Pharmacology HESI V2 Preparation Graded A
A client is prescribed phenobarbital sodium (Luminal) for a seizure disorder. The medication has a
long half-life of 4 days. Based on this half-life, the medication will most likely be prescribed
A. once a day.
B. twice a day.
C. three times a day.
D. four times a day. ANS: A
Medication with long half-lives remain at their therapeutic levels between doses for long periods of
time. Therefore, this medication can be administered once a day.
A nurse educator is reviewing medication dosages and factors that influence medication metabolism
with a group of nurses. Medication dosages may need to be decreased for which of the following
reasons? (Select all that apply.)
A. Increased renal excretion
B. Increased medication-metabolizing enzymes
C. Liver failure
D. Peripheral vascular disease
E. Concurrent use of medication metabolized by the same pathway ANS: C, E
Liver failure decreases metabolism and thus increase the concentration of medication. This may
require decreasing the dosage of medication. When two medications are metabolized in the same
way, they may compete for metabolism, thereby increasing the concentration of one or both
medications.
Increased renal excretion may decrease concentration of the medication, requiring increased dosage.
Increased medication-metabolizing enzymes can decrease the concentration of the medication. The
dose might need increased. Peripheral vascular disease may impair distribution, and more of the
medication may be needed.
A nurse s preparing to administer eye drops to a client. Which of the following are appropriate
nursing interventions related to this procedure? (Select all that apply.)
A. Using medical aseptic technique
B. Asking the client to look up at the ceiling
C. Having the client lie in a side-lying position
D. Dropping medication into the center of the client's conjunctival sac
,E. Instructing the client to close the eye gently ANS:B, D, E
The medication should be dropped into the center of the conjunctival sac to promote better
distribution of the medication. The client should close the eye gently to allow improved distribution
of the medication.
Surgical aseptic technique is used to administer eye drops. The client should be sitting or in a supine
position to facilitate proper administration of eye drops.
A nurse is completing discharge teaching to a client who has a new prescription for a transdermal
medication. Which of the following statements by the client indicates understanding of the teaching?
A. "I will clean the site with an alcohol swab prior to applying the patch."
B. "I will rotate the application site weekly."
C. "I will apply the patch to an area of skin with no hair."
D. "I will place the new patch on the site of the old patch." ANS: C
Transdermal medication should be applied to a hairless area of skin to promote absorption of
medication.
The skin should be washed with soap and water and dried thoroughly before applying a transdermal
patch. Application sites should be rotated on a daily basis to prevent skin irritation.
A nurse is reviewing a client's health record and notes a new prescription by the provider to verify
the trough level of the client's medication. Which of the following actions should the nurse take?
A. Have a blood specimen obtained immediately prior to the next dose of medication.
B. Verify that the client has been on the medication for 24 hr before ordering a blood specimen.
C. Ask the client to provide a urine specimen after the next dose of medication.
D. Begin administering the medication, and obtain a blood specimen. ANS: A
To verify trough levels of a medication, a blood specimen is obtained immediately before the next
dose of medication.
A nurse is preparing a client's medication. Which of the following are legal responsibilities of the
nurse? (Select all that apply.)
A. Maintaining skill competency
B. Determining the dosage
C. Monitoring for adverse effects
,D. Safeguarding medications
E. Identifying the client's diagnosis ANS: A, C, D
Determining medication dosage and identifying a diagnosis is the role/responsibility of the provider.
The nurse should be informed about a client's diagnosis.
A nurse is reviewing a client's health record and notes a new prescription by the provider for
lisinopril (Zestril) 10 mg PO every day. The nurse should recognize this as which of the following types
of prescription?
A. Single prescription
B. Stat prescription
C. Routine prescription
D. Standing prescription ANS: C
A routine prescription identifies a medication that is given on a regular schedule. This medication is
administered every day until discontinued.
A single prescription is to be given once at a specified time or as soon as possible. A stat prescription
is only given once, and it is given immediately. A standing prescription is written for specific
circumstances or a specific unit.
A nurse is reviewing a new prescription for ondansetron (Zofran) 4 mg PO PRN nausea and vomiting
for a client who has hyperemesis gravidarum. The nurse should clarify which of the following parts of
the prescription with the provider?
A. Name
B. Dosage
C. Route
D. Time ANS: D
The time and frequency of medication administration is not included and should be clarified with the
provider.
A nurse is orienting a newly hired nurse and discussing how to take telephone prescription. Which of
the following statements by the newly hired nurse indicates understanding of the discussion?
A. "A second nurse enters the prescription into the client's health record."
B. "Another nurse should listen to the phone call."
C. "The provider can clarify the prescription when he signs the health record."
, D. "The 'read back' is omitted if this is a one-time prescription." ANS: B
The second nurse should listen to a telephone prescription to prevent errors in communication.
The nurse who takes the telephone prescription should enter it into the client's health record to
prevent errors in translation. The nurse verifies the prescription is complete and accurate at the time
it is given by reading it back to the provider. A telephone prescription includes reading back all types
of medication prescription.
A nurse on a medical unit is admitting a client and completing a preassessment before administration
of medications. Which of the following data should the nurse include in the preassessment? (Select
all that apply.)
A. Use of herbal teas
B. Daily fluid intake
C. Current health status
D. Previous surgical history
E. Food allergies ANS: A, C, E
Use of herbal product,s which often contains caffeine, should be assessed prior to medication
administration because caffeine can affect medication biotransformation. Current health status
should be reviewed because new prescriptions can cause alterations in current health status. Food
allergies should be included in the preassessment that is completed prior to medication
administration to identify any potential interactions.
Daily fluid intake and surgical history is important, but it is not part of the presassessment that is
completed prior to medication administration.
A nurse is assessing a client's IV. Which of the following findings is indicative of phlebitis? (Select all
that apply.)
A. Tingling sensation below insertion site
B. Tachycardia
C. Palpable, hard mass above insertion site
D. Cool, pale skin
E. Pain at site ANS: C, E
Pain at the IV site and a palpable, hard mass above the insertion site is a clinical manifestation of
thrombophlebitis.
A client is prescribed phenobarbital sodium (Luminal) for a seizure disorder. The medication has a
long half-life of 4 days. Based on this half-life, the medication will most likely be prescribed
A. once a day.
B. twice a day.
C. three times a day.
D. four times a day. ANS: A
Medication with long half-lives remain at their therapeutic levels between doses for long periods of
time. Therefore, this medication can be administered once a day.
A nurse educator is reviewing medication dosages and factors that influence medication metabolism
with a group of nurses. Medication dosages may need to be decreased for which of the following
reasons? (Select all that apply.)
A. Increased renal excretion
B. Increased medication-metabolizing enzymes
C. Liver failure
D. Peripheral vascular disease
E. Concurrent use of medication metabolized by the same pathway ANS: C, E
Liver failure decreases metabolism and thus increase the concentration of medication. This may
require decreasing the dosage of medication. When two medications are metabolized in the same
way, they may compete for metabolism, thereby increasing the concentration of one or both
medications.
Increased renal excretion may decrease concentration of the medication, requiring increased dosage.
Increased medication-metabolizing enzymes can decrease the concentration of the medication. The
dose might need increased. Peripheral vascular disease may impair distribution, and more of the
medication may be needed.
A nurse s preparing to administer eye drops to a client. Which of the following are appropriate
nursing interventions related to this procedure? (Select all that apply.)
A. Using medical aseptic technique
B. Asking the client to look up at the ceiling
C. Having the client lie in a side-lying position
D. Dropping medication into the center of the client's conjunctival sac
,E. Instructing the client to close the eye gently ANS:B, D, E
The medication should be dropped into the center of the conjunctival sac to promote better
distribution of the medication. The client should close the eye gently to allow improved distribution
of the medication.
Surgical aseptic technique is used to administer eye drops. The client should be sitting or in a supine
position to facilitate proper administration of eye drops.
A nurse is completing discharge teaching to a client who has a new prescription for a transdermal
medication. Which of the following statements by the client indicates understanding of the teaching?
A. "I will clean the site with an alcohol swab prior to applying the patch."
B. "I will rotate the application site weekly."
C. "I will apply the patch to an area of skin with no hair."
D. "I will place the new patch on the site of the old patch." ANS: C
Transdermal medication should be applied to a hairless area of skin to promote absorption of
medication.
The skin should be washed with soap and water and dried thoroughly before applying a transdermal
patch. Application sites should be rotated on a daily basis to prevent skin irritation.
A nurse is reviewing a client's health record and notes a new prescription by the provider to verify
the trough level of the client's medication. Which of the following actions should the nurse take?
A. Have a blood specimen obtained immediately prior to the next dose of medication.
B. Verify that the client has been on the medication for 24 hr before ordering a blood specimen.
C. Ask the client to provide a urine specimen after the next dose of medication.
D. Begin administering the medication, and obtain a blood specimen. ANS: A
To verify trough levels of a medication, a blood specimen is obtained immediately before the next
dose of medication.
A nurse is preparing a client's medication. Which of the following are legal responsibilities of the
nurse? (Select all that apply.)
A. Maintaining skill competency
B. Determining the dosage
C. Monitoring for adverse effects
,D. Safeguarding medications
E. Identifying the client's diagnosis ANS: A, C, D
Determining medication dosage and identifying a diagnosis is the role/responsibility of the provider.
The nurse should be informed about a client's diagnosis.
A nurse is reviewing a client's health record and notes a new prescription by the provider for
lisinopril (Zestril) 10 mg PO every day. The nurse should recognize this as which of the following types
of prescription?
A. Single prescription
B. Stat prescription
C. Routine prescription
D. Standing prescription ANS: C
A routine prescription identifies a medication that is given on a regular schedule. This medication is
administered every day until discontinued.
A single prescription is to be given once at a specified time or as soon as possible. A stat prescription
is only given once, and it is given immediately. A standing prescription is written for specific
circumstances or a specific unit.
A nurse is reviewing a new prescription for ondansetron (Zofran) 4 mg PO PRN nausea and vomiting
for a client who has hyperemesis gravidarum. The nurse should clarify which of the following parts of
the prescription with the provider?
A. Name
B. Dosage
C. Route
D. Time ANS: D
The time and frequency of medication administration is not included and should be clarified with the
provider.
A nurse is orienting a newly hired nurse and discussing how to take telephone prescription. Which of
the following statements by the newly hired nurse indicates understanding of the discussion?
A. "A second nurse enters the prescription into the client's health record."
B. "Another nurse should listen to the phone call."
C. "The provider can clarify the prescription when he signs the health record."
, D. "The 'read back' is omitted if this is a one-time prescription." ANS: B
The second nurse should listen to a telephone prescription to prevent errors in communication.
The nurse who takes the telephone prescription should enter it into the client's health record to
prevent errors in translation. The nurse verifies the prescription is complete and accurate at the time
it is given by reading it back to the provider. A telephone prescription includes reading back all types
of medication prescription.
A nurse on a medical unit is admitting a client and completing a preassessment before administration
of medications. Which of the following data should the nurse include in the preassessment? (Select
all that apply.)
A. Use of herbal teas
B. Daily fluid intake
C. Current health status
D. Previous surgical history
E. Food allergies ANS: A, C, E
Use of herbal product,s which often contains caffeine, should be assessed prior to medication
administration because caffeine can affect medication biotransformation. Current health status
should be reviewed because new prescriptions can cause alterations in current health status. Food
allergies should be included in the preassessment that is completed prior to medication
administration to identify any potential interactions.
Daily fluid intake and surgical history is important, but it is not part of the presassessment that is
completed prior to medication administration.
A nurse is assessing a client's IV. Which of the following findings is indicative of phlebitis? (Select all
that apply.)
A. Tingling sensation below insertion site
B. Tachycardia
C. Palpable, hard mass above insertion site
D. Cool, pale skin
E. Pain at site ANS: C, E
Pain at the IV site and a palpable, hard mass above the insertion site is a clinical manifestation of
thrombophlebitis.
