diabetes insipidus is a reduction in urinary output.
Prednisone is prescribed for a client with diabetes mellitus who is taking Humulin neutral protamine Hagedorn (NPH) insulin daily. Which of the following prescription changes does the nurse anticipate during therapy with prednisone?
Select the best answer.
Explanation:
When prednisone is prescribed for a client with diabetes mellitus who is taking Humulin NPH insulin daily, the nurse should anticipate an increased amount of daily Humulin NPH insulin. Prednisone, a glucocorticoid, can elevate blood glucose levels, requiring an increase in insulin dosage to maintain optimal blood sugar control.
A client is taking docusate sodium (Colace). The nurse monitors which of the following to determine whether the client is experiencing a therapeutic effect from this medication?
Select the best answer.
Explanation:
The therapeutic effect of docusate sodium (Colace) is to soften stools and promote regular bowel movements, making option D the correct choice. Monitoring for regular bowel movements would indicate that the medication is working as intended by relieving or preventing constipation. Options A, B, and C are not directly related to the therapeutic effect of docusate sodium. Abdominal pain (option A) is a symptom that might indicate a problem rather than a therapeutic effect. Reduction in steatorrhea (option B) and Hematest-negative stools (option C) are not specific outcomes associated with docusate sodium.
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?
Select the best answer.
Explanation:
Hyperventilation is an indication of a systemic effect of mafenide acetate (Sulfamylon) due to its potential to cause acidosis by suppressing renal excretion of acid. If hyperventilation occurs, the medication should be discontinued to prevent further complications.
A client is diagnosed with an acute myocardial infarction and is receiving tissue plasminogen activator, alteplase (Activase, tPA). Which action is a priority nursing intervention?
Select the best answer.
Explanation:
The priority nursing intervention for a client receiving tissue plasminogen activator (alteplase) for an acute myocardial infarction is to monitor for signs of bleeding. Alteplase is a thrombolytic medication that can lead to hemorrhage as a complication. Therefore, closely monitoring the client for any signs of bleeding is essential to promptly address and manage this potential adverse effect.
The healthcare provider prescribes exenatide (Byetta) for a client with type 1 diabetes mellitus who takes insulin. What is the appropriate intervention for the nurse?
Select the best answer.
Explanation:
Exenatide (Byetta) is specifically indicated for the treatment of type 2 diabetes mellitus and is not recommended for clients with type 1 diabetes mellitus who are taking insulin. Choice A is incorrect because exenatide should not be administered to a client with type 1 diabetes mellitus who takes insulin. Choice C is not the most appropriate initial action when the prescription is not suitable for the client. Choice D is unrelated to the administration of exenatide. Therefore, the appropriate intervention for the nurse is to withhold the medication and question the prescription with the healthcare provider to ensure the safety and appropriateness of the treatment plan for the client.
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