HESI PHARMACOLOGY PRACTICE QUESTIONS FOR
FINAL RATED A
A client is receiving clonidine (Catapres) 0.1 mg/24hr via transdermal patch. Which assessment
finding indicates that the desired effect of the medication has been achieved?
A. Client denies recent episodes of angina.
B. Change in peripheral edema from +3 to +1.
C. Client denies recent nausea or vomiting.
D. Blood pressure has changed from 180/120 to 140/70. Correct Catapres acts as a centrally-
acting analgesic and antihypertensive agent. (D) indicates a reduction in hypertension. Catapres does
not affect (A, B, or C), so these findings do not indicate desired outcomes of Catapres
After abdominal surgery, a male client is prescribed low molecular weight heparin (LMWH). During
administration of the medication, the client asks the nurse why he is receiving this medication.
Which is the best response for the nurse to provide?
A. This medication is a blood thinner given to prevent blood clot formation. Correct
B. This medication enhances antibiotics to prevent infection.
C. This medication dissolves any clots that develop in the legs. Incorrect
D. This abdominal injection assists in the healing of the abdominal wound. Unfractionated
heparin or low molecular weight heparin (LMWH) is an anticoagulant that inhibits thrombin-
mediated conversion of fibrinogen to fibrin and is given prophylactically to prevent postoperative
venous thrombosis (A) or to treat pulmonary embolism or deep vein thrombosis following knee and
abdominal surgeries. Heparin does not dissolve clots but prevents clot extension or further clot
formation (C). The anticoagulant heparin does not prevent infection (B) or influence operative wound
healing (D).
A client with coronary artery disease who is taking digoxin (Lanoxin) receives a new prescription for
atorvastatin (Lipitor). Two weeks after initiation of the Lipitor prescription, the nurse assesses the
client. Which finding requires the most immediate intervention?
A. Heartburn.
B. Headache.
C. Constipation.
D. Vomiting. Correct Vomiting, anorexia and abdominal pain are early indications of digitalis
toxicity. Since Lipitor increases the risk for digitalis toxicity, this finding requires the most immediate
intervention by the nurse (D). (A, B and C) are expected side effects of Lipitor
,A client with heart failure is prescribed spironolactone (Aldactone). Which information is most
important 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. Correct
Restrict fluid intake to 1000 ml per day.
Increase intake of milk and milk products. Spironolactone (Aldactone), an aldosterone
antagonist, is a potassium-sparing diuretic, so a diet high in potassium 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 important with Aldactone. Restriction
of fluids (C) or increasing milk and milk products (D) are not indicated with this prescription.
A client with a dysrhythmia is to receive procainamide (Pronestyl) in 4 divided doses over the next 24
hours. What dosing schedule is best for the nurse to implement?
q6h. Correct
QID.
AC and bedtime.
PC and bedtime. Pronestyl is a class 1A antidysrhythmic. It should be taken around-the-clock (A)
so that a stable blood level of the drug can be maintained, thereby decreasing the possibility of
hypotension (an adverse effect) occurring because of too much of the drug circulating systemically at
any particular time of day. (B, C, and D) do not provide an around-the-clock dosing schedule.
Pronestyl may be given with food if GI distress is a problem, but an around-the-clock schedule should
still be maintained.
A client who was prescribed atorvastatin (Lipitor) one month ago calls the triage nurse at the clinic
complaining of muscle pain and weakness in his legs. Which statement reflects the correct drug-
specific teaching the nurse should provide to this client?
A. Increase consumption of potassium-rich foods since low potassium levels can cause muscle
spasms.
B. Have serum electrolytes checked at the next scheduled appointment to assess hyponatremia, a
cause of cramping.
,C. Make an appointment to see the healthcare provider, because muscle pain may be an indication of
a serious side effect. Correct
D. Be sure to consume a low-cholesterol diet while taking the drug to enhance the effectiveness of
the drug. Myopathy, suggested by the leg pain and weakness, is a serious, and potentially life-
threatening, complication of Lipitor, and should be evaluated immediately by the healthcare provider
(C). Although electrolyte imbalances such as (A or B) can cause muscle spasms in some cases, this is
not the likely cause of leg pain in the client receiving Lipitor, and evaluation by the healthcare
provider should not be delayed for any reason. A low-cholesterol diet is recommended for those
taking Lipitor since the drug is used to lower total cholesterol (D), but diet is not related to the leg
pain symptom.
A category X drug is prescribed for a young adult female client. Which instruction is most important
for the nurse to teach this client?
A. Use a reliable form of birth control. Correct
B. Avoid exposure to ultra violet light.
C. Refuse this medication if planning pregnancy.
D. Abstain from intercourse while on this drug. Drugs classified in the category X place a client
who is in the first trimester of pregnancy at risk for teratogenesis, so women in the childbearing
years should be counseled to use a reliable form of birth control (A) during drug therapy. (B) is not a
specific precaution with Category X drugs. The client should be encouraged to discuss plans for
pregnancy with the healthcare provider, so a safer alternative prescription (C) can be provided if
pregnancy occurs. Although the risk of birth defects during pregnancy explains the restriction of
these drugs during pregnancy, (D) is not indicated.
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. Correct 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.
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. Correct
B. Check the client's apical pulse.
C. Notify the healthcare provider.
D. Repeat the serum potassium level. 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.
FINAL RATED A
A client is receiving clonidine (Catapres) 0.1 mg/24hr via transdermal patch. Which assessment
finding indicates that the desired effect of the medication has been achieved?
A. Client denies recent episodes of angina.
B. Change in peripheral edema from +3 to +1.
C. Client denies recent nausea or vomiting.
D. Blood pressure has changed from 180/120 to 140/70. Correct Catapres acts as a centrally-
acting analgesic and antihypertensive agent. (D) indicates a reduction in hypertension. Catapres does
not affect (A, B, or C), so these findings do not indicate desired outcomes of Catapres
After abdominal surgery, a male client is prescribed low molecular weight heparin (LMWH). During
administration of the medication, the client asks the nurse why he is receiving this medication.
Which is the best response for the nurse to provide?
A. This medication is a blood thinner given to prevent blood clot formation. Correct
B. This medication enhances antibiotics to prevent infection.
C. This medication dissolves any clots that develop in the legs. Incorrect
D. This abdominal injection assists in the healing of the abdominal wound. Unfractionated
heparin or low molecular weight heparin (LMWH) is an anticoagulant that inhibits thrombin-
mediated conversion of fibrinogen to fibrin and is given prophylactically to prevent postoperative
venous thrombosis (A) or to treat pulmonary embolism or deep vein thrombosis following knee and
abdominal surgeries. Heparin does not dissolve clots but prevents clot extension or further clot
formation (C). The anticoagulant heparin does not prevent infection (B) or influence operative wound
healing (D).
A client with coronary artery disease who is taking digoxin (Lanoxin) receives a new prescription for
atorvastatin (Lipitor). Two weeks after initiation of the Lipitor prescription, the nurse assesses the
client. Which finding requires the most immediate intervention?
A. Heartburn.
B. Headache.
C. Constipation.
D. Vomiting. Correct Vomiting, anorexia and abdominal pain are early indications of digitalis
toxicity. Since Lipitor increases the risk for digitalis toxicity, this finding requires the most immediate
intervention by the nurse (D). (A, B and C) are expected side effects of Lipitor
,A client with heart failure is prescribed spironolactone (Aldactone). Which information is most
important 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. Correct
Restrict fluid intake to 1000 ml per day.
Increase intake of milk and milk products. Spironolactone (Aldactone), an aldosterone
antagonist, is a potassium-sparing diuretic, so a diet high in potassium 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 important with Aldactone. Restriction
of fluids (C) or increasing milk and milk products (D) are not indicated with this prescription.
A client with a dysrhythmia is to receive procainamide (Pronestyl) in 4 divided doses over the next 24
hours. What dosing schedule is best for the nurse to implement?
q6h. Correct
QID.
AC and bedtime.
PC and bedtime. Pronestyl is a class 1A antidysrhythmic. It should be taken around-the-clock (A)
so that a stable blood level of the drug can be maintained, thereby decreasing the possibility of
hypotension (an adverse effect) occurring because of too much of the drug circulating systemically at
any particular time of day. (B, C, and D) do not provide an around-the-clock dosing schedule.
Pronestyl may be given with food if GI distress is a problem, but an around-the-clock schedule should
still be maintained.
A client who was prescribed atorvastatin (Lipitor) one month ago calls the triage nurse at the clinic
complaining of muscle pain and weakness in his legs. Which statement reflects the correct drug-
specific teaching the nurse should provide to this client?
A. Increase consumption of potassium-rich foods since low potassium levels can cause muscle
spasms.
B. Have serum electrolytes checked at the next scheduled appointment to assess hyponatremia, a
cause of cramping.
,C. Make an appointment to see the healthcare provider, because muscle pain may be an indication of
a serious side effect. Correct
D. Be sure to consume a low-cholesterol diet while taking the drug to enhance the effectiveness of
the drug. Myopathy, suggested by the leg pain and weakness, is a serious, and potentially life-
threatening, complication of Lipitor, and should be evaluated immediately by the healthcare provider
(C). Although electrolyte imbalances such as (A or B) can cause muscle spasms in some cases, this is
not the likely cause of leg pain in the client receiving Lipitor, and evaluation by the healthcare
provider should not be delayed for any reason. A low-cholesterol diet is recommended for those
taking Lipitor since the drug is used to lower total cholesterol (D), but diet is not related to the leg
pain symptom.
A category X drug is prescribed for a young adult female client. Which instruction is most important
for the nurse to teach this client?
A. Use a reliable form of birth control. Correct
B. Avoid exposure to ultra violet light.
C. Refuse this medication if planning pregnancy.
D. Abstain from intercourse while on this drug. Drugs classified in the category X place a client
who is in the first trimester of pregnancy at risk for teratogenesis, so women in the childbearing
years should be counseled to use a reliable form of birth control (A) during drug therapy. (B) is not a
specific precaution with Category X drugs. The client should be encouraged to discuss plans for
pregnancy with the healthcare provider, so a safer alternative prescription (C) can be provided if
pregnancy occurs. Although the risk of birth defects during pregnancy explains the restriction of
these drugs during pregnancy, (D) is not indicated.
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. Correct 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.
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. Correct
B. Check the client's apical pulse.
C. Notify the healthcare provider.
D. Repeat the serum potassium level. 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.
