HESI PHARMACOLOGY EXAM 150 PRACTICE
QUESTIONS AND 100% CORRECT ANSWERS AND
RATIONALES
1. A client is being treated for hyperthyroidism with propylthiouracil (PTU). The nurse knows
that the action of this drug is to
A) decrease the amount of thyroid-stimulating hormone circulating in the blood.
B) increase the amount of thyroid-stimulating hormone circulating in the blood.
C) increase the amount of T4 and decrease the amount of T3 produced by the thyroid.
D) inhibit synthesis of T3 and T4 by the thyroid gland.
D) inhibit synthesis of T3 and T4 by the thyroid gland.
PTU is an adjunct therapy used to control hyperthyroidism by inhibiting production of thyroid
hormones (D). It is often prescribed in preparation for thyroidectomy or radioactive iodine
therapy. Thyroid-stimulating hormone (TSH) is produced by the pituitary gland, and PTU does
not affect the pituitary (A and B). PTU inhibits the synthesis of all thyroid hormones--both T3
and T4(C).
2. A client has myxedema, which results from a deficiency of thyroid hormone synthesis in
adults. The nurse knows that which medication should be contraindicated for this client? A)
Liothyronine (Cytomel) to replace iodine.
B) Furosemide (Lasix) for relief of fluid retention.
C) Pentobarbital sodium (Nembutal Sodium) for sleep.
D) Nitroglycerin (Nitrostat) for angina pain.
C) Pentobarbital sodium (Nembutal Sodium) for sleep.
Persons with myxedema are dangerously hypersensitive to narcotics, barbiturates (C), and
anesthetics. They do tolerate liothyronine (Cytomel) (A) and usually receive iodine
replacement therapy. These clients are also susceptible to heart problems such as angina for
which nitroglycerin (Nitrostat) (D) would be indicated, and congestive heart failure for which
furosemide (Lasix) (B) would be indicated.
,3. Which change in data indicates to the nurse that the desired effect of the
angiotensin II receptor antagonist valsartan (Diovan) 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/minute.
D) Blood pressure reduced from 160/90 to 130/80.
D) Blood pressure reduced from 160/90 to 130/80.
Diovan is an angiotensin receptor blocker, prescribed for the treatment of hypertension. The
desired effect is a decrease in blood pressure (D). (A, B, and C) do not describe effects of
Diovan.
4. A client is receiving digoxin for the onset of supraventricular tachycardia (SVT). Which
laboratory findings should the nurse identify that places this client at risk? A) Hypokalemia.
B) Hyponatremia.
C) Hypercalcemia.
D) Low uric acid levels.
A) Hypokalemia.
Hypokalemia affects myocardial contractility, so (A) places this client at greatest risk for
dysrhythmias that may be unresponsive to drug therapy. Although an imbalance of serum
electrolytes, (B and C), can effect cardiac rhythm, the greatest risk for the client receiving
digoxin is (A). (D) does not cause any interactions related to digoxin therapy for
supraventricular tachycardia (SVT).
5. Which dosing schedule should the nurse teach the client to observe for a controlled-release
oxycodone prescription?
,A) As needed.
B) Every 12 hours.
C) Every 24 hours.
D) Every 4 to 6 hours.
B) Every 12 hours.
A controlled-release oxycodone provides long-acting analgesia to relieve moderate to severe
pain, so a dosing schedule of every 12 hours (B) provides the best around-the-clock pain
management. Controlled-release oxycodone is not prescribed for breakthrough pain on a PRN
or as needed schedule (A). (C) is inadequate for continuous pain management. Using a
schedule of every 4 to 6 hours (D) may jeopardize patient safety due to cumulative effects.
6. postoperative client has been receiving a continuous IV infusion of meperidine (Demerol) 35
mg/hr for four days. The client has a PRN prescription for Demerol 100 mg PO q3h. The nurse
notes that the client has become increasingly restless, irritable and confused, stating that
there are bugs all over the walls. What action should the nurse take first?
A) Administer a PRN dose of the PO meperidine (Demerol).
B) Administer naloxone (Narcan) IV per PRN protocol.
C) Decrease the IV infusion rate of the meperidine (Demerol) per protocol.
D) Notify the healthcare provider of the client's confusion and hallucinations.
C) Decrease the IV infusion rate of the meperidine (Demerol) per protocol.
The client is exhibiting symptoms of Demerol toxicity, which is consistent with the large dose
of Demerol received over four days. (C) is the most effective action to immediately decrease
the amount of serum Demerol. (A) will increase the toxic level of medication in the
bloodstream. Naloxone (B) is an opioid antagonist that is used during an opioid overdose, but
it is not beneficial during Demerol toxicity and can precipitate seizures. The healthcare
provider should be notified (D), but that is not the initial action the nurse should take; first the
amount of drug infusing should be decreased.
, 7. A client is being treated for osteoporosis with alendronate (Fosamax), and the nurse has
completed discharge teaching regarding medication administration. Which morning schedule
would indicate to the nurse that the client teaching has been effective?
A) Take medication, go for a 30 minute morning walk, then eat breakfast.
B) Take medication, rest in bed for 30 minutes, eat breakfast, go for morning walk.
C) Take medication with breakfast, then take a 30 minute morning walk.
D) Go for a 30 minute morning walk, eat breakfast, then take medication.
A) Take medication, go for a 30 minute morning walk, then eat breakfast.
Alendronate (Fosamax) is best absorbed when taken thirty minutes before eating in the
morning. The client should also be advised to remain in an upright position for at least thirty
minutes after taking the medication to reduce the risk of esophageal reflux and irritation. (A)
is the best schedule to meet these needs. (B, C, and D) do not meet these criteria.
28. In teaching a client who had a liver transplant about cyclosporine (Sandimmune),
the nurse should encourage the client to report which adverse response to the
healthcare provider? A) Changes in urine color.
B) Presence of hand tremors.
C) Increasing body hirsutism.
D) Nausea and vomiting.
B) Presence of hand tremors.
Neurological complications, such as hand tremors (B), occur in about 50% of clients taking
cyclosporine and should be reported. Although this drug can be nephrotoxic, (A) typically does
not occur. (C and D) are common side effects, but are not usually severe.
29. taking a nursing history, the client states, "I am allergic to penicillin." What related allergy
to another type of antiinfective agent should the nurse ask the client about when taking the
nursing history? A) Aminoglycosides.
B) Cephalosporins.
QUESTIONS AND 100% CORRECT ANSWERS AND
RATIONALES
1. A client is being treated for hyperthyroidism with propylthiouracil (PTU). The nurse knows
that the action of this drug is to
A) decrease the amount of thyroid-stimulating hormone circulating in the blood.
B) increase the amount of thyroid-stimulating hormone circulating in the blood.
C) increase the amount of T4 and decrease the amount of T3 produced by the thyroid.
D) inhibit synthesis of T3 and T4 by the thyroid gland.
D) inhibit synthesis of T3 and T4 by the thyroid gland.
PTU is an adjunct therapy used to control hyperthyroidism by inhibiting production of thyroid
hormones (D). It is often prescribed in preparation for thyroidectomy or radioactive iodine
therapy. Thyroid-stimulating hormone (TSH) is produced by the pituitary gland, and PTU does
not affect the pituitary (A and B). PTU inhibits the synthesis of all thyroid hormones--both T3
and T4(C).
2. A client has myxedema, which results from a deficiency of thyroid hormone synthesis in
adults. The nurse knows that which medication should be contraindicated for this client? A)
Liothyronine (Cytomel) to replace iodine.
B) Furosemide (Lasix) for relief of fluid retention.
C) Pentobarbital sodium (Nembutal Sodium) for sleep.
D) Nitroglycerin (Nitrostat) for angina pain.
C) Pentobarbital sodium (Nembutal Sodium) for sleep.
Persons with myxedema are dangerously hypersensitive to narcotics, barbiturates (C), and
anesthetics. They do tolerate liothyronine (Cytomel) (A) and usually receive iodine
replacement therapy. These clients are also susceptible to heart problems such as angina for
which nitroglycerin (Nitrostat) (D) would be indicated, and congestive heart failure for which
furosemide (Lasix) (B) would be indicated.
,3. Which change in data indicates to the nurse that the desired effect of the
angiotensin II receptor antagonist valsartan (Diovan) 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/minute.
D) Blood pressure reduced from 160/90 to 130/80.
D) Blood pressure reduced from 160/90 to 130/80.
Diovan is an angiotensin receptor blocker, prescribed for the treatment of hypertension. The
desired effect is a decrease in blood pressure (D). (A, B, and C) do not describe effects of
Diovan.
4. A client is receiving digoxin for the onset of supraventricular tachycardia (SVT). Which
laboratory findings should the nurse identify that places this client at risk? A) Hypokalemia.
B) Hyponatremia.
C) Hypercalcemia.
D) Low uric acid levels.
A) Hypokalemia.
Hypokalemia affects myocardial contractility, so (A) places this client at greatest risk for
dysrhythmias that may be unresponsive to drug therapy. Although an imbalance of serum
electrolytes, (B and C), can effect cardiac rhythm, the greatest risk for the client receiving
digoxin is (A). (D) does not cause any interactions related to digoxin therapy for
supraventricular tachycardia (SVT).
5. Which dosing schedule should the nurse teach the client to observe for a controlled-release
oxycodone prescription?
,A) As needed.
B) Every 12 hours.
C) Every 24 hours.
D) Every 4 to 6 hours.
B) Every 12 hours.
A controlled-release oxycodone provides long-acting analgesia to relieve moderate to severe
pain, so a dosing schedule of every 12 hours (B) provides the best around-the-clock pain
management. Controlled-release oxycodone is not prescribed for breakthrough pain on a PRN
or as needed schedule (A). (C) is inadequate for continuous pain management. Using a
schedule of every 4 to 6 hours (D) may jeopardize patient safety due to cumulative effects.
6. postoperative client has been receiving a continuous IV infusion of meperidine (Demerol) 35
mg/hr for four days. The client has a PRN prescription for Demerol 100 mg PO q3h. The nurse
notes that the client has become increasingly restless, irritable and confused, stating that
there are bugs all over the walls. What action should the nurse take first?
A) Administer a PRN dose of the PO meperidine (Demerol).
B) Administer naloxone (Narcan) IV per PRN protocol.
C) Decrease the IV infusion rate of the meperidine (Demerol) per protocol.
D) Notify the healthcare provider of the client's confusion and hallucinations.
C) Decrease the IV infusion rate of the meperidine (Demerol) per protocol.
The client is exhibiting symptoms of Demerol toxicity, which is consistent with the large dose
of Demerol received over four days. (C) is the most effective action to immediately decrease
the amount of serum Demerol. (A) will increase the toxic level of medication in the
bloodstream. Naloxone (B) is an opioid antagonist that is used during an opioid overdose, but
it is not beneficial during Demerol toxicity and can precipitate seizures. The healthcare
provider should be notified (D), but that is not the initial action the nurse should take; first the
amount of drug infusing should be decreased.
, 7. A client is being treated for osteoporosis with alendronate (Fosamax), and the nurse has
completed discharge teaching regarding medication administration. Which morning schedule
would indicate to the nurse that the client teaching has been effective?
A) Take medication, go for a 30 minute morning walk, then eat breakfast.
B) Take medication, rest in bed for 30 minutes, eat breakfast, go for morning walk.
C) Take medication with breakfast, then take a 30 minute morning walk.
D) Go for a 30 minute morning walk, eat breakfast, then take medication.
A) Take medication, go for a 30 minute morning walk, then eat breakfast.
Alendronate (Fosamax) is best absorbed when taken thirty minutes before eating in the
morning. The client should also be advised to remain in an upright position for at least thirty
minutes after taking the medication to reduce the risk of esophageal reflux and irritation. (A)
is the best schedule to meet these needs. (B, C, and D) do not meet these criteria.
28. In teaching a client who had a liver transplant about cyclosporine (Sandimmune),
the nurse should encourage the client to report which adverse response to the
healthcare provider? A) Changes in urine color.
B) Presence of hand tremors.
C) Increasing body hirsutism.
D) Nausea and vomiting.
B) Presence of hand tremors.
Neurological complications, such as hand tremors (B), occur in about 50% of clients taking
cyclosporine and should be reported. Although this drug can be nephrotoxic, (A) typically does
not occur. (C and D) are common side effects, but are not usually severe.
29. taking a nursing history, the client states, "I am allergic to penicillin." What related allergy
to another type of antiinfective agent should the nurse ask the client about when taking the
nursing history? A) Aminoglycosides.
B) Cephalosporins.
