Free HESI Pharmacology practice for Pharmacology HESI (HESI RN). Answer 46 nursing exam-style questions with rationales, exam mode, and progress tracking on Nur
The client with breast cancer is receiving cyclophosphamide (Neosar). The nurse is reinforcing medication instructions and advises the client to:
Select the best answer.
Explanation:
The correct answer is to increase fluid intake to 2000 to 3000 mL daily. Cyclophosphamide can cause hemorrhagic cystitis as a toxic effect. By increasing fluid intake, the client can help prevent this complication by promoting frequent urination, which reduces the concentration of the drug and its metabolites in the bladder. This dilution effect can help reduce the risk of bladder toxicity.
A client is prescribed alendronate (Fosamax) for the treatment of osteoporosis. Which instruction should the nurse provide to the client?
Select the best answer.
Explanation:
The correct instruction for a client prescribed alendronate (Fosamax) for osteoporosis is to take the medication with a full glass of water first thing in the morning. It should be taken at least 30 minutes before any food, beverage, or other medication. The client should also remain upright for at least 30 minutes after taking the medication to prevent esophageal irritation. Taking alendronate at bedtime or with food is not recommended as it may reduce its absorption and effectiveness.
When a client taking warfarin sodium (Coumadin) is prescribed ciprofloxacin (Cipro), the nurse should closely monitor the client for which potential effect of this drug interaction?
Select the best answer.
Explanation:
When ciprofloxacin (Cipro) is given with warfarin sodium (Coumadin), it can potentiate the effects of warfarin, leading to an increased risk of bleeding. Therefore, the nurse should closely monitor the client's INR levels and watch for signs of bleeding such as bruising, petechiae, or black tarry stools.
A client with chronic renal failure is receiving ferrous sulfate (Feosol). The nurse monitors the client for which common side effect associated with this medication?
Select the best answer.
Explanation:
Constipation is a common side effect of iron supplements such as ferrous sulfate. Iron can cause constipation by slowing down the movement of the digestive system and hardening the stool. Patients should be advised to increase their fluid intake, dietary fiber, and physical activity to help alleviate this side effect. Diarrhea (Choice A) is not a common side effect associated with ferrous sulfate. Weakness (Choice B) and headache (Choice C) are not typically linked to this medication.
A client is taking Humulin NPH insulin daily every morning. The nurse reinforces instructions for the client and tells the client that the most likely time for a hypoglycemic reaction to occur is:
Select the best answer.
Explanation:
Humulin NPH is an intermediate-acting insulin with a peak action time of 4 to 12 hours after administration. During this period, the risk of hypoglycemic reactions is highest. It is important for the client to be aware of this timing to prevent, recognize, and manage hypoglycemia effectively.
A client is receiving bethanechol chloride (Urecholine). The nurse monitors the client for adverse effects of the medication and should observe for which of the following?
Select the best answer.
Explanation:
Corrected Rationale: Bethanechol chloride (Urecholine) stimulates muscarinic receptors, which can lead to bradycardia as an adverse effect. Monitoring for bradycardia is crucial when administering this medication. Constipation, hypertension, and dry mouth are not typically associated with the effects of bethanechol chloride. Bradycardia is the correct adverse effect to monitor for, making option A the correct answer. Constipation, hypertension, and dry mouth are not commonly seen with bethanechol chloride and are therefore incorrect choices.
A client with a peptic ulcer is diagnosed with a Helicobacter pylori infection. The nurse is reinforcing teaching for the client about the medications prescribed, including clarithromycin (Biaxin), esomeprazole (Nexium), and amoxicillin (Amoxil). Which statement by the client indicates the best understanding of the medication regimen?
Select the best answer.
Explanation:
Triple therapy for Helicobacter pylori infection usually includes two antibacterial drugs and a proton pump inhibitor. These medications will kill the bacteria and decrease acid production.
A client receives a prescription for methocarbamol (Robaxin), and the nurse reinforces instructions to the client regarding the medication. Which client statement would indicate a need for further instructions?
Select the best answer.
Explanation:
The correct answer is C because blurred vision is an adverse effect of methocarbamol (Robaxin) and should be reported to a healthcare provider. Choices A, B, and D are all correct statements. Option A informs the client about a possible discoloration of urine, which is a known side effect. Option B correctly explains the purpose of the medication. Option D correctly advises the client to contact their doctor if they experience nasal congestion, which could indicate an adverse reaction.
A client is taking phenytoin (Dilantin) for seizure control, and a sample for a serum drug level is drawn. Which of the following indicates a therapeutic serum drug range?
Select the best answer.
Explanation:
The correct therapeutic serum drug level range for phenytoin (Dilantin) is 10 to 20 mcg/mL. This range is considered optimal for seizure control while minimizing the risk of toxicity. Monitoring drug levels helps ensure that the client is within the therapeutic range for effective treatment.
A client is to begin a 6-month course of therapy with isoniazid (INH). A nurse plans to teach the client to:
Select the best answer.
Explanation:
When a client is on isoniazid (INH) therapy, they should be instructed to report any signs of hepatitis, such as yellowing of the eyes or skin, immediately. Alcohol consumption should be avoided during INH therapy due to the risk of hepatotoxicity. Foods high in tyramine, such as Swiss or aged cheeses, should also be avoided to prevent adverse reactions. Additionally, while on INH therapy, it is essential to avoid vitamin supplements containing pyridoxine (vitamin B6) to prevent potential interactions.
A client with Crohn's disease is scheduled to receive an infusion of infliximab (Remicade). The nurse assisting in caring for the client should take which action to monitor the effectiveness of treatment?
Select the best answer.
Explanation:
To monitor the effectiveness of infliximab (Remicade) treatment in a client with Crohn's disease, the nurse should observe the frequency and consistency of bowel movements. Infliximab is an immunomodulator that works to reduce inflammation in the colon, leading to improvements in bowel symptoms such as frequency and consistency. Monitoring these bowel patterns can provide valuable insight into the response to the medication and the overall management of Crohn's disease. Checking the leukocyte count (Choice A) is not specific to monitoring the effectiveness of infliximab for Crohn's disease. Checking serum liver enzyme levels (Choice C) may be important for liver function but does not directly monitor the effectiveness of infliximab. Carrying out a Hematest on gastric fluids (Choice D) is not relevant to monitoring the effectiveness of infliximab in Crohn's disease.
The client has reinforced instructions for taking cholestyramine (Questran). Which statement indicates a need for further instructions?
Select the best answer.
Explanation:
The correct answer is C because cholestyramine should not only be taken with water. Flavored products or fruit juices can improve the taste. Choices A, B, and D are all correct statements. It is important for the client to continue taking vitamin supplements, understand that cholestyramine helps lower cholesterol, and maintain a high-fiber diet while taking this medication to enhance its effectiveness.
A healthcare professional is monitoring a client who is receiving intravenous amphotericin B. Which of the following should prompt the healthcare professional to notify the healthcare provider immediately?
Select the best answer.
Explanation:
Amphotericin B is known to cause nephrotoxicity, which can lead to kidney damage. Oliguria, which is decreased urine output, is a concerning sign of kidney dysfunction and should be reported promptly to the healthcare provider to prevent further complications. Fever, headache, and nausea are common side effects of amphotericin B but are not as critical as oliguria in indicating potential kidney damage.
A nurse is providing instructions to an adolescent who has a history of seizures and is taking an anticonvulsant medication. Which of the following statements indicates that the client understands the instructions?
Select the best answer.
Explanation:
The correct answer is C: 'I can't drink alcohol while I am taking my medication.' Alcohol can lower the seizure threshold and should be avoided by individuals taking anticonvulsants. Choice A is incorrect because it is an extreme statement and not necessary for someone taking anticonvulsants. Choice B is incorrect as anticonvulsant medications are not used to clear skin conditions. Choice D is incorrect because doubling up medication doses can be harmful and should not be done without healthcare provider approval.
The client who chronically uses nonsteroidal anti-inflammatory drugs (NSAIDs) has been taking misoprostol (Cytotec). The nurse determines that the medication is having the intended therapeutic effect if which of the following is noted?
Select the best answer.
Explanation:
Misoprostol is a gastric protectant administered to clients using NSAIDs to prevent gastric mucosal injury. Relief of epigastric pain signifies the medication's therapeutic effect as it indicates a reduction in gastrointestinal symptoms associated with NSAID use.
The client with acute myelocytic leukemia is being treated with busulfan (Myleran). Which laboratory value should the nurse specifically monitor during treatment with this medication?
Select the best answer.
Explanation:
The correct answer is B, Uric acid level. Busulfan can cause an increase in uric acid levels, leading to hyperuricemia, renal stones, and acute renal failure. Monitoring uric acid levels is crucial to detect and manage potential complications associated with busulfan therapy.
A client with severe acne is seen in the clinic, and the healthcare provider prescribes isotretinoin. The nurse reviews the client's medication record and would contact the healthcare provider if the client is taking which medication?
Select the best answer.
Explanation:
Isotretinoin is a metabolite of vitamin A, which can lead to toxicity when taken together. Therefore, it is crucial to avoid concurrent use of vitamin A supplements with isotretinoin. Contacting the healthcare provider to discuss discontinuing vitamin A supplements is important to prevent potential adverse effects. Choices B, C, and D are incorrect as they are not known to interact significantly with isotretinoin.
Isosorbide mononitrate (Imdur) is prescribed for a client with angina pectoris. The client tells the nurse that the medication is causing a chronic headache. The nurse appropriately suggests that the client:
Select the best answer.
Explanation:
Isosorbide mononitrate can cause headaches, which usually disappear during continued therapy. Taking the medication with food or meals can help alleviate the headache. It is important to recommend this approach before considering dose adjustments or discontinuation of the medication. Contacting the healthcare provider would be necessary if the headache persists despite taking the medication with food.
A client is learning how to mix regular insulin and NPH insulin in the same syringe. Which action, if performed by the client, indicates the need for further teaching?
Select the best answer.
Explanation:
When mixing regular insulin with another insulin preparation, it is crucial to withdraw the regular insulin first to prevent contamination. NPH insulin should be drawn after the regular insulin to maintain the integrity of each insulin type. Therefore, if the client withdraws the NPH insulin first, it indicates the need for further teaching. Choice B is correct as withdrawing regular insulin first is the appropriate step. Choice C is incorrect as air should be injected into the vial containing the regular insulin to maintain pressure. Choice D is incorrect as injecting air equal to the desired dose of insulin into the vial is a correct step in preparing the insulin for withdrawal.
The client with ovarian cancer is being treated with vincristine (Oncovin). The nurse monitors the client, knowing that which of the following indicates a side effect specific to this medication?
Select the best answer.
Explanation:
The correct answer is D: Numbness and tingling in the fingers and toes. Vincristine is known to cause peripheral neuropathy as a side effect, resulting in numbness and tingling in the fingers and toes. Diarrhea, hair loss, and chest pain are not typically associated with vincristine use.
A client is prescribed allopurinol (Zyloprim) for chronic gout. Which instruction should the nurse include in the teaching plan?
Select the best answer.
Explanation:
The correct instruction for a client prescribed allopurinol (Zyloprim) for chronic gout is to take the medication with a full glass of water. This helps prevent kidney stones which can be a side effect of the medication. It is important for the client to avoid purine-rich foods to help manage gout symptoms. They should continue taking the medication even during a gout attack as prescribed by the healthcare provider. Allopurinol can be taken with or without food, so there is no need to take it on an empty stomach. Therefore, option A is the correct choice. Options B, C, and D are incorrect as increasing purine-rich foods is not recommended, stopping the medication during a gout attack is not advised, and allopurinol can be taken with or without food.
When a client is taking lansoprazole (Prevacid), which question should the nurse ask during data collection to determine medication effectiveness?
Select the best answer.
Explanation:
When a client is taking lansoprazole (Prevacid), a gastric acid pump inhibitor used to treat gastroesophageal reflux disease (GERD), the nurse should ask if the client is experiencing any heartburn to determine medication effectiveness. Heartburn is a common symptom of GERD, and the reduction of heartburn indicates the effectiveness of lansoprazole in managing acid reflux symptoms. Choices A, C, and D are not relevant to assessing the effectiveness of lansoprazole for GERD.
A healthcare professional is planning to administer amlodipine (Norvasc) to a client. The healthcare professional plans to check which of the following before giving the medication?
Select the best answer.
Explanation:
Before administering amlodipine, it is important to check the client's blood pressure and heart rate. Amlodipine is known to lower blood pressure and heart rate as part of its mechanism of action. Monitoring these vital signs helps ensure the safety of the client and allows for appropriate assessment of the medication's effects post-administration.
Intravenous heparin therapy is prescribed for a client. While implementing this prescription, a nurse ensures that which of the following medications is available on the nursing unit?
Select the best answer.
Explanation:
Protamine sulfate is the antidote for heparin, working to reverse its effects in case of excessive bleeding. It should be readily available when administering heparin to manage any potential bleeding complications effectively. Potassium chloride is not the antidote for heparin and is typically used to correct low potassium levels. Phytonadione (vitamin K) is used to reverse the effects of warfarin, not heparin. Aminocaproic acid (Amicar) is used to treat or prevent excessive bleeding but is not the antidote for heparin.
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?
Select the best answer.
Explanation:
The correct answer is A: Tinnitus. Salicylic acid can lead to systemic toxicity, known as salicylism, which may manifest with symptoms like tinnitus, dizziness, hyperventilation, and mental disturbances. Tinnitus is a common early sign of salicylism and should be monitored closely by the nurse to prevent further complications.
Before initiating a client with tuberculosis on anti-tuberculosis therapy with isoniazid (INH), a nurse ensures that which of the following baseline study has been completed?
Select the best answer.
Explanation:
Before starting INH therapy for tuberculosis, it is essential to assess liver enzyme levels as INH can cause hepatotoxicity. Monitoring liver enzyme levels before and during the initial 3 months of therapy is crucial to detect any liver damage early and prevent further complications. Choice A, electrolyte levels, are not directly impacted by INH therapy. Choice B, coagulation times, are not routinely monitored before starting INH therapy. Choice D, serum creatinine level, is not specifically required as a baseline study before initiating INH therapy for tuberculosis.
A client with rheumatoid arthritis is prescribed methotrexate. Which instruction should the nurse include in the client's teaching plan?
Select the best answer.
Explanation:
The correct instruction for the nurse to include in the client's teaching plan when taking methotrexate is to report any signs of infection immediately. Methotrexate can suppress the immune system, making the client more susceptible to infections. It is important for the client to promptly report any signs of infection to receive timely medical intervention. Choice A is incorrect because folic acid supplements are often recommended to reduce side effects of methotrexate. Choice C is incorrect as methotrexate is usually taken on an empty stomach unless the client experiences gastrointestinal upset. Choice D is incorrect as there is no need to limit fluid intake while on methotrexate; in fact, maintaining adequate fluid intake is important to prevent complications such as kidney damage.
A healthcare professional prepares to administer sodium polystyrene sulfonate (Kayexalate) to a client. Before administering the medication, the professional reviews the action of the medication and understands that it:
Select the best answer.
Explanation:
Sodium polystyrene sulfonate, such as Kayexalate, is a cation exchange resin that functions by releasing sodium ions in exchange for primarily potassium ions. This medication is commonly used to treat hyperkalemia, a condition characterized by elevated levels of potassium in the blood.
When assessing the effectiveness of leflunomide (Arava) in a client with rheumatoid arthritis, which question should the nurse ask during data collection?
Select the best answer.
Explanation:
To assess the effectiveness of leflunomide (Arava), a medication used to treat rheumatoid arthritis, the nurse should inquire about joint pain. Joint pain is a common symptom of rheumatoid arthritis, and improvement in joint pain indicates the medication's effectiveness in managing the condition.
A client with hyperparathyroidism has a serum calcium level of 13 mg/dL. Which medication should be prepared to administer as prescribed to the client?
Select the best answer.
Explanation:
The normal serum calcium level ranges from 8.6 to 10.0 mg/dL. In hypercalcemia, as seen in this client, Calcitonin (Miacalcin) is used to decrease plasma calcium levels by inhibiting bone resorption. Calcium gluconate and calcium chloride are typically used for hypocalcemia, not hypercalcemia. Large doses of vitamin D should be avoided in hypercalcemia as they can exacerbate hypercalcemia by increasing calcium absorption from the intestines.
A client is being educated about the use of levodopa-carbidopa (Sinemet) for Parkinson's disease. Which statement by the client indicates a need for further teaching?
Select the best answer.
Explanation:
The correct answer is A. Levodopa-carbidopa (Sinemet) should not be taken with a high-protein meal as protein can interfere with the absorption of the medication. It is recommended to take it on an empty stomach or with a light meal. Choices B, C, and D are accurate statements regarding potential side effects and actions to take while on levodopa-carbidopa therapy, indicating a good understanding by the client.
The client has begun medication therapy with pancrelipase (Pancrease MT). The nurse evaluates that the medication is having the optimal intended benefit if which effect is observed?
Select the best answer.
Explanation:
Pancrelipase (Pancrease MT) is a pancreatic enzyme replacement therapy used to aid digestion in clients with pancreatic insufficiency. One of the key goals of pancrelipase therapy is to reduce the amount of undigested fat in the stool, known as steatorrhea. Therefore, the nurse should evaluate the effectiveness of pancrelipase by looking for a reduction in steatorrhea, indicating improved digestion and absorption of fats.
A client is being taught about the use of enoxaparin (Lovenox) for the prevention of deep vein thrombosis. Which instruction should the nurse include in the teaching plan?
Select the best answer.
Explanation:
Enoxaparin (Lovenox) is administered subcutaneously at the same time each day to maintain consistent blood levels. Injecting the medication into the muscle is incorrect, as it should be given subcutaneously. Massaging the injection site should be avoided to prevent bruising. The air bubble in the prefilled syringe should not be expelled, as it ensures the full dose is administered.
An older client recently has been taking cimetidine (Tagamet). The nurse monitors the client for which most frequent central nervous system side effect of this medication?
Select the best answer.
Explanation:
Older clients are particularly vulnerable to central nervous system side effects of cimetidine. The most frequent side effect is confusion. It is crucial for nurses to be vigilant in monitoring for confusion as it can impact the client's safety and well-being. While tremors, dizziness, and hallucinations are possible side effects, confusion is the most common in older clients taking cimetidine.
Before administering furosemide (Lasix) to a client with heart failure, what is the most important laboratory test result for the nurse to check?
Select the best answer.
Explanation:
The correct answer is to check the potassium level before administering furosemide (Lasix) to a client with heart failure. Furosemide is a loop diuretic that can cause hypokalemia, so it is crucial to assess the potassium level to prevent complications like cardiac arrhythmias associated with low potassium levels.
A client has been prescribed cyclosporine (Sandimmune). Which food item should the client avoid based on the medication's interaction?
Select the best answer.
Explanation:
Grapefruit juice should be avoided when taking cyclosporine because it inhibits the metabolism of the medication, leading to increased blood levels and a higher risk of toxicity. It is important for the client to follow this dietary instruction to ensure the safe and effective use of cyclosporine.
A client is taking levothyroxine (Synthroid) for hypothyroidism. Which symptom would indicate to the nurse that the client is taking too much medication?
Select the best answer.
Explanation:
When a client is taking an excessive dose of levothyroxine (Synthroid), it can lead to symptoms of hyperthyroidism. Tremors are a common sign of excessive medication, along with tachycardia and insomnia. Bradycardia, lethargy, and constipation are typical symptoms of hypothyroidism, indicating that the client may require a higher dose of levothyroxine rather than too much.
The healthcare 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 treatment?
Select the best answer.
Explanation:
The correct answer is C. Silver sulfadiazine is an antibacterial used to treat burns, helping in the healing process. It does not permanently stain the skin. Therefore, the statement indicating a lack of understanding is that the medication will permanently stain the skin.
A nurse reinforces discharge instructions to a postoperative client who is taking warfarin sodium (Coumadin). Which statement, if made by the client, reflects the need for further teaching?
Select the best answer.
Explanation:
Ecotrin is an aspirin-containing product and should be avoided. Clients should avoid alcohol consumption, take prescribed medication at the same time each day, and use a Medic-Alert bracelet for emergency information.
Tamoxifen is prescribed for the client with metastatic breast carcinoma. The nurse understands that the primary action of this medication is to:
Select the best answer.
Explanation:
The primary action of tamoxifen, an antineoplastic medication used in metastatic breast carcinoma, is to compete with estradiol for binding to estrogen receptors in tissues with high receptor concentrations. By doing so, tamoxifen reduces DNA synthesis and estrogen response, leading to its therapeutic effect in inhibiting the growth of estrogen-sensitive breast cancer cells.
A client has a prescription to take guaifenesin (Humibid) every 4 hours, as needed. The nurse determines that the client understands the most effective use of this medication if the client states that he or she will:
Select the best answer.
Explanation:
Guaifenesin is an expectorant used to help loosen mucus and make coughs more productive. Taking it with a full glass of water helps decrease the viscosity of secretions, making it easier to expel mucus from the respiratory tract. It is important not to crush sustained-release tablets, as this can alter the intended release of the medication and lead to potential adverse effects.
When providing instructions to a client taking ciprofloxacin (Cipro), which of the following should the nurse include in the teaching plan?
Select the best answer.
Explanation:
The correct answer is to avoid taking ciprofloxacin (Cipro) with milk or antacids. These can interfere with the medication's absorption. Consuming extra dairy products or taking it with a multivitamin is not recommended for the same reason. If gastrointestinal upset occurs, the medication can be taken with food to help alleviate the symptoms.
A healthcare provider notes that a client is receiving lamivudine (Epivir). The healthcare provider determines that this medication has been prescribed to treat which of the following?
Select the best answer.
Explanation:
Lamivudine, known by the brand name Epivir, is an antiretroviral medication used in the treatment of human immunodeficiency virus (HIV) infection. This medication helps to inhibit the replication of HIV and improve the immune system function in individuals with HIV. Therefore, the correct answer is option D, Human immunodeficiency virus (HIV) infection.
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:
Select the best answer.
Explanation:
Azelaic acid (Azelex) is a topical medication used to treat mild to moderate acne. It works by suppressing the growth of Propionibacterium acnes and decreasing the proliferation of keratinocytes in the skin. Therefore, if a client is prescribed azelaic acid, the nurse would suspect that the client is being treated for acne.
When reviewing laboratory results for a client receiving tacrolimus (Prograf), which laboratory result would indicate to the nurse that the client is experiencing an adverse effect of the medication?
Select the best answer.
Explanation:
An elevated blood glucose level of 200 mg/dL indicates an adverse effect of tacrolimus. This finding suggests hyperglycemia, which is a known adverse effect of the medication. Other potential adverse effects of tacrolimus include neurotoxicity and hypertension. Monitoring blood glucose levels is crucial to detect and manage this adverse effect promptly. Choices B, C, and D are not directly associated with adverse effects of tacrolimus. Potassium, platelet count, and white blood cell count are important parameters to monitor for other reasons but not specifically for detecting adverse effects of tacrolimus.
A client is diagnosed with pulmonary embolism and is to be treated with streptokinase (Streptase). A nurse would report which priority data collection finding to the registered nurse before initiating this therapy?
Select the best answer.
Explanation:
The correct answer is C. Streptokinase therapy is contraindicated in severe uncontrolled hypertension due to the risk of cerebral hemorrhage. A blood pressure of 198/110 mm Hg indicates severe hypertension, which needs to be addressed before initiating streptokinase to prevent potential complications.
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