HESI Pharmacology FINAL EXAM 3
Questions and Answers A+ Graded
(2025)
A .healthcare .provider .prescribes .cephalexin .monohydrate .(Keflex) .for .a .client
.with .a .postoperative .infection. .It .is .most .important .for .the .nurse .to .assess .for
.what .additional .drug .allergy .before .administering .this .prescription?
A) .Penicillins. .
B) .Aminoglycosides. .
C) .Erythromycins. .
D) .Sulfonamides. .- .A) .Penicillins. .
Cross-allergies .exist .between .penicillins .(A) .and .cephalosporins, .such .as
.cephalexin .monohydrate .(Keflex), .so .checking .for .penicillin .allergy .is .a .wise
.precaution .before .administering .this .drug.
Which .nursing .intervention .is .most .important .when .caring .for .a .client .receiving
.the .antimetabolite .cytosine .arabinoside .(Arc-C) .for .chemotherapy?
A) .Hydrate .the .client .with .IV .fluids .before .and .after .infusion. .
B) .Assess .the .client .for .numbness .and .tingling .of .extremities. .
C) .Inspect .the .client's .oral .mucosa .for .ulcerations. .
D) .Monitor .the .client's .urine .pH .for .increased .acidity. .- .C) .Inspect .the .client's
.oral .mucosa .for .ulcerations. .
Cytosine .arabinoside .(Arc-C) .affects .the .rapidly .growing .cells .of .the .body,
.therefore .stomatitis .and .mucosal .ulcerations .are .key .signs .of .antimetabolite
.toxicity .(C). .(A, .B, .and .D) .are . not .typical .interventions .associated .with .the
.administration .of .antimetabolites.
When .assessing .an .adolescent .who .recently .overdosed .on .acetaminophen
.(Tylenol), .it .is .most .important .for .the .nurse .to .assess .for .pain .in .which .area .of
.the .body?
A) .Flank. .
B) .Abdomen. .
C) .Chest. .
D) .Head. .- .B) .Abdomen. .
Acetaminophen .toxicity .can .result .in .liver .damage; .therefore, .it .is .especially
.important .for .the .nurse .to .assess .for .pain .in .the .right . upper .quadrant .of .the
,abdomen .(B), .which .might .indicate .liver .damage. .(A, .C, .and .D) .are .not .areas
.
where .pain .would .be .anticipated.
.
An .adult .client .is .given .a .prescription .for .a .scopolamine .patch .(Transderm .Scop)
.to .prevent .motion .sickness .while .on .a .cruise. .Which .information .should .the
.nurse .provide .to .the .client?
A) .Apply .the .patch .at .least .4 .hours .prior .to .departure. .
B) .Change .the .patch .every .other .day .while .on .the .cruise. .
C) .Place .the .patch .on .a .hairless .area .at .the .base .of .the .skull. .
D) .Drink .no .more .than .2 .alcoholic .drinks .during .the .cruise. .- .A) .Apply .the .patch
.at .least .4 .hours .prior .to .departure. .
Scopolamine, .an .anticholinergic .agent, .is .used .to .prevent .motion .sickness .and
.has .a .peak .onset .in .6 .hours, .so .the .client .should .be .instructed .to .apply .the
.patch .at .least .4 .hours .before .departure .(A) .on .the .cruise .ship. .The .duration .of
.the .transdermal .patch .is .72 .hours, .so .(B) .is .not .needed. .Scolopamine .blocks
.muscarinic . receptors .in .the .inner .ear .and . to .the .vomiting .center, .so .the .best
.application .site .of .the .patch .is .behind .the .ear, .not .at .the .base .of .the .skull .(C).
.Anticholinergic .medications .are .CNS .depressants, .so .the .client .should .be
.instructed .to .avoid .alcohol .(D) .while .using .the .patch.
The .nurse .is .reviewing .the .use .of .the .patient-controlled .analgesia .(PCA) .pump
.with .a .client .in .the .immediate .postoperative .period. .The .client .will .receive
.morphine .1 . mg .IV .per .hour .basal .rate .with .1 .mg . IV .every .15 . minutes .per .PCA .to
.total .5 .mg .IV .maximally .per . hour. .What .assessment .has .the .highest .priority
.before .initiating .the .PCA .pump?
A) .The .expiration .date .on .the .morphine .syringe .in .the .pump. .
B) .The .rate .and .depth .of .the .client's .respirations. .
C) .The .type .of .anesthesia .used .during .the .surgical .procedure. .
D) .The .client's .subjective .and .objective .signs .of .pain. .- .B) .The .rate .and .depth .of
.the .client's .respirations. .
A .life-threatening .side .effect .of .intravenous .administration .of .morphine .sulfate,
.an .opiate .narcotic, .is .respiratory .depression .(B). .The .PCA .pump .should .be
.stopped .and .the .healthcare .provider .notified .if .the .client's .respiratory .rate .falls
.below .12 .breaths .per .minute, .and .the .nurse .should .anticipate .adjustments .in .the
.client's .dosage .before .the .PCA .pump .is .restarted. .(A, .C, .and .D) .provide .helpful
.information, .but .are .not .as .high .a .priority . as .the .assessment .described .in .(B).
A .medication .that .is .classified .as .a .beta-1 .agonist .is .most .commonly .prescribed
.for .a .client .with .which .condition?
A) .Glaucoma. .
B) .Hypertension. .
C) .Heart .failure. .
D) .Asthma. .- .C) .Heart .failure. .
Beta-1 .agonists .improve .cardiac .output .by .increasing .the .heart .rate .and .blood
.pressure .and .are .indicated .in .heart .failure .(C), .shock, .atrioventricular .block
.dysrhythmias, .and .cardiac .arrest. .Glaucoma .(A) .is .managed .using .adrenergic
,.agents .and .beta-adrenergic .blocking .agents. .Beta-1 .blocking .agents .are .used .in
.the .management .of .hypertension .(B). .Medications .that .stimulate .beta-2
.receptors .in .the .bronchi .are .effective .for .bronchoconstriction .in .respiratory
.disorders, .such .as .asthma .(D).
A .female .client .with .rheumatoid .arthritis .take .ibuprofen .(Motrin) .600 .mg .PO .4
.times .a .day. .To .prevent .gastrointestinal .bleeding, .misoprostol .(Cytotec) .100
.mcg .PO .is .prescribed. .Which .information .is .most .important .for .the .nurse .to
.include .in .client .teaching?
A) .Use .contraception .during .intercourse. .
B) .Ensure .the .Cytotec .is .taken .on .an .empty .stomach. .
C) .Encourage .oral .fluid .intake .to .prevent .constipation. .
D) .Take .Cytotec .30 .minutes .prior .to .Motrin. .- .A) .Use .contraception .during
.intercourse. .
Cytotec, .a .synthetic .form .of .a .prostaglandin, .is .classified .as .pregnancy .Category
.X .and .can .act .as .an .abortifacient, .so .the .client .should .be .instructed .to .use
.contraception .during .intercourse .(A) .to .prevent .loss .of .an .early .pregnancy. .(B)
.is .not .necessary. . A .common .side .effect .of .Cytotec .is .diarrhea, .so .constipation
.prevention .strategies .are .usually . not .needed .(C). .Cytotec .and .Motrin .should .be
.taken .together .(D) .to .provide .protective .properties .against .gastrointestinal
.bleeding.
A .client .with .heart .failure .is .prescribed .spironolactone .(Aldactone). .Which
.information .is .most .important .for .the .nurse .to .provide .to .the .client .about .diet
.modifications?
A) .Do .not .add .salt .to .foods .during .preparation. .
B) .Refrain .for .eating .foods .high .in .potassium. .
C) .Restrict .fluid .intake .to .1000 .ml .per .day. .
D) .Increase .intake .of .milk .and .milk .products. .- .B) .Refrain .for .eating .foods .high .in
.potassium. .
Spironolactone .(Aldactone), .an .aldosterone .antagonist, .is .a .potassium-sparing
.diuretic, .so .a .diet .high .in .potassium .should .be .avoided .(B), .including .potassium
.salt .substitutes, .which .can .lead .to .hyperkalemia. .Although .(A) .is .a .common .diet
.modification .in .heart .failure, .the .risk .of .hyperkalemia .is .more .important .with
.Aldactone. .Restriction .of .fluids .(C) .or .increasing .milk .and .milk .products .(D) .are
.not .indicated .with .this .prescription.
In .evaluating .the .effects .of .lactulose .(Cephulac), .which .outcome .should .indicate
.that .the .drug .is .performing .as .intended?
A) .An .increase .in .urine .output. .
B) .Two .or .three .soft .stools .per .day. .
C) .Watery, .diarrhea .stools. .
D) .Increased .serum .bilirubin. .- .B) .Two .or .three .soft .stools .per .day. .
Lactulose .is .administered .to .reduce .blood .ammonia .by .excretion .of .ammonia
.through .the .stool. .Two .to .three .stools .a .day .indicate .that .lactulose .is .performing
.as .intended .(B). .(A) .would .be .expected .if .the .patient .received .a .diuretic. .(C)
, would .indicate .an .overdose .of .lactulose .and .is .not .expected. .Lactulose .does .not
.
affect .(D).
.
The .healthcare .provider .prescribes .naproxen .(Naproxen) .twice .daily .for .a .client
.with .osteoarthritis .of .the .hands. .The .client .tells .the .nurse .that .the .drug .does .not
.seem .to .be .effective .after .three .weeks. .Which .is .the .best .response .for .the .nurse
.to .provide?
A) .The .frequency .of .the .dosing .is .necessary .to .increase .the .effectiveness. .
B) .Therapeutic .blood .levels .of .this .drug .are .reached .in .4 .to .6 .weeks. .
C) .Another .type .of .nonsteroidal .antiinflammatory .drug .may .be .indicated. .
D) .Systemic .corticosteroids .are .the .next .drugs .of .choice .for .pain .relief. .- .C)
.Another .type .of .nonsteroidal .antiinflammatory .drug .may .be .indicated. .
Individual .responses .to .nonsteroidal .antiinflammatory .drugs .are .variable, .so .(C)
.is .the .best .response. .Naproxen .is .usually . prescribed .every .8 .hours, .so .(A) .is .not
.indicated. .The .peak .for .naproxen .is .one .to .two .hours, .not .(B). .Corticosteroids
.are .not .indicated .for .osteoarthritis .(D).
Which .instruction(s) .should .the .nurse .give .to .a .female .client .who .just .received .a
.prescription .for .oral .metronidazole .(Flagyl) .for .treatment .of .trichomonas
.vaginalis? .(Select .all .that .apply.)
A) .Increase .fluid .intake, .especially .cranberry .juice. .
B) .Do .not .abruptly .discontinue .the .medication; .taper .use. .
C) .Check .blood .pressure .daily .to .detect .hypertension. .
D) .Avoid .drinking .alcohol .while .taking .this .medication. .
E) .Use .condoms .until .treatment .is .completed. .
F) .Ensure .that .all .sexual .partners .are .treated .at .the .same .time. .- .A) .Increase .fluid
.intake, .especially .cranberry .juice. .
D) .Avoid .drinking .alcohol .while .taking .this .medication. .
E) .Use .condoms .until .treatment .is .completed.
F) .Ensure .that .all .sexual .partners .are .treated .at .the .same .time.
Correct .selections .are .(A, .D, .E, .and .F). .Increased .fluid .intake .and .cranberry .juice
.(A) .are .recommended .for .prevention .and .treatment .of .urinary .tract .infections,
.which .frequently .accompany . vaginal .infections. .It .is .not .necessary .to .taper .use
.of .this .drug .(B) .or .to .check .the .blood .pressure .daily .(C), .as .this .condition .is .not
.related .to .hypertension. .Flagyl .can .cause . a .disulfiram-like .reaction .if .taken .in
.conjunction .with .ingestion .of .alcohol, .so .the .client .should .be .instructed .to .avoid
.alcohol .(D). .All .sexual .partners .should .be .treated .at .the .same .time .(E) .and
.condoms .should .be .used .until .after .treatment .is .completed .to .avoid .reinfection
.(F).
A .client .receiving .albuterol .(Proventil) .tablets .complains .of .nausea .every
.evening .with . her .9 .p.m. .dose. .What .action .should .the .nurse .take .to .alleviate .this
.side .effect?
A) .Change .the .time .of .the .dose. .
B) .Hold .the .9 .p.m. .dose. .
C) .Administer .the .dose .with .a .snack. .
Questions and Answers A+ Graded
(2025)
A .healthcare .provider .prescribes .cephalexin .monohydrate .(Keflex) .for .a .client
.with .a .postoperative .infection. .It .is .most .important .for .the .nurse .to .assess .for
.what .additional .drug .allergy .before .administering .this .prescription?
A) .Penicillins. .
B) .Aminoglycosides. .
C) .Erythromycins. .
D) .Sulfonamides. .- .A) .Penicillins. .
Cross-allergies .exist .between .penicillins .(A) .and .cephalosporins, .such .as
.cephalexin .monohydrate .(Keflex), .so .checking .for .penicillin .allergy .is .a .wise
.precaution .before .administering .this .drug.
Which .nursing .intervention .is .most .important .when .caring .for .a .client .receiving
.the .antimetabolite .cytosine .arabinoside .(Arc-C) .for .chemotherapy?
A) .Hydrate .the .client .with .IV .fluids .before .and .after .infusion. .
B) .Assess .the .client .for .numbness .and .tingling .of .extremities. .
C) .Inspect .the .client's .oral .mucosa .for .ulcerations. .
D) .Monitor .the .client's .urine .pH .for .increased .acidity. .- .C) .Inspect .the .client's
.oral .mucosa .for .ulcerations. .
Cytosine .arabinoside .(Arc-C) .affects .the .rapidly .growing .cells .of .the .body,
.therefore .stomatitis .and .mucosal .ulcerations .are .key .signs .of .antimetabolite
.toxicity .(C). .(A, .B, .and .D) .are . not .typical .interventions .associated .with .the
.administration .of .antimetabolites.
When .assessing .an .adolescent .who .recently .overdosed .on .acetaminophen
.(Tylenol), .it .is .most .important .for .the .nurse .to .assess .for .pain .in .which .area .of
.the .body?
A) .Flank. .
B) .Abdomen. .
C) .Chest. .
D) .Head. .- .B) .Abdomen. .
Acetaminophen .toxicity .can .result .in .liver .damage; .therefore, .it .is .especially
.important .for .the .nurse .to .assess .for .pain .in .the .right . upper .quadrant .of .the
,abdomen .(B), .which .might .indicate .liver .damage. .(A, .C, .and .D) .are .not .areas
.
where .pain .would .be .anticipated.
.
An .adult .client .is .given .a .prescription .for .a .scopolamine .patch .(Transderm .Scop)
.to .prevent .motion .sickness .while .on .a .cruise. .Which .information .should .the
.nurse .provide .to .the .client?
A) .Apply .the .patch .at .least .4 .hours .prior .to .departure. .
B) .Change .the .patch .every .other .day .while .on .the .cruise. .
C) .Place .the .patch .on .a .hairless .area .at .the .base .of .the .skull. .
D) .Drink .no .more .than .2 .alcoholic .drinks .during .the .cruise. .- .A) .Apply .the .patch
.at .least .4 .hours .prior .to .departure. .
Scopolamine, .an .anticholinergic .agent, .is .used .to .prevent .motion .sickness .and
.has .a .peak .onset .in .6 .hours, .so .the .client .should .be .instructed .to .apply .the
.patch .at .least .4 .hours .before .departure .(A) .on .the .cruise .ship. .The .duration .of
.the .transdermal .patch .is .72 .hours, .so .(B) .is .not .needed. .Scolopamine .blocks
.muscarinic . receptors .in .the .inner .ear .and . to .the .vomiting .center, .so .the .best
.application .site .of .the .patch .is .behind .the .ear, .not .at .the .base .of .the .skull .(C).
.Anticholinergic .medications .are .CNS .depressants, .so .the .client .should .be
.instructed .to .avoid .alcohol .(D) .while .using .the .patch.
The .nurse .is .reviewing .the .use .of .the .patient-controlled .analgesia .(PCA) .pump
.with .a .client .in .the .immediate .postoperative .period. .The .client .will .receive
.morphine .1 . mg .IV .per .hour .basal .rate .with .1 .mg . IV .every .15 . minutes .per .PCA .to
.total .5 .mg .IV .maximally .per . hour. .What .assessment .has .the .highest .priority
.before .initiating .the .PCA .pump?
A) .The .expiration .date .on .the .morphine .syringe .in .the .pump. .
B) .The .rate .and .depth .of .the .client's .respirations. .
C) .The .type .of .anesthesia .used .during .the .surgical .procedure. .
D) .The .client's .subjective .and .objective .signs .of .pain. .- .B) .The .rate .and .depth .of
.the .client's .respirations. .
A .life-threatening .side .effect .of .intravenous .administration .of .morphine .sulfate,
.an .opiate .narcotic, .is .respiratory .depression .(B). .The .PCA .pump .should .be
.stopped .and .the .healthcare .provider .notified .if .the .client's .respiratory .rate .falls
.below .12 .breaths .per .minute, .and .the .nurse .should .anticipate .adjustments .in .the
.client's .dosage .before .the .PCA .pump .is .restarted. .(A, .C, .and .D) .provide .helpful
.information, .but .are .not .as .high .a .priority . as .the .assessment .described .in .(B).
A .medication .that .is .classified .as .a .beta-1 .agonist .is .most .commonly .prescribed
.for .a .client .with .which .condition?
A) .Glaucoma. .
B) .Hypertension. .
C) .Heart .failure. .
D) .Asthma. .- .C) .Heart .failure. .
Beta-1 .agonists .improve .cardiac .output .by .increasing .the .heart .rate .and .blood
.pressure .and .are .indicated .in .heart .failure .(C), .shock, .atrioventricular .block
.dysrhythmias, .and .cardiac .arrest. .Glaucoma .(A) .is .managed .using .adrenergic
,.agents .and .beta-adrenergic .blocking .agents. .Beta-1 .blocking .agents .are .used .in
.the .management .of .hypertension .(B). .Medications .that .stimulate .beta-2
.receptors .in .the .bronchi .are .effective .for .bronchoconstriction .in .respiratory
.disorders, .such .as .asthma .(D).
A .female .client .with .rheumatoid .arthritis .take .ibuprofen .(Motrin) .600 .mg .PO .4
.times .a .day. .To .prevent .gastrointestinal .bleeding, .misoprostol .(Cytotec) .100
.mcg .PO .is .prescribed. .Which .information .is .most .important .for .the .nurse .to
.include .in .client .teaching?
A) .Use .contraception .during .intercourse. .
B) .Ensure .the .Cytotec .is .taken .on .an .empty .stomach. .
C) .Encourage .oral .fluid .intake .to .prevent .constipation. .
D) .Take .Cytotec .30 .minutes .prior .to .Motrin. .- .A) .Use .contraception .during
.intercourse. .
Cytotec, .a .synthetic .form .of .a .prostaglandin, .is .classified .as .pregnancy .Category
.X .and .can .act .as .an .abortifacient, .so .the .client .should .be .instructed .to .use
.contraception .during .intercourse .(A) .to .prevent .loss .of .an .early .pregnancy. .(B)
.is .not .necessary. . A .common .side .effect .of .Cytotec .is .diarrhea, .so .constipation
.prevention .strategies .are .usually . not .needed .(C). .Cytotec .and .Motrin .should .be
.taken .together .(D) .to .provide .protective .properties .against .gastrointestinal
.bleeding.
A .client .with .heart .failure .is .prescribed .spironolactone .(Aldactone). .Which
.information .is .most .important .for .the .nurse .to .provide .to .the .client .about .diet
.modifications?
A) .Do .not .add .salt .to .foods .during .preparation. .
B) .Refrain .for .eating .foods .high .in .potassium. .
C) .Restrict .fluid .intake .to .1000 .ml .per .day. .
D) .Increase .intake .of .milk .and .milk .products. .- .B) .Refrain .for .eating .foods .high .in
.potassium. .
Spironolactone .(Aldactone), .an .aldosterone .antagonist, .is .a .potassium-sparing
.diuretic, .so .a .diet .high .in .potassium .should .be .avoided .(B), .including .potassium
.salt .substitutes, .which .can .lead .to .hyperkalemia. .Although .(A) .is .a .common .diet
.modification .in .heart .failure, .the .risk .of .hyperkalemia .is .more .important .with
.Aldactone. .Restriction .of .fluids .(C) .or .increasing .milk .and .milk .products .(D) .are
.not .indicated .with .this .prescription.
In .evaluating .the .effects .of .lactulose .(Cephulac), .which .outcome .should .indicate
.that .the .drug .is .performing .as .intended?
A) .An .increase .in .urine .output. .
B) .Two .or .three .soft .stools .per .day. .
C) .Watery, .diarrhea .stools. .
D) .Increased .serum .bilirubin. .- .B) .Two .or .three .soft .stools .per .day. .
Lactulose .is .administered .to .reduce .blood .ammonia .by .excretion .of .ammonia
.through .the .stool. .Two .to .three .stools .a .day .indicate .that .lactulose .is .performing
.as .intended .(B). .(A) .would .be .expected .if .the .patient .received .a .diuretic. .(C)
, would .indicate .an .overdose .of .lactulose .and .is .not .expected. .Lactulose .does .not
.
affect .(D).
.
The .healthcare .provider .prescribes .naproxen .(Naproxen) .twice .daily .for .a .client
.with .osteoarthritis .of .the .hands. .The .client .tells .the .nurse .that .the .drug .does .not
.seem .to .be .effective .after .three .weeks. .Which .is .the .best .response .for .the .nurse
.to .provide?
A) .The .frequency .of .the .dosing .is .necessary .to .increase .the .effectiveness. .
B) .Therapeutic .blood .levels .of .this .drug .are .reached .in .4 .to .6 .weeks. .
C) .Another .type .of .nonsteroidal .antiinflammatory .drug .may .be .indicated. .
D) .Systemic .corticosteroids .are .the .next .drugs .of .choice .for .pain .relief. .- .C)
.Another .type .of .nonsteroidal .antiinflammatory .drug .may .be .indicated. .
Individual .responses .to .nonsteroidal .antiinflammatory .drugs .are .variable, .so .(C)
.is .the .best .response. .Naproxen .is .usually . prescribed .every .8 .hours, .so .(A) .is .not
.indicated. .The .peak .for .naproxen .is .one .to .two .hours, .not .(B). .Corticosteroids
.are .not .indicated .for .osteoarthritis .(D).
Which .instruction(s) .should .the .nurse .give .to .a .female .client .who .just .received .a
.prescription .for .oral .metronidazole .(Flagyl) .for .treatment .of .trichomonas
.vaginalis? .(Select .all .that .apply.)
A) .Increase .fluid .intake, .especially .cranberry .juice. .
B) .Do .not .abruptly .discontinue .the .medication; .taper .use. .
C) .Check .blood .pressure .daily .to .detect .hypertension. .
D) .Avoid .drinking .alcohol .while .taking .this .medication. .
E) .Use .condoms .until .treatment .is .completed. .
F) .Ensure .that .all .sexual .partners .are .treated .at .the .same .time. .- .A) .Increase .fluid
.intake, .especially .cranberry .juice. .
D) .Avoid .drinking .alcohol .while .taking .this .medication. .
E) .Use .condoms .until .treatment .is .completed.
F) .Ensure .that .all .sexual .partners .are .treated .at .the .same .time.
Correct .selections .are .(A, .D, .E, .and .F). .Increased .fluid .intake .and .cranberry .juice
.(A) .are .recommended .for .prevention .and .treatment .of .urinary .tract .infections,
.which .frequently .accompany . vaginal .infections. .It .is .not .necessary .to .taper .use
.of .this .drug .(B) .or .to .check .the .blood .pressure .daily .(C), .as .this .condition .is .not
.related .to .hypertension. .Flagyl .can .cause . a .disulfiram-like .reaction .if .taken .in
.conjunction .with .ingestion .of .alcohol, .so .the .client .should .be .instructed .to .avoid
.alcohol .(D). .All .sexual .partners .should .be .treated .at .the .same .time .(E) .and
.condoms .should .be .used .until .after .treatment .is .completed .to .avoid .reinfection
.(F).
A .client .receiving .albuterol .(Proventil) .tablets .complains .of .nausea .every
.evening .with . her .9 .p.m. .dose. .What .action .should .the .nurse .take .to .alleviate .this
.side .effect?
A) .Change .the .time .of .the .dose. .
B) .Hold .the .9 .p.m. .dose. .
C) .Administer .the .dose .with .a .snack. .
