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NR 509 HESI PRACTICE PHARMACOLOGY EXAM 3
QUESTIONS AND ANSWERS (ANSWER WELL EXPLAINED)
GRADED A+ LATEST UPDATE 2025-2026
A. Capsule contents can be sprinkled on pudding or applesauce.
B. Chew the medication thoroughly to enhance absorption.
C. Take the medication with a large glass of water or juice.
D. Contact the health care provider for another form of medication.
D. Contact the health care provider for another form of medication.
Rationale:
Venlafaxine (Effexor XR) is administered PO in capsule form. Capsules that are extended-
release (XR) or continuous-release (CR) contain delayed-release, enteric- coated granules to
prevent decomposition of the drug in the acidic pH of the stomach. The client should notify the
health care provider about the inability to swallow the capsule (D). This medication should not
be chewed or opened so that the delayed-release, enteric-coated granules can remain intact (A
and B). Water or juice (C) will not affect the medication.
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?
,A. Hematocrit (HCT) of 58%
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,B. Hemoglobin of 10.8 g/dL
C. White blood cell count of 5000 mm3
D. Serum potassium level of 5 mEq/L
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A. Hematocrit (HCT) of 58%
Rationale:
(A) should be reported to the health care provider immediately because of the likelihood of a
hypertensive crisis and because seizure activity increases with an increase in HCT of more
than 4 points, or an HCT above 36%. Epogen stimulates erythropoiesis (production of red
blood cells), thereby decreasing the need for blood transfusions. Uncontrolled hypertension
can occur if erythropoietin levels are too high. (B) is the reason why the client is receiving
Epogen. (C and D) are within normal limits.
The nurse is scheduling a client's antibiotic peak and trough levels with the laboratory personnel.
What is the best schedule for drawing the trough level?
A. Give the dose of medication, and call the laboratory to draw the trough STAT.
B. Arrange for the laboratory to draw the trough 1 hour after the dose is given.
C. Instruct the laboratory to draw the trough immediately before the next scheduled
dose.
D. Give the first dose of medication after the laboratory reports that the trough has been
drawn.
C. Instruct the laboratory to draw the trough immediately before the next scheduled dose.
Rationale:
The best time to draw a trough is the closest time to the next administration (C).
(A) will provide a peak level. (B) will not provide the most accurate trough level. The
medication is given before peak and trough levels are obtained (D).
During administration of theophylline (Theo-Dur), the nurse should monitor for signs of toxicity.
Which symptom would cause the nurse to suspect Theo-Dur toxicity?
, A. Dry mouth
B. Urinary retention
C. Restlessness
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D. Sedation
C. Restlessness
Rationale:
Restlessness (C) is a sign of theophylline intoxication. Other signs of toxicity are anorexia,
nausea, vomiting, insomnia, tachycardia, arrhythmias, and seizures. (A, B, and D) are common
side effects of antihistamines but do not indicate theophylline (Theo-Dur) intoxication.
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?
A. Take one pill at the same time every day until all the pills are gone.
B. Use condoms and foam instead of the pill while on any antibiotics.
C. Limit sexual intercourse for at least one cycle after starting the pill.
D. Use another contraceptive if two or more pills are missed in one cycle.
A. Take one pill at the same time every day until all the pills are gone.
Rationale:
The correct selections are (C, D, and F). To maintain adequate hormonal levels for contraception
and enhance compliance, oral contraceptives should be taken at the same time each day (A).
There is no strong pharmacokinetic evidence that shows a relationship between the category of
broad-spectrum antibiotic use and altered hormone levels in oral contraceptive users, so (B) is
not indicated at this time. Abstinence (C) is the best method to prevent pregnancy during the
first cycle. If a client misses two pills during the first week (D), the client should take two pills a
day for 2 days and finish the package while using a backup method of birth control until her next
menstrual cycle.
For which client(s) should the nurse withhold the initial dose of a cyclooxygenase 2 (COX-2)
inhibitor until notifying the health care provider? (Select all that apply.)
NR 509 HESI PRACTICE PHARMACOLOGY EXAM 3
QUESTIONS AND ANSWERS (ANSWER WELL EXPLAINED)
GRADED A+ LATEST UPDATE 2025-2026
A. Capsule contents can be sprinkled on pudding or applesauce.
B. Chew the medication thoroughly to enhance absorption.
C. Take the medication with a large glass of water or juice.
D. Contact the health care provider for another form of medication.
D. Contact the health care provider for another form of medication.
Rationale:
Venlafaxine (Effexor XR) is administered PO in capsule form. Capsules that are extended-
release (XR) or continuous-release (CR) contain delayed-release, enteric- coated granules to
prevent decomposition of the drug in the acidic pH of the stomach. The client should notify the
health care provider about the inability to swallow the capsule (D). This medication should not
be chewed or opened so that the delayed-release, enteric-coated granules can remain intact (A
and B). Water or juice (C) will not affect the medication.
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?
,A. Hematocrit (HCT) of 58%
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,B. Hemoglobin of 10.8 g/dL
C. White blood cell count of 5000 mm3
D. Serum potassium level of 5 mEq/L
Page | 3
A. Hematocrit (HCT) of 58%
Rationale:
(A) should be reported to the health care provider immediately because of the likelihood of a
hypertensive crisis and because seizure activity increases with an increase in HCT of more
than 4 points, or an HCT above 36%. Epogen stimulates erythropoiesis (production of red
blood cells), thereby decreasing the need for blood transfusions. Uncontrolled hypertension
can occur if erythropoietin levels are too high. (B) is the reason why the client is receiving
Epogen. (C and D) are within normal limits.
The nurse is scheduling a client's antibiotic peak and trough levels with the laboratory personnel.
What is the best schedule for drawing the trough level?
A. Give the dose of medication, and call the laboratory to draw the trough STAT.
B. Arrange for the laboratory to draw the trough 1 hour after the dose is given.
C. Instruct the laboratory to draw the trough immediately before the next scheduled
dose.
D. Give the first dose of medication after the laboratory reports that the trough has been
drawn.
C. Instruct the laboratory to draw the trough immediately before the next scheduled dose.
Rationale:
The best time to draw a trough is the closest time to the next administration (C).
(A) will provide a peak level. (B) will not provide the most accurate trough level. The
medication is given before peak and trough levels are obtained (D).
During administration of theophylline (Theo-Dur), the nurse should monitor for signs of toxicity.
Which symptom would cause the nurse to suspect Theo-Dur toxicity?
, A. Dry mouth
B. Urinary retention
C. Restlessness
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D. Sedation
C. Restlessness
Rationale:
Restlessness (C) is a sign of theophylline intoxication. Other signs of toxicity are anorexia,
nausea, vomiting, insomnia, tachycardia, arrhythmias, and seizures. (A, B, and D) are common
side effects of antihistamines but do not indicate theophylline (Theo-Dur) intoxication.
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?
A. Take one pill at the same time every day until all the pills are gone.
B. Use condoms and foam instead of the pill while on any antibiotics.
C. Limit sexual intercourse for at least one cycle after starting the pill.
D. Use another contraceptive if two or more pills are missed in one cycle.
A. Take one pill at the same time every day until all the pills are gone.
Rationale:
The correct selections are (C, D, and F). To maintain adequate hormonal levels for contraception
and enhance compliance, oral contraceptives should be taken at the same time each day (A).
There is no strong pharmacokinetic evidence that shows a relationship between the category of
broad-spectrum antibiotic use and altered hormone levels in oral contraceptive users, so (B) is
not indicated at this time. Abstinence (C) is the best method to prevent pregnancy during the
first cycle. If a client misses two pills during the first week (D), the client should take two pills a
day for 2 days and finish the package while using a backup method of birth control until her next
menstrual cycle.
For which client(s) should the nurse withhold the initial dose of a cyclooxygenase 2 (COX-2)
inhibitor until notifying the health care provider? (Select all that apply.)
