HESI Pharmacology Exam

The nurse is assessing the effectiveness of high dose aspirin therapy for an 88-year-old client with arthritis. The client reports hearing non-stop ringing in the ears. Which 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. C. Notify the healthcare provider of the finding immediately. D. Face the client directly and speak in a low, monotone voice. - ANS C. Notify the healthcare provider of the finding immediately. Which antidiarrheal agent should be used with caution in clients taking high dosages of aspirin for arthritis? A. Loperamide (Imodium). B. Probanthine (Propantheline). C. Bismuth subsalicylate (Pepto Bismol). D. Diphenoxylate hydrochloride with atropine (Lomotil). - ANS C. Bismuth subsalicylate (Pepto Bismol). 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. - ANS B. Abdomen. A client's dose of isosorbide dinitrate (Imdur) is increased from 40 mg to 60 mg PO daily. When the client reports the onset of a headache prior to the next scheduled dose, which action should the nurse implement? A. Hold the next scheduled dose of Imdur 60 mg and administer a PRN dose of acetaminophen (Tylenol). B. Administer the 40 mg of Imdur and then contact the healthcare provider. C. Administer the 60 mg dose of Imdur and a PRN dose of acetaminophen (Tylenol). D. Do not administer the next dose of Imdur or any acetaminophen until notifying the healthcare provider. - ANS C. Administer the 60 mg dose of Imdur and a PRN dose of acetaminophen (Tylenol). An adult client has prescriptions for morphine sulfate 2.5 mg IV every 6 hours and ketorolac (Toradol) 30 mg IV every 6 hours. Which action should the nurse implement? A. Administer both medications according to the prescription. B. Hold the ketorolac to prevent an antagonistic effect. C. Hold the morphine to prevent an additive drug interaction. D. Contact the healthcare provider to clarify the prescription. - ANS A. Administer both medications according to the prescription. A client is receiving methylprednisolone 40 mg IV daily. The nurse should monitor which laboratory value closely? A. Serum glucose. B. Serum calcium. C. Red blood cells. D. Serum potassium. - ANS A. Serum glucose. A client is receiving clonidine 0.1 mg/24 hr via transdermal patch. Which assessment finding indicates the desired effect of the medication has been achieved? A. Absence of nausea and vomiting. B. Change in peripheral edema from +3 to +1. C. Denial of anginal pain and shortness of breath. D. Blood pressure from 180/120 mmHg to 140/70 mmHg. - ANS D. Blood pressure from 180/120 mmHg to 140/70 mmHg. 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. D. Be sure to consume a low-cholesterol diet while taking the drug to enhance the effectiveness of the drug. - ANS C. Make an appointment to see the healthcare provider, because muscle pain may be an indication of a serious side effect. Which nursing diagnosis is important to include in the plan of care for a client receiving the angiotensin-2 receptor antagonist irbesartan (Avapro)? A. Fluid volume deficit. B. Risk for infection. C. Risk for injury. D. Impaired sleep patterns. - ANS C. Risk for injury. A client has a continuous IV infusion of dopamine (Intropin) and an IV of normal saline at 50 mL/hour. The nurse notes that the client's urinary output has been 20 mL/hour for the last 2 hours. Which intervention should the nurse initiate? A. Stop the infusion of dopamine. B. Change the normal saline to a keep open rate. C. Replace the urinary catheter. D. Notify the healthcare provider of the urinary output. - ANS D. Notify the healthcare provider of the urinary output. Which action is most important for the nurse to implement prior to the administration of the antiarrhythmic drug adenosine (Adenocard)? A. Assess pupillary response to light. B. Instruct the client that facial flushing may occur. C. Apply continuous cardiac monitoring. D. Request that family members leave the room. - ANS C. Apply continuous cardiac monitoring. A client with a dysrhythmia is prescribed procainamide (Pronestyl) in 4 divided doses over the next 24 hours. Which dosing schedule is best for the nurse to implement? A. Every 6 hours. B. QID. C. AC and bedtime. D. PC and bedtime. - ANS A. Every 6 hours. The nurse administers a dose of metoprolol for a client. Which assessment is most important for the nurse to obtain? A. Temperature. B. Lung sounds. C. Blood pressure. D. Urinary output. - ANS C. Blood pressure. A client is being treated for osteoporosis with alendronate (Fosamax), and the nurse has completed discharge teaching regarding medication administration. Which morning schedule would indicate to the nurse that the client teaching has been effective? A. Take medication, go for a 30 minute morning walk, then eat breakfast. B. Take medication, rest in bed for 30 minutes, eat breakfast, go for morning walk. C. Take medication with breakfast, then take a 30 minute morning walk. D. Go for a 30 minute morning walk, eat breakfast, then take medication. - ANS A. Take medication, go for a 30 minute morning walk, then eat breakfast. A postoperative client receiving a continuous IV infusion of meperidine 35 mg/hr for the past four days has become increasingly restless and irritable, and begins to hallucinate. Which action should the nurse take first? A. Administer a PRN dose of the PO lithium. B. Administer naloxone IV push. C. Decrease the IV infusion rate of the meperidine. D. Increase the IV infusion rate of the meperidine. - ANS C. Decrease the IV infusion rate of the meperidine. A client being discharged is prescribed warfarin for the treatment following a pulmonary embolism. Which diagnostic test should the nurse instruct the client to receive once a month? A. Perfusion scan. B. Prothrombin Time (PT). C. Activated partial thromboplastin (aPTT). D. Serum Coumadin level (SCL). - ANS B. Prothrombin Time (PT). A client with Parkinson's disease is taking carbidopa-levodopa (Sinemet). Which observation by the nurse would indicate that the desired outcome of the medication is being achieved? A. Decreased blood pressure. B. Lessening of tremors. C. Increased salivation. D. Increased attention span. - ANS B. Lessening of tremors. A client being treated for hyperthyroidism with propylthiouracil (PTU) asks the nurse how the medication works. Which is the best response to give the client? A. It decreases the amount of thyroid-stimulating hormone circulating in the blood. B. It increases the amount of thyroid-stimulating hormone circulating in the blood. C. It enhances the amount of T4 and diminishes the amount of T3 produced by the thyroid. D. It inhibits the synthesis of T3 and T4 by the thyroid gland. - ANS D. It inhibits the synthesis of T3 and T4 by the thyroid gland. A client with heart failure is being discharged with a new prescription for the angiotensin-converting enzyme (ACE) inhibitor captopril (Capoten). The nurse's discharge instructions should include reporting which problem to the healthcare provider? A. Weight loss. B. Dizziness. C. Muscle cramps. D. Dry mucous membranes. - ANS B. Dizziness. Following the administration of sublingual nitroglycerin to a client experiencing an acute anginal attack, which assessment finding indicates to the nurse that the desired effect has been achieved? A. Client states chest pain is relieved. B. Client's pulse decreases from 120 to 90. C. Client's systolic blood pressure decreases from 180 to 90. D. Client's SaO2 level increases from 92% to 96%. - ANS A. Client states chest pain is relieved. The healthcare provider prescribes digitalis (Digoxin) for a client diagnosed with heart failure. Which intervention should the nurse implement prior to administering the digoxin? A. Observe respiratory rate and depth. B. Assess the serum potassium level. C. Obtain the client's blood pressure. D. Monitor the serum glucose level. - ANS B. Assess the serum potassium level. In evaluating the effects of lactulose (Cephulac), which outcome would indicate that the drug is performing as intended? A. An increase in urine output. B. Two or three soft stools per day. C. Watery, diarrhea stools. D. Increased serum bilirubin. - ANS B. Two or three soft stools per day. A client is prescribed aluminum hydroxide for peptic ulcer disease. Which statement by the client demonstrates an understanding of the action of the medication? A. It decreases the production of gastric secretions. B. It produces an adherent barrier over the ulcer. C. It helps maintain a gastric pH of 3.5 or above. D. It slows down the gastric motor activity. - ANS C. It helps maintain a gastric pH of 3.5 or above.