Pharmacology HESI Comprehensive Review for the
NCLEX-PN Exam, 6th Edition Study Mode REAL
EXAM\\\\\\\\\Pharmacology HESI Comprehensive
Review for the NCLEX-PN Exam, 6th Edition Study
Mode GRADED A+
A client who received a prescription for cyclosporine ophthalmic emulsion for dry eyes asks the practical
nurse (PN) if it is safe to continue using artificial tears. What information should the PN provide?
a. Avoid the use of artificial tears because they decrease the efficacy of cyclosporine.
b. Discontinue the use of both products if transient blurring occurs after administration.
c. Allow a 15-minute interval between the administration of cyclosporine and artificial tears.
d. Discontinue the use of cyclosporine and artificial tears when tear production reaches a normal level. -
---ANS---c. Allow a 15-minute interval between the administration of cyclosporine and artificial tears.
Rationale:
Cyclosporine, an ophthalmic emulsion which increases tear production, may be used in conjunction with
artificial tears as long as the products are administered 15 minutes apart. Transient blurring after
administration is a side effect of cyclosporine and does not necessitate discontinuation of the
medication. After tear production is increased, artificial tears may be stopped, but discontinuing
cyclosporine will result in a decrease in tear production.
A first-day postoperative client vomits 30 minutes after receiving a dose of hydromorphone. What initial
intervention is best for the practical nurse (PN) to implement?
a. Obtain a prescription for nasogastric intubation.
b. Administer a prn dose of ondansetron.
c. Reduce the next scheduled dose of hydromorphone.
d. Assess the client's abdomen and bowel sounds. - ---ANS---b. Administer a prn dose of ondansetron.
,Rationale:
Because the emesis appears to be directly related to the administration of the opiate analgesic, the first
action should be to reduce the client's nausea with the administration of the ondansetron, which is an
antiemetic.
A client is receiving heparin to treat a deep vein thrombosis. The nurse should monitor which laboratory
result to assist in evaluating the efficacy of the drug?
a. Platelet count
b. Prothrombin time
c. Partial thromboplastin time
d. Serum levels of protamine sulfate - ---ANS---c. Partial thromboplastin time
Rationale:
The nurse should monitor the partial thromboplastin time to evaluate the efficacy of heparin. The
platelet count does not monitor heparin efficacy. A client who is taking warfarin should have the
prothrombin time monitored. Protamine sulfate levels do not monitor efficacy of heparin.
A client who is being discharged to home asks the practical nurse (PN) for a dose of hydrocodone before
leaving the hospital. How should the PN respond to this client's request?
a. Determine if a take-home prescription for hydrocodone was provided and, if so, tell him to take one
of them.
b. Encourage him to wait until he is at home to take a medication that might impair reasoning.
c. Give him a tablet from the hospital stock and tell him to wait until he is almost home to take it.
d. Ask him to describe the location and severity of the pain and to rate it on a scale from 1 to 10. - ---
ANS---d. Ask him to describe the location and severity of the pain and to rate it on a scale from 1 to 10.
Rationale:
Hydrocodone is a narcotic analgesic, and the practical nurse should gather more data from the client
about the pain he is experiencing before giving the medication. The client's need for pain medication
should be addressed, and pain medication should not be withheld because he is going home.
A client is prescribed clonidine 0.1 mg/24 hour via transdermal patch. Which client outcome would
indicate the medication is effective?
a. No complaints of recent episodes of angina
b. Change in peripheral edema from +3 to +1
,c. No complaints of new onset of nausea or vomiting
d. Blood pressure changes from 180/120 to 140/70 mm Hg - ---ANS---d. Blood pressure changes from
180/120 to 140/70 mm Hg
Rationale:
Clonidine acts as a centrally acting analgesic and antihypertensive agent. The decrease in the blood
pressure indicates a reduction in hypertension.
A client has been prescribed losartan. Which change in data indicates to the practical nurse (PN) that the
desired effect of this medication has been achieved?
a. Dependent edema reduced from +3 to +1.
b. Serum HDL increased from 35 to 55 mg/dL.
c. Pulse rate reduced from 150 to 90 beats/min.
d. Blood pressure reduced from 160/90 to 130/80 mm Hg. - ---ANS---d. Blood pressure reduced from
160/90 to 130/80 mm Hg.
Rationale:
Losartan is prescribed for the treatment of hypertension. The desired effect is a decrease in blood
pressure.
A child is admitted to the emergency department for accidental ingestion of a poison. The practical
nurse (PN) should know that inducing vomiting is recommended for which child?
a. An 8 month old who ate four to six ibuprofen tablets
b. A 3 year old who drank an unknown amount of charcoal lighter fluid
c. A 16 month old who drank 2 ounces of acetaminophen elixir
d. A 2 year old who ate a handful of automatic dishwasher detergent - ---ANS---c. A 16 month old who
drank 2 ounces of acetaminophen elixir
Rationale:
Emesis should be induced for the child who drank the large dose of acetaminophen elixir because this
medication is hepatotoxic. Vomiting is contraindicated for children younger than 1 year of age. Inducing
vomiting of corrosives such as dishwasher detergents and lighter fluid is contraindicated.
A practical nurse (PN) is reviewing teaching with the client and/or significant others about the
concurrent use of benztropine and olanzapine to manage psychotic behavior. What information should
the PN reinforce?
a. Benztropine will reduce the olanzapine's side effect of urinary retention.
, b. Benztropine potentiates the effect of olanzapine.
c. The benztropine is used to control the side effects of olanzapine.
d. The combined effect of these drugs will modify psychotic behavior. - ---ANS---c. The benztropine is
used to control the side effects of olanzapine.
Rationale:
Benztropine, an anticholinergic drug, is used to control extrapyramidal symptoms associated with
olanzapine use. Caution is required in the dosage of benztropine used in conjunction with olanzapine.
A client diagnosed with a herniated disc is prescribed hydrocodone/acetaminophen 10 mg/300 mg prn
every 4 to 6 hours. As the practical nurse (PN) enters the client's room to administer their requested
medication, the client is seen talking and laughing with his visiting family. Which action should the PN
implement?
a. Hold the pain medication until after the visitors leave.
b. Notify the health care provider of the client's drug-seeking behavior.
c. Administer analgesia as requested by the client.
d. Inform the client based on their display behavior, the medication is not needed. - ---ANS---c.
Administer analgesia as requested by the client.
Rationale:
The medication should be administered as per client's request. The client's self-report of pain is the
single most reliable indication of the existence, character, and intensity of pain. Analgesics should be
administered as soon as pain occurs and before it increases in intensity. The PN should consult with the
charge nurse after administering the medication about the situation.
The nurse is assisting with evaluating the effectiveness of the drug amiodarone. Which client statement
best indicates the drug has been effective?
a. "I have not had as many spells of angina."
b. "I have not had as much swelling in my ankles lately."
c. "My doctor told me my cholesterol levels were getting better every visit."
d. "I do not notice as many irregular heartbeats as before I started taking this medication." - ---ANS---d.
"I do not notice as many irregular heartbeats as before I started taking this medication."
Rationale:
Amiodarone is the first choice drugs to treat ventricular dysrhythmias. It will not reduce angina spells,
reduce ankle swelling, or improve cholesterol levels.
NCLEX-PN Exam, 6th Edition Study Mode REAL
EXAM\\\\\\\\\Pharmacology HESI Comprehensive
Review for the NCLEX-PN Exam, 6th Edition Study
Mode GRADED A+
A client who received a prescription for cyclosporine ophthalmic emulsion for dry eyes asks the practical
nurse (PN) if it is safe to continue using artificial tears. What information should the PN provide?
a. Avoid the use of artificial tears because they decrease the efficacy of cyclosporine.
b. Discontinue the use of both products if transient blurring occurs after administration.
c. Allow a 15-minute interval between the administration of cyclosporine and artificial tears.
d. Discontinue the use of cyclosporine and artificial tears when tear production reaches a normal level. -
---ANS---c. Allow a 15-minute interval between the administration of cyclosporine and artificial tears.
Rationale:
Cyclosporine, an ophthalmic emulsion which increases tear production, may be used in conjunction with
artificial tears as long as the products are administered 15 minutes apart. Transient blurring after
administration is a side effect of cyclosporine and does not necessitate discontinuation of the
medication. After tear production is increased, artificial tears may be stopped, but discontinuing
cyclosporine will result in a decrease in tear production.
A first-day postoperative client vomits 30 minutes after receiving a dose of hydromorphone. What initial
intervention is best for the practical nurse (PN) to implement?
a. Obtain a prescription for nasogastric intubation.
b. Administer a prn dose of ondansetron.
c. Reduce the next scheduled dose of hydromorphone.
d. Assess the client's abdomen and bowel sounds. - ---ANS---b. Administer a prn dose of ondansetron.
,Rationale:
Because the emesis appears to be directly related to the administration of the opiate analgesic, the first
action should be to reduce the client's nausea with the administration of the ondansetron, which is an
antiemetic.
A client is receiving heparin to treat a deep vein thrombosis. The nurse should monitor which laboratory
result to assist in evaluating the efficacy of the drug?
a. Platelet count
b. Prothrombin time
c. Partial thromboplastin time
d. Serum levels of protamine sulfate - ---ANS---c. Partial thromboplastin time
Rationale:
The nurse should monitor the partial thromboplastin time to evaluate the efficacy of heparin. The
platelet count does not monitor heparin efficacy. A client who is taking warfarin should have the
prothrombin time monitored. Protamine sulfate levels do not monitor efficacy of heparin.
A client who is being discharged to home asks the practical nurse (PN) for a dose of hydrocodone before
leaving the hospital. How should the PN respond to this client's request?
a. Determine if a take-home prescription for hydrocodone was provided and, if so, tell him to take one
of them.
b. Encourage him to wait until he is at home to take a medication that might impair reasoning.
c. Give him a tablet from the hospital stock and tell him to wait until he is almost home to take it.
d. Ask him to describe the location and severity of the pain and to rate it on a scale from 1 to 10. - ---
ANS---d. Ask him to describe the location and severity of the pain and to rate it on a scale from 1 to 10.
Rationale:
Hydrocodone is a narcotic analgesic, and the practical nurse should gather more data from the client
about the pain he is experiencing before giving the medication. The client's need for pain medication
should be addressed, and pain medication should not be withheld because he is going home.
A client is prescribed clonidine 0.1 mg/24 hour via transdermal patch. Which client outcome would
indicate the medication is effective?
a. No complaints of recent episodes of angina
b. Change in peripheral edema from +3 to +1
,c. No complaints of new onset of nausea or vomiting
d. Blood pressure changes from 180/120 to 140/70 mm Hg - ---ANS---d. Blood pressure changes from
180/120 to 140/70 mm Hg
Rationale:
Clonidine acts as a centrally acting analgesic and antihypertensive agent. The decrease in the blood
pressure indicates a reduction in hypertension.
A client has been prescribed losartan. Which change in data indicates to the practical nurse (PN) that the
desired effect of this medication has been achieved?
a. Dependent edema reduced from +3 to +1.
b. Serum HDL increased from 35 to 55 mg/dL.
c. Pulse rate reduced from 150 to 90 beats/min.
d. Blood pressure reduced from 160/90 to 130/80 mm Hg. - ---ANS---d. Blood pressure reduced from
160/90 to 130/80 mm Hg.
Rationale:
Losartan is prescribed for the treatment of hypertension. The desired effect is a decrease in blood
pressure.
A child is admitted to the emergency department for accidental ingestion of a poison. The practical
nurse (PN) should know that inducing vomiting is recommended for which child?
a. An 8 month old who ate four to six ibuprofen tablets
b. A 3 year old who drank an unknown amount of charcoal lighter fluid
c. A 16 month old who drank 2 ounces of acetaminophen elixir
d. A 2 year old who ate a handful of automatic dishwasher detergent - ---ANS---c. A 16 month old who
drank 2 ounces of acetaminophen elixir
Rationale:
Emesis should be induced for the child who drank the large dose of acetaminophen elixir because this
medication is hepatotoxic. Vomiting is contraindicated for children younger than 1 year of age. Inducing
vomiting of corrosives such as dishwasher detergents and lighter fluid is contraindicated.
A practical nurse (PN) is reviewing teaching with the client and/or significant others about the
concurrent use of benztropine and olanzapine to manage psychotic behavior. What information should
the PN reinforce?
a. Benztropine will reduce the olanzapine's side effect of urinary retention.
, b. Benztropine potentiates the effect of olanzapine.
c. The benztropine is used to control the side effects of olanzapine.
d. The combined effect of these drugs will modify psychotic behavior. - ---ANS---c. The benztropine is
used to control the side effects of olanzapine.
Rationale:
Benztropine, an anticholinergic drug, is used to control extrapyramidal symptoms associated with
olanzapine use. Caution is required in the dosage of benztropine used in conjunction with olanzapine.
A client diagnosed with a herniated disc is prescribed hydrocodone/acetaminophen 10 mg/300 mg prn
every 4 to 6 hours. As the practical nurse (PN) enters the client's room to administer their requested
medication, the client is seen talking and laughing with his visiting family. Which action should the PN
implement?
a. Hold the pain medication until after the visitors leave.
b. Notify the health care provider of the client's drug-seeking behavior.
c. Administer analgesia as requested by the client.
d. Inform the client based on their display behavior, the medication is not needed. - ---ANS---c.
Administer analgesia as requested by the client.
Rationale:
The medication should be administered as per client's request. The client's self-report of pain is the
single most reliable indication of the existence, character, and intensity of pain. Analgesics should be
administered as soon as pain occurs and before it increases in intensity. The PN should consult with the
charge nurse after administering the medication about the situation.
The nurse is assisting with evaluating the effectiveness of the drug amiodarone. Which client statement
best indicates the drug has been effective?
a. "I have not had as many spells of angina."
b. "I have not had as much swelling in my ankles lately."
c. "My doctor told me my cholesterol levels were getting better every visit."
d. "I do not notice as many irregular heartbeats as before I started taking this medication." - ---ANS---d.
"I do not notice as many irregular heartbeats as before I started taking this medication."
Rationale:
Amiodarone is the first choice drugs to treat ventricular dysrhythmias. It will not reduce angina spells,
reduce ankle swelling, or improve cholesterol levels.
