HESI PHARMACOLOGY V1 EXAM
1) A nurse is caring for a client with hyperparathyroidism and notes that
the client's serum calcium level is 13 mg/dL. Which medication should the
nurse prepare to administer as prescribed to the client?
1. Calcium chloride
1. Calcium gluconate
2. Calcitonin (Miacalcin)
3. Large doses of vitamin D
3. Calcitonin (Miacalcin) Rationale:
The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is
experiencing hypercalcemia. Calcium gluconate and calcium chloride
are medications used for the treatment of tetany, which occurs as a
result of acute hypocalcemia. In hypercalcemia, large doses of vitamin
D need to be avoided. Calcitonin, a thyroid hormone, decreases the
plasma calcium level by inhibiting bone resorption and lowering the
serum calcium concentration.
2.) Oral iron supplements are prescribed for a 6-year-old child with iron
deficiency anemia. The nurse instructs the mother to administer the iron
with which best food item?
1. Milk
1. Water
2. Apple juice
3. Orange juice
4. Orange juice Rationale:
Vitamin C increases the absorption of iron by the body. The mother should
be instructed to administer the medication with a citrus fruit or a juice
that is high in vitamin C. Milk may affect absorption of the iron. Water will
not assist in absorption. Orange juice contains a greater amount of
vitamin C than apple juice.
3.) Salicylic acid is prescribed for a client with a diagnosis of psoriasis.
The nurse monitors the client, knowing that which of the following would
indicate the presence of systemic toxicity from this medication?
1. Tinnitus
1. Diarrhea
2. Constipation
3. Decreased respirations
,1. Tinnitus Rationale:
Salicylic acid is absorbed readily through the skin, and systemic toxicity
(salicylism) can result. Symptoms include tinnitus, dizziness, hyperpnea,
and psychological disturbances. Constipation and diarrhea are not
associated with salicylism.
4.) 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:
1. Immediately before swimming
1. 15 minutes before exposure to the sun
2. Immediately before exposure to the sun
3. At least 30 minutes before exposure to the sun
4. At least 30 minutes before exposure to the sun
Rationale:
Sunscreens are most effective when applied at least 30 minutes before
exposure to the sun so that they can penetrate the skin. All sunscreens
should be reapplied after swimming or sweating.
5.) Mafenide acetate (Sulfamylon) is prescribed for the client with a burn
injury. When applying the medication, the client complains of local
discomfort and burning. Which of the following is the most appropriate
nursing action?
1. Notifying the registered nurse
1. Discontinuing the medication
2. Informing the client that this is normal
3. Applying a thinner film than prescribed to the burn site 3.
Informing the client that this is normal
Rationale:
Mafenide acetate is bacteriostatic for gram-negative and gram-positive
organisms and is used to treat burns to reduce bacteria present in
avascular tissues. The client should be informed that the medication will
cause local discomfort and burning and that this is a normal reaction;
therefore options 1, 2, and 4 are incorrect
6.) The burn client is receiving treatments of topical mafenide acetate
(Sulfamylon) to the site of injury. The nurse monitors the client, knowing
that which of the following indicates that a systemic effect has
occurred?
1.Hyperventilation
2.Elevated blood
,pressure 3.Local pain at
the burn site
4.Local rash at the burn site
1.Hyperventilation
Rationale:
Mafenide acetate is a carbonic anhydrase inhibitor and can suppress
renal excretion of acid, thereby causing acidosis. Clients receiving this
treatment should be monitored for signs of an acid-base imbalance
(hyperventilation). If this occurs, the medication should be discontinued
for 1 to 2 days. Options 3 and 4 describe local rather than systemic
effects. An elevated blood pressure may be expected from the pain that
occurs with a burn injury.
7.) 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?
1. Platelet count
1. Triglyceride level
2. Complete blood count
3. White blood cell count
2. Triglyceride level Rationale:
Isotretinoin can elevate triglyceride levels. Blood triglyceride levels should
be measured before treatment and periodically thereafter until the effect
on the triglycerides has been evaluated. Options 1, 3, and 4 do not need
to be monitored specifically during this treatment.
8.) A client with severe acne is seen in the clinic and the health care
provider (HCP) prescribes isotretinoin. The nurse reviews the client's
medication record and would contact the (HCP) if the client is taking
which medication?
1. Vitamin A
1. Digoxin (Lanoxin)
2. Furosemide (Lasix)
3. Phenytoin (Dilantin)
1. Vitamin A Rationale:
Isotretinoin is a metabolite of vitamin A and can produce generalized
intensification of isotretinoin toxicity. Because of the potential for
increased toxicity, vitamin A supplements should be discontinued before
isotretinoin therapy. Options 2, 3, and 4 are not contraindicated with the
use of isotretinoin.
, 9.) The nurse is applying a topical corticosteroid to a client with eczema.
The nurse would monitor for the potential for increased systemic
absorption of the medication if the medication were being applied to
which of the following body areas?
1. Back
1. Axilla
2. Soles of the feet
3. Palms of the hands
2. Axilla Rationale:
Topical corticosteroids can be absorbed into the systemic circulation.
Absorption is higher from regions where the skin is especially permeable
(scalp, axilla, face, eyelids, neck, perineum, genitalia), and lower from
regions in which permeability is poor (back, palms, soles).
10.) The clinic nurse is performing an admission assessment on a client.
The nurse notes that the client is taking azelaic acid (Azelex). Because of
the medication prescription, the nurse would suspect that the client is
being treated for:
1. Acne
1. Eczema
2. Hair loss
3. Herpes simplex
1. Acne Rationale:
Azelaic acid is a topical medication used to treat mild to moderate
acne. The acid appears to work by suppressing the growth of
Propionibacterium acnes and decreasing the proliferation of
keratinocytes. Options 2, 3, and 4 are incorrect.
11.) The health care provider has prescribed silver sulfadiazine
(Silvadene) for the client with a partial-thickness burn, which has cultured
positive for gram-negative bacteria. The nurse is reinforcing information
to the client about the medication. Which statement made by the client
indicates a lack of understanding about the treatments?
1. "The medication is an antibacterial."
1. "The medication will help heal the burn."
2. "The medication will permanently stain my skin."
3. "The medication should be applied directly to the wound."
3. "The medication will permanently stain my skin."
Rationale:
Silver sulfadiazine (Silvadene) is an antibacterial that has a broad
spectrum of activity against gram-negative bacteria, gram-positive
1) A nurse is caring for a client with hyperparathyroidism and notes that
the client's serum calcium level is 13 mg/dL. Which medication should the
nurse prepare to administer as prescribed to the client?
1. Calcium chloride
1. Calcium gluconate
2. Calcitonin (Miacalcin)
3. Large doses of vitamin D
3. Calcitonin (Miacalcin) Rationale:
The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is
experiencing hypercalcemia. Calcium gluconate and calcium chloride
are medications used for the treatment of tetany, which occurs as a
result of acute hypocalcemia. In hypercalcemia, large doses of vitamin
D need to be avoided. Calcitonin, a thyroid hormone, decreases the
plasma calcium level by inhibiting bone resorption and lowering the
serum calcium concentration.
2.) Oral iron supplements are prescribed for a 6-year-old child with iron
deficiency anemia. The nurse instructs the mother to administer the iron
with which best food item?
1. Milk
1. Water
2. Apple juice
3. Orange juice
4. Orange juice Rationale:
Vitamin C increases the absorption of iron by the body. The mother should
be instructed to administer the medication with a citrus fruit or a juice
that is high in vitamin C. Milk may affect absorption of the iron. Water will
not assist in absorption. Orange juice contains a greater amount of
vitamin C than apple juice.
3.) Salicylic acid is prescribed for a client with a diagnosis of psoriasis.
The nurse monitors the client, knowing that which of the following would
indicate the presence of systemic toxicity from this medication?
1. Tinnitus
1. Diarrhea
2. Constipation
3. Decreased respirations
,1. Tinnitus Rationale:
Salicylic acid is absorbed readily through the skin, and systemic toxicity
(salicylism) can result. Symptoms include tinnitus, dizziness, hyperpnea,
and psychological disturbances. Constipation and diarrhea are not
associated with salicylism.
4.) 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:
1. Immediately before swimming
1. 15 minutes before exposure to the sun
2. Immediately before exposure to the sun
3. At least 30 minutes before exposure to the sun
4. At least 30 minutes before exposure to the sun
Rationale:
Sunscreens are most effective when applied at least 30 minutes before
exposure to the sun so that they can penetrate the skin. All sunscreens
should be reapplied after swimming or sweating.
5.) Mafenide acetate (Sulfamylon) is prescribed for the client with a burn
injury. When applying the medication, the client complains of local
discomfort and burning. Which of the following is the most appropriate
nursing action?
1. Notifying the registered nurse
1. Discontinuing the medication
2. Informing the client that this is normal
3. Applying a thinner film than prescribed to the burn site 3.
Informing the client that this is normal
Rationale:
Mafenide acetate is bacteriostatic for gram-negative and gram-positive
organisms and is used to treat burns to reduce bacteria present in
avascular tissues. The client should be informed that the medication will
cause local discomfort and burning and that this is a normal reaction;
therefore options 1, 2, and 4 are incorrect
6.) The burn client is receiving treatments of topical mafenide acetate
(Sulfamylon) to the site of injury. The nurse monitors the client, knowing
that which of the following indicates that a systemic effect has
occurred?
1.Hyperventilation
2.Elevated blood
,pressure 3.Local pain at
the burn site
4.Local rash at the burn site
1.Hyperventilation
Rationale:
Mafenide acetate is a carbonic anhydrase inhibitor and can suppress
renal excretion of acid, thereby causing acidosis. Clients receiving this
treatment should be monitored for signs of an acid-base imbalance
(hyperventilation). If this occurs, the medication should be discontinued
for 1 to 2 days. Options 3 and 4 describe local rather than systemic
effects. An elevated blood pressure may be expected from the pain that
occurs with a burn injury.
7.) 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?
1. Platelet count
1. Triglyceride level
2. Complete blood count
3. White blood cell count
2. Triglyceride level Rationale:
Isotretinoin can elevate triglyceride levels. Blood triglyceride levels should
be measured before treatment and periodically thereafter until the effect
on the triglycerides has been evaluated. Options 1, 3, and 4 do not need
to be monitored specifically during this treatment.
8.) A client with severe acne is seen in the clinic and the health care
provider (HCP) prescribes isotretinoin. The nurse reviews the client's
medication record and would contact the (HCP) if the client is taking
which medication?
1. Vitamin A
1. Digoxin (Lanoxin)
2. Furosemide (Lasix)
3. Phenytoin (Dilantin)
1. Vitamin A Rationale:
Isotretinoin is a metabolite of vitamin A and can produce generalized
intensification of isotretinoin toxicity. Because of the potential for
increased toxicity, vitamin A supplements should be discontinued before
isotretinoin therapy. Options 2, 3, and 4 are not contraindicated with the
use of isotretinoin.
, 9.) The nurse is applying a topical corticosteroid to a client with eczema.
The nurse would monitor for the potential for increased systemic
absorption of the medication if the medication were being applied to
which of the following body areas?
1. Back
1. Axilla
2. Soles of the feet
3. Palms of the hands
2. Axilla Rationale:
Topical corticosteroids can be absorbed into the systemic circulation.
Absorption is higher from regions where the skin is especially permeable
(scalp, axilla, face, eyelids, neck, perineum, genitalia), and lower from
regions in which permeability is poor (back, palms, soles).
10.) The clinic nurse is performing an admission assessment on a client.
The nurse notes that the client is taking azelaic acid (Azelex). Because of
the medication prescription, the nurse would suspect that the client is
being treated for:
1. Acne
1. Eczema
2. Hair loss
3. Herpes simplex
1. Acne Rationale:
Azelaic acid is a topical medication used to treat mild to moderate
acne. The acid appears to work by suppressing the growth of
Propionibacterium acnes and decreasing the proliferation of
keratinocytes. Options 2, 3, and 4 are incorrect.
11.) The health care provider has prescribed silver sulfadiazine
(Silvadene) for the client with a partial-thickness burn, which has cultured
positive for gram-negative bacteria. The nurse is reinforcing information
to the client about the medication. Which statement made by the client
indicates a lack of understanding about the treatments?
1. "The medication is an antibacterial."
1. "The medication will help heal the burn."
2. "The medication will permanently stain my skin."
3. "The medication should be applied directly to the wound."
3. "The medication will permanently stain my skin."
Rationale:
Silver sulfadiazine (Silvadene) is an antibacterial that has a broad
spectrum of activity against gram-negative bacteria, gram-positive
