Free HESI Pharmacology practice for Pharmacology HESI Quizlet (HESI RN). Answer 47 nursing exam-style questions with rationales, exam mode, and progress trackin
A client with a prescription to take theophylline (Theo-24) daily has been given medication instructions by the nurse. The nurse determines that the client needs further information about the medication if the client states that he or she will:
Select the best answer.
Explanation:
The correct answer is B. Taking theophylline at bedtime is inappropriate because it can cause insomnia. The medication should be taken early in the morning to avoid disrupting sleep patterns. It is important to follow the healthcare provider's instructions regarding the timing of the medication to achieve optimal therapeutic effects.
A client has been taking isoniazid (INH) for 2 months. The client complains to a nurse about numbness, paresthesias, and tingling in the extremities. The nurse interprets that the client is experiencing:
Select the best answer.
Explanation:
The client's symptoms of numbness, paresthesias, and tingling in the extremities indicate peripheral neuritis, a common side effect of isoniazid (INH). This condition can be managed by supplementing with pyridoxine (vitamin B6) to minimize the symptoms.
A client with type 2 diabetes mellitus is prescribed metformin (Glucophage). Which instruction should the nurse include in the teaching plan?
Select the best answer.
Explanation:
Clients taking metformin (Glucophage) should avoid alcohol as it can increase the risk of lactic acidosis. Metformin should be taken with meals to reduce gastrointestinal upset. While hypoglycemia is less common with metformin compared to other diabetes medications, clients should still be aware of its symptoms.
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?
Select the best answer.
Explanation:
Before administering Isotretinoin, it is important to check the client's triglyceride levels. Isotretinoin is known to elevate triglyceride levels, hence monitoring them before and periodically during treatment is essential to prevent potential adverse effects.
While assisting in caring for a pregnant client receiving intravenous magnesium sulfate for preeclampsia management, a nurse notes the client's absent deep tendon reflexes. What determination should the nurse make based on this data?
Select the best answer.
Explanation:
When a pregnant client receiving intravenous magnesium sulfate for preeclampsia management exhibits absent deep tendon reflexes, this indicates magnesium toxicity. Magnesium toxicity can occur as a complication of magnesium sulfate therapy, leading to suppressed reflexes. It is crucial for the nurse to recognize this sign promptly and report it to prevent further complications or harm to the client.
The clinic nurse is reviewing a teaching plan for a client receiving antineoplastic medication. When implementing the plan, the nurse should advise the client:
Select the best answer.
Explanation:
The correct advice for a client receiving antineoplastic medication is to consult with healthcare providers (HCPs) before receiving immunizations. Antineoplastic medications can lower the body's resistance, making it crucial to seek guidance from healthcare providers to prevent potential complications that may arise due to the medication's impact on the immune system. Choices A, B, and D are incorrect because taking aspirin for a headache, avoiding alcohol, and consulting only before a flu vaccine at a local health fair do not directly address the specific risk related to antineoplastic medications and immunizations.
Megestrol acetate (Megace), an antineoplastic medication, is prescribed for a client with metastatic endometrial carcinoma. The nurse reviews the client's history and contacts the registered nurse if which diagnosis is documented in the client's history?
Select the best answer.
Explanation:
Megestrol acetate can increase the risk of thromboembolic events. Clients with a history of thrombophlebitis should not receive this medication due to the increased risk of thromboembolic events. Therefore, the nurse should contact the registered nurse if thrombophlebitis is documented in the client's history to ensure appropriate medication management.
A client is taking levothyroxine (Synthroid). The nurse instructs the client to notify the health care provider (HCP) if which of the following occurs?
Select the best answer.
Explanation:
Tremors are a sign of excessive doses of levothyroxine, indicating hyperthyroidism. It is important for the client to report tremors to the healthcare provider to prevent complications associated with overdosing on levothyroxine.
A health care provider (HCP) writes a prescription for digoxin (Lanoxin), 0.25 mg daily. The nurse teaches the client about the medication and tells the client that it is important to:
Select the best answer.
Explanation:
When taking digoxin, monitoring the pulse rate is essential due to its potential effects on heart rate. Digoxin can lead to bradycardia, where the pulse rate drops significantly. Withholding the medication and promptly contacting the healthcare provider if the pulse falls below 60 beats per minute is crucial to prevent severe complications and ensure appropriate management. Choices A, B, and C are incorrect because counting radial and carotid pulses, checking blood pressure, or stopping the medication based on a pulse rate higher than 100 beats per minute are not the primary monitoring parameters for a client taking digoxin.
A healthcare professional is preparing to administer digoxin (Lanoxin), 0.125 mg orally, to a client with heart failure. Which vital sign is most important for the healthcare professional to check before administering the medication?
Select the best answer.
Explanation:
Before administering digoxin, it is essential to assess the client's heart rate as this medication directly affects cardiac function. Monitoring the heart rate helps identify if it is within the acceptable range for administering digoxin. A pulse rate below 60 beats per minute warrants withholding the medication to prevent potential adverse effects like bradycardia or cardiac arrhythmias.
Which of the following herbal therapies would be prescribed for its use as an antispasmodic? Select all that apply.
Select the best answer.
Explanation:
Chamomile is known for its antispasmodic properties. It helps in relaxing muscles and reducing spasms. Aloe is a laxative, kava has anxiolytic and sedative effects, and ginger is commonly used to relieve nausea.
A client is on nicotinic acid (niacin) for hyperlipidemia and the nurse provides instructions to the client about the medication. Which statement by the client would indicate an understanding of the instructions?
Select the best answer.
Explanation:
Aspirin or a nonsteroidal anti-inflammatory drug can be taken 30 minutes before taking the medication to decrease flushing. Alcohol consumption needs to be avoided because it will enhance this side effect. The medication should be taken with meals, this will decrease gastrointestinal upset. Taking the medication with meals has no effect on the flushing. Clay-colored stools are a sign of hepatic dysfunction and should be immediately reported to the health care provider (HCP).
The client with metastatic breast cancer is receiving tamoxifen. The nurse specifically monitors which laboratory value while the client is taking this medication?
Select the best answer.
Explanation:
The correct answer is B: Calcium level. Tamoxifen may increase calcium levels, leading to hypercalcemia. Symptoms of hypercalcemia include increased urine volume, excessive thirst, nausea, vomiting, constipation, muscle weakness, and bone pain. Monitoring serum calcium levels is essential to detect and manage this potential side effect. Choices A, C, and D are incorrect because tamoxifen does not directly affect glucose, potassium, or prothrombin time levels significantly.
Phenazopyridine hydrochloride (Pyridium) is prescribed for a client for symptomatic relief of pain resulting from a lower urinary tract infection. The nurse reinforces to the client:
Select the best answer.
Explanation:
The nurse should instruct the client that a reddish-orange discoloration of urine may occur. The nurse should also educate the client that this discoloration can stain fabric. It is recommended to take the medication after meals to reduce the possibility of gastrointestinal upset. While a headache is an occasional side effect of the medication, it does not warrant discontinuation of the medication.
A client is instructed to take levothyroxine (Synthroid). The medication should be taken:
Select the best answer.
Explanation:
Levothyroxine should be taken on an empty stomach to enhance absorption. Taking it with food or at bedtime can interfere with its absorption, reducing its effectiveness. Therefore, it is essential for the client to take levothyroxine on an empty stomach to ensure optimal therapeutic outcomes.
A client is being monitored while receiving bethanechol chloride (Urecholine) for urinary retention. Which of the following indicates a therapeutic effect of this medication?
Select the best answer.
Explanation:
Bethanechol chloride (Urecholine) is administered to stimulate the bladder and treat urinary retention. The therapeutic effect is indicated by an increased urinary output, as it demonstrates the medication's ability to prompt the bladder to empty. Increased heart rate and passage of flatus are unrelated to the therapeutic effects of bethanechol. Although bethanechol can increase peristalsis, the primary therapeutic goal is to address urinary retention.
A histamine (H2)-receptor antagonist will be prescribed for a client. The nurse understands that which medications are H2-receptor antagonists? Select one that doesn't apply.
Select the best answer.
Explanation:
H2-receptor antagonists like Nizatidine, Ranitidine, and Famotidine are used to suppress gastric acid secretion, relieve heartburn symptoms, and prevent complications of peptic ulcer disease. Ibuprofen, on the other hand, is a nonsteroidal anti-inflammatory drug (NSAID) commonly used for pain relief and inflammation, but it is not an H2-receptor antagonist. It is essential to differentiate between these medication classes to ensure appropriate treatment for gastrointestinal conditions.
The home health care nurse is visiting a client who was recently diagnosed with type 2 diabetes mellitus. The client is prescribed repaglinide (Prandin) and metformin (Glucophage) and asks the nurse to explain these medications. The nurse should reinforce which instructions to the client? Select one that doesn't apply.
Select the best answer.
Explanation:
Repaglinide is a rapid-acting oral hypoglycemic that should be taken before meals and withheld if the client does not eat. Hypoglycemia is a side effect of repaglinide, so carrying a simple sugar is essential. Metformin decreases hepatic glucose production and can cause diarrhea. Muscle pain may occur as an adverse effect and should be reported to the HCP.
A client with diabetes mellitus is prescribed Humulin NPH insulin. The client asks the nurse how to store unopened vials of insulin. The nurse instructs the client to:
Select the best answer.
Explanation:
Unopened vials of insulin should be stored in the refrigerator until needed. Freezing insulin can damage it, affecting its efficacy. Storing insulin in a dark, dry place or at room temperature is not recommended as it can lead to degradation of the insulin. Refrigeration helps maintain the stability and effectiveness of insulin.
A nurse is monitoring a client receiving lithium carbonate for bipolar disorder. Which finding should the nurse report immediately to the healthcare provider?
Select the best answer.
Explanation:
Persistent vomiting can be a sign of lithium toxicity, which requires immediate medical attention. Increased thirst, fine hand tremors, and frequent urination are common side effects of lithium.
A client has just taken a dose of trimethobenzamide (Tigan). The nurse plans to monitor this client for relief of:
Select the best answer.
Explanation:
The correct answer is D: Nausea and vomiting. Trimethobenzamide (Tigan) is an antiemetic medication used to treat nausea and vomiting. Therefore, the nurse would monitor the client for relief of nausea and vomiting after taking this medication.
When is the best time for a client to take a daily dose of prednisone?
Select the best answer.
Explanation:
The correct time for a client to take a daily dose of prednisone is early morning. Corticosteroids like prednisone should be taken in the morning to mimic the body's natural hormone release pattern. This timing helps reduce the risk of disrupting the body's internal clock and minimizes the potential for insomnia or other sleep disturbances.
A client is receiving morphine sulfate subcutaneously for pain. Because morphine sulfate has been prescribed for this client, which nursing action would be included in the plan of care?
Select the best answer.
Explanation:
Morphine sulfate suppresses the cough reflex, which can lead to the retention of secretions in the lungs. Encouraging the client to cough and deep breathe helps prevent pneumonia by clearing the airways of any accumulated secretions. This intervention is crucial in clients receiving morphine sulfate to maintain optimal respiratory function.
A healthcare professional is preparing to administer an intramuscular dose of penicillin to a client with a history of anaphylactic reactions to penicillin. Which action should the healthcare professional take first?
Select the best answer.
Explanation:
When dealing with a client who has a history of anaphylactic reactions to penicillin, the priority action for the healthcare professional is to have an epinephrine injection readily available in case of a severe allergic reaction. In such cases, the immediate focus is on being prepared to manage a potentially life-threatening situation. While checking the medication order for accuracy, administering a test dose, and asking the client about allergies are essential steps in medication administration, the first priority is ensuring the availability of epinephrine to address a severe allergic reaction promptly.
A clinic nurse prepares to administer an MMR (measles, mumps, rubella) vaccine to a child. How is this vaccine best administered?
Select the best answer.
Explanation:
The MMR vaccine is best administered subcutaneously in the outer aspect of the upper arm. This route allows for proper absorption and efficacy of the vaccine while minimizing the risk of injury or discomfort to the child.
A client has been prescribed furosemide (Lasix), and the nurse is monitoring for adverse effects associated with this medication. Which of the following should the nurse recognize as a potential adverse effect? Select one that doesn't apply.
Select the best answer.
Explanation:
Furosemide is a loop diuretic that can lead to adverse effects such as tinnitus, hypotension, and hypokalemia. While nausea is a common side effect of many medications, it is not typically associated with furosemide. Therefore, the nurse should recognize nausea as a potential adverse effect that doesn't apply to furosemide.
A client who has been taking isoniazid (INH) for tuberculosis asks the nurse about the medication. Which statement by the client indicates the need for further teaching?
Select the best answer.
Explanation:
Isoniazid (INH) is best absorbed when taken on an empty stomach. However, if gastrointestinal upset occurs, it can be taken with food. Limiting alcohol intake, monitoring for jaundice, and notifying the doctor of peripheral neuropathy symptoms are all appropriate actions while taking INH.
A client with chronic pain is prescribed transdermal fentanyl (Duragesic) patches. Which instruction should the nurse include in the teaching plan?
Select the best answer.
Explanation:
Clients using transdermal fentanyl (Duragesic) patches should avoid using heating pads over the patch as heat can increase the release of the medication, potentially leading to overdose. The patch should be applied to a different site each time, changed every 72 hours, and the old patch should be removed before applying a new one to prevent accidental overdose or excessive drug absorption.
The client has a PRN prescription for loperamide hydrochloride (Imodium). The nurse understands that this medication is used for which condition?
Select the best answer.
Explanation:
Loperamide hydrochloride (Imodium) is an antidiarrheal medication commonly used to manage episodes of diarrhea. It works by slowing down gut movement and reducing the frequency of bowel movements. Loperamide is not indicated for constipation, abdominal pain, or hematest-positive nasogastric tube drainage. It is specifically useful in acute and chronic diarrhea, such as in cases of inflammatory bowel disease, to help control symptoms and decrease fluid loss.
When administering etanercept (Enbrel) to a client with rheumatoid arthritis for 3 weeks, what is the most important assessment for the nurse to perform?
Select the best answer.
Explanation:
The priority when administering etanercept (Enbrel) to a client with rheumatoid arthritis is to monitor white blood cell counts and platelet counts. Etanercept can lead to infections and pancytopenia, making it crucial to assess for changes in these blood parameters to detect any potential complications early on.
Insulin glargine (Lantus) is prescribed for a client with diabetes mellitus. The nurse tells the client that it is best to take the insulin:
Select the best answer.
Explanation:
Insulin glargine (Lantus) is a long-acting insulin with a duration of action of approximately 24 hours, making it suitable for once-daily dosing at the same time each day. This regimen helps maintain consistent blood glucose levels and simplifies the client's treatment routine. Taking insulin glargine once daily provides basal insulin coverage throughout the day, reducing the risk of hypoglycemia compared to short-acting insulins that are taken before each meal.
Before administering Methylergonovine (Methergine) to a client with postpartum hemorrhage caused by uterine atony, the nurse checks which of the following as the important client parameter?
Select the best answer.
Explanation:
Methylergonovine (Methergine) acts by stimulating uterine contractions and causing vasoconstriction. As vasoconstriction can potentially impact blood pressure, it is crucial to check the client's blood pressure before administering Methylergonovine to monitor for any hypertensive effects.
When monitoring a client for acute toxicity associated with bethanechol chloride (Urecholine), what sign should the nurse check for to indicate toxicity?
Select the best answer.
Explanation:
The correct answer is C: Bradycardia. Toxicity from bethanechol chloride (Urecholine) can lead to excessive muscarinic stimulation, resulting in manifestations like salivation, sweating, involuntary urination and defecation, bradycardia, and severe hypotension. When facing toxicity, treatment involves supportive measures and administering atropine sulfate subcutaneously or intravenously.
When administering hydrochlorothiazide (HydroDIURIL) to a client, the nurse should be aware of which of the following concerns?
Select the best answer.
Explanation:
The correct answer is C. Hydrochlorothiazide is a thiazide diuretic, which can lead to hypokalemia and hyperglycemia. It is also associated with hypercalcemia, hyperlipidemia, and hyperuricemia. Being a sulfa-based medication, individuals with a sulfa allergy are at risk for an allergic reaction when taking hydrochlorothiazide. Choice A is incorrect because hydrochlorothiazide can cause hyperkalemia rather than hypouricemia. Choice B is incorrect as there is no direct link between hydrochlorothiazide and an increased risk of osteoporosis. Choice D is incorrect because hypoglycemia and penicillin allergy are not typically associated with hydrochlorothiazide use.
What instruction should be included in the client's teaching plan when prescribed montelukast (Singulair) for asthma?
Select the best answer.
Explanation:
The correct instruction to include in the teaching plan for a client prescribed montelukast (Singulair) is to take the medication in the evening. Montelukast is most effective when taken in the evening to provide optimal control of asthma symptoms. It is not intended for use as a rescue medication for asthma attacks. There is no specific recommendation to increase fluid intake or use the medication before exercise in relation to montelukast therapy.
A client who is taking hydrochlorothiazide (HydroDIURIL, HCTZ) has been started on triamterene (Dyrenium) as well. The client asks the nurse why both medications are required. The nurse formulates a response, based on the understanding that:
Select the best answer.
Explanation:
The combination of triamterene and hydrochlorothiazide is used because triamterene is a potassium-sparing diuretic, which helps retain potassium, while hydrochlorothiazide is a potassium-losing diuretic, which promotes potassium excretion. This combination helps balance potassium levels in the body, preventing imbalances that can occur when using potassium-losing diuretics alone.
When caring for a client with cancer receiving cisplatin, what adverse effects should the nurse monitor for? Select all that apply.
Select the best answer.
Explanation:
Cisplatin, a chemotherapy medication, can lead to various adverse effects, including ototoxicity manifesting as tinnitus, hypokalemia, hypocalcemia, hypomagnesemia, and nephrotoxicity. Therefore, the nurse should closely monitor for these side effects during the client's treatment.
A client who has begun taking fosinopril (Monopril) is very distressed, telling the nurse that he cannot taste food normally since beginning the medication 2 weeks ago. The nurse provides the best support to the client by:
Select the best answer.
Explanation:
The correct answer is to inform the client that impaired taste is an expected side effect of ACE inhibitors like fosinopril, such as Monopril, and typically resolves within 2 to 3 months. It is essential for the nurse to offer reassurance and education to the client about this common side effect to alleviate distress and encourage compliance with the medication regimen.
A client with chronic obstructive pulmonary disease (COPD) is prescribed tiotropium (Spiriva). Which instruction should the nurse include in the teaching plan?
Select the best answer.
Explanation:
Tiotropium (Spiriva) is not a rescue inhaler but a maintenance medication for COPD. The correct instruction for the nurse to include in the teaching plan is to advise the client to rinse their mouth after using the inhaler. This practice helps prevent dry mouth and throat irritation, common side effects of tiotropium. There are no specific recommendations to take tiotropium on an empty stomach or with a full glass of water.
A client is receiving furosemide (Lasix) and is being discharged. What should the nurse include in the teaching plan?
Select the best answer.
Explanation:
The correct answer is to instruct the client to change positions slowly to prevent dizziness. Furosemide (Lasix) is a diuretic that can lead to orthostatic hypotension, causing dizziness. Consuming potassium-rich foods is essential to prevent hypokalemia when taking furosemide. Taking the medication in the morning helps reduce the need for frequent urination at night. Encouraging the client to maintain an adequate fluid intake is crucial to prevent dehydration while on this medication.
A client is taking propranolol (Inderal LA). Which data collection finding would indicate a potential serious complication associated with propranolol?
Select the best answer.
Explanation:
The development of audible expiratory wheezes may indicate a serious adverse reaction, bronchospasm, associated with propranolol. Beta-blockers can trigger bronchospasm, especially in clients with chronic obstructive pulmonary disease or asthma. This complication can lead to significant respiratory distress and should be addressed promptly to prevent further complications.
A client is being educated about the use of sertraline (Zoloft) for depression. Which statement by the client indicates a need for further teaching?
Select the best answer.
Explanation:
The statement 'I should take the medication with a high-protein meal' indicates a need for further teaching as sertraline (Zoloft) should not be taken with a high-protein meal due to potential interference with medication absorption. Choices B, C, and D are correct statements associated with the use of sertraline for depression. It is common to experience dizziness when quickly getting up, notice a decrease in sex drive, and important to report any thoughts of self-harm to the healthcare provider while on this medication.
Cycloserine (Seromycin) is added to the medication regimen for a client with tuberculosis. Which of the following would the nurse include in the client-teaching plan regarding this medication?
Select the best answer.
Explanation:
Cycloserine requires weekly serum drug level determinations to monitor for neurotoxicity. The medication must be taken after meals, and the client should avoid alcohol. Additionally, the client should report any signs of skin rash or central nervous system toxicity to the healthcare provider.
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:
Select the best answer.
Explanation:
Chemical sunscreens are most effective when applied at least 30 minutes before exposure to the sun to allow them to penetrate the skin and provide optimal protection. Applying sunscreen immediately before swimming (Choice A) or immediately before exposure to the sun (Choice C) may not provide sufficient time for the sunscreen to be absorbed and offer proper protection. Applying sunscreen 15 minutes before sun exposure (Choice B) is also not ideal as it may not allow enough time for the sunscreen to work effectively. Therefore, the correct answer is to apply chemical sunscreen at least 30 minutes before exposure to the sun to ensure it can be absorbed and offer the intended protection. It is important to reapply sunscreen after swimming or sweating to maintain its effectiveness.
A client with diabetes mellitus is prescribed prednisone for an acute exacerbation of asthma. Which of the following should the nurse include in the client's teaching plan?
Select the best answer.
Explanation:
The correct answer is to monitor blood glucose levels closely. Prednisone can elevate blood glucose levels, necessitating close monitoring. Adjusting the insulin dose may be necessary, but this should be managed by a healthcare provider. Prednisone should be taken with food to reduce gastrointestinal discomfort and should not be stopped suddenly to prevent adverse effects.
In a client with chronic renal failure receiving epoetin alfa (Epogen, Procrit), which laboratory result would indicate a therapeutic effect of the medication?
Select the best answer.
Explanation:
A hematocrit of 32% indicates a therapeutic effect of epoetin alfa in a client with chronic renal failure. Epoetin alfa is used to treat anemia in these patients by stimulating red blood cell production, leading to an increase in the hematocrit level. Monitoring the hematocrit is essential to assess the response to epoetin alfa therapy.
A client with trigeminal neuralgia tells the nurse that acetaminophen (Tylenol) is taken on a frequent daily basis for relief of generalized discomfort. The nurse reviews the client's laboratory results and determines that which of the following indicates toxicity associated with the medication?
Select the best answer.
Explanation:
A direct bilirubin level of 2 mg/dL indicates liver damage, which can be caused by an overdose of acetaminophen. Acetaminophen toxicity can lead to liver injury, manifesting as elevated bilirubin levels and other liver function test abnormalities.
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