HESI PHARMACOLOGY QUESTIONS WITH ANSWERS GRADED A LATEST VERSION DOWNLOAD
TO SCORE A
1. The healthcare provider prescribes naproxen (Naproxen) twice daily for a client with osteoarthritis of the
hands. The client tells the nurse that the drug does not seem to be effective after three weeks. Which is the
best response for the nurse to provide?
A) The frequency of the dosing is necessary to increase the effectiveness.
B) Therapeutic blood levels of this drug are reached in 4 to 6 weeks.
C) Another type of nonsteroidal antiinflammatory drug may be indicated.
D) Systemic corticosteroids are the next drugs of choice for pain relief.
C) Another type of nonsteroidal antiinflammatory drug may be indicated.
Individual responses to nonsteroidal antiinflammatory drugs are variable, so (C) is the best response.
Naproxen is usually prescribed every 8 hours, so (A) is not indicated. The peak for naproxen is one to two
hours, not (B). Corticosteroids are not indicated for osteoarthritis (D).
2. Which instruction(s) should the nurse give to a female client who just received a prescription for oral
metronidazole (Flagyl) for treatment of trichomonas vaginalis? (Select all that apply.)
A) Increase fluid intake, especially cranberry juice.
B) Do not abruptly discontinue the medication; taper use.
C) Check blood pressure daily to detect hypertension.
D) Avoid drinking alcohol while taking this medication.
E) Use condoms until treatment is completed.
F) Ensure that all sexual partners are treated at the same time.
A) Increase fluid intake, especially cranberry juice.
,D) Avoid drinking alcohol while taking this medication.
E) Use condoms until treatment is completed.
F) Ensure that all sexual partners are treated at the same time.
,Correct selections are (A, D, E, and F). Increased fluid intake and cranberry juice (A) are recommended for
prevention and treatment of urinary tract infections, which frequently accompany vaginal infections. It is not
necessary to taper use of this drug (B) or to check the blood pressure daily (C), as this condition is not related
to hypertension. Flagyl can cause a disulfiram-like reaction if taken in conjunction with ingestion of alcohol, so
the client should be instructed to avoid alcohol (D). All sexual partners should be treated at the same time (E)
and condoms should be used until after treatment is completed to avoid reinfection (F).
3. A client receiving albuterol (Proventil) tablets complains of nausea every evening with her 9 p.m. dose.
What action should the nurse take to alleviate this side effect?
A) Change the time of the dose.
B) Hold the 9 p.m. dose.
C) Administer the dose with a snack.
D) Administer an antiemetic with the dose.
C) Administer the dose with a snack.
Administering oral doses with food (C) helps minimize GI discomfort. (A) would be appropriate only if changing
the time of the dose corresponds to meal times while at the same time maintaining an appropriate time
interval between doses. (B) would disrupt the dosing schedule, and could result in a nontherapeutic serum
level of the medication. (D) should not be attempted before other interventions, such as (C), have been
proven ineffective in relieving the nausea.
4. A client receiving Doxorubicin (Adriamycin) intravenously (IV) complains of pain at the insertion site, and
the nurse notes edema at the site. Which intervention is most important for the nurse to implement?
A) Assess for erythema.
B) Administer the antidote.
C) Apply warm compresses.
D) Discontinue the IV fluids.
D) Discontinue the IV fluids.
Doxorubicin is an antineoplastic agent that causes inflammation, blistering, and necrosis of tissue upon
extravasation. First, all IV fluids should be discontinued at the site (D) to prevent further tissue damage by the
vesicant. Erythema is one sign of infiltration and should be noted, but edema and pain at the infusion site
require stopping the IV fluids (A). Although an antidote may be available (B), additional fluids contribute to the
trauma of the subcutaneous tissues. Depending on the type of vesicant, warm or cold compresses (C) may be
prescribed after the infusion is discontinued.
, 5. A client with congestive heart failure (CHF) is being discharged with a new prescription for the
angiotensin-converting enzyme (ACE) inhibitor captopril (Capoten). The nurse's discharge instruction should
include reporting which problem to the healthcare provider?
A) Weight loss.
B) Dizziness.
C) Muscle cramps.
D) Dry mucous membranes.
B) Dizziness.
Angiotensin-converting enzyme (ACE) inhibitors are used in CHF to reduce afterload by reversing
vasoconstriction common in heart failure. This vasodilation can cause hypotension and resultant dizziness (B).
(A) is desired if fluid overload is present, and may occur as the result of effective combination drug therapy
such as diuretics with ACE inhibitors. (C) often indicates hypokalemia in the client receiving diuretics. Excessive
diuretic administration may result in fluid volume deficit, manifested by symptoms such as (D).
6. The nurse is preparing the 0900 dose of losartan (Cozaar), an angiotensin II receptor blocker (ARB), for a
client with hypertension and heart failure. The nurse reviews the client's laboratory results and notes that the
client's serum potassium level is 5.9 mEq/L. What action should the nurse take first?
A) Withhold the scheduled dose.
B) Check the client's apical pulse.
C) Notify the healthcare provider.
D) Repeat the serum potassium level.
A) Withhold the scheduled dose.
The nurse should first withhold the scheduled dose of Cozaar (A) because the client is hyperkalemic (normal
range 3.5 to 5 mEq/L). Although hypokalemia is usually associated with diuretic therapy in heart failure,
hyperkalemia is associated with several heart failure medications, including ARBs. Because hyperkalemia may
lead to cardiac dysrhythmias, the nurse should check the apical pulse for rate and rhythm (B), and the blood
pressure. Before repeating the serum study (D), the nurse should notify the healthcare provider (C) of the
findings.
7. The nurse is assessing the effectiveness of high dose aspirin therapy for an 88-year-old client with
arthritis. The client reports that she can't hear the nurse's questions because her ears are ringing. What action
should the nurse implement?
A) Refer the client to an audiologist for evaluation of her hearing.
B) Advise the client that this is a common side effect of aspirin therapy.
TO SCORE A
1. The healthcare provider prescribes naproxen (Naproxen) twice daily for a client with osteoarthritis of the
hands. The client tells the nurse that the drug does not seem to be effective after three weeks. Which is the
best response for the nurse to provide?
A) The frequency of the dosing is necessary to increase the effectiveness.
B) Therapeutic blood levels of this drug are reached in 4 to 6 weeks.
C) Another type of nonsteroidal antiinflammatory drug may be indicated.
D) Systemic corticosteroids are the next drugs of choice for pain relief.
C) Another type of nonsteroidal antiinflammatory drug may be indicated.
Individual responses to nonsteroidal antiinflammatory drugs are variable, so (C) is the best response.
Naproxen is usually prescribed every 8 hours, so (A) is not indicated. The peak for naproxen is one to two
hours, not (B). Corticosteroids are not indicated for osteoarthritis (D).
2. Which instruction(s) should the nurse give to a female client who just received a prescription for oral
metronidazole (Flagyl) for treatment of trichomonas vaginalis? (Select all that apply.)
A) Increase fluid intake, especially cranberry juice.
B) Do not abruptly discontinue the medication; taper use.
C) Check blood pressure daily to detect hypertension.
D) Avoid drinking alcohol while taking this medication.
E) Use condoms until treatment is completed.
F) Ensure that all sexual partners are treated at the same time.
A) Increase fluid intake, especially cranberry juice.
,D) Avoid drinking alcohol while taking this medication.
E) Use condoms until treatment is completed.
F) Ensure that all sexual partners are treated at the same time.
,Correct selections are (A, D, E, and F). Increased fluid intake and cranberry juice (A) are recommended for
prevention and treatment of urinary tract infections, which frequently accompany vaginal infections. It is not
necessary to taper use of this drug (B) or to check the blood pressure daily (C), as this condition is not related
to hypertension. Flagyl can cause a disulfiram-like reaction if taken in conjunction with ingestion of alcohol, so
the client should be instructed to avoid alcohol (D). All sexual partners should be treated at the same time (E)
and condoms should be used until after treatment is completed to avoid reinfection (F).
3. A client receiving albuterol (Proventil) tablets complains of nausea every evening with her 9 p.m. dose.
What action should the nurse take to alleviate this side effect?
A) Change the time of the dose.
B) Hold the 9 p.m. dose.
C) Administer the dose with a snack.
D) Administer an antiemetic with the dose.
C) Administer the dose with a snack.
Administering oral doses with food (C) helps minimize GI discomfort. (A) would be appropriate only if changing
the time of the dose corresponds to meal times while at the same time maintaining an appropriate time
interval between doses. (B) would disrupt the dosing schedule, and could result in a nontherapeutic serum
level of the medication. (D) should not be attempted before other interventions, such as (C), have been
proven ineffective in relieving the nausea.
4. A client receiving Doxorubicin (Adriamycin) intravenously (IV) complains of pain at the insertion site, and
the nurse notes edema at the site. Which intervention is most important for the nurse to implement?
A) Assess for erythema.
B) Administer the antidote.
C) Apply warm compresses.
D) Discontinue the IV fluids.
D) Discontinue the IV fluids.
Doxorubicin is an antineoplastic agent that causes inflammation, blistering, and necrosis of tissue upon
extravasation. First, all IV fluids should be discontinued at the site (D) to prevent further tissue damage by the
vesicant. Erythema is one sign of infiltration and should be noted, but edema and pain at the infusion site
require stopping the IV fluids (A). Although an antidote may be available (B), additional fluids contribute to the
trauma of the subcutaneous tissues. Depending on the type of vesicant, warm or cold compresses (C) may be
prescribed after the infusion is discontinued.
, 5. A client with congestive heart failure (CHF) is being discharged with a new prescription for the
angiotensin-converting enzyme (ACE) inhibitor captopril (Capoten). The nurse's discharge instruction should
include reporting which problem to the healthcare provider?
A) Weight loss.
B) Dizziness.
C) Muscle cramps.
D) Dry mucous membranes.
B) Dizziness.
Angiotensin-converting enzyme (ACE) inhibitors are used in CHF to reduce afterload by reversing
vasoconstriction common in heart failure. This vasodilation can cause hypotension and resultant dizziness (B).
(A) is desired if fluid overload is present, and may occur as the result of effective combination drug therapy
such as diuretics with ACE inhibitors. (C) often indicates hypokalemia in the client receiving diuretics. Excessive
diuretic administration may result in fluid volume deficit, manifested by symptoms such as (D).
6. The nurse is preparing the 0900 dose of losartan (Cozaar), an angiotensin II receptor blocker (ARB), for a
client with hypertension and heart failure. The nurse reviews the client's laboratory results and notes that the
client's serum potassium level is 5.9 mEq/L. What action should the nurse take first?
A) Withhold the scheduled dose.
B) Check the client's apical pulse.
C) Notify the healthcare provider.
D) Repeat the serum potassium level.
A) Withhold the scheduled dose.
The nurse should first withhold the scheduled dose of Cozaar (A) because the client is hyperkalemic (normal
range 3.5 to 5 mEq/L). Although hypokalemia is usually associated with diuretic therapy in heart failure,
hyperkalemia is associated with several heart failure medications, including ARBs. Because hyperkalemia may
lead to cardiac dysrhythmias, the nurse should check the apical pulse for rate and rhythm (B), and the blood
pressure. Before repeating the serum study (D), the nurse should notify the healthcare provider (C) of the
findings.
7. The nurse is assessing the effectiveness of high dose aspirin therapy for an 88-year-old client with
arthritis. The client reports that she can't hear the nurse's questions because her ears are ringing. What action
should the nurse implement?
A) Refer the client to an audiologist for evaluation of her hearing.
B) Advise the client that this is a common side effect of aspirin therapy.
