HESI-PHARMACOLOGY ACTUAL EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS ALREADY GRADED A
A female client is receiving tamoxifen following surgery for breast cancer.
She reports the onset of hot flashes to the nurse. Which intervention should
the nurse implement?
A. Instruct the client that hot flashes are a side effect that often occurs with
the use of this medication
B. Encourage the client to verbalize her feelings and fears about the
recurrence of her breast cancer
C. Help the client schedule an appointment for evaluation of the need to
increase the dose of medication
D. Notify the HCP that the client needs immediate evaluation for medication
toxicity - ANSWER>>>Correct ANSWER: A
Rationale: Tamoxifen is an estrogen receptor blocker used to treat breast
carcinoma. Hot flashes are a common side effect. If the hot flashes become
bothersome, the client can be instructed in measures to reduce the
discomfort. Hot flashes are not an indication of option B, C, or D.
The charge nurse is reviewing the admission history and physical data for
four clients newly admitted to the unit. Which client is at greater risk for
adverse reactions to medications?
A. 30-year-old man with a fracture
B. 7-year-old child with an ear infection
C. 75-year-old woman with liver disease
D. 50-year-old man with an URI - ANSWER>>>Correct ANSWER: C
Rationale: Impaired hepatic metabolic pathways for drug and chemical
degradation place option C at greatest risk for adverse reactions to
,medications based on advancing age and liver disease. Options A and D have
no predisposing factors, such as genetics, pathophysiologic dysfunction, or
drug allergies, that would increase the risk for cumulative toxicity or ADRs.
Option B is at risk for dose-related adverse reactions but is at less risk than
option C.
A client is ordered 22 mg of gentamicin by IM injection. The drug is available
in 20 mg/2 mL. How many milliliters should be administered?
A. 1.8
B. 2.0
C. 2.4
D. 2.2 - ANSWER>>>Correct ANSWER: D
Rationale:
(22 mg/20 mg) × (x mL/2 mL) = 22x = 40x = 2.2 mL
A client with metastatic cancer reports severe continuous pain. Which route
of administration should the nurse use to provide the most effective
continuous analgesia?
A. Oral
B. Intravenous (IV)
D. Transdermal
D. Intramuscular (IM) - ANSWER>>>Correct ANSWER: C
Rationale: Continuous pain is best managed by maintaining a constant
serum drug level. Transdermal drug administration of an analgesic provides
around-the-clock, controlled release of the medication that is absorbed
through intact skin into the bloodstream to provide continuous pain relief.
Option A is convenient, but gastrointestinal variables affect the absorption
rate of the drug, its onset and intensity, and duration of response and
,requires repeated doses around the clock. Option B provides immediate
action because the drug is infused directly into the bloodstream and is
quickly metabolized, and repeated IV doses are required to maintain a
continuous blood level. Option D requires repeated injections at regular
intervals, which are uncomfortable, and absorption rates vary between
muscle sites.
Minocycline, 50 mg PO every 8 hours, is prescribed for an adolescent girl
diagnosed with acne. The nurse discusses self-care with the client while she
is taking the medication. Which teaching points should be included in the
discussion? (Select all that apply.)
A. Report vaginal itching or discharge
B. Take the medication at 0800, 1500, and 2200 hours
C. Protect skin from natural and artificial UV light
D. Avoid drinking until response to medication is known
E. Take with an antacid tablet to prevent nausea
F. use a non-hormonal method of contraception if sexually active -
ANSWER>>>Correct ANSWER: A, C, D, F
Rationale: Adverse effects of tetracyclines include superinfections,
photosensivity, and decreased efficacy of oral contraceptives. Therefore, the
client should report vaginal itching or discharge (A), protect the skin from
UV light (C), and use a non-hormonal method of contraception (F) while on
teh medication. Minocycline is known to cause dizziness and ataxia, so until
the client's response to the medication is known, driving (D) should be
avoided. Tetracyclines should be taken around the clock (B) but exhibit
decreased absorption when taken with antacids, so (E) is contraindicated.
, A 3-year-old boy is admitted to the ED after ingesting an unknown amount
of phenobarbital elixir prescribed for his brother's seizure disorder. Which
nursing intervention should the nurse implement first?
A. Administer syrup of ipecac
B. Take the child's vital signs
C. Draw a blood specimen for a phenobarbital level
D. Teach the mother safe medication storage practices - ANSWER>>>Correct
ANSWER: B
Rationale: Phenobarbital causes respiratory depression, so the priority
intervention is assessment of vital signs. Options A, C, and D are actions that
may be used in the treatment of this child, but they do not have the priority
of option B
Following the administration of sublingual nitroglycerin, which assessment
finding indicates that the medication was effective?
A. Decrease in level of chest pain
B. Clear bilateral breath sounds
C. Increase in blood pressure
D. Increase in urinary output - ANSWER>>>Correct ANSWER: A
Rationale: Nitroglycerin reduces myocardial oxygen consumption, which
decreases ischemia and reduces chest pain. Options B, D, and D are not
expected outcomes of sublingual nitroglycerin.
A client who is receiving chlorpromazine HCl to control is psychotic behavior
also has a prescription for benztropine. When teaching thh client and/or
significant others about these medications, what should the nurse explain
about the use of benztropine in the treatment plan for this client?
A. This medication will reduce the side effects of urinary retention
DETAILED ANSWERS ALREADY GRADED A
A female client is receiving tamoxifen following surgery for breast cancer.
She reports the onset of hot flashes to the nurse. Which intervention should
the nurse implement?
A. Instruct the client that hot flashes are a side effect that often occurs with
the use of this medication
B. Encourage the client to verbalize her feelings and fears about the
recurrence of her breast cancer
C. Help the client schedule an appointment for evaluation of the need to
increase the dose of medication
D. Notify the HCP that the client needs immediate evaluation for medication
toxicity - ANSWER>>>Correct ANSWER: A
Rationale: Tamoxifen is an estrogen receptor blocker used to treat breast
carcinoma. Hot flashes are a common side effect. If the hot flashes become
bothersome, the client can be instructed in measures to reduce the
discomfort. Hot flashes are not an indication of option B, C, or D.
The charge nurse is reviewing the admission history and physical data for
four clients newly admitted to the unit. Which client is at greater risk for
adverse reactions to medications?
A. 30-year-old man with a fracture
B. 7-year-old child with an ear infection
C. 75-year-old woman with liver disease
D. 50-year-old man with an URI - ANSWER>>>Correct ANSWER: C
Rationale: Impaired hepatic metabolic pathways for drug and chemical
degradation place option C at greatest risk for adverse reactions to
,medications based on advancing age and liver disease. Options A and D have
no predisposing factors, such as genetics, pathophysiologic dysfunction, or
drug allergies, that would increase the risk for cumulative toxicity or ADRs.
Option B is at risk for dose-related adverse reactions but is at less risk than
option C.
A client is ordered 22 mg of gentamicin by IM injection. The drug is available
in 20 mg/2 mL. How many milliliters should be administered?
A. 1.8
B. 2.0
C. 2.4
D. 2.2 - ANSWER>>>Correct ANSWER: D
Rationale:
(22 mg/20 mg) × (x mL/2 mL) = 22x = 40x = 2.2 mL
A client with metastatic cancer reports severe continuous pain. Which route
of administration should the nurse use to provide the most effective
continuous analgesia?
A. Oral
B. Intravenous (IV)
D. Transdermal
D. Intramuscular (IM) - ANSWER>>>Correct ANSWER: C
Rationale: Continuous pain is best managed by maintaining a constant
serum drug level. Transdermal drug administration of an analgesic provides
around-the-clock, controlled release of the medication that is absorbed
through intact skin into the bloodstream to provide continuous pain relief.
Option A is convenient, but gastrointestinal variables affect the absorption
rate of the drug, its onset and intensity, and duration of response and
,requires repeated doses around the clock. Option B provides immediate
action because the drug is infused directly into the bloodstream and is
quickly metabolized, and repeated IV doses are required to maintain a
continuous blood level. Option D requires repeated injections at regular
intervals, which are uncomfortable, and absorption rates vary between
muscle sites.
Minocycline, 50 mg PO every 8 hours, is prescribed for an adolescent girl
diagnosed with acne. The nurse discusses self-care with the client while she
is taking the medication. Which teaching points should be included in the
discussion? (Select all that apply.)
A. Report vaginal itching or discharge
B. Take the medication at 0800, 1500, and 2200 hours
C. Protect skin from natural and artificial UV light
D. Avoid drinking until response to medication is known
E. Take with an antacid tablet to prevent nausea
F. use a non-hormonal method of contraception if sexually active -
ANSWER>>>Correct ANSWER: A, C, D, F
Rationale: Adverse effects of tetracyclines include superinfections,
photosensivity, and decreased efficacy of oral contraceptives. Therefore, the
client should report vaginal itching or discharge (A), protect the skin from
UV light (C), and use a non-hormonal method of contraception (F) while on
teh medication. Minocycline is known to cause dizziness and ataxia, so until
the client's response to the medication is known, driving (D) should be
avoided. Tetracyclines should be taken around the clock (B) but exhibit
decreased absorption when taken with antacids, so (E) is contraindicated.
, A 3-year-old boy is admitted to the ED after ingesting an unknown amount
of phenobarbital elixir prescribed for his brother's seizure disorder. Which
nursing intervention should the nurse implement first?
A. Administer syrup of ipecac
B. Take the child's vital signs
C. Draw a blood specimen for a phenobarbital level
D. Teach the mother safe medication storage practices - ANSWER>>>Correct
ANSWER: B
Rationale: Phenobarbital causes respiratory depression, so the priority
intervention is assessment of vital signs. Options A, C, and D are actions that
may be used in the treatment of this child, but they do not have the priority
of option B
Following the administration of sublingual nitroglycerin, which assessment
finding indicates that the medication was effective?
A. Decrease in level of chest pain
B. Clear bilateral breath sounds
C. Increase in blood pressure
D. Increase in urinary output - ANSWER>>>Correct ANSWER: A
Rationale: Nitroglycerin reduces myocardial oxygen consumption, which
decreases ischemia and reduces chest pain. Options B, D, and D are not
expected outcomes of sublingual nitroglycerin.
A client who is receiving chlorpromazine HCl to control is psychotic behavior
also has a prescription for benztropine. When teaching thh client and/or
significant others about these medications, what should the nurse explain
about the use of benztropine in the treatment plan for this client?
A. This medication will reduce the side effects of urinary retention
