HESI: Pharmacology Test Bank_ distinction level Exam Sol
w w w w w w w
utions has everything; Spring 2022.
w w w w
NCLEX-PNwstylewstudywquestionsw&wAnswers.
1)wAwnursewiswcaringwforwawclientwwithwhyperparathyroidismwandwnoteswthatwthewclient'swserumwcalciumwl
evelwisw13wmg/dL.wWhichwmedicationwshouldwthewnursewpreparewtowadministerwaswprescribedwtowthewclie
nt?
1. Calciumwchloride
2. Calciumwgluconate
3. Calcitoninw(Miacalcin)
4. LargewdoseswofwvitaminwDwANS
✅-
w3.wCalcitoninw(Miacalcin)wRat
ionale:
Thewnormalwserumwcalciumwlevelwisw8.6wtow10.0wmg/dL.wThiswclientwiswexperiencingwhypercalcemia.wCalci
umwgluconatewandwcalciumwchloridewarewmedicationswusedwforwthewtreatmentwofwtetany,wwhichwoccurswa
swawresultwofwacutewhypocalcemia.wInwhypercalcemia,wlargewdoseswofwvitaminwDwneedwtowbewavoided.wCalc
itonin,wawthyroidwhormone,wdecreaseswthewplasmawcalciumwlevelwbywinhibitingwbonewresorptionwandwlow
eringwthewserumwcalciumwconcentration.
2.) Oralwironwsupplementswarewprescribedwforwaw6-year-
oldwchildwwithwironwdeficiencywanemia.wThewnursewinstructswthewmotherwtowadministerwthewironwwithw
whichwbestwfoodwitem?
1. Milk
2. Water
3. Applewjuice
4. OrangewjuicewANS
✅-
w4.wOrangewjuicewRationale:
VitaminwCwincreaseswthewabsorptionwofwironwbywthewbody.wThewmotherwshouldwbewinstructedwtowadminis
terwthewmedicationwwithwawcitruswfruitworwawjuicewthatwiswhighwinwvitaminwC.wMilkwmaywaffectwabsorptionw
ofwthewiron.wWaterwwillwnotwassistwinwabsorption.wOrangewjuicewcontainswawgreaterwamountwofwvitaminwCw
thanwapplewjuice.
3.) Salicylicwacidwiswprescribedwforwawclientwwithwawdiagnosiswofwpsoriasis.wThewnursewmonitorswthewcli
ent,wknowingwthatwwhichwofwthewfollowingwwouldwindicatewthewpresencewofwsystemicwtoxicitywfromwt
hiswmedication?
1. Tinnitus
2. Diarrhea
3. Constipation
4. Decreasedwrespirations
ANS✅-
w1.wTinnituswRational
e:
,Salicylicwacidwiswabsorbedwreadilywthroughwthewskin,wandwsystemicwtoxicityw(salicylism)wcanwresult.wSympto
mswincludewtinnitus,wdizziness,whyperpnea,wandwpsychologicalwdisturbances.wConstipationwandwdiarrheawa
rewnotwassociatedwwithwsalicylism.
4.) Thewcampwnursewaskswthewchildrenwpreparingwtowswimwinwthewlakewifwtheywhavewappliedwsunscreen.w
Thewnursewremindswthewchildrenwthatwchemicalwsunscreenswarewmostweffectivewwhenwapplied:
1. Immediatelywbeforewswimming
2. 15wminuteswbeforewexposurewtowthewsun
3. Immediatelywbeforewexposurewtowthewsun
4. Atwleastw30wminuteswbeforewexposurewtowthewsun
ANS✅-
w4.wAtwleastw30wminuteswbeforewexposurewtowthewsunwRation
ale:
Sunscreenswarewmostweffectivewwhenwappliedwatwleastw30wminuteswbeforewexposurewtowthewsunwsowthatwt
heywcanwpenetratewthewskin.wAllwsunscreenswshouldwbewreappliedwafterwswimmingworwsweating.
5.) Mafenidewacetatew(Sulfamylon)wiswprescribedwforwthewclientwwithwawburnwinjury.wWhenwapplyingw
thewmedication,wthewclientwcomplainswofwlocalwdiscomfortwandwburning.wWhichwofwthewfollowingwiswt
hewmostwappropriatewnursingwaction?
1. Notifyingwthewregisteredwnurse
2. Discontinuingwthewmedication
3. Informingwthewclientwthatwthiswiswnormal
4. Applyingwawthinnerwfilmwthanwprescribedwtowthewburnwsi
tewANS✅-
w3.wInformingwthewclientwthatwthiswiswnormalwRationale:
Mafenidewacetatewiswbacteriostaticwforwgram-negativewandwgram-
positiveworganismswandwiswusedwtowtreatwburnswtowreducewbacteriawpresentwinwavascularwtissues.wThewclie
ntwshouldwbewinformedwthatwthewmedicationwwillwcausewlocalwdiscomfortwandwburningwandwthatwthiswiswaw
normalwreaction;wthereforewoptionsw1,w2,wandw4warewincorrect
6.) Thewburnwclientwiswreceivingwtreatmentswofwtopicalwmafenidewacetatew(Sulfamylon)wtowthewsitewofwinj
ury.wThewnursewmonitorswthewclient,wknowingwthatwwhichwofwthewfollowingwindicateswthatwawsystemicwef
fectwhaswoccurred?
1. Hyperventilation
2. Elevatedwbloodwpressure
3. Localwpainwatwthewburnwsite
4. Localwrashwatwthewburnwsit
ewANS✅-
w1.HyperventilationwRational
e:
Mafenidewacetatewiswawcarbonicwanhydrasewinhibitorwandwcanwsuppresswrenalwexcretionwofwacid,wtherebyw
causingwacidosis.wClientswreceivingwthiswtreatmentwshouldwbewmonitoredwforwsignswofwanwacid-
basewimbalancew(hyperventilation).wIfwthiswoccurs,wthewmedicationwshouldwbewdiscontinuedwforw1wtow2wd
ays.
,Optionsw3wandw4wdescribewlocalwratherwthanwsystemicweffects.wAnwelevatedwbloodwpressurewmaywbewexp
ectedwfromwthewpainwthatwoccurswwithwawburnwinjury.
7.) Isotretinoinwiswprescribedwforwawclientwwithwseverewacne.wBeforewthewadministrationwofwthiswmedicati
on,wthewnursewanticipateswthatwwhichwlaboratorywtestwwillwbewprescribed?
1. Plateletwcount
2. Triglyceridewlevel
3. Completewbloodwcount
4. Whitewbloodwcellwcountw
ANS✅-
w2.wTriglyceridewlevelwRation
ale:
Isotretinoinwcanwelevatewtriglyceridewlevels.wBloodwtriglyceridewlevelswshouldwbewmeasuredwbeforewtreat
mentwandwperiodicallywthereafterwuntilwtheweffectwonwthewtriglycerideswhaswbeenwevaluated.wOptionsw1,w3
,wandw4wdownotwneedwtowbewmonitoredwspecificallywduringwthiswtreatment.
8.) Awclientwwithwseverewacnewiswseenwinwthewclinicwandwthewhealthwcarewproviderw(HCP)wprescribeswisotre
tinoin.wThewnursewreviewswthewclient'swmedicationwrecordwandwwouldwcontactwthew(HCP)wifwthewclientwiswt
akingwwhichwmedication?
1. VitaminwA
2. Digoxinw(Lanoxin)
3. Furosemidew(Lasix)
4. Phenytoinw(Dilantin
)wANS✅-
w1.wVitaminwAwRational
e:
IsotretinoinwiswawmetabolitewofwvitaminwAwandwcanwproducewgeneralizedwintensificationwofwisotretinoinwt
oxicity.wBecausewofwthewpotentialwforwincreasedwtoxicity,wvitaminwAwsupplementswshouldwbewdiscontinue
dwbeforewisotretinoinwtherapy.wOptionsw2,w3,wandw4warewnotwcontraindicatedwwithwthewusewofwisotretinoi
n.
9.) Thewnursewiswapplyingwawtopicalwcorticosteroidwtowawclientwwithweczema.wThewnursewwouldwmonitorw
forwthewpotentialwforwincreasedwsystemicwabsorptionwofwthewmedicationwifwthewmedicationwwerewbeingw
appliedwtowwhichwofwthewfollowingwbodywareas?
1. Back
2. Axilla
3. Soleswofwthewfeet
4. Palmswofwthewhand
swANS✅-
w2.wAxillawRationale:
Topicalwcorticosteroidswcanwbewabsorbedwintowthewsystemicwcirculation.wAbsorptionwiswhigherwfromwregi
onswwherewthewskinwiswespeciallywpermeablew(scalp,waxilla,wface,weyelids,wneck,wperineum,wgenitalia),wan
dwlowerwfromwregionswinwwhichwpermeabilitywiswpoorw(back,wpalms,wsoles).
, 10.) Thewclinicwnursewiswperformingwanwadmissionwassessmentwonwawclient.wThewnursewnoteswthatwthewclie
ntwiswtakingwazelaicwacidw(Azelex).wBecausewofwthewmedicationwprescription,wthewnursewwouldwsuspectwth
atwthewclientwiswbeingwtreatedwfor:
1. Acne
2. Eczema
3. Hairwloss
4. Herpeswsimplex
ANS✅-
w1.wAcnewRationale:
Azelaicwacidwiswawtopicalwmedicationwusedwtowtreatwmildwtowmoderatewacne.wThewacidwappearswtowworkwbywsu
ppressingwthewgrowthwofwPropionibacteriumwacneswandwdecreasingwthewproliferationwofwkeratinocytes.wOptio
nsw2,w3,wandw4warewincorrect.
11.) Thewhealthwcarewproviderwhaswprescribedwsilverwsulfadiazinew(Silvadene)wforwthewclientwwithwawpart
ial-wthicknesswburn,wwhichwhaswculturedwpositivewforwgram-
negativewbacteria.wThewnursewiswreinforcingwinformationwtowthewclientwaboutwthewmedication.wWhichwst
atementwmadewbywthewclientwindicateswawlackwofwunderstandingwaboutwthewtreatments?
1. "Thewmedicationwiswanwantibacterial."
2. "Thewmedicationwwillwhelpwhealwthewburn."
3. "Thewmedicationwwillwpermanentlywstainwmywskin."
4. "Thewmedicationwshouldwbewappliedwdirectlywtowthewwound
."wANS✅-
w3.w"Thewmedicationwwillwpermanentlywstainwmywskin."wRation
ale:
Silverwsulfadiazinew(Silvadene)wiswanwantibacterialwthatwhaswawbroadwspectrumwofwactivitywagainstwgram-
wnegativewbacteria,wgram-
positivewbacteria,wandwyeast.wItwiswappliedwdirectlywtowthewwoundwtowassistwinwhealing.wItwdoeswnotwstainw
thewskin.
12.) Awnursewiswcaringwforwawclientwwhowiswreceivingwanwintravenousw(IV)winfusionwofwanwantineoplasticw
medication.wDuringwthewinfusion,wthewclientwcomplainswofwpainwatwthewinsertionwsite.wDuringwanwinspect
ionwofwthewsite,wthewnursewnoteswrednesswandwswellingwandwthatwthewratewofwinfusionwofwthewmedicatio
nwhaswslowed.wThewnursewshouldwtakewwhichwappropriatewaction?
1. Notifywthewregisteredwnurse.
2. Administerwpainwmedicationwtowreducewthewdiscomfort.
3. Applywicewandwmaintainwthewinfusionwrate,waswprescribed.
4. ElevatewthewextremitywofwthewIVwsite,wandwslowwthewinfusio
n.wANS✅-w1.wNotifywthewregisteredwnurse.
Rationale:
Whenwantineoplasticwmedicationsw(ChemotheraputicwAgents)warewadministeredwviawIV,wgreatwcarewmustw
bewtakenwtowpreventwthewmedicationwfromwescapingwintowthewtissueswsurroundingwthewinjectionwsite,wbe
causewpain,wtissuewdamage,wandwnecrosiswcanwresult.wThewnursewmonitorswforwsignswofwextravasation,wsu
chwas
w w w w w w w
utions has everything; Spring 2022.
w w w w
NCLEX-PNwstylewstudywquestionsw&wAnswers.
1)wAwnursewiswcaringwforwawclientwwithwhyperparathyroidismwandwnoteswthatwthewclient'swserumwcalciumwl
evelwisw13wmg/dL.wWhichwmedicationwshouldwthewnursewpreparewtowadministerwaswprescribedwtowthewclie
nt?
1. Calciumwchloride
2. Calciumwgluconate
3. Calcitoninw(Miacalcin)
4. LargewdoseswofwvitaminwDwANS
✅-
w3.wCalcitoninw(Miacalcin)wRat
ionale:
Thewnormalwserumwcalciumwlevelwisw8.6wtow10.0wmg/dL.wThiswclientwiswexperiencingwhypercalcemia.wCalci
umwgluconatewandwcalciumwchloridewarewmedicationswusedwforwthewtreatmentwofwtetany,wwhichwoccurswa
swawresultwofwacutewhypocalcemia.wInwhypercalcemia,wlargewdoseswofwvitaminwDwneedwtowbewavoided.wCalc
itonin,wawthyroidwhormone,wdecreaseswthewplasmawcalciumwlevelwbywinhibitingwbonewresorptionwandwlow
eringwthewserumwcalciumwconcentration.
2.) Oralwironwsupplementswarewprescribedwforwaw6-year-
oldwchildwwithwironwdeficiencywanemia.wThewnursewinstructswthewmotherwtowadministerwthewironwwithw
whichwbestwfoodwitem?
1. Milk
2. Water
3. Applewjuice
4. OrangewjuicewANS
✅-
w4.wOrangewjuicewRationale:
VitaminwCwincreaseswthewabsorptionwofwironwbywthewbody.wThewmotherwshouldwbewinstructedwtowadminis
terwthewmedicationwwithwawcitruswfruitworwawjuicewthatwiswhighwinwvitaminwC.wMilkwmaywaffectwabsorptionw
ofwthewiron.wWaterwwillwnotwassistwinwabsorption.wOrangewjuicewcontainswawgreaterwamountwofwvitaminwCw
thanwapplewjuice.
3.) Salicylicwacidwiswprescribedwforwawclientwwithwawdiagnosiswofwpsoriasis.wThewnursewmonitorswthewcli
ent,wknowingwthatwwhichwofwthewfollowingwwouldwindicatewthewpresencewofwsystemicwtoxicitywfromwt
hiswmedication?
1. Tinnitus
2. Diarrhea
3. Constipation
4. Decreasedwrespirations
ANS✅-
w1.wTinnituswRational
e:
,Salicylicwacidwiswabsorbedwreadilywthroughwthewskin,wandwsystemicwtoxicityw(salicylism)wcanwresult.wSympto
mswincludewtinnitus,wdizziness,whyperpnea,wandwpsychologicalwdisturbances.wConstipationwandwdiarrheawa
rewnotwassociatedwwithwsalicylism.
4.) Thewcampwnursewaskswthewchildrenwpreparingwtowswimwinwthewlakewifwtheywhavewappliedwsunscreen.w
Thewnursewremindswthewchildrenwthatwchemicalwsunscreenswarewmostweffectivewwhenwapplied:
1. Immediatelywbeforewswimming
2. 15wminuteswbeforewexposurewtowthewsun
3. Immediatelywbeforewexposurewtowthewsun
4. Atwleastw30wminuteswbeforewexposurewtowthewsun
ANS✅-
w4.wAtwleastw30wminuteswbeforewexposurewtowthewsunwRation
ale:
Sunscreenswarewmostweffectivewwhenwappliedwatwleastw30wminuteswbeforewexposurewtowthewsunwsowthatwt
heywcanwpenetratewthewskin.wAllwsunscreenswshouldwbewreappliedwafterwswimmingworwsweating.
5.) Mafenidewacetatew(Sulfamylon)wiswprescribedwforwthewclientwwithwawburnwinjury.wWhenwapplyingw
thewmedication,wthewclientwcomplainswofwlocalwdiscomfortwandwburning.wWhichwofwthewfollowingwiswt
hewmostwappropriatewnursingwaction?
1. Notifyingwthewregisteredwnurse
2. Discontinuingwthewmedication
3. Informingwthewclientwthatwthiswiswnormal
4. Applyingwawthinnerwfilmwthanwprescribedwtowthewburnwsi
tewANS✅-
w3.wInformingwthewclientwthatwthiswiswnormalwRationale:
Mafenidewacetatewiswbacteriostaticwforwgram-negativewandwgram-
positiveworganismswandwiswusedwtowtreatwburnswtowreducewbacteriawpresentwinwavascularwtissues.wThewclie
ntwshouldwbewinformedwthatwthewmedicationwwillwcausewlocalwdiscomfortwandwburningwandwthatwthiswiswaw
normalwreaction;wthereforewoptionsw1,w2,wandw4warewincorrect
6.) Thewburnwclientwiswreceivingwtreatmentswofwtopicalwmafenidewacetatew(Sulfamylon)wtowthewsitewofwinj
ury.wThewnursewmonitorswthewclient,wknowingwthatwwhichwofwthewfollowingwindicateswthatwawsystemicwef
fectwhaswoccurred?
1. Hyperventilation
2. Elevatedwbloodwpressure
3. Localwpainwatwthewburnwsite
4. Localwrashwatwthewburnwsit
ewANS✅-
w1.HyperventilationwRational
e:
Mafenidewacetatewiswawcarbonicwanhydrasewinhibitorwandwcanwsuppresswrenalwexcretionwofwacid,wtherebyw
causingwacidosis.wClientswreceivingwthiswtreatmentwshouldwbewmonitoredwforwsignswofwanwacid-
basewimbalancew(hyperventilation).wIfwthiswoccurs,wthewmedicationwshouldwbewdiscontinuedwforw1wtow2wd
ays.
,Optionsw3wandw4wdescribewlocalwratherwthanwsystemicweffects.wAnwelevatedwbloodwpressurewmaywbewexp
ectedwfromwthewpainwthatwoccurswwithwawburnwinjury.
7.) Isotretinoinwiswprescribedwforwawclientwwithwseverewacne.wBeforewthewadministrationwofwthiswmedicati
on,wthewnursewanticipateswthatwwhichwlaboratorywtestwwillwbewprescribed?
1. Plateletwcount
2. Triglyceridewlevel
3. Completewbloodwcount
4. Whitewbloodwcellwcountw
ANS✅-
w2.wTriglyceridewlevelwRation
ale:
Isotretinoinwcanwelevatewtriglyceridewlevels.wBloodwtriglyceridewlevelswshouldwbewmeasuredwbeforewtreat
mentwandwperiodicallywthereafterwuntilwtheweffectwonwthewtriglycerideswhaswbeenwevaluated.wOptionsw1,w3
,wandw4wdownotwneedwtowbewmonitoredwspecificallywduringwthiswtreatment.
8.) Awclientwwithwseverewacnewiswseenwinwthewclinicwandwthewhealthwcarewproviderw(HCP)wprescribeswisotre
tinoin.wThewnursewreviewswthewclient'swmedicationwrecordwandwwouldwcontactwthew(HCP)wifwthewclientwiswt
akingwwhichwmedication?
1. VitaminwA
2. Digoxinw(Lanoxin)
3. Furosemidew(Lasix)
4. Phenytoinw(Dilantin
)wANS✅-
w1.wVitaminwAwRational
e:
IsotretinoinwiswawmetabolitewofwvitaminwAwandwcanwproducewgeneralizedwintensificationwofwisotretinoinwt
oxicity.wBecausewofwthewpotentialwforwincreasedwtoxicity,wvitaminwAwsupplementswshouldwbewdiscontinue
dwbeforewisotretinoinwtherapy.wOptionsw2,w3,wandw4warewnotwcontraindicatedwwithwthewusewofwisotretinoi
n.
9.) Thewnursewiswapplyingwawtopicalwcorticosteroidwtowawclientwwithweczema.wThewnursewwouldwmonitorw
forwthewpotentialwforwincreasedwsystemicwabsorptionwofwthewmedicationwifwthewmedicationwwerewbeingw
appliedwtowwhichwofwthewfollowingwbodywareas?
1. Back
2. Axilla
3. Soleswofwthewfeet
4. Palmswofwthewhand
swANS✅-
w2.wAxillawRationale:
Topicalwcorticosteroidswcanwbewabsorbedwintowthewsystemicwcirculation.wAbsorptionwiswhigherwfromwregi
onswwherewthewskinwiswespeciallywpermeablew(scalp,waxilla,wface,weyelids,wneck,wperineum,wgenitalia),wan
dwlowerwfromwregionswinwwhichwpermeabilitywiswpoorw(back,wpalms,wsoles).
, 10.) Thewclinicwnursewiswperformingwanwadmissionwassessmentwonwawclient.wThewnursewnoteswthatwthewclie
ntwiswtakingwazelaicwacidw(Azelex).wBecausewofwthewmedicationwprescription,wthewnursewwouldwsuspectwth
atwthewclientwiswbeingwtreatedwfor:
1. Acne
2. Eczema
3. Hairwloss
4. Herpeswsimplex
ANS✅-
w1.wAcnewRationale:
Azelaicwacidwiswawtopicalwmedicationwusedwtowtreatwmildwtowmoderatewacne.wThewacidwappearswtowworkwbywsu
ppressingwthewgrowthwofwPropionibacteriumwacneswandwdecreasingwthewproliferationwofwkeratinocytes.wOptio
nsw2,w3,wandw4warewincorrect.
11.) Thewhealthwcarewproviderwhaswprescribedwsilverwsulfadiazinew(Silvadene)wforwthewclientwwithwawpart
ial-wthicknesswburn,wwhichwhaswculturedwpositivewforwgram-
negativewbacteria.wThewnursewiswreinforcingwinformationwtowthewclientwaboutwthewmedication.wWhichwst
atementwmadewbywthewclientwindicateswawlackwofwunderstandingwaboutwthewtreatments?
1. "Thewmedicationwiswanwantibacterial."
2. "Thewmedicationwwillwhelpwhealwthewburn."
3. "Thewmedicationwwillwpermanentlywstainwmywskin."
4. "Thewmedicationwshouldwbewappliedwdirectlywtowthewwound
."wANS✅-
w3.w"Thewmedicationwwillwpermanentlywstainwmywskin."wRation
ale:
Silverwsulfadiazinew(Silvadene)wiswanwantibacterialwthatwhaswawbroadwspectrumwofwactivitywagainstwgram-
wnegativewbacteria,wgram-
positivewbacteria,wandwyeast.wItwiswappliedwdirectlywtowthewwoundwtowassistwinwhealing.wItwdoeswnotwstainw
thewskin.
12.) Awnursewiswcaringwforwawclientwwhowiswreceivingwanwintravenousw(IV)winfusionwofwanwantineoplasticw
medication.wDuringwthewinfusion,wthewclientwcomplainswofwpainwatwthewinsertionwsite.wDuringwanwinspect
ionwofwthewsite,wthewnursewnoteswrednesswandwswellingwandwthatwthewratewofwinfusionwofwthewmedicatio
nwhaswslowed.wThewnursewshouldwtakewwhichwappropriatewaction?
1. Notifywthewregisteredwnurse.
2. Administerwpainwmedicationwtowreducewthewdiscomfort.
3. Applywicewandwmaintainwthewinfusionwrate,waswprescribed.
4. ElevatewthewextremitywofwthewIVwsite,wandwslowwthewinfusio
n.wANS✅-w1.wNotifywthewregisteredwnurse.
Rationale:
Whenwantineoplasticwmedicationsw(ChemotheraputicwAgents)warewadministeredwviawIV,wgreatwcarewmustw
bewtakenwtowpreventwthewmedicationwfromwescapingwintowthewtissueswsurroundingwthewinjectionwsite,wbe
causewpain,wtissuewdamage,wandwnecrosiswcanwresult.wThewnursewmonitorswforwsignswofwextravasation,wsu
chwas
