PHARMACOLOGY HESI COMPREHENSIVE REVIEW FOR
THE NCLEX-PN EXAM, 6TH EDITION STUDY QUESTIONS
AND VERIFIED ANSWERS AND RATIONALE LATEST
UPDATE ALREADY GRADED A+
A client has been diagnosed with open-angle glaucoma. The health care provider
prescribes pilocarpine 1% eye drops. The nurse explains that which action of this
drug makes it a useful treatment for the client's condition?
a. The production of aqueous humor in the eyes is decreased.
b. Ciliary muscles are paralyzed to decrease accommodation.
c. Bilateral mydriasis with cycloplegia is accomplished.
d. The ciliary muscle contracts increasing the outflow of aqueous humor in the eye.
- ANS... -d. The ciliary muscle contracts increasing the outflow of aqueous humor
in the eye.
Rationale:
Pilocarpine, a cholinergic agent, causes pupillary constriction (miosis), which
facilitates outflow of aqueous humor, causing a decrease in intraocular pressure.
An immobile client is prescribed dalteparin subcutaneously and has been receiving
the medication for 5 days. Which finding indicates that the PN should hold the
prescribed dose?
a. Tachypnea
b. Guaiac-positive stool
c. Dependent pitting edema
d. Multiple small abdominal bruises - ANS... -b. Guaiac-positive stool
Rationale:
Dalteparin is a low-molecular-weight heparin (LMWH) anticoagulant used to
prevent DVT in the at-risk client. If the client develops overt signs of bleeding
such as guaiac-positive stool while receiving an anticoagulant, the medication
should be held and coagulation studies completed.
A client who is taking hydrochlorothiazide is admitted to the hospital and is
experiencing muscle weakness and cramps. Which condition should the practical
nurse suspect is causing these changes?
a. Hypolipidemia
b. Hypermagnesemia
,c. Hyperchloremia
d. Hyponatremia - ANS... -d. Hyponatremia
Rationale:
Hydrochlorothiazide acts on the distal tubule and ascending limb of loop of Henle
by increasing excretion of water, sodium, chloride, and potassium. The signs and
symptoms of hyponatremia include muscle weakness and cramps.
A client diagnosed with asthma is prescribed methylprednisolone 40 mg IV daily.
Which laboratory test results should the practical nurse closely monitor for
increased values?
a. Serum glucose
b. Serum calcium
c. Red blood cells
d. Serum potassium - ANS... -a. Serum glucose
Rationale:
Methylprednisolone is a corticosteroid with glucocorticoid and mineralocorticoid
actions. These effects can increase a client's glucose levels, which can lead to
hyperglycemia.
A practical nurse is getting ready to administer digoxin to a client. Which
assessment finding would require the nurse to hold the medication?
a. Irregular apical pulse rhythm
b. Apical pulse rate of 50 beats/min
c. Apical pulse heard best at the pulmonic site
d. Presence of a systolic heart murmur - ANS... -b. Apical pulse rate of 50
beats/min
Rationale:
Digoxin slows the contractions of the heart. Bradycardia is a late sign of toxicity.
Therefore, the practical nurse (PN) must always assess the apical pulse for 1
minute to determine that the rate is 60 beats/min or greater. If the apical pulse is
less than 60 beats /min, the PN should not administer the medication and notify the
health care provider.
A 78-year-old client with congestive heart failure (CHF) receives digoxin 0.25 mg
PO daily. Which observation by the nurse indicates that the medication has been
effective?
a. Systolic blood pressure readings range from 120 to 130 mm Hg
b. Clear breath sounds bilaterally
c. Jugular venous distention present with supine positioning
d. Radial pulse volume of +4 bilaterally - ANS... -b. Clear breath sounds bilaterally
,Rationale:
Digoxin is a cardiac glycoside, which increases force of the heart contractions and
decreases heart rate, which in turn increases cardiac output. Clear breath sounds
bilaterally indicates that the medication was effective in increasing the cardiac
output thus preventing pulmonary edema.
A client has been taking lithium carbonate to treat symptoms of the manic phase of
bipolar disorder. The nurse is monitoring for which early manifestation of lithium
toxicity?
a. Fever
b. Diarrhea
c. Weight loss
d. Hypernatremia - ANS... -b. Diarrhea
Rationale:
The nurse is monitoring for diarrhea, an early manifestation of lithium toxicity.
Fever is not associated with lithium toxicity. The client may gain weight when
taking lithium. Hyponatremia can increase lithium levels; lithium does not cause
hypernatremia.
A client diagnosed with a urinary tract infection has been prescribed
phenazopyridine. Which data would indicate to the practical nurse that the
therapeutic outcome has been achieved?
a. White blood cell count is 5000/mm3.
b. Urine is a bright yellow and without sediment.
c. Client denies pain when voiding.
d. Urine culture is negative for bacterial growth. - ANS... -c. Client denies pain
when voiding.
Rationale:
Phenazopyridine is a urinary analgesic that relieves the symptoms of UTI but does
not treat the underlying cause. One of the side effects of phenazopyridine is that it
changes the color of the urine to a bright yellow, but that is not a therapeutic effect.
A client who received a prescription for cyclosporine ophthalmic emulsion for dry
eyes asks the practical nurse (PN) if it is safe to continue using artificial tears.
What information should the PN provide?
a. Avoid the use of artificial tears because they decrease the efficacy of
cyclosporine.
b. Discontinue the use of both products if transient blurring occurs after
administration.
, c. Allow a 15-minute interval between the administration of cyclosporine and
artificial tears.
d. Discontinue the use of cyclosporine and artificial tears when tear production
reaches a normal level. - ANS... -c. Allow a 15-minute interval between the
administration of cyclosporine and artificial tears.
Rationale:
Cyclosporine, an ophthalmic emulsion which increases tear production, may be
used in conjunction with artificial tears as long as the products are administered 15
minutes apart. Transient blurring after administration is a side effect of
cyclosporine and does not necessitate discontinuation of the medication. After tear
production is increased, artificial tears may be stopped, but discontinuing
cyclosporine will result in a decrease in tear production.
A first-day postoperative client vomits 30 minutes after receiving a dose of
hydromorphone. What initial intervention is best for the practical nurse (PN) to
implement?
a. Obtain a prescription for nasogastric intubation.
b. Administer a prn dose of ondansetron.
c. Reduce the next scheduled dose of hydromorphone.
d. Assess the client's abdomen and bowel sounds. - ANS... -b. Administer a prn
dose of ondansetron.
Rationale:
Because the emesis appears to be directly related to the administration of the opiate
analgesic, the first action should be to reduce the client's nausea with the
administration of the ondansetron, which is an antiemetic.
A client has been prescribed losartan. Which change in data indicates to the
practical nurse (PN) that the desired effect of this medication has been achieved?
a. Dependent edema reduced from +3 to +1.
b. Serum HDL increased from 35 to 55 mg/dL.
c. Pulse rate reduced from 150 to 90 beats/min.
d. Blood pressure reduced from 160/90 to 130/80 mm Hg. - ANS... -d. Blood
pressure reduced from 160/90 to 130/80 mm Hg.
Rationale:
Losartan is prescribed for the treatment of hypertension. The desired effect is a
decrease in blood pressure.
A child is admitted to the emergency department for accidental ingestion of a
poison. The practical nurse (PN) should know that inducing vomiting is
recommended for which child?
THE NCLEX-PN EXAM, 6TH EDITION STUDY QUESTIONS
AND VERIFIED ANSWERS AND RATIONALE LATEST
UPDATE ALREADY GRADED A+
A client has been diagnosed with open-angle glaucoma. The health care provider
prescribes pilocarpine 1% eye drops. The nurse explains that which action of this
drug makes it a useful treatment for the client's condition?
a. The production of aqueous humor in the eyes is decreased.
b. Ciliary muscles are paralyzed to decrease accommodation.
c. Bilateral mydriasis with cycloplegia is accomplished.
d. The ciliary muscle contracts increasing the outflow of aqueous humor in the eye.
- ANS... -d. The ciliary muscle contracts increasing the outflow of aqueous humor
in the eye.
Rationale:
Pilocarpine, a cholinergic agent, causes pupillary constriction (miosis), which
facilitates outflow of aqueous humor, causing a decrease in intraocular pressure.
An immobile client is prescribed dalteparin subcutaneously and has been receiving
the medication for 5 days. Which finding indicates that the PN should hold the
prescribed dose?
a. Tachypnea
b. Guaiac-positive stool
c. Dependent pitting edema
d. Multiple small abdominal bruises - ANS... -b. Guaiac-positive stool
Rationale:
Dalteparin is a low-molecular-weight heparin (LMWH) anticoagulant used to
prevent DVT in the at-risk client. If the client develops overt signs of bleeding
such as guaiac-positive stool while receiving an anticoagulant, the medication
should be held and coagulation studies completed.
A client who is taking hydrochlorothiazide is admitted to the hospital and is
experiencing muscle weakness and cramps. Which condition should the practical
nurse suspect is causing these changes?
a. Hypolipidemia
b. Hypermagnesemia
,c. Hyperchloremia
d. Hyponatremia - ANS... -d. Hyponatremia
Rationale:
Hydrochlorothiazide acts on the distal tubule and ascending limb of loop of Henle
by increasing excretion of water, sodium, chloride, and potassium. The signs and
symptoms of hyponatremia include muscle weakness and cramps.
A client diagnosed with asthma is prescribed methylprednisolone 40 mg IV daily.
Which laboratory test results should the practical nurse closely monitor for
increased values?
a. Serum glucose
b. Serum calcium
c. Red blood cells
d. Serum potassium - ANS... -a. Serum glucose
Rationale:
Methylprednisolone is a corticosteroid with glucocorticoid and mineralocorticoid
actions. These effects can increase a client's glucose levels, which can lead to
hyperglycemia.
A practical nurse is getting ready to administer digoxin to a client. Which
assessment finding would require the nurse to hold the medication?
a. Irregular apical pulse rhythm
b. Apical pulse rate of 50 beats/min
c. Apical pulse heard best at the pulmonic site
d. Presence of a systolic heart murmur - ANS... -b. Apical pulse rate of 50
beats/min
Rationale:
Digoxin slows the contractions of the heart. Bradycardia is a late sign of toxicity.
Therefore, the practical nurse (PN) must always assess the apical pulse for 1
minute to determine that the rate is 60 beats/min or greater. If the apical pulse is
less than 60 beats /min, the PN should not administer the medication and notify the
health care provider.
A 78-year-old client with congestive heart failure (CHF) receives digoxin 0.25 mg
PO daily. Which observation by the nurse indicates that the medication has been
effective?
a. Systolic blood pressure readings range from 120 to 130 mm Hg
b. Clear breath sounds bilaterally
c. Jugular venous distention present with supine positioning
d. Radial pulse volume of +4 bilaterally - ANS... -b. Clear breath sounds bilaterally
,Rationale:
Digoxin is a cardiac glycoside, which increases force of the heart contractions and
decreases heart rate, which in turn increases cardiac output. Clear breath sounds
bilaterally indicates that the medication was effective in increasing the cardiac
output thus preventing pulmonary edema.
A client has been taking lithium carbonate to treat symptoms of the manic phase of
bipolar disorder. The nurse is monitoring for which early manifestation of lithium
toxicity?
a. Fever
b. Diarrhea
c. Weight loss
d. Hypernatremia - ANS... -b. Diarrhea
Rationale:
The nurse is monitoring for diarrhea, an early manifestation of lithium toxicity.
Fever is not associated with lithium toxicity. The client may gain weight when
taking lithium. Hyponatremia can increase lithium levels; lithium does not cause
hypernatremia.
A client diagnosed with a urinary tract infection has been prescribed
phenazopyridine. Which data would indicate to the practical nurse that the
therapeutic outcome has been achieved?
a. White blood cell count is 5000/mm3.
b. Urine is a bright yellow and without sediment.
c. Client denies pain when voiding.
d. Urine culture is negative for bacterial growth. - ANS... -c. Client denies pain
when voiding.
Rationale:
Phenazopyridine is a urinary analgesic that relieves the symptoms of UTI but does
not treat the underlying cause. One of the side effects of phenazopyridine is that it
changes the color of the urine to a bright yellow, but that is not a therapeutic effect.
A client who received a prescription for cyclosporine ophthalmic emulsion for dry
eyes asks the practical nurse (PN) if it is safe to continue using artificial tears.
What information should the PN provide?
a. Avoid the use of artificial tears because they decrease the efficacy of
cyclosporine.
b. Discontinue the use of both products if transient blurring occurs after
administration.
, c. Allow a 15-minute interval between the administration of cyclosporine and
artificial tears.
d. Discontinue the use of cyclosporine and artificial tears when tear production
reaches a normal level. - ANS... -c. Allow a 15-minute interval between the
administration of cyclosporine and artificial tears.
Rationale:
Cyclosporine, an ophthalmic emulsion which increases tear production, may be
used in conjunction with artificial tears as long as the products are administered 15
minutes apart. Transient blurring after administration is a side effect of
cyclosporine and does not necessitate discontinuation of the medication. After tear
production is increased, artificial tears may be stopped, but discontinuing
cyclosporine will result in a decrease in tear production.
A first-day postoperative client vomits 30 minutes after receiving a dose of
hydromorphone. What initial intervention is best for the practical nurse (PN) to
implement?
a. Obtain a prescription for nasogastric intubation.
b. Administer a prn dose of ondansetron.
c. Reduce the next scheduled dose of hydromorphone.
d. Assess the client's abdomen and bowel sounds. - ANS... -b. Administer a prn
dose of ondansetron.
Rationale:
Because the emesis appears to be directly related to the administration of the opiate
analgesic, the first action should be to reduce the client's nausea with the
administration of the ondansetron, which is an antiemetic.
A client has been prescribed losartan. Which change in data indicates to the
practical nurse (PN) that the desired effect of this medication has been achieved?
a. Dependent edema reduced from +3 to +1.
b. Serum HDL increased from 35 to 55 mg/dL.
c. Pulse rate reduced from 150 to 90 beats/min.
d. Blood pressure reduced from 160/90 to 130/80 mm Hg. - ANS... -d. Blood
pressure reduced from 160/90 to 130/80 mm Hg.
Rationale:
Losartan is prescribed for the treatment of hypertension. The desired effect is a
decrease in blood pressure.
A child is admitted to the emergency department for accidental ingestion of a
poison. The practical nurse (PN) should know that inducing vomiting is
recommended for which child?
