HESI Pharmacology Exam Practice 600
QUESTIONS AND ANSWERS GRADED A
LATEST VERSIONS 2023/2024 WITH
RATIONALE
A healthcare provider prescribes cephalexin monohydrate (Keflex) for a client with
a postoperative infection. It is most important for the nurse to assess for what
additional drug allergy before administering this prescription?
A) Penicillins.
B) Aminoglycosides.
C) Erythromycins.
D) Sulfonamides. - CORRECT ANSWER 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 antimetabolite cytosine arabinoside (Arc-C) for chemotherapy?
A) Hydrate the client with IV fluids before and after infusion.
B) Assess the client for numbness and tingling of extremities.
C) Inspect the client's oral mucosa for ulcerations.
D) Monitor the client's urine pH for increased acidity. - CORRECT ANSWER C)
Inspect the client's oral mucosa for ulcerations.
,Cytosine arabinoside (Arc-C) affects the rapidly growing cells of the body,
therefore stomatitis and mucosal 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 most important for the nurse to assess for pain in which area of the
body?
A) Flank.
B) Abdomen.
C) Chest.
D) Head. - CORRECT ANSWER 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 motion sickness while on a cruise. Which information should the nurse
provide to the client?
A) Apply the patch at least 4 hours prior to departure.
B) Change the patch every other day while on the cruise.
C) Place the patch on a hairless area at the base of the skull.
D) Drink no more than 2 alcoholic drinks during the cruise. - CORRECT ANSWER
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 patch is 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 mg IV every 15 minutes per PCA to
total 5 mg IV maximally per hour. What assessment has the highest priority before
initiating the PCA pump?
A) The expiration date on the morphine syringe in the pump.
B) The rate and depth of the client's respirations.
C) The type of anesthesia used during the surgical procedure.
D) The client's subjective and objective signs of pain. - CORRECT ANSWER 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 the client's respiratory rate falls below 12
breaths per minute, and the nurse should anticipate adjustments in 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 which condition?
A) Glaucoma.
, B) Hypertension.
C) Heart failure.
D) Asthma. - CORRECT ANSWER 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 (A) 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 bronchi are 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 is most important for the nurse to include in
client teaching?
A) Use contraception during intercourse.
B) Ensure the Cytotec is taken on an empty stomach.
C) Encourage oral fluid intake to prevent constipation.
D) Take Cytotec 30 minutes prior to Motrin. - CORRECT ANSWER 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 prevent loss 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.
QUESTIONS AND ANSWERS GRADED A
LATEST VERSIONS 2023/2024 WITH
RATIONALE
A healthcare provider prescribes cephalexin monohydrate (Keflex) for a client with
a postoperative infection. It is most important for the nurse to assess for what
additional drug allergy before administering this prescription?
A) Penicillins.
B) Aminoglycosides.
C) Erythromycins.
D) Sulfonamides. - CORRECT ANSWER 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 antimetabolite cytosine arabinoside (Arc-C) for chemotherapy?
A) Hydrate the client with IV fluids before and after infusion.
B) Assess the client for numbness and tingling of extremities.
C) Inspect the client's oral mucosa for ulcerations.
D) Monitor the client's urine pH for increased acidity. - CORRECT ANSWER C)
Inspect the client's oral mucosa for ulcerations.
,Cytosine arabinoside (Arc-C) affects the rapidly growing cells of the body,
therefore stomatitis and mucosal 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 most important for the nurse to assess for pain in which area of the
body?
A) Flank.
B) Abdomen.
C) Chest.
D) Head. - CORRECT ANSWER 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 motion sickness while on a cruise. Which information should the nurse
provide to the client?
A) Apply the patch at least 4 hours prior to departure.
B) Change the patch every other day while on the cruise.
C) Place the patch on a hairless area at the base of the skull.
D) Drink no more than 2 alcoholic drinks during the cruise. - CORRECT ANSWER
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 patch is 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 mg IV every 15 minutes per PCA to
total 5 mg IV maximally per hour. What assessment has the highest priority before
initiating the PCA pump?
A) The expiration date on the morphine syringe in the pump.
B) The rate and depth of the client's respirations.
C) The type of anesthesia used during the surgical procedure.
D) The client's subjective and objective signs of pain. - CORRECT ANSWER 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 the client's respiratory rate falls below 12
breaths per minute, and the nurse should anticipate adjustments in 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 which condition?
A) Glaucoma.
, B) Hypertension.
C) Heart failure.
D) Asthma. - CORRECT ANSWER 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 (A) 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 bronchi are 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 is most important for the nurse to include in
client teaching?
A) Use contraception during intercourse.
B) Ensure the Cytotec is taken on an empty stomach.
C) Encourage oral fluid intake to prevent constipation.
D) Take Cytotec 30 minutes prior to Motrin. - CORRECT ANSWER 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 prevent loss 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.
