Pharm HESI Questions
Which medication should the nurse caution the client about taking while receiving an opioid
analgesic?
A. antacids
B. benzodiazepines
C. antihypertensives
D. oral antidiabetics - ANS-B. benzodiazepines
Respiratory depression increases with the concurrent use of opioid analgesics and other central
nervous system depressant agents, such as alcohol, barbiturates, and benzodiazepines
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. - ANS-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
A client with Parkinson's disease is taking carbidopa-levodopa (Sinemet). Which observation by
the nurse should indicate that the desired outcome of the medication is being achieved?
A. decreased BP
B. lessening of tremors
C. increased salivation
D. increased attention span - ANS-B. lessening of tremors
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. BP reduced from 160/90 to 130/80 - ANS-D. BP 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
A 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 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 - ANS-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 client is admitted to the coronary care unit with a medical diagnosis of acute myocardial
infarction. Which medication prescription decreases both preload and afterload?
A. nitroglycerin
B. propranolol (inderal)
C. morphine
D. captopril (capoten) - ANS-A. nitroglycerin
Nitroglycerin (A) is a nitrate that causes peripheral vasodilation and decreases contractility,
thereby decreasing both preload and afterload.
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 BP daily to detect hypertension
D. avoid drinking alcohol while taking this medication
E. use condoms until treatment is completed
F. ensure that are sexual partners are treated at the same time. - ANS-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 are sexual partners are treated at the same time.
, In evaluating the effects of lactulose (Cephulac), which outcome should indicate that the drug is
performing as intended?
A. increase in urine output
B. 2 or 3 soft stools per day.
C. watery, diarrhea stools
D. increased serum bilirubin - ANS-B. 2 or 3 soft stools per day.
Lactulose is administered to reduce blood ammonia by excretion of ammonia through stool.
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. tale cytotec 30 minutes prior to motrin - ANS-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.
A client with giardiasis is taking metronidazole (Flagyl) 2 grams PO. Which information should
the nurse include in the client's instruction?
A. notify the clinic of any changes in the color of urine
B. avoid overexposure to the sun
C. stop the medication after the diarrhea resolves
D. take the medication with food - ANS-D. take the medication with food
Flagyl, an amoebicide and antibacterial agent, may cause gastric distress, so the client should
be instructed to take the medication on a full stomach
A client is receiving metoprolol (Lopressor SR). What assessment is most important for the
nurse to obtain?
A. temperature
B. lung sounds
C. BP
D. urinary output - ANS-C. BP
It is most important to monitor the blood pressure (C) of clients taking this medication because
Lopressor is an antianginal, antiarrhythmic, antihypertensive agent.
Which medication should the nurse caution the client about taking while receiving an opioid
analgesic?
A. antacids
B. benzodiazepines
C. antihypertensives
D. oral antidiabetics - ANS-B. benzodiazepines
Respiratory depression increases with the concurrent use of opioid analgesics and other central
nervous system depressant agents, such as alcohol, barbiturates, and benzodiazepines
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. - ANS-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
A client with Parkinson's disease is taking carbidopa-levodopa (Sinemet). Which observation by
the nurse should indicate that the desired outcome of the medication is being achieved?
A. decreased BP
B. lessening of tremors
C. increased salivation
D. increased attention span - ANS-B. lessening of tremors
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. BP reduced from 160/90 to 130/80 - ANS-D. BP 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
A 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 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 - ANS-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 client is admitted to the coronary care unit with a medical diagnosis of acute myocardial
infarction. Which medication prescription decreases both preload and afterload?
A. nitroglycerin
B. propranolol (inderal)
C. morphine
D. captopril (capoten) - ANS-A. nitroglycerin
Nitroglycerin (A) is a nitrate that causes peripheral vasodilation and decreases contractility,
thereby decreasing both preload and afterload.
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 BP daily to detect hypertension
D. avoid drinking alcohol while taking this medication
E. use condoms until treatment is completed
F. ensure that are sexual partners are treated at the same time. - ANS-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 are sexual partners are treated at the same time.
, In evaluating the effects of lactulose (Cephulac), which outcome should indicate that the drug is
performing as intended?
A. increase in urine output
B. 2 or 3 soft stools per day.
C. watery, diarrhea stools
D. increased serum bilirubin - ANS-B. 2 or 3 soft stools per day.
Lactulose is administered to reduce blood ammonia by excretion of ammonia through stool.
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. tale cytotec 30 minutes prior to motrin - ANS-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.
A client with giardiasis is taking metronidazole (Flagyl) 2 grams PO. Which information should
the nurse include in the client's instruction?
A. notify the clinic of any changes in the color of urine
B. avoid overexposure to the sun
C. stop the medication after the diarrhea resolves
D. take the medication with food - ANS-D. take the medication with food
Flagyl, an amoebicide and antibacterial agent, may cause gastric distress, so the client should
be instructed to take the medication on a full stomach
A client is receiving metoprolol (Lopressor SR). What assessment is most important for the
nurse to obtain?
A. temperature
B. lung sounds
C. BP
D. urinary output - ANS-C. BP
It is most important to monitor the blood pressure (C) of clients taking this medication because
Lopressor is an antianginal, antiarrhythmic, antihypertensive agent.
