HESI PHARMACOLOGY VERION 1_2020 100 QUESTIONS & ANSWERS WITH
RATIONALE
2020 HESI Pharmacology Version 1
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
2. Calcium gluconate
3. Calcitonin (Miacalcin)
4. 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
2. Water
3. Apple juice
4. 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
2. Diarrhea
3. Constipation
4. 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
2. 15 minutes before exposure to the sun
3. Immediately before exposure to the sun
4. 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
2. Discontinuing the medication
3. Informing the client that this is normal
4. 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.Hyperventilati
on 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
2. Triglyceride level
3. Complete blood count
4. 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
2. Digoxin (Lanoxin)
3. Furosemide (Lasix)
4. 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
2. Axilla
3. Soles of the feet
4. Palms of the hands
2. Axilla
Rational
e:
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
2. Eczema
RATIONALE
2020 HESI Pharmacology Version 1
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
2. Calcium gluconate
3. Calcitonin (Miacalcin)
4. 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
2. Water
3. Apple juice
4. 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
2. Diarrhea
3. Constipation
4. 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
2. 15 minutes before exposure to the sun
3. Immediately before exposure to the sun
4. 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
2. Discontinuing the medication
3. Informing the client that this is normal
4. 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.Hyperventilati
on 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
2. Triglyceride level
3. Complete blood count
4. 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
2. Digoxin (Lanoxin)
3. Furosemide (Lasix)
4. 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
2. Axilla
3. Soles of the feet
4. Palms of the hands
2. Axilla
Rational
e:
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
2. Eczema
