HESI RN PHARMACOLOGY EXAM VERSION (1-200)
QUESTIONS WITH COMPLETE AND VERIFIED
ANSWERS AND RATIONALE/A+ GRADE (NCLEX-RN)
1) .A .nurse .is .caring .for .a .client .with .hyperparathyroidism .and .notes .that .the .client's .serum .calcium
.level .is .13 .mg/dL. .Which .medication .should .the .nurse .prepare .to .administer .as .prescribed .to .the
.client?
1. Calcium .chloride
2. Calcium .gluconate
3. Calcitonin .(Miacalcin)
4. Large .doses .of .vitamin .D
3. .Calcitonin .(Miacalcin)
.Rationale:
The .normal .serum .calcium .level .is .8.6 .to .10.0 .mg/dL. .This .client .is .experiencing .hypercalcemia.
.Calcium .gluconate .and .calcium .chloride .are .medications .used .for .the .treatment .of .tetany, .which
.occurs .as .a .result .of .acute .hypocalcemia. .In .hypercalcemia, .large .doses .of .vitamin .D .need .to .be
.avoided. .Calcitonin, .a .thyroid .hormone, .decreases .the .plasma .calcium .level .by .inhibiting .bone
.resorption .and .lowering .the .serum .calcium .concentration.
2.) Oral .iron .supplements .are .prescribed .for .a .6−year−old .child .with .iron .deficiency .anemia. .The
.nurse .instructs .the .mother .to .administer .the .iron .with .which .best .food .item?
1. Milk
2. Water
3. Apple .juice
4. Orange .juice
4. .Orange .juice
.Rationale:
Vitamin .C .increases .the .absorption .of .iron .by .the .body. .The .mother .should .be .instructed .to
.administer .the .medication .with .a .citrus .fruit .or .a .juice .that .is .high .in .vitamin .C. .Milk .may .affect
.absorption .of .the .iron. .Water .will .not .assist .in .absorption. .Orange .juice .contains .a .greater .amount .of
.vitamin .C .than .apple .juice.
3.) Salicylic .acid .is .prescribed .for .a .client .with .a .diagnosis .of .psoriasis. .The .nurse .monitors .the
.client, .knowing .that .which .of .the .following .would .indicate .the .presence .of .systemic .toxicity
.from .this .medication?
1. Tinnitus
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,2. Diarrhea
3. Constipation
4. Decreased .respirations
1. Tinnitus
.Rationale:
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,Salicylic .acid .is .absorbed .readily .through .the .skin, .and .systemic .toxicity .(salicylism) .can .result.
.Symptoms .include .tinnitus, .dizziness, .hyperpnea, .and .psychological .disturbances. .Constipation .and
.diarrhea .are .not .associated .with .salicylism.
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, 4.) The .camp .nurse .asks .the .children .preparing .to .swim .in .the .lake .if .they .have .applied .sunscreen.
.The .nurse .reminds .the .children .that .chemical .sunscreens .are .most .effective .when .applied:
1. Immediately .before .swimming
2. 15 .minutes .before .exposure .to .the .sun
3. Immediately .before .exposure .to .the .sun
4. At .least .30 .minutes .before .exposure .to .the .sun
4. .At .least .30 .minutes .before .exposure .to .the .sun
.Rationale:
Sunscreens .are .most .effective .when .applied .at .least .30 .minutes .before .exposure .to .the .sun .so .that
.they .can .penetrate .the .skin. .All .sunscreens .should .be .reapplied .after .swimming .or .sweating.
5.) Mafenide .acetate .(Sulfamylon) .is .prescribed .for .the .client .with .a .burn .injury. .When .applying
.the .medication, .the .client .complains .of .local .discomfort .and .burning. .Which .of .the .following .is
.the .most .appropriate .nursing .action?
1. Notifying .the .registered .nurse
2. Discontinuing .the .medication
3. Informing .the .client .that .this .is .normal
4. Applying .a .thinner .film .than .prescribed .to .the .burn .site
3. .Informing .the .client .that .this .is .normal
.Rationale:
Mafenide .acetate .is .bacteriostatic .for .gram−negative .and .gram−positive .organisms .and .is .used .to
.treat .burns .to .reduce .bacteria .present .in .avascular .tissues. .The .client .should .be .informed .that .the
.medication .will .cause .local .discomfort .and .burning .and .that .this .is .a .normal .reaction; .therefore
.options .1, .2, .and .4 .are .incorrect
6.) The .burn .client .is .receiving .treatments .of .topical .mafenide .acetate .(Sulfamylon) .to .the .site .of
.injury. .The .nurse .monitors .the .client, .knowing .that .which .of .the .following .indicates .that .a .systemic
.effect .has .occurred?
1. Hyperventilation
2. Elevated .blood .pressure
3. Local .pain .at .the .burn .site
4. Local .rash .at .the .burn .site
1. Hyperventilation
.Rationale:
Mafenide .acetate .is .a .carbonic .anhydrase .inhibitor .and .can .suppress .renal .excretion .of .acid,
.thereby .causing .acidosis. .Clients .receiving .this .treatment .should .be .monitored .for .signs .of .an
.acid−base .imbalance .(hyperventilation). .If .this .occurs, .the .medication .should .be .discontinued .for .1
.to .2 .days. .Options .3 .and .4 .describe .local .rather .than .systemic .effects. .An .elevated .blood .pressure .may
.be .expected .from .the .pain .that .occurs .with .a .burn .injury.
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QUESTIONS WITH COMPLETE AND VERIFIED
ANSWERS AND RATIONALE/A+ GRADE (NCLEX-RN)
1) .A .nurse .is .caring .for .a .client .with .hyperparathyroidism .and .notes .that .the .client's .serum .calcium
.level .is .13 .mg/dL. .Which .medication .should .the .nurse .prepare .to .administer .as .prescribed .to .the
.client?
1. Calcium .chloride
2. Calcium .gluconate
3. Calcitonin .(Miacalcin)
4. Large .doses .of .vitamin .D
3. .Calcitonin .(Miacalcin)
.Rationale:
The .normal .serum .calcium .level .is .8.6 .to .10.0 .mg/dL. .This .client .is .experiencing .hypercalcemia.
.Calcium .gluconate .and .calcium .chloride .are .medications .used .for .the .treatment .of .tetany, .which
.occurs .as .a .result .of .acute .hypocalcemia. .In .hypercalcemia, .large .doses .of .vitamin .D .need .to .be
.avoided. .Calcitonin, .a .thyroid .hormone, .decreases .the .plasma .calcium .level .by .inhibiting .bone
.resorption .and .lowering .the .serum .calcium .concentration.
2.) Oral .iron .supplements .are .prescribed .for .a .6−year−old .child .with .iron .deficiency .anemia. .The
.nurse .instructs .the .mother .to .administer .the .iron .with .which .best .food .item?
1. Milk
2. Water
3. Apple .juice
4. Orange .juice
4. .Orange .juice
.Rationale:
Vitamin .C .increases .the .absorption .of .iron .by .the .body. .The .mother .should .be .instructed .to
.administer .the .medication .with .a .citrus .fruit .or .a .juice .that .is .high .in .vitamin .C. .Milk .may .affect
.absorption .of .the .iron. .Water .will .not .assist .in .absorption. .Orange .juice .contains .a .greater .amount .of
.vitamin .C .than .apple .juice.
3.) Salicylic .acid .is .prescribed .for .a .client .with .a .diagnosis .of .psoriasis. .The .nurse .monitors .the
.client, .knowing .that .which .of .the .following .would .indicate .the .presence .of .systemic .toxicity
.from .this .medication?
1. Tinnitus
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,2. Diarrhea
3. Constipation
4. Decreased .respirations
1. Tinnitus
.Rationale:
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.()
,Salicylic .acid .is .absorbed .readily .through .the .skin, .and .systemic .toxicity .(salicylism) .can .result.
.Symptoms .include .tinnitus, .dizziness, .hyperpnea, .and .psychological .disturbances. .Constipation .and
.diarrhea .are .not .associated .with .salicylism.
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.()
, 4.) The .camp .nurse .asks .the .children .preparing .to .swim .in .the .lake .if .they .have .applied .sunscreen.
.The .nurse .reminds .the .children .that .chemical .sunscreens .are .most .effective .when .applied:
1. Immediately .before .swimming
2. 15 .minutes .before .exposure .to .the .sun
3. Immediately .before .exposure .to .the .sun
4. At .least .30 .minutes .before .exposure .to .the .sun
4. .At .least .30 .minutes .before .exposure .to .the .sun
.Rationale:
Sunscreens .are .most .effective .when .applied .at .least .30 .minutes .before .exposure .to .the .sun .so .that
.they .can .penetrate .the .skin. .All .sunscreens .should .be .reapplied .after .swimming .or .sweating.
5.) Mafenide .acetate .(Sulfamylon) .is .prescribed .for .the .client .with .a .burn .injury. .When .applying
.the .medication, .the .client .complains .of .local .discomfort .and .burning. .Which .of .the .following .is
.the .most .appropriate .nursing .action?
1. Notifying .the .registered .nurse
2. Discontinuing .the .medication
3. Informing .the .client .that .this .is .normal
4. Applying .a .thinner .film .than .prescribed .to .the .burn .site
3. .Informing .the .client .that .this .is .normal
.Rationale:
Mafenide .acetate .is .bacteriostatic .for .gram−negative .and .gram−positive .organisms .and .is .used .to
.treat .burns .to .reduce .bacteria .present .in .avascular .tissues. .The .client .should .be .informed .that .the
.medication .will .cause .local .discomfort .and .burning .and .that .this .is .a .normal .reaction; .therefore
.options .1, .2, .and .4 .are .incorrect
6.) The .burn .client .is .receiving .treatments .of .topical .mafenide .acetate .(Sulfamylon) .to .the .site .of
.injury. .The .nurse .monitors .the .client, .knowing .that .which .of .the .following .indicates .that .a .systemic
.effect .has .occurred?
1. Hyperventilation
2. Elevated .blood .pressure
3. Local .pain .at .the .burn .site
4. Local .rash .at .the .burn .site
1. Hyperventilation
.Rationale:
Mafenide .acetate .is .a .carbonic .anhydrase .inhibitor .and .can .suppress .renal .excretion .of .acid,
.thereby .causing .acidosis. .Clients .receiving .this .treatment .should .be .monitored .for .signs .of .an
.acid−base .imbalance .(hyperventilation). .If .this .occurs, .the .medication .should .be .discontinued .for .1
.to .2 .days. .Options .3 .and .4 .describe .local .rather .than .systemic .effects. .An .elevated .blood .pressure .may
.be .expected .from .the .pain .that .occurs .with .a .burn .injury.
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