HESI PRACTICE EXAM 3
PHARMACOLOGY
A client with mild parkinsonism is started on oral amantadine (Symmetrel).
What statement accurately describes the action of this medication?
dopamine in central nervous system is increased
A 52-year-old client is admitted to the hospital for possible duodenal ulcers.
The healthcare provider prescribes ranitidine hydrochloride (Zantac) 150 mg
BID PO. Which data would indicate that this medication is effective?
Within 4 hours after meals, the client denies having pain.
A 78-year-old client with congestive heart failure receives the cardiac glycoside
digoxin (Lanoxin) 0.25 mg PO daily. Which observation by the nurse indicates that
the medication has been effective?
Clear breath sounds anteriorly and posteriorly
Minocycline (Minocin) 50 mg 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.)
Report vaginal itching or discharge.
Protect skin from natural and artificial ultraviolet light.
Avoid driving until response to medication is known.
Use a nonhormonal method of contraception if sexually active.
The nurse is assessing a stuporous client in the emergency department who is
suspected of overdosing with opioids. Which agent should the nurse prepare to
administer if the client becomes comatose?
Naloxone hydrochloride (Narcan)
,The healthcare provider prescribes captopril (Capoten) 37.5 mg. The medication is
available in 25 mg tablets. What should the nurse administer?
1½ tablets
A client who is HIV positive is receiving epoetin (Epogen) for management of
anemia secondary to zidovudine (AZT) therapy. Which laboratory finding is most
important for the nurse to report to the healthcare provider?
Hematocrit (HCT) of 58%
A 75-year-old male client taking hydrochlorothiazide (HCTZ) is admitted to the
hospital having "palpitations" and "skipped heart beats." What is the most likely
cause of these symptoms given the client's medication history?
Hypokalemia
Which parameter is most important for the nurse to check prior to administering a
subcutaneous injection of heparin?
A. Heart rate
B. Urinary output
C. Activated partial thromboplastin time (aPTT)
D. Prothrombin time (PT) and international normalized ratio (INR)
C. Activated partial thromboplastin time, commonly referred to as aPTT
Rationale:
The laboratory value that measures heparin's therapeutic anticoagulation time is
the aPTT (C). (A) should be checked before the administration of digoxin. (B) is
valuable information but not a parameter measured for heparin therapy. (D) is
evaluated during anticoagulation therapy using sodium warfarin (Coumadin).
A client is prescribed a cholinesterase inhibitor, and a family member asks the
nurse how this medication works. Which pharmacophysiologic explanation should
the nurse use to describe this class of drug?
Improves nerve impulse transmission
,In developing a nursing care plan for a 9-month-old infant with cystic fibrosis, the
nurse writes a nursing diagnosis of Alteration in nutrition: less than body
requirements, related to inadequate digestion of nutrients. Which intervention
would best meet this child's needs?
Give pancrelipase (Cotazym-S) capsule mixed with applesauce before each meal.
When providing client teaching about the administration of methylphenidate
(Ritalin) to the mother of a child diagnosed with attention-deficit/hyperactive
disorder (ADHD), what instruction should the nurse include in the teaching plan?
Offer the child the medication before eating breakfast and after eating lunch.
Alteration of which laboratory finding represents achievement of a therapeutic
goal for heparin administration?
Partial thromboplastin time
The charge nurse is reviewing the admission history and physical data for four
clients newly admitted to the unit. Which client is at greatest 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 upper respiratory tract
infection A. 75-year-old woman with liver disease
Rationale:
Impaired hepatic metabolic pathways for drug and chemical degradation place (C)
at greatest risk for adverse reactions to medications based on advancing age and
liver disease. (A and D) have no predisposing factors, such as genetics,
pathophysiologic dysfunction, or drug allergies, that would increase the risk for
cumulative toxicity or adverse drug reactions. (B) is at risk for dose-related
adverse reactions but is at less risk than (C).
, The healthcare provider prescribes ipratropium (Atrovent) for a client. An allergic
reaction to what other medication would cause the nurse to question the
prescription for Atrovent?
Atropine sulfate (Atropine)
68-year-old client has been diagnosed with open-angle glaucoma. The healthcare
provider prescribes pilocarpine (Isopto Carpine) eye drops. What action of this
drug makes it a useful treatment for the client's condition?
The outflow of aqueous humor in the eyes is increased.
The nurse is preparing to apply a surface anesthetic agent for a client. Which
action should the nurse implement to reduce the risk of systemic absorption?
A. Apply the anesthetic to mucous membranes.
B. Limit the area of application to inflamed areas.
C. Avoid abraded skin areas when applying the anesthetic.
D. Spread the topical agent over a large surface area.
C. Avoid abraded skin areas when applying the anesthetic
Rationale:
To minimize systemic absorption of topical anesthetics, the anesthetic agent
should be applied to the smallest surface area of intact skin (C). Application to the
mucous membranes poses the greatest risk (A) of systemic absorption because
absorption occurs more readily through mucous membranes than through the
skin. Inflamed areas generally have an increased blood supply, which increases
the risk of systemic absorption, so (B) should be avoided. A large surface area
increases the amount of topical drug that is available for transdermal absorption,
so the smallest area should be covered, not (D).
The healthcare provider prescribes the anticonvulsant carbamazepine
(Tegretol) for a client with a seizure disorder. The nurse should instruct the
client to notify the healthcare provider if which condition occurs?
Experiences a sore throat
PHARMACOLOGY
A client with mild parkinsonism is started on oral amantadine (Symmetrel).
What statement accurately describes the action of this medication?
dopamine in central nervous system is increased
A 52-year-old client is admitted to the hospital for possible duodenal ulcers.
The healthcare provider prescribes ranitidine hydrochloride (Zantac) 150 mg
BID PO. Which data would indicate that this medication is effective?
Within 4 hours after meals, the client denies having pain.
A 78-year-old client with congestive heart failure receives the cardiac glycoside
digoxin (Lanoxin) 0.25 mg PO daily. Which observation by the nurse indicates that
the medication has been effective?
Clear breath sounds anteriorly and posteriorly
Minocycline (Minocin) 50 mg 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.)
Report vaginal itching or discharge.
Protect skin from natural and artificial ultraviolet light.
Avoid driving until response to medication is known.
Use a nonhormonal method of contraception if sexually active.
The nurse is assessing a stuporous client in the emergency department who is
suspected of overdosing with opioids. Which agent should the nurse prepare to
administer if the client becomes comatose?
Naloxone hydrochloride (Narcan)
,The healthcare provider prescribes captopril (Capoten) 37.5 mg. The medication is
available in 25 mg tablets. What should the nurse administer?
1½ tablets
A client who is HIV positive is receiving epoetin (Epogen) for management of
anemia secondary to zidovudine (AZT) therapy. Which laboratory finding is most
important for the nurse to report to the healthcare provider?
Hematocrit (HCT) of 58%
A 75-year-old male client taking hydrochlorothiazide (HCTZ) is admitted to the
hospital having "palpitations" and "skipped heart beats." What is the most likely
cause of these symptoms given the client's medication history?
Hypokalemia
Which parameter is most important for the nurse to check prior to administering a
subcutaneous injection of heparin?
A. Heart rate
B. Urinary output
C. Activated partial thromboplastin time (aPTT)
D. Prothrombin time (PT) and international normalized ratio (INR)
C. Activated partial thromboplastin time, commonly referred to as aPTT
Rationale:
The laboratory value that measures heparin's therapeutic anticoagulation time is
the aPTT (C). (A) should be checked before the administration of digoxin. (B) is
valuable information but not a parameter measured for heparin therapy. (D) is
evaluated during anticoagulation therapy using sodium warfarin (Coumadin).
A client is prescribed a cholinesterase inhibitor, and a family member asks the
nurse how this medication works. Which pharmacophysiologic explanation should
the nurse use to describe this class of drug?
Improves nerve impulse transmission
,In developing a nursing care plan for a 9-month-old infant with cystic fibrosis, the
nurse writes a nursing diagnosis of Alteration in nutrition: less than body
requirements, related to inadequate digestion of nutrients. Which intervention
would best meet this child's needs?
Give pancrelipase (Cotazym-S) capsule mixed with applesauce before each meal.
When providing client teaching about the administration of methylphenidate
(Ritalin) to the mother of a child diagnosed with attention-deficit/hyperactive
disorder (ADHD), what instruction should the nurse include in the teaching plan?
Offer the child the medication before eating breakfast and after eating lunch.
Alteration of which laboratory finding represents achievement of a therapeutic
goal for heparin administration?
Partial thromboplastin time
The charge nurse is reviewing the admission history and physical data for four
clients newly admitted to the unit. Which client is at greatest 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 upper respiratory tract
infection A. 75-year-old woman with liver disease
Rationale:
Impaired hepatic metabolic pathways for drug and chemical degradation place (C)
at greatest risk for adverse reactions to medications based on advancing age and
liver disease. (A and D) have no predisposing factors, such as genetics,
pathophysiologic dysfunction, or drug allergies, that would increase the risk for
cumulative toxicity or adverse drug reactions. (B) is at risk for dose-related
adverse reactions but is at less risk than (C).
, The healthcare provider prescribes ipratropium (Atrovent) for a client. An allergic
reaction to what other medication would cause the nurse to question the
prescription for Atrovent?
Atropine sulfate (Atropine)
68-year-old client has been diagnosed with open-angle glaucoma. The healthcare
provider prescribes pilocarpine (Isopto Carpine) eye drops. What action of this
drug makes it a useful treatment for the client's condition?
The outflow of aqueous humor in the eyes is increased.
The nurse is preparing to apply a surface anesthetic agent for a client. Which
action should the nurse implement to reduce the risk of systemic absorption?
A. Apply the anesthetic to mucous membranes.
B. Limit the area of application to inflamed areas.
C. Avoid abraded skin areas when applying the anesthetic.
D. Spread the topical agent over a large surface area.
C. Avoid abraded skin areas when applying the anesthetic
Rationale:
To minimize systemic absorption of topical anesthetics, the anesthetic agent
should be applied to the smallest surface area of intact skin (C). Application to the
mucous membranes poses the greatest risk (A) of systemic absorption because
absorption occurs more readily through mucous membranes than through the
skin. Inflamed areas generally have an increased blood supply, which increases
the risk of systemic absorption, so (B) should be avoided. A large surface area
increases the amount of topical drug that is available for transdermal absorption,
so the smallest area should be covered, not (D).
The healthcare provider prescribes the anticonvulsant carbamazepine
(Tegretol) for a client with a seizure disorder. The nurse should instruct the
client to notify the healthcare provider if which condition occurs?
Experiences a sore throat
