Hesi Pharmacology Practice Quiz
Following heparin treatment for a pulmonary embolism, a client is being discharged with
a prescription for warfarin (Coumadin). In conducting discharge teaching, the nurse
advises the client to have which diagnostic test monitored regularly after discharge?
A. Perfusion scan.
B. Prothrombin Time (PT/INR).
C. Activated partial thromboplastin (APTT).
D. Serum Coumadin level (SCL). Correct answer- B. Prothrombin Time (PT/INR)
When used for a client with pulmonary embolus, the therapeutic goal for warfarin
therapy is PT 1.5-2.5 times greater than the control, or an INR of 2-3. A perfusion might
be performed to monitor lung function, but not monthly. APTT is monitored for the client
receiving heparin therapy. A blood level for Coumadin cannot be measured.
A client receiving Doxorubicin (Adriamycin) intravenously (IV) complains of pain at the
insertion site, and the nurse notes edema at the site. Which intervention is most
important for the nurse to implement?
A. Assess for erythema.
B. Administer the antidote.
C. Apply warm compresses.
D. Discontinue the IV fluids. Correct answer- D. Disconinue the IV fluids.
Doxorubicin is an antineoplastic agent that causes inflammation, blistering, and necrosis
of the tissue upon extravasation. First, all IV fluids should be discontinued at the site to
prevent further tissue damage by the vesicant. Erythema is one sign of infiltration and
should be noted, but edem and pain at the infusion site require stopping the IV fluids.
Although an antidote may be available, additional fluids contribute to the trauma of the
subcutaneous tissues. Depending on the type of vesicant, warm or cold compresses
may be prescribed after the infusion is discontinued.
Which method of medication administration provides the client with the greatest first-
pass effect?
A. Oral.
B. Sublingual.
C. Intravenous.
D. Subcutaneous. Correct answer- A. Oral
The first-pass effect is a pharmacokinetic phenomenon that is related to the drug's
metabolism in the liver. After oral medications are absorbed from the GI tract, the drug
is carried directly to the liver via the hepatic portal circulation where hepatic inactivation
occurs and reduces the bioavailability of the drug. Alternative methods of administration,
such as sublingual, IV, and subcutaneous routes, avoid this first-pass effect.
Following heparin treatment for a pulmonary embolism, a client is being discharged with
a prescription for warfarin (Coumadin). In conducting discharge teaching, the nurse
advises the client to have which diagnostic test monitored regularly after discharge?
A. Perfusion scan.
B. Prothrombin Time (PT/INR).
C. Activated partial thromboplastin (APTT).
D. Serum Coumadin level (SCL). Correct answer- B. Prothrombin Time (PT/INR)
When used for a client with pulmonary embolus, the therapeutic goal for warfarin
therapy is PT 1.5-2.5 times greater than the control, or an INR of 2-3. A perfusion might
be performed to monitor lung function, but not monthly. APTT is monitored for the client
receiving heparin therapy. A blood level for Coumadin cannot be measured.
A client receiving Doxorubicin (Adriamycin) intravenously (IV) complains of pain at the
insertion site, and the nurse notes edema at the site. Which intervention is most
important for the nurse to implement?
A. Assess for erythema.
B. Administer the antidote.
C. Apply warm compresses.
D. Discontinue the IV fluids. Correct answer- D. Disconinue the IV fluids.
Doxorubicin is an antineoplastic agent that causes inflammation, blistering, and necrosis
of the tissue upon extravasation. First, all IV fluids should be discontinued at the site to
prevent further tissue damage by the vesicant. Erythema is one sign of infiltration and
should be noted, but edem and pain at the infusion site require stopping the IV fluids.
Although an antidote may be available, additional fluids contribute to the trauma of the
subcutaneous tissues. Depending on the type of vesicant, warm or cold compresses
may be prescribed after the infusion is discontinued.
Which method of medication administration provides the client with the greatest first-
pass effect?
A. Oral.
B. Sublingual.
C. Intravenous.
D. Subcutaneous. Correct answer- A. Oral
The first-pass effect is a pharmacokinetic phenomenon that is related to the drug's
metabolism in the liver. After oral medications are absorbed from the GI tract, the drug
is carried directly to the liver via the hepatic portal circulation where hepatic inactivation
occurs and reduces the bioavailability of the drug. Alternative methods of administration,
such as sublingual, IV, and subcutaneous routes, avoid this first-pass effect.
