HESI ADAPTIVE QUIZ
PHARMACOLOGY EXAM WITH
A client with a partial occlusion of the left common carotid artery is to be discharged while still
receiving warfarin. Which clinical adverse effect should the nurse identify as a reason for the
client to seek medical consultation? Select all that apply.
A. Presence of blood in urine (hematuria).
B. Bruising noted at various stages of healing.
C. Delayed clotting from minor cuts and scrapes.
D. Bleeding from gums when brushing teeth.
E. Vomiting coffee-ground emesis. ( CORRECT ANSWER: ) ANSWER: A, E
[Presence of blood in urine (hematuria).
Vomiting coffee-ground emesis.]
Rationale
Warfarin causes an increase in the prothrombin time and international normalized ratio (INR)
level, leading to an increased risk for bleeding. Any abnormal or prolonged bleeding must be
reported, because it may indicate an excessive level of the drug. Common side effects including
GRADED A+
,bruising, delayed clotting and bleeding gums do not require immediate intervention. However,
hematuria and hemoptysis are evidence of more serious bleeding and require immediate
attention. Coffee-ground emesis is a sign of gastric bleeding. Even though the emesis is not
bright red, it still requires immediate attention by a healthcare provider.
What should the nurse keep in mind when administering a benzodiazepine to a client?
A. The medication can cause rebound insomnia if it is discontinued abruptly.
B. The medication should be administered cautiously for infants less than 6 months old.
C. The medication should be administered in higher dosage if the client becomes incontinent.
D. The medication can cause fewer problems with dependence and abuse than does a
nonbenzodiazepine. ( CORRECT ANSWER: ) ANSWER: A [The medication can cause rebound
insomnia if it is discontinued abruptly.]
Rationale
Benzodiazepine often leads to tolerance and withdrawal; therefore, it can cause rebound
insomnia when discontinued abruptly. Benzodiazepine is contraindicated for infants less than 6
months old. Benzodiazepine should be discontinued if the client becomes incontinent.
Nonbenzodiazepines cause fewer problems with dependence and abuse than do
benzodiazepines.
Which medication requires the nurse to monitor the client for signs of hyperkalemia?
A. Furosemide
B. Metolazone
C. Spironolactone
D. Hydrochlorothiazide ( CORRECT ANSWER: ) ANSWER: C [Spironolactone]
GRADED A+
, Rationale
Spironolactone is a potassium-sparing diuretic; hyperkalemia is an adverse effect. Furosemide,
metolazone, and hydrochlorothiazide generally cause hypokalemia.
A client is taking lithium sodium. The nurse should notify the healthcare provider for which
laboratory value?
A. Negative protein in the urine
B. Prothrombin of 12.0 seconds
C. Blood urea nitrogen (BUN) of 20 mg/dL (7.1 mmol/L)
D. White blood cell (WBC) count of 15,000 mm 3 (15 X 10 9/L) ( CORRECT ANSWER: )
ANSWER: D [White blood cell (WBC) count of 15,000 mm 3 (15 X 10 9/L)]
Rationale
White cell counts can increase with this drug. The expected range of the WBC count is 5000 to
10,000 mm 3 (5-10 X 10 9/L) for a healthy adult. Urinalysis, BUN, and prothrombin are not
necessary, and these are normal values.
A client with an intractable infection is receiving vancomycin. Which laboratory blood test result
should the nurse report?
A. Hematocrit: 45%
B. Calcium: 9.0 mg/dL (2.25 mmol/L)
C. White blood cells (WBC): 10,000 mm 3 (10 X 10 9/L)
D. Blood urea nitrogen (BUN): 30 mg/dL (10.2 mmol/L) ( CORRECT ANSWER: ) ANSWER: D
[Blood urea nitrogen (BUN): 30 mg/dL (10.2 mmol/L)]
Rationale
GRADED A+
PHARMACOLOGY EXAM WITH
A client with a partial occlusion of the left common carotid artery is to be discharged while still
receiving warfarin. Which clinical adverse effect should the nurse identify as a reason for the
client to seek medical consultation? Select all that apply.
A. Presence of blood in urine (hematuria).
B. Bruising noted at various stages of healing.
C. Delayed clotting from minor cuts and scrapes.
D. Bleeding from gums when brushing teeth.
E. Vomiting coffee-ground emesis. ( CORRECT ANSWER: ) ANSWER: A, E
[Presence of blood in urine (hematuria).
Vomiting coffee-ground emesis.]
Rationale
Warfarin causes an increase in the prothrombin time and international normalized ratio (INR)
level, leading to an increased risk for bleeding. Any abnormal or prolonged bleeding must be
reported, because it may indicate an excessive level of the drug. Common side effects including
GRADED A+
,bruising, delayed clotting and bleeding gums do not require immediate intervention. However,
hematuria and hemoptysis are evidence of more serious bleeding and require immediate
attention. Coffee-ground emesis is a sign of gastric bleeding. Even though the emesis is not
bright red, it still requires immediate attention by a healthcare provider.
What should the nurse keep in mind when administering a benzodiazepine to a client?
A. The medication can cause rebound insomnia if it is discontinued abruptly.
B. The medication should be administered cautiously for infants less than 6 months old.
C. The medication should be administered in higher dosage if the client becomes incontinent.
D. The medication can cause fewer problems with dependence and abuse than does a
nonbenzodiazepine. ( CORRECT ANSWER: ) ANSWER: A [The medication can cause rebound
insomnia if it is discontinued abruptly.]
Rationale
Benzodiazepine often leads to tolerance and withdrawal; therefore, it can cause rebound
insomnia when discontinued abruptly. Benzodiazepine is contraindicated for infants less than 6
months old. Benzodiazepine should be discontinued if the client becomes incontinent.
Nonbenzodiazepines cause fewer problems with dependence and abuse than do
benzodiazepines.
Which medication requires the nurse to monitor the client for signs of hyperkalemia?
A. Furosemide
B. Metolazone
C. Spironolactone
D. Hydrochlorothiazide ( CORRECT ANSWER: ) ANSWER: C [Spironolactone]
GRADED A+
, Rationale
Spironolactone is a potassium-sparing diuretic; hyperkalemia is an adverse effect. Furosemide,
metolazone, and hydrochlorothiazide generally cause hypokalemia.
A client is taking lithium sodium. The nurse should notify the healthcare provider for which
laboratory value?
A. Negative protein in the urine
B. Prothrombin of 12.0 seconds
C. Blood urea nitrogen (BUN) of 20 mg/dL (7.1 mmol/L)
D. White blood cell (WBC) count of 15,000 mm 3 (15 X 10 9/L) ( CORRECT ANSWER: )
ANSWER: D [White blood cell (WBC) count of 15,000 mm 3 (15 X 10 9/L)]
Rationale
White cell counts can increase with this drug. The expected range of the WBC count is 5000 to
10,000 mm 3 (5-10 X 10 9/L) for a healthy adult. Urinalysis, BUN, and prothrombin are not
necessary, and these are normal values.
A client with an intractable infection is receiving vancomycin. Which laboratory blood test result
should the nurse report?
A. Hematocrit: 45%
B. Calcium: 9.0 mg/dL (2.25 mmol/L)
C. White blood cells (WBC): 10,000 mm 3 (10 X 10 9/L)
D. Blood urea nitrogen (BUN): 30 mg/dL (10.2 mmol/L) ( CORRECT ANSWER: ) ANSWER: D
[Blood urea nitrogen (BUN): 30 mg/dL (10.2 mmol/L)]
Rationale
GRADED A+
