HESI
HESIPHARMACOLOGY LATEST-
PHARMACOLOGY
1 . A healthcare provider prescribes cephalexin monohydrate (Keflex) for a client with a
postoperativeinfection. It is most important for the nurse to assess for what additional
drug allergy before administering this prescription?
• Penicillins.
• Aminoglycosides.
• Erythromycins.
• Sulfonamides.
A) Penicillins.
Cross-allergies exist between penicillins (A) and cephalosporins, such as cephalexin
monohydrate(Keflex), so checking for penicillin allergy is a wise precaution before
administering this drug.
Ⓒ
• Which nursing intervention is most important when caring for a client receiving
the antimetabolitecytosine arabinoside (Arc-C) for chemotherapy?
• Hydrate the client with IV fluids before and after infusion.
• Assess the client for numbness and tingling of extremities.
• Inspect the client's oral mucosa for ulcerations.
• Monitor the client's urine pH for increased acidity.
C) Inspect the client's oral mucosa for ulcerations.
Cytosine arabinoside (Arc-C) affects the rapidly growing cells of the body, therefore
stomatitis andmucosal ulcerations are key signs of antimetabolite toxicity (C). (A, B,
and D) are not typical interventions associated with the administration of
antimetabolites.
Ⓒ
• When assessing an adolescent who recently overdosed on acetaminophen
(Tylenol), it is mostimportant for the nurse to assess for pain in which area of
the body?
• Flank.
• Abdomen.
• Chest.
,• Head.
B) Abdomen.
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 (B), which might indicate
liver damage. (A, C,and D) are not areas where pain would be anticipated.
Ⓒ
• An adult client is given a prescription for a scopolamine patch (Transderm Scop) to
prevent motionsickness while on a cruise. Which information should the nurse
provide to the client?
• Apply the patch at least 4 hours prior to departure.
• Change the patch every other day while on the cruise.
• Place the patch on a hairless area at the base of the skull.
• Drink no more than 2 alcoholic drinks during the cruise.
A) Apply the patch at least 4 hours prior to departure.
Scopolamine, an anticholinergic agent, is used to prevent motion sickness and has a
peak onset in 6 hours, so the client should be instructed to apply the patch at least 4
hours before departure (A) on the cruise ship. The duration of the transdermal patch is
72 hours, so (B) is not needed. Scolopamine blocks muscarinic receptors in the inner ear
and to the vomiting center, so the best application site of the patchis behind the ear,
not at the base of the skull (C). Anticholinergic medications are CNS depressants, so the
client should be instructed to avoid alcohol (D) while using the patch.
Ⓒ
• The nurse is reviewing the use of the patient-controlled analgesia (PCA) pump with
a client in the immediate postoperative period. The client will receive morphine 1 mg
IV per hour basal rate with 1 mgIV every 15 minutes per PCA to total 5 mg IV maximally
per hour. What assessment has the highest priority before initiating the PCA pump?
• The expiration date on the morphine syringe in the pump.
• The rate and depth of the client's respirations.
• The type of anesthesia used during the surgical procedure.
• The client's subjective and objective signs of pain.
B) The rate and depth of the client's respirations.
,A life-threatening side effect of intravenous administration of morphine sulfate, an
opiate narcotic, is respiratory depression (B). The PCA pump should be stopped and
the healthcare provider notified if theclient's respiratory rate falls below 12 breaths
per minute, and the nurse should anticipate adjustmentsin the client's dosage before
the PCA pump is restarted. (A, C, and D) provide helpful information, but are not as
high a priority as the assessment described in (B).
Ⓒ
• A medication that is classified as a beta-1 agonist is most commonly prescribed for a
client with whichcondition?
• Glaucoma.
• Hypertension.
• Heart failure.
• Asthma.
C) Heart failure.
Beta-1 agonists improve cardiac output by increasing the heart rate and blood
pressure and are indicated in heart failure (C), shock, atrioventricular block
dysrhythmias, and cardiac arrest. Glaucoma
• is managed using adrenergic agents and beta-adrenergic blocking agents. Beta-1
blocking agents are used in the management of hypertension (B). Medications that
stimulate beta-2 receptors in the bronchiare effective for bronchoconstriction in
respiratory disorders, such as asthma (D).
Ⓒ
• A female client with rheumatoid arthritis take ibuprofen (Motrin) 600 mg PO 4
times a day. To prevent gastrointestinal bleeding, misoprostol (Cytotec) 100 mcg PO is
prescribed. Which information ismost important for the nurse to include in client
teaching?
• Use contraception during intercourse.
• Ensure the Cytotec is taken on an empty stomach.
• Encourage oral fluid intake to prevent constipation.
• Take Cytotec 30 minutes prior to Motrin.
A) Use contraception during intercourse.
Cytotec, a synthetic form of a prostaglandin, is classified as pregnancy Category X and
can act as an abortifacient, so the client should be instructed to use contraception
, during intercourse (A) to preventloss of an early pregnancy. (B) is not necessary. A
common side effect of Cytotec is diarrhea, so constipation prevention strategies are
usually not needed (C). Cytotec and Motrin should be taken together (D) to provide
protective properties against gastrointestinal bleeding.
Ⓒ
• A client with heart failure is prescribed spironolactone (Aldactone). Which
information is mostimportant for the nurse to provide to the client about diet
modifications?
• Do not add salt to foods during preparation.
• Refrain for eating foods high in potassium.
• Restrict fluid intake to 1000 ml per day.
• Increase intake of milk and milk products.
B) Refrain for eating foods high in potassium.
Spironolactone (Aldactone), an aldosterone antagonist, is a potassium-sparing diuretic, so a
diet high inpotassium should be avoided (B), including potassium salt substitutes, which can
lead to hyperkalemia.
Although (A) is a common diet modification in heart failure, the risk of hyperkalemia is
more importantwith Aldactone. Restriction of fluids (C) or increasing milk and milk
products (D) are not indicated with this prescription.
Ⓒ
• In evaluating the effects of lactulose (Cephulac), which outcome should
indicate that the drug isperforming as intended?
• An increase in urine output.
• Two or three soft stools per day.
• Watery, diarrhea stools.
• Increased serum bilirubin.
B) Two or three soft stools per day.
Lactulose is administered to reduce blood ammonia by excretion of ammonia through
the stool. Two tothree stools a day indicate that lactulose is performing as intended
(B). (A) would be expected if the patient received a diuretic. (C) would indicate an
overdose of lactulose and is not expected. Lactulose does not affect (D).
Ⓒ
HESIPHARMACOLOGY LATEST-
PHARMACOLOGY
1 . A healthcare provider prescribes cephalexin monohydrate (Keflex) for a client with a
postoperativeinfection. It is most important for the nurse to assess for what additional
drug allergy before administering this prescription?
• Penicillins.
• Aminoglycosides.
• Erythromycins.
• Sulfonamides.
A) Penicillins.
Cross-allergies exist between penicillins (A) and cephalosporins, such as cephalexin
monohydrate(Keflex), so checking for penicillin allergy is a wise precaution before
administering this drug.
Ⓒ
• Which nursing intervention is most important when caring for a client receiving
the antimetabolitecytosine arabinoside (Arc-C) for chemotherapy?
• Hydrate the client with IV fluids before and after infusion.
• Assess the client for numbness and tingling of extremities.
• Inspect the client's oral mucosa for ulcerations.
• Monitor the client's urine pH for increased acidity.
C) Inspect the client's oral mucosa for ulcerations.
Cytosine arabinoside (Arc-C) affects the rapidly growing cells of the body, therefore
stomatitis andmucosal ulcerations are key signs of antimetabolite toxicity (C). (A, B,
and D) are not typical interventions associated with the administration of
antimetabolites.
Ⓒ
• When assessing an adolescent who recently overdosed on acetaminophen
(Tylenol), it is mostimportant for the nurse to assess for pain in which area of
the body?
• Flank.
• Abdomen.
• Chest.
,• Head.
B) Abdomen.
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 (B), which might indicate
liver damage. (A, C,and D) are not areas where pain would be anticipated.
Ⓒ
• An adult client is given a prescription for a scopolamine patch (Transderm Scop) to
prevent motionsickness while on a cruise. Which information should the nurse
provide to the client?
• Apply the patch at least 4 hours prior to departure.
• Change the patch every other day while on the cruise.
• Place the patch on a hairless area at the base of the skull.
• Drink no more than 2 alcoholic drinks during the cruise.
A) Apply the patch at least 4 hours prior to departure.
Scopolamine, an anticholinergic agent, is used to prevent motion sickness and has a
peak onset in 6 hours, so the client should be instructed to apply the patch at least 4
hours before departure (A) on the cruise ship. The duration of the transdermal patch is
72 hours, so (B) is not needed. Scolopamine blocks muscarinic receptors in the inner ear
and to the vomiting center, so the best application site of the patchis behind the ear,
not at the base of the skull (C). Anticholinergic medications are CNS depressants, so the
client should be instructed to avoid alcohol (D) while using the patch.
Ⓒ
• The nurse is reviewing the use of the patient-controlled analgesia (PCA) pump with
a client in the immediate postoperative period. The client will receive morphine 1 mg
IV per hour basal rate with 1 mgIV every 15 minutes per PCA to total 5 mg IV maximally
per hour. What assessment has the highest priority before initiating the PCA pump?
• The expiration date on the morphine syringe in the pump.
• The rate and depth of the client's respirations.
• The type of anesthesia used during the surgical procedure.
• The client's subjective and objective signs of pain.
B) The rate and depth of the client's respirations.
,A life-threatening side effect of intravenous administration of morphine sulfate, an
opiate narcotic, is respiratory depression (B). The PCA pump should be stopped and
the healthcare provider notified if theclient's respiratory rate falls below 12 breaths
per minute, and the nurse should anticipate adjustmentsin the client's dosage before
the PCA pump is restarted. (A, C, and D) provide helpful information, but are not as
high a priority as the assessment described in (B).
Ⓒ
• A medication that is classified as a beta-1 agonist is most commonly prescribed for a
client with whichcondition?
• Glaucoma.
• Hypertension.
• Heart failure.
• Asthma.
C) Heart failure.
Beta-1 agonists improve cardiac output by increasing the heart rate and blood
pressure and are indicated in heart failure (C), shock, atrioventricular block
dysrhythmias, and cardiac arrest. Glaucoma
• is managed using adrenergic agents and beta-adrenergic blocking agents. Beta-1
blocking agents are used in the management of hypertension (B). Medications that
stimulate beta-2 receptors in the bronchiare effective for bronchoconstriction in
respiratory disorders, such as asthma (D).
Ⓒ
• A female client with rheumatoid arthritis take ibuprofen (Motrin) 600 mg PO 4
times a day. To prevent gastrointestinal bleeding, misoprostol (Cytotec) 100 mcg PO is
prescribed. Which information ismost important for the nurse to include in client
teaching?
• Use contraception during intercourse.
• Ensure the Cytotec is taken on an empty stomach.
• Encourage oral fluid intake to prevent constipation.
• Take Cytotec 30 minutes prior to Motrin.
A) Use contraception during intercourse.
Cytotec, a synthetic form of a prostaglandin, is classified as pregnancy Category X and
can act as an abortifacient, so the client should be instructed to use contraception
, during intercourse (A) to preventloss of an early pregnancy. (B) is not necessary. A
common side effect of Cytotec is diarrhea, so constipation prevention strategies are
usually not needed (C). Cytotec and Motrin should be taken together (D) to provide
protective properties against gastrointestinal bleeding.
Ⓒ
• A client with heart failure is prescribed spironolactone (Aldactone). Which
information is mostimportant for the nurse to provide to the client about diet
modifications?
• Do not add salt to foods during preparation.
• Refrain for eating foods high in potassium.
• Restrict fluid intake to 1000 ml per day.
• Increase intake of milk and milk products.
B) Refrain for eating foods high in potassium.
Spironolactone (Aldactone), an aldosterone antagonist, is a potassium-sparing diuretic, so a
diet high inpotassium should be avoided (B), including potassium salt substitutes, which can
lead to hyperkalemia.
Although (A) is a common diet modification in heart failure, the risk of hyperkalemia is
more importantwith Aldactone. Restriction of fluids (C) or increasing milk and milk
products (D) are not indicated with this prescription.
Ⓒ
• In evaluating the effects of lactulose (Cephulac), which outcome should
indicate that the drug isperforming as intended?
• An increase in urine output.
• Two or three soft stools per day.
• Watery, diarrhea stools.
• Increased serum bilirubin.
B) Two or three soft stools per day.
Lactulose is administered to reduce blood ammonia by excretion of ammonia through
the stool. Two tothree stools a day indicate that lactulose is performing as intended
(B). (A) would be expected if the patient received a diuretic. (C) would indicate an
overdose of lactulose and is not expected. Lactulose does not affect (D).
Ⓒ
