Pharmacology HESI Comprehensive Review 2024

A client with mild parkinsonism is started on oral amantadine (Symmetrel). Which statement accurately describes the action of this medication? - Dopamine in the central nervous system is increased. The nurse is reviewing a client's laboratory results before a procedure in which a neuromuscular blocking agent is a standing order. Which finding should the nurse report to the health care provider? - Hypokalemia A male client asks the nurse why condoms should not be lubricated with the spermicide nonoxynol-9. Which response is best for the nurse to provide? - Nonoxynol-9 provides no protection from STDs and has been linked to the transmission of HIV. The nurse is assessing a stuporous client in the emergency department who is suspected of overdosing with opioids. Which agent should the nurse prepare to administer if the client becomes comatose? - Naloxone hydrochloride (Narcan) A 2-month-old infant is scheduled to receive the first DPT immunization. What is the preferred injection site to administer this immunization? - Vastus lateralis A psychiatric client is discharged from the hospital with a prescription for haloperidol (Haldol). Which instruction should the nurse include in the discharge teaching plan for this client? - Use sunglasses and sunscreen when outdoors. A primigravida at 34 weeks of gestation is admitted to labor and delivery in preterm labor. She is started on a terbutaline sulfate (Brethine) continuous IV infusion via pump. This therapy is ineffective, and the baby is delivered vaginally. For which complication should the nurse monitor in this infant during the first few hours after delivery? - Hypoglycemia A client with metastatic cancer reports severe continuous pain. Which route of administration should the nurse use to provide the most effective continuous analgesia? - Transdermal A client who is hypertensive receives a prescription for hydrochlorothiazide (HCTZ). When teaching about the side effects of this drug, which symptoms are most important for the nurse to instruct the client to report? - Fatigue and muscle weakness Methylphenidate HCl (Concerta) is prescribed for daily administration to a 10- year-old child with attention deficit-hyperactivity disorder (ADHD). In preparing a teaching plan for the parents of this child newly diagnosed with ADHD, which instruction is most important for the nurse to provide to the parents? - Administer the medication in the morning before the child goes to school. Prior to administering a scheduled dose of digoxin (Lanoxin), the nurse reviews the client's current serum digoxin level, which is 1.3 ng/dL. Which action should the nurse implement? - Give the dose of digoxin if the client's heart rate is within a safe range. The health care provider has prescribed a low-molecular-weight heparin, enoxaparin (Lovenox) prefilled syringe, 30 mg/0.3 mL IV every 12 hours, for a client following hip replacement. Prior to administering the first dose, which intervention is most important for the nurse to implement? - Contact the health care provider to clarify the prescription. In administering the antiinfective agent chloramphenicol (Chloromycetin) IV to a client with bacterial meningitis, the nurse observes the client closely for signs of bone marrow depression. Which laboratory data would be most important for the nurse to monitor? - Platelet count A client with viral influenza is receiving vitamin C, 1000 mg PO daily, and acetaminophen elixir, 650 mg PO every 4 hours PRN. The nurse calls the health care provider to report that the client has developed diarrhea. Which change in prescriptions should the nurse anticipate? - Decrease the dose of vitamin C. A client who is receiving chlorpromazine HCl (Thorazine) to control his psychotic behavior also has a prescription for benztropine (Cogentin). When teaching the client and/or significant others about these medications, what should the nurse explain about the use of benztropine (Cogentin) in the treatment plan for this client? - The benztropine (Cogentin) is used to control extrapyramidal symptoms. A female client with myasthenia gravis is taking a cholinesterase inhibitor and asks the nurse what can be done to remedy her fatigue and difficulty swallowing. What action should the nurse implement? - Develop a teaching plan for the client to self-adjust the dose of medication in response to symptoms. The health care provider prescribes oral contraceptives for a client who wants to prevent pregnancy. Which information is the most important for the nurse to provide to this client? - Take one pill at the same time every day until all the pills are gone. The nurse is preparing a plan of care for a client receiving the glucocorticoid methylprednisolone (Solu-Medrol). Which nursing diagnosis reflects a problem related to this medication that should be included in the care plan? - Risk for infection Two hours after taking the first dose of penicillin, a client arrives at the emergency department complaining of feeling ill, exhibiting hives, having difficulty breathing, and experiencing hypotension. These findings are consistent with which client response that requires immediate action? - Severe acute anaphylactic response The health care provider prescribes carbamazepine (Tegretol) for a child whose tonic-clonic seizures have been poorly controlled. The nurse informs the mother that the child must have blood tests every week. The mother asks why so many blood tests are necessary. Which complication is assessed through frequent laboratory testing that the nurse should explain to this mother? - Myelosuppression When caring for a client on digoxin (Lanoxin) therapy, the nurse knows to be alert for digoxin (Lanoxin) toxicity. Which finding would predispose this client to developing digoxin toxicity? - Low serum potassium level A client being treated for an acute myocardial infarction is to receive the tissue plasminogen activator alteplase (Activase). The nurse would be correct in providing which explanation to the client regarding the purpose of this drug? - This drug is a clot buster that dissolves clots within a coronary artery. A lidocaine IV infusion at 4 mg/min via infusion pump is prescribed for a client having premature ventricular contractions (PVCs). The available premixed infusion contains 2 mg/mL of D5W. How many milliliters per hour should the nurse program the pump to deliver to this client? - 120 An older client who had a colon resection yesterday is receiving a constant dose of hydromorphone (Dilaudid) via a patient-controlled analgesia (PCA) pump. Which assessment finding is most significant and requires that the nurse intervene? - Respirations decrease to 14 breaths/min. The health care provider prescribes the H2 antagonist famotidine (Pepcid), 20 mg PO in the morning and at bedtime. Which statement regarding the action of H2 antagonists offers the correct rationale for administering the medication at bedtime? - Hydrochloric acid secreted during the night is blocked. Amoxicillin, 500 mg PO every 8 hours, is prescribed for a client with an infection. The drug is available in a suspension of 125 mg/5 mL. How many milliliters should the nurse administer with each dose? - 20 Which factor is most important to ensure compliance when planning to teach a client about a drug regimen? - Client education The nurse is preparing to administer amphotericin B (Fungizone) IV to a client. What laboratory data is most important for the nurse to assess before initiating an IV infusion of this medication? - Serum potassium level In developing a nursing care plan for a 9-month-old infant with cystic fibrosis, the nurse writes a nursing diagnosis of Alteration in nutrition: less than body requirements, related to inadequate digestion of nutrients. Which intervention would best meet this child's needs? - Give pancrelipase (Cotazym-S) capsule mixed with applesauce before each meal. A client who is HIV-positive is receiving epoetin alfa (Epogen) for the management of anemia secondary to zidovudine (AZT) therapy. Which laboratory finding is most important for the nurse to report to the health care provider? - Hematocrit (HCT) of 58% A client with Tourette's syndrome takes haloperidol (Haldol) to control tics and vocalizations. The client has become increasingly drowsy over the past 2 days and reports becoming dizzy when changing from a supine to sitting position. Which action should the nurse take? - Assess for poor skin turgor, sunken eyeballs, and concentrated urine output. The nurse is providing discharge instructions to a client who has received a prescription for an antibiotic that is hepatotoxic. Which information should the nurse include in the instructions? - Avoid ingesting any alcohol or acetaminophen (Tylenol). Alteration of which laboratory finding represents the achievement of a therapeutic goal for heparin administration? - Partial thromboplastin time (PTT) A client is ordered 22 mg of gentamicin by IM injection. The drug is available in 20 mg/2 mL. How many mL should be administered? - 2.2 mL A client has a positive skin test for tuberculosis. Which prophylactic drug should the nurse expect to administer to this client? - Isoniazid (INH) The charge nurse is reviewing the admission history and physical data for four clients newly admitted to the unit. Which client is at greatest risk for adverse reactions to medications? - 75-year-old woman with liver disease Methenamine mandelate (Mandelamine) is prescribed for a client with a urinary tract infection and renal calculi. Which finding indicates to the nurse that the medication is effective? - The frequency of urinary tract infections decreases. During therapy with isoniazid (INH), it is most important for the nurse to monitor which laboratory value closely? - Liver enzyme levels A client receives an antihypertensive agent daily. Which action is most important for the nurse to implement prior to administering the medication? - Obtain the client's blood pressure. To evaluate whether the administration of an antihypertensive medication has caused a therapeutic effect, which action should the nurse implement? - Compare the client's blood pressure before and after the client takes the medication. The nurse is preparing a teaching plan for a client who has received a new prescription for levothyroxine sodium (Synthroid). Which instruction should be included? - "Take your pulse daily, and if it exceeds 100 beats/min, contact the health care provider." A client with a dislocated shoulder is being prepared for a closed manual reduction using conscious sedation. Which medication should the nurse explain as a sedative used during the procedure? - Midazolam (Versed) IV A client with angina pectoris is instructed to take sublingual nitroglycerin tablets PRN for chest pain. Which instruction should the nurse include in the client's teaching plan? - Take one tablet at the onset of angina and stop activity. A female client who has started long-term corticosteroid therapy tells the nurse that she is careful to take her daily dose at bedtime with a snack of crackers and milk. Which is the best response by the nurse? - Advise the client to take the medication in the morning, rather than at bedtime. A client taking linezolid (Zyvox) at home for an infected foot ulcer calls the home care nurse to report the onset of watery diarrhea. Which intervention should the nurse implement? - Instruct the client to obtain a stool specimen to be taken to the laboratory for analysis. Which physiologic mechanism explains a drug's increased metabolism that is triggered by a disease process? - Pharmacokinetics A client is receiving acyclovir sodium (Zovirax) IV for a severe herpes simplex infection. Which intervention should the nurse implement during this drug therapy? - Increase daily fluids to 2000 to 4000 mL/day. A 42-year-old client is admitted to the emergency department after taking an overdose of amitriptyline (Elavil) in a suicide attempt. Which drug should the nurse plan to administer to reverse the cardiac and central nervous system effects of amitriptyline (Elavil)? - Sodium bicarbonate A male client who has chronic back pain is on long-term pain medication management and asks the nurse why his pain relief therapy is not as effective as it was 2 months ago. How should the nurse respond? - Pharmacodynamic tolerance requires increased drug levels to achieve the same effect. A 55-year-old client was diagnosed with schizophrenia 5 years earlier. Numerous hospitalizations have occurred since the diagnosis because of noncompliance with the prescribed medication regimen. Which drug might work best for this particular client? - Fluphenazine decanoate (Prolixin decanoate) The nurse is evaluating a client's understanding of the prescribed antilipemic drug lovastatin (Mevacor). Which client statement indicates that further teaching is needed? - "I will take the medication every day before breakfast." A 45-year-old female client is receiving alprazolam (Xanax) for anxiety. Which client behaviors would indicate that the drug is effective? - The staff observes the client sitting in the day room reading a book. The apical heart rate of an infant receiving digoxin (Lanoxin) for congestive heart failure is 80 beats/min. Which intervention should the nurse implement first? - Obtain a serum digoxin level. The nurse performs a client assessment prior to the administration of a prescribed dose of dipyridamole and aspirin (Aggrenox) PO. The nurse notes that the client's carotid bruit is louder than previously assessed. Which action should the nurse implement? - Administer the prescribed dose of Aggrenox as scheduled. A client who arrives in the postanesthesia care unit (PACU) after surgery is not awake from general anesthesia. Which action should the nurse implement first? - Review the medication administration record (MAR).