HESI Pharmacology Spring 2024/2025 Test
Bank(LatestUpdate):Expert Solved
/ACE Inhibitors Mechanism/Therapeutic Effects - Answer-ACE inhibitors prevent
vasoconstriction and the retention of sodium and water.
Preload and afterload are decreased.
The therapeutic effects of ACE inhibitors are decreased blood pressure and diuresis.
/.ACE Inhibitors Contraindications - Answer-Drug allergy, hyperkalemia, bilateral renal
stenosis, pregnancy, and lactation
/.ACE Inhibitors Drug Interactions - Answer-Increased effects occur with other
antihypertensive drugs and diuretics.
Decreased effects occur with aspirin and NSAIDs.
Risk for hyperkalemia occurs if given with potassium
supplements or potassium-sparing diuretics.
Risk for lithium toxicity occurs if administered
concurrently with lithium.
/.ACE Inhibitors Adverse Effects - Answer-Effects may include fatigue; dizziness; mood
changes; headache; dry, nonproductive cough;
first-dose hypotension; loss of taste; proteinuria; hyperkalemia; rash; pruritus; anemia;
neutropenia; thrombocytosis; and agranulocytosis.
/.Nursing Implications of ACE Inhibitors - Answer-Assess blood pressure, apical pulse,
and respiratory status prior to administration.
Withhold medication if serum potassium >5 mEq/L and notify the health care provider.
Monitor for angioedema and notify the health care provider immediately if it occurs.
Monitor sodium and fluid volume status.
Monitor dietary and fluid intake because ACE inhibitors can cause anorexia secondary
to impaired taste.
/.Patient Teaching for ACE Inhibitors - Answer-Take medication exactly as prescribed.
Do not stop taking it abruptly.
Do not use with potassium supplements or increased dietary intake of potassium.
Move and change positions slowly to prevent postural hypotension.
This medication may cause an irritating dry cough.
Impaired taste may be an adverse effect that may last up to 2 to 3 months after the
drug has been discontinued.
Monitor blood pressure and understand which parameters to report.
,/.Opioid Mechanism/Therapeutic Effects - Answer-Opioid analgesics bind to opioid
receptors in the brain, blocking the transmission of pain messages and causing a
reduction in pain sensation. They also cause euphoria and sedation.
Full agonists cause the strongest analgesic effect but also have the strongest adverse
reactions. Partial or mixed agonists are weaker analgesics but also cause fewer
adverse effects.
/.Contraindications of Opioids - Answer-Drug allergy, severe asthma or other respiratory
insufficiency, increased intracranial pressure, myasthenia gravis, paralytic ileus, acute
abdominal conditions, and pregnancy and lactation
/.Drug Interactions of Opioids - Answer-Alcohol, antihistamines, barbiturates,
benzodiazepines, phenothiazine, and other central nervous system depressants can
result in additive respiratory-depressant effects. Monoamine oxidase inhibitors can
result in respiratory depression and hypotension.
/.Adverse Effects of Opioids - Answer-Effects include central nervous system
depression, respiratory depression, hypotension, flushing, palpitations, constipation,
nausea and vomiting, urinary retention, itching, rash, and biliary tract spasm.
/.Nursing Implications of Opioids - Answer-¬ Assess vital signs (blood pressure, pulse,
respirations, and pain level) prior to administration.
¬ Withhold medication if respiratory rate is <12 breaths/minute or systolic blood
pressure is <90.
¬ Administer oral medications with food to decrease nausea and vomiting.
¬ Monitor urinary output and bowel status.
¬ Institute safety precautions (i.e., side rail up, call bell in place).
/.Mechanism/Therapeutic Effects Hydantoins (Antiepileptic) - Answer-First, they
increase the threshold of activity in the area of the brain called the motor cortex, making
it more difficult for a nerve to be excited. Second, they act to depress or limit the spread
of a seizure discharge from its origin. Third, they can decrease the speed of nerve
impulse conduction within a given neuron.
The major therapeutic indication for AEDs is the prevention or control of seizure activity.
/.Contraindications of AEDs - Answer-Pregnancy and Drug Allergy
/.Drug Interactions of AEDs - Answer-Increased hydantoin levels occur with disulfiram,
isoniazid, and valproic acid.
Increased risk for seizures occurs with tricyclic antidepressants.
/.Adverse Effects of AEDs - Answer-The most common effects are lethargy, abnormal
movements, mental confusion, and cognitive changes. These drugs can also cause
bone marrow suppression, exfoliative dermatitis, lupus erythematosus, Stevens-
Johnson syndrome, and neuropathies.
At toxic levels, they can cause nystagmus, ataxia, dysarthria, and encephalopathy.
, Long-term therapy can cause gingival hyperplasia, acne, hirsutism, osteoporosis, and
hypertrophy of subcutaneous facial tissue resulting in an appearance known as Dilantin
facies.
/.Nursing Implications of AEDs - Answer-¬ Assess complete blood count, serum
chemistry, and drug levels prior to administration. Know that therapeutic drug levels are
usually 10 to 20 mcg/mL.
¬ Know that 150 mg of fosphenytoin yield 100 mg of phenytoin and that the
concentration and infusion rate of fosphenytoin would be expressed as a phenytoin
equivalent (PE).
¬ Administer phenytoin no faster than 50 mg/min and fosphenytoin at 150 mg PE/min to
avoid hypotension or cardiorespiratory depression.
¬ Dilute phenytoin only with normal saline solution. Flush intravenous lines with saline
before and after administration.
¬ Monitor the patient for ataxia and dizziness after an infusion.
¬ Do not confuse fosphenytoin (Cerebyx) with Celebrex.
¬ Administer oral dosage forms of the drug with food. Instruct the patient not to open,
chew, or break capsules; however, the non-sustained-release tablets may be chewed.
/.Patient Teaching for AEDs - Answer-Avoid tasks requiring alertness until a steady
state of the drug has been achieved (which takes 4 to 5 half-lives) to help prevent injury.
⎫ Avoid drinking alcohol and smoking.
⎫ Do not abruptly withdraw from an AED; rebound seizure activity could occur.
⎫ Phenytoin may turn urine to pink or red-brown. This color change commonly
diminishes over time.
⎫ Drowsiness commonly decreases after several weeks because tolerance to this
particular adverse effect occurs.
⎫ Frequent oral care and dental visits are necessary so as to prevent the adverse effect
of gingival hyperplasia.
⎫ Avoid any form of stimulant (e.g., caffeine) because there is a higher risk for seizure.
⎫ Therapy is usually lifelong. Resources available include national and local support
groups.
⎫ Contact the physician if any unusual reactions occur, such as glandular swelling,
fever, sore throat, tarry stools, back pain, hematuria, easy bruising, lethargy, or mouth
ulcers.
/.SSRI Mechanism/Therapeutic Effects - Answer-Selective serotonin reuptake inhibitors
(SSRIs) inhibit the reuptake of serotonin into presynaptic terminals (nerve endings) and
thus increase the levels of serotonin available for neurotransmission at the postsynaptic
nerve endings. They also demonstrate weak inhibition of norepinephrine and dopamine
reuptake. Increased levels of these neurotransmitters are responsible for the
improvement of the symptoms of depression.
SSRIs are the first-line treatment for major depression and are also indicated for the
treatment of obsessive-compulsive disorder, anxiety disorders, panic disorders, and
compulsive eating disorders such as bulimia nervosa.
Bank(LatestUpdate):Expert Solved
/ACE Inhibitors Mechanism/Therapeutic Effects - Answer-ACE inhibitors prevent
vasoconstriction and the retention of sodium and water.
Preload and afterload are decreased.
The therapeutic effects of ACE inhibitors are decreased blood pressure and diuresis.
/.ACE Inhibitors Contraindications - Answer-Drug allergy, hyperkalemia, bilateral renal
stenosis, pregnancy, and lactation
/.ACE Inhibitors Drug Interactions - Answer-Increased effects occur with other
antihypertensive drugs and diuretics.
Decreased effects occur with aspirin and NSAIDs.
Risk for hyperkalemia occurs if given with potassium
supplements or potassium-sparing diuretics.
Risk for lithium toxicity occurs if administered
concurrently with lithium.
/.ACE Inhibitors Adverse Effects - Answer-Effects may include fatigue; dizziness; mood
changes; headache; dry, nonproductive cough;
first-dose hypotension; loss of taste; proteinuria; hyperkalemia; rash; pruritus; anemia;
neutropenia; thrombocytosis; and agranulocytosis.
/.Nursing Implications of ACE Inhibitors - Answer-Assess blood pressure, apical pulse,
and respiratory status prior to administration.
Withhold medication if serum potassium >5 mEq/L and notify the health care provider.
Monitor for angioedema and notify the health care provider immediately if it occurs.
Monitor sodium and fluid volume status.
Monitor dietary and fluid intake because ACE inhibitors can cause anorexia secondary
to impaired taste.
/.Patient Teaching for ACE Inhibitors - Answer-Take medication exactly as prescribed.
Do not stop taking it abruptly.
Do not use with potassium supplements or increased dietary intake of potassium.
Move and change positions slowly to prevent postural hypotension.
This medication may cause an irritating dry cough.
Impaired taste may be an adverse effect that may last up to 2 to 3 months after the
drug has been discontinued.
Monitor blood pressure and understand which parameters to report.
,/.Opioid Mechanism/Therapeutic Effects - Answer-Opioid analgesics bind to opioid
receptors in the brain, blocking the transmission of pain messages and causing a
reduction in pain sensation. They also cause euphoria and sedation.
Full agonists cause the strongest analgesic effect but also have the strongest adverse
reactions. Partial or mixed agonists are weaker analgesics but also cause fewer
adverse effects.
/.Contraindications of Opioids - Answer-Drug allergy, severe asthma or other respiratory
insufficiency, increased intracranial pressure, myasthenia gravis, paralytic ileus, acute
abdominal conditions, and pregnancy and lactation
/.Drug Interactions of Opioids - Answer-Alcohol, antihistamines, barbiturates,
benzodiazepines, phenothiazine, and other central nervous system depressants can
result in additive respiratory-depressant effects. Monoamine oxidase inhibitors can
result in respiratory depression and hypotension.
/.Adverse Effects of Opioids - Answer-Effects include central nervous system
depression, respiratory depression, hypotension, flushing, palpitations, constipation,
nausea and vomiting, urinary retention, itching, rash, and biliary tract spasm.
/.Nursing Implications of Opioids - Answer-¬ Assess vital signs (blood pressure, pulse,
respirations, and pain level) prior to administration.
¬ Withhold medication if respiratory rate is <12 breaths/minute or systolic blood
pressure is <90.
¬ Administer oral medications with food to decrease nausea and vomiting.
¬ Monitor urinary output and bowel status.
¬ Institute safety precautions (i.e., side rail up, call bell in place).
/.Mechanism/Therapeutic Effects Hydantoins (Antiepileptic) - Answer-First, they
increase the threshold of activity in the area of the brain called the motor cortex, making
it more difficult for a nerve to be excited. Second, they act to depress or limit the spread
of a seizure discharge from its origin. Third, they can decrease the speed of nerve
impulse conduction within a given neuron.
The major therapeutic indication for AEDs is the prevention or control of seizure activity.
/.Contraindications of AEDs - Answer-Pregnancy and Drug Allergy
/.Drug Interactions of AEDs - Answer-Increased hydantoin levels occur with disulfiram,
isoniazid, and valproic acid.
Increased risk for seizures occurs with tricyclic antidepressants.
/.Adverse Effects of AEDs - Answer-The most common effects are lethargy, abnormal
movements, mental confusion, and cognitive changes. These drugs can also cause
bone marrow suppression, exfoliative dermatitis, lupus erythematosus, Stevens-
Johnson syndrome, and neuropathies.
At toxic levels, they can cause nystagmus, ataxia, dysarthria, and encephalopathy.
, Long-term therapy can cause gingival hyperplasia, acne, hirsutism, osteoporosis, and
hypertrophy of subcutaneous facial tissue resulting in an appearance known as Dilantin
facies.
/.Nursing Implications of AEDs - Answer-¬ Assess complete blood count, serum
chemistry, and drug levels prior to administration. Know that therapeutic drug levels are
usually 10 to 20 mcg/mL.
¬ Know that 150 mg of fosphenytoin yield 100 mg of phenytoin and that the
concentration and infusion rate of fosphenytoin would be expressed as a phenytoin
equivalent (PE).
¬ Administer phenytoin no faster than 50 mg/min and fosphenytoin at 150 mg PE/min to
avoid hypotension or cardiorespiratory depression.
¬ Dilute phenytoin only with normal saline solution. Flush intravenous lines with saline
before and after administration.
¬ Monitor the patient for ataxia and dizziness after an infusion.
¬ Do not confuse fosphenytoin (Cerebyx) with Celebrex.
¬ Administer oral dosage forms of the drug with food. Instruct the patient not to open,
chew, or break capsules; however, the non-sustained-release tablets may be chewed.
/.Patient Teaching for AEDs - Answer-Avoid tasks requiring alertness until a steady
state of the drug has been achieved (which takes 4 to 5 half-lives) to help prevent injury.
⎫ Avoid drinking alcohol and smoking.
⎫ Do not abruptly withdraw from an AED; rebound seizure activity could occur.
⎫ Phenytoin may turn urine to pink or red-brown. This color change commonly
diminishes over time.
⎫ Drowsiness commonly decreases after several weeks because tolerance to this
particular adverse effect occurs.
⎫ Frequent oral care and dental visits are necessary so as to prevent the adverse effect
of gingival hyperplasia.
⎫ Avoid any form of stimulant (e.g., caffeine) because there is a higher risk for seizure.
⎫ Therapy is usually lifelong. Resources available include national and local support
groups.
⎫ Contact the physician if any unusual reactions occur, such as glandular swelling,
fever, sore throat, tarry stools, back pain, hematuria, easy bruising, lethargy, or mouth
ulcers.
/.SSRI Mechanism/Therapeutic Effects - Answer-Selective serotonin reuptake inhibitors
(SSRIs) inhibit the reuptake of serotonin into presynaptic terminals (nerve endings) and
thus increase the levels of serotonin available for neurotransmission at the postsynaptic
nerve endings. They also demonstrate weak inhibition of norepinephrine and dopamine
reuptake. Increased levels of these neurotransmitters are responsible for the
improvement of the symptoms of depression.
SSRIs are the first-line treatment for major depression and are also indicated for the
treatment of obsessive-compulsive disorder, anxiety disorders, panic disorders, and
compulsive eating disorders such as bulimia nervosa.
