HESI PHARMACOLOGY ACTUAL EXAM - Pharm HESI V1 B

HESI PHARMACOLOGY ACTUAL EXAM A male client who has been taking a high dose of a nonsteroidal anti-inflammatory drug (NSAID) comes to the clinic complaining of gastric pain and blood in his stool. The healthcare provider discontinues the NSAIDs and prescribes esomeprazole. Which information should the client include in the nurse's teaching plan? A. Once pain subsides, NSAID therapy can be continued B. Resume a diet that consists of milk, cream, and bland foods C. Notify the healthcare provider of the passage of black stool D. Call the clinic if diarrhea or headache occur when taking esomeprazole - Answer: C. Notify the healthcare provider of the passage of black stool When administering zolpidem to an older client, which computer documentation indicates that the desired outcome has been achieved? A. Sleeps soundly through the night B. Decreased episodes of incontinence C. Exhibits fewer emotional outburst D. Improved ability to concentrate - Answer: A. Sleeps soundly through the night A male client with a fungal infection of the toenail reports to the nurse that he has been applying an over-the-counter triple antibiotic ointment to the infection daily for two weeks without any improvement. Which action should the nurse take? A. Instruct the client to obtain a prescription for oral terbinafine B. Suggest that the client use the ointment twice a day to be more effective C. Reassure that the treatment of fungus-infected toenails often takes several months D. Advise the client to obtain a prescription-strength formulation of the ointment - Answer: A. Instruct the client to obtain a prescription for oral terbinafine A client with a nasogastric tube (NGT) has a prescription for sucralfate. The liquid form of the medication is not currently available in the pharmacy and tablets have been delivered to the medication dispensing system. Which action should the nurse include when administering the medication? A. Crush the tablet and mix it with water separately from other medications B. Crush the tablet and mix it with other crushed tablets diluted in water C. Withhold the medication until a liquid form is available on the nursing unit D. Crush the tablet and mix it with other liquid medications for administration - Answer: A. Crush the tablet and mix it with water separately from other medications A client with chronic asthma receives a prescription for montelukast, a leukotriene modifier. Which statement by the client indicates to the nurse that medication teaching was effective? A. I should take this medication only when I am having an asthma attack B. I will take the tablet every evening to control my asthma C. This medication will stop an asthma attack immediately D. I will not need to use my inhalers twice a day when I start this medication - Answer: B. I will take the tablet every evening to control my asthma The nurse is planning to administer the antiulcer GI agent sucralfate to a client with peptic ulcer disease. Which action should the nurse include in this client's plan of care? A. Assess for secondary Candida infection B. Administer sucralfate once a day, preferably at bedtime C. Give sucralfate on an empty stomach D. Monitor for electrolyte imbalance - Answer: C. Give sucralfate once a day, preferably at bedtime A client with anemia secondary to chronic kidney disease (CKD) started a prescription for epoetin alfa two months ago. Which client finding best indicates that the medication is effective? A. Reports of increased energy levels and decreased fatigue B. Takes concurrent iron therapy without adverse effects C. Food diary shows increased consumption of iron-rich foods D. Hemoglobin level increased to 12 grams/dL (120 mmol/L) - Answer: D. Hemoglobin level increased to 12 grams/dL (120 mmol/L) The healthcare provider prescribes propylthiouracil (PTU) and Lugol's solution, a strong idoine solution, for a client with hyperthyroidism. How should the nurse schedule the administration of these medications? A. Administer iodine one hour before PTU B. Offer both drugs together with a meal C. Schedule both medications at bedtime D. Give parental dose once every 24 hours - Answer: B. Offer both drugs together with a meal Twenty minutes after the nurse starts a secondary IV infusion of cefepime 2 grams using an infusion pump to deliver the dose in one hour, the client reports feeling nauseate. Which action should the nurse implement? A. Continue the infusion and administer a PRN antiemetic prescription B. Stop the medication infusion and notify the healthcare provider of the adverse effect C. Reassure the client that the nausea us not related to the IV infusion D. Increase the rate of the infusion to complete the dose of the medication more rapidly - Answer: A. Continue the infusion and administer a PRN antiemetic prescription A client with diabetic peripheral neuropathy, who has been taking pregabalin for 2 weeks reports diminished foot pain. The nurse notes that there is no improvement in the healing of several toe ulcerations. Which action should the nurse take? A. Review the plan of care for strategies used to manage the foot ulcerations B. Reassure the client that diabetic foot ulcers take several months to heal C. Explain that the medication dosage will probably need to be increased D. Withhold the next dose of the drug until the healthcare provider is notified - Answer: A. Review the plan of care for strategies used to manage the foot ulcerations A client with type 2 diabetes mellitus who takes glimepiride by mouth daily calls the nurse to report a recent onset of nausea, vomiting and diarrhea. Which response should the nurse provide? A. Increases oral fluid intake until these symptoms subside B. Use insulin sliding scale until symptoms are resolved C. Schedule a visit for evaluation by the healthcare provider D. Return to the clinic for laboratory test for an infection - Answer: A. Increases oral fluid intake until these symptoms subside The healthcare provider increases a client's prescription for glipizide 5mg to glipizide 7.5 mg by mouth every 12 hours. The medication is available in 5 mg scored tablets. How many tablets should the nurse administer with each dose? - Answer: 1.5 The nurse is administering the muscle relaxant baclofen PO to a client diagnosed with multiple sclerosis. Which interventions should the nurse implement? A. Advise the client to move slowly and cautiously when rising and walking B. Ensure the client knows to stop baclofen before using other antispasmodics C. Monitor intake and output every 8 hours D. Evaluate muscle strength every 4 hours - Answer: D. Evaluate muscle strength every 4 hours The nurse retrieves hydromorphone 4 mg/ml from the Pyxis Medstation, an automated dispensing system, for a client who is receiving hydromorphone 3 mg IM every 8 hours PRN severe pain. How many mL should the nurse administer to the client? (Round to the nearest tenth) - Answer: 0.8 When conducting a drug education about an oral prescription for cyclosporine, which juice should the nurse instruct the client to avoid because it can increase the serum cyclosporine levels? A. Apple B. Grape C. Grapefruit D. Orange - Answer: C. Grapefruit A patient with hepatic encephalopathy is receiving lactulose. Which assessment provides the nurse with the best information to evaluate the client's therapeutic response to the drug?A. Serum electrolyte and ammonia B. Stool color and character C. Fingerstick glucose D. Serum Hepatic enzymes - Answer: B. Stool color and character A client is recieving morphine sulfate via a PCA pump postoperatively. Which assessment finding should prompt the nurse to administer a prescribed PRN dose of naloxone? A. Respiratory rate of 7 breaths/minute B. Pulse oximeter reading of 89% on room air C. Expresses that they cannot get enough air to breathe D. Intercostal retractions and bilateral wheezing on auscultation - Answer: A. Respiratory rate of 7 breaths/minute The nurse is providing instructions about a client's new medications. how should the nurse explain the purpose of probenecid, a uricosuric drug? A. Promotes excretion of uric acid in the urine B. Increases the strength of the urine stream C. Prevents the formation of kidney stones D. Decreases pain and burning during urination - Answer: A. Promotes excretion of uric acid in the urine A female client who has trichomoniasis vaginitis receives a prescription for metronidazole. Which instruction should the nurse provide this client? A. Urine may turn an orange color B. Report any difficulty with hearing C. Male partners must also be treated D. Take the medication only when symptomatic - Answer: C. Male partners must also be treated After receiving five doses of filgrastim the nurse notes that the client's white blood cell count has increased from 2500/mm (2.5* 10/LSI) to 5,000/mm(5* 10/LSI). What action should the nurse implement? A. Assess the client's vital signs B. Implement neutropenic precautions C. Review the client's culture and sensitivity reports D. Inform the client that the medication has been effective - Answer: B. Implement neutropenic precautions The nurse is preparing a discharge teaching plan for a client who is taking ciprofloxacin hydrochloride (Cipro) tablets, which were prescribed because of suspected anthrax exposure. Which instructions should be included in the teaching plan? (Select all that apply) A. Increase fluid intake while taking the medication B. Crush and mix the tablets with pudding if you have trouble swallowing the tablets C. Use NSAIDs to relieve mild joint aches and pains caused by the medication D. Report any tendon pain or swelling to the HCP immediatelyE. Limit exposure to sunlight and avoid tanning beds - Answers: A, D, and E A client with chronic lower back pain has been taking the non-steroidal antiinflammatory drug (NSAID) ibuprofen, by mouth twice a day for several months. Which assessment is most important for the nurse to complete? A. Assess back pain using numeric scale B. Palpate volume of pedal pulses C. Determine presence of abdominal pain D. Evaluate ongoing sleep patterns - Answer: C. Determine presence of abdominal pain A 48 year-old male client tells the nurse that he obtained sildenafil without a prescription over the internet and asks the nurse if it is safe to take. In addition to advising the client to obtain medical evaluation. It is important that the nurse immediately determine if he takes what other type of medication? A. Anticoagulants, such as warfarin B. Statins, such as atorvastatin C. Nitrates, such as nitroglycerine D. Analgesics, such as acetaminophen - Answer: C. Nitrates, such as nitroglycerine A client recently diagnosed with early stage Alzheimer's disease receives a prescription for donepezil, an acetylcholinesterase inhibitor. Which content should the nurse include in the client medication teaching? A. Discuss the fact that Aricept may slow the progression of the disease over the next year. B. Instruct the client to get monthly liver function studies to assess for liver failure C. Encourage the client to avoid foods high in Vitamin K, such as green leafy vegetables D. Explain that the psychiatrist has prescribed the maximum dose and will decrease it gradually - Answer: A. Discuss the fact that Aricept may slow the progression of the disease over the next year The nurse is planning care for a client with major depression who is receiving a new prescription for duloxetine. Which information is most important for the nurse to obtain?A. Liver function laboratory resultsB. Family history of mental illness C. Recent use of other antidepressantsD. Weight change in the last month - Answer: A. Liver function laboratory results The nurse is preparing a client with COPD and a chronic productive cough for discharged home. Which prescribed medication should the nurse review with the client to manage this symptom A. Tiotropium B. Salmeterol C. Prednisone D. Guaifenesin - Answer: D. Guaifenesin A client who receives multiple antihypertensive medications experience syncope due to a drop in blood pressure to 70/40 mm Hg. Which is the rationale for the nurse's decision to hold the client's scheduled antihypertensive medications? A. The synergetic effect of the multiple medications has resulted in drug toxicity and resulting hypotension B. Increased urinary clearance of the multiple medications has produced diuresis and lowered the blood pressure C. The antagonistic interaction among the various blood pressure medications has reduced their effectiveness D. The additive effect of multiple medications has caused the blood pressure to drop too low - Answer: D. The additive effect of multiple medications has caused the blood pressure to drop too low A client who is taking dextroamphetamine-amphetamine extended-release tablets for attention deficit hyperactivity disorder (ADHD) complains about having difficulty sleeping at night. Which assessment is most important for the nurse to obtain? A. Ask about the client's bedtime routine B. Determine what time the dose is taken C. Inquire about perceived anxiety D. Determine daily caffeine intake - Answer B: Determine what time the does is taken Based on the capillary glucose measurement, a client is to receive 10 units of regular insulin. The client's medication drawer contains 1 vial of 70/30 mixture of regular insulin and isophane insulin. How should the nurse prepare the prescribed dose? A. Withdraw ten units regular insulin from the 70/30 vial B. Withhold the dose until insulin regular is available on the unit C. Put up 30 units from the 70/30 vial, but only administer one third D. Obtain a new vial of regular insulin and withdraw ten units - Answer: D. Obtain a new vial of regular insulin and withdraw ten units