NURS 2042 Pharm 3 HESI Practice Exam
Questions With Correct Answers
In teaching a client who had a liver transplant about cyclosporine
(Sandimmune), the nurse should encourage the client to report which adverse
response to the healthcare provider?
A. Changes in urine color.
B. Presence of hand tremors.
C. Increasing body hirsutism.
D. Nausea and vomiting. - ANSWER B. Presence of hand tremors.
Rationale:
Neurological complications, such as hand tremors, occur in about 50% of clients
taking cyclosporine and should be reported.
Although this drug can be nephrotoxic, changes in urine color typically does not
occur.
Nausea is a common side effect, but is not usually severe.
The healthcare provider prescribes digitalis (Digoxin) for a client diagnosed with
heart failure. Which intervention should the nurse implement prior to
administering the digoxin?
A. Observe respiratory rate and depth.
B. Assess the serum potassium level.
C. Obtain the client's blood pressure.
D. Monitor the serum glucose level. - ANSWER B. Assess the serum potassium
level.
Rationale:
Hypokalemia (decreased serum potassium) will precipitate digitalis toxicity in
persons receiving digoxin. The nurse should monitor the client's serum
potassium levels. Blood pressure and respiratory rate will not inform the nurse
about potential safety issues with digitalis.
Which drug is used as a palliative treatment for a client with tumor-induced
spinal cord compression?
A) Morphine Sulfate (Duromorph).
,B) Ibuprofen (Advil).
C) Amitriptyline (Amitril).
D) Dexamethasone (Decadron). - ANSWER D) Dexamethasone (Decadron).
Rationale:
Dexamethasone is a palliative treatment modality to manage symptoms related
to compression due to tumor growth (the focus of this question).
Morphine sulphate is an opioid analgesic used in oncology to manage severe or
intractable pain.
Ibuprofen, a nonsteroidal antiinflammatory drug (NSAID), provides relief for mild
to moderate pain, suppression of inflammation, and reduction of fever.
Amitriptyline, a tricyclic antidepressant, is often prescribed for pain related to
neuropathic origin and provides a reduction in opioid dosage.
When assessing an adolescent who recently overdosed on acetaminophen
(Tylenol), it is most important for the nurse to assess for pain in which area of
the body?
A) Flank.
B) Abdomen.
C) Chest.
D) Head. - ANSWER B) Abdomen.
Rationale:
Acetaminophen toxicity can result in liver damage; therefore, it is especially
important for the nurse to assess for pain in the right upper quadrant of the
abdomen, which might indicate liver damage, along with nausea and vomiting.
A client with hyperlipidemia receives a prescription for niacin (Niaspan). Which
client teaching is most important for the nurse to provide?
A) Expected duration of flushing.
B) Symptoms of hyperglycemia.
C) Diets that minimize GI irritation.
D) Comfort measures for pruritus. - ANSWER A) Expected duration of flushing.
Rationale:
Flushing of the face and neck, lasting up to an hour, is a frequent reason for
discontinuing niacin. Inclusion of this effect in client teaching may promote
compliance in taking the medication.
, While nutrition tips and managing pruritus are worthwhile instructions to help
clients minimize or cope with normal side effects associated with niacin,
flushing is intense and causes the most concern for the client.
An adult client has prescriptions for morphine sulfate 2.5 mg IV q6h an ketorolac
(Toradol) 30 mg IV q6h. Which action should the nurse implement?
A) Administer both medications according to the prescription.
B) Hold the ketorolac to prevent an antagonistic effect.
C) Hold the morphine to prevent an additive drug interaction.
D) Contact the healthcare provider to clarify the prescription. - ANSWER A)
Administer both medications according to the prescription.
Rationale: Morphine and ketorolac (Toradol) can be administered concurrently,
and may produce an additive analgesic effect, resulting in the ability to reduce
the dose of morphine, as seen in this prescription. Toradol is an
antiinflammatory analgesic, and does not have an antagonistic effect with
morphine.
A client is taking hydromorphone (Dilaudid) PO q4h at home. Following surgery,
Dilaudid IV q4h PRN and butorphanol tartrate (Stadol) IV q4h PRN are
prescribed for pain. The client received a dose of the Dilaudid IV four hours ago,
and is again requesting pain medication. What intervention should the nurse
implement?
A) Alternate the two medications q4h PRN for pain.
B) Alternate the two medications q2h PRN for pain.
C) Administer only the Dilaudid q4h PRN for pain.
D) Administer only the Stadol q4h PRN for pain. - ANSWER C) Administer only
the Dilaudid q4h PRN for pain.
Rationale:
Dilaudid is an opioid agonist. Stadol is an opioid agonist-antagonist. Use of an
agonist-antagonist for the client who has been receiving opioid agonists may
result in abrupt withdrawal symptoms, and should be avoided.
Which nursing diagnosis is important to include in the plan of care for a client
receiving the angiotensin-2 receptor antagonist (ARB) irbesartan (Avapro)?
A) Fluid volume deficit.
B) Risk for infection.
C) Risk for injury.
D) Impaired sleep patterns. - ANSWER C) Risk for injury.
Rationale:
Questions With Correct Answers
In teaching a client who had a liver transplant about cyclosporine
(Sandimmune), the nurse should encourage the client to report which adverse
response to the healthcare provider?
A. Changes in urine color.
B. Presence of hand tremors.
C. Increasing body hirsutism.
D. Nausea and vomiting. - ANSWER B. Presence of hand tremors.
Rationale:
Neurological complications, such as hand tremors, occur in about 50% of clients
taking cyclosporine and should be reported.
Although this drug can be nephrotoxic, changes in urine color typically does not
occur.
Nausea is a common side effect, but is not usually severe.
The healthcare provider prescribes digitalis (Digoxin) for a client diagnosed with
heart failure. Which intervention should the nurse implement prior to
administering the digoxin?
A. Observe respiratory rate and depth.
B. Assess the serum potassium level.
C. Obtain the client's blood pressure.
D. Monitor the serum glucose level. - ANSWER B. Assess the serum potassium
level.
Rationale:
Hypokalemia (decreased serum potassium) will precipitate digitalis toxicity in
persons receiving digoxin. The nurse should monitor the client's serum
potassium levels. Blood pressure and respiratory rate will not inform the nurse
about potential safety issues with digitalis.
Which drug is used as a palliative treatment for a client with tumor-induced
spinal cord compression?
A) Morphine Sulfate (Duromorph).
,B) Ibuprofen (Advil).
C) Amitriptyline (Amitril).
D) Dexamethasone (Decadron). - ANSWER D) Dexamethasone (Decadron).
Rationale:
Dexamethasone is a palliative treatment modality to manage symptoms related
to compression due to tumor growth (the focus of this question).
Morphine sulphate is an opioid analgesic used in oncology to manage severe or
intractable pain.
Ibuprofen, a nonsteroidal antiinflammatory drug (NSAID), provides relief for mild
to moderate pain, suppression of inflammation, and reduction of fever.
Amitriptyline, a tricyclic antidepressant, is often prescribed for pain related to
neuropathic origin and provides a reduction in opioid dosage.
When assessing an adolescent who recently overdosed on acetaminophen
(Tylenol), it is most important for the nurse to assess for pain in which area of
the body?
A) Flank.
B) Abdomen.
C) Chest.
D) Head. - ANSWER B) Abdomen.
Rationale:
Acetaminophen toxicity can result in liver damage; therefore, it is especially
important for the nurse to assess for pain in the right upper quadrant of the
abdomen, which might indicate liver damage, along with nausea and vomiting.
A client with hyperlipidemia receives a prescription for niacin (Niaspan). Which
client teaching is most important for the nurse to provide?
A) Expected duration of flushing.
B) Symptoms of hyperglycemia.
C) Diets that minimize GI irritation.
D) Comfort measures for pruritus. - ANSWER A) Expected duration of flushing.
Rationale:
Flushing of the face and neck, lasting up to an hour, is a frequent reason for
discontinuing niacin. Inclusion of this effect in client teaching may promote
compliance in taking the medication.
, While nutrition tips and managing pruritus are worthwhile instructions to help
clients minimize or cope with normal side effects associated with niacin,
flushing is intense and causes the most concern for the client.
An adult client has prescriptions for morphine sulfate 2.5 mg IV q6h an ketorolac
(Toradol) 30 mg IV q6h. Which action should the nurse implement?
A) Administer both medications according to the prescription.
B) Hold the ketorolac to prevent an antagonistic effect.
C) Hold the morphine to prevent an additive drug interaction.
D) Contact the healthcare provider to clarify the prescription. - ANSWER A)
Administer both medications according to the prescription.
Rationale: Morphine and ketorolac (Toradol) can be administered concurrently,
and may produce an additive analgesic effect, resulting in the ability to reduce
the dose of morphine, as seen in this prescription. Toradol is an
antiinflammatory analgesic, and does not have an antagonistic effect with
morphine.
A client is taking hydromorphone (Dilaudid) PO q4h at home. Following surgery,
Dilaudid IV q4h PRN and butorphanol tartrate (Stadol) IV q4h PRN are
prescribed for pain. The client received a dose of the Dilaudid IV four hours ago,
and is again requesting pain medication. What intervention should the nurse
implement?
A) Alternate the two medications q4h PRN for pain.
B) Alternate the two medications q2h PRN for pain.
C) Administer only the Dilaudid q4h PRN for pain.
D) Administer only the Stadol q4h PRN for pain. - ANSWER C) Administer only
the Dilaudid q4h PRN for pain.
Rationale:
Dilaudid is an opioid agonist. Stadol is an opioid agonist-antagonist. Use of an
agonist-antagonist for the client who has been receiving opioid agonists may
result in abrupt withdrawal symptoms, and should be avoided.
Which nursing diagnosis is important to include in the plan of care for a client
receiving the angiotensin-2 receptor antagonist (ARB) irbesartan (Avapro)?
A) Fluid volume deficit.
B) Risk for infection.
C) Risk for injury.
D) Impaired sleep patterns. - ANSWER C) Risk for injury.
Rationale:
