HESI Pharmacology Exam

(CHECK THE LAST PAGE FOR MULTIPLE VERSIONS OF THE EXAM

AND OTHER HESI EXAMS)

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.

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2. 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.

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3. 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.

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4. 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.

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5. 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 client with mild parkinsonism is started on oral amantadine (Symmetrel).

What statement accurately describes the action of this medication?

dopamine in central nervous system is increased

A 52-year-old client is admitted to the hospital for possible duodenal ulcers.

The healthcare provider prescribes ranitidine hydrochloride (Zantac) 150 mg

BID PO. Which data would indicate that this medication is effective?

Within 4 hours after meals, the client denies having pain.

A 78-year-old client with congestive heart failure receives the cardiac glycoside

digoxin (Lanoxin) 0.25 mg PO daily. Which observation by the nurse indicates that

the medication has been effective?

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Clear breath sounds anteriorly and posteriorly

Minocycline (Minocin) 50 mg every 8 hours is prescribed for an adolescent girl

diagnosed with acne. The nurse discusses self-care with the client while she is

taking the medication. Which teaching points should be included in the

discussion? (Select all that apply.)

Report vaginal itching or discharge.

Protect skin from natural and artificial ultraviolet light.

Avoid driving until response to medication is known.

Use a nonhormonal method of contraception if sexually active.

The nurse is assessing a stuporous client in the emergency department who is

suspected of overdosing with opioids. Which agent should the nurse prepare to

administer if the client becomes comatose?

Naloxone hydrochloride (Narcan)

The healthcare provider prescribes captopril (Capoten) 37.5 mg. The medication

is available in 25 mg tablets. What should the nurse administer?

1½ tablets

A client who is HIV positive is receiving epoetin (Epogen) for management of

anemia secondary to zidovudine (AZT) therapy. Which laboratory finding is most

important for the nurse to report to the healthcare provider?

Hematocrit (HCT) of 58%

Una mujer de 42 años se presenta en el departamento de emergencias después de ser violada. El

AGACNP la examina y se da cuenta de que el esposo de la paciente es el violador. La paciente no quiere

presentar cargos y quiere regresar a casa con su esposo. La acción inicial de AGACNP debe ser:

A. Denuncie el asalto físico a la policía.

B. Haga que la paciente firme una autorización para irse a casa con su esposo.

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