2021 HESI Pharmacology Version 1 – Questions 1 through 100(WITH RATIONALE)/LATEST UPDATE WITH A GUARANTEE OF AN A+

2021 HESI Pharmacology Version 1 –

Questions 1 through 100(WITH RATIONALE

1) A nurse is caring for a client with hyperparathyroidism and notes that

the client's serum calcium level is 13 mg/dL. Which medication should

the nurse prepare to administer as prescribed to the client?

1. Calcium chloride

2. Calcium gluconate

3. Calcitonin (Miacalcin)

4. Large doses of vitamin D 3. Calcitonin

(Miacalcin) Rationale:

The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is

experiencing hypercalcemia. Calcium gluconate and calcium chloride

are medications used for the treatment of tetany, which occurs as a

result of acute hypocalcemia. In hypercalcemia, large doses of vitamin D

need to be avoided. Calcitonin, a thyroid hormone, decreases the

plasma calcium level by inhibiting bone resorption and lowering the

serum calcium concentration.

3.) Salicylic acid is prescribed for a client with a diagnosis of psoriasis.

The nurse monitors the client, knowing that which of the following would

indicate the presence of systemic toxicity from this medication?

1. Tinnitus

2. Diarrhea

3. Constipation

4. Decreased respirations 1.

Tinnitus Rationale:

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Salicylic acid is absorbed readily through the skin, and systemic toxicity

(salicylism) can result. Symptoms include tinnitus, dizziness, hyperpnea,

and psychological disturbances. Constipation and diarrhea are not

associated with salicylism.

4.) The camp nurse asks the children preparing to swim in the lake if

they have applied sunscreen. The nurse reminds the children that

chemical sunscreens are most effective when applied:

1. Immediately before swimming

2. 15 minutes before exposure to the sun

3. Immediately before exposure to the sun

4. At least 30 minutes before exposure to the sun 4. At least 30

minutes before exposure to the sun

Rationale:

Sunscreens are most effective when applied at least 30 minutes before

exposure to the sun so that they can penetrate the skin. All sunscreens

should be reapplied after swimming or sweating.

5.) Mafenide acetate (Sulfamylon) is prescribed for the client with a burn

injury. When applying the medication, the client complains of local

discomfort and burning. Which of the following is the most appropriate

nursing action?

1. Notifying the registered nurse

2. Discontinuing the medication

3. Informing the client that this is normal

4. Applying a thinner film than prescribed to the burn site 3.

Informing the client that this is normal

Rationale:

Mafenide acetate is bacteriostatic for gram-negative and gram-positive

organisms and is used to treat burns to reduce bacteria present in

avascular tissues. The client should be informed that the medication will

cause local discomfort and burning and that this is a normal reaction;

therefore options 1, 2, and 4 are incorrect

6.) The burn client is receiving treatments of topical mafenide acetate

(Sulfamylon) to the site of injury. The nurse monitors the client, knowing

that which of the following indicates that a systemic effect has

occurred?

1.Hyperventilation

2.Elevated blood

pressure 3.Local pain at

the burn site

4.Local rash at the burn site 1.Hyperventilation

 2 / 4

Rationale:

Mafenide acetate is a carbonic anhydrase inhibitor and can suppress

renal excretion of acid, thereby causing acidosis. Clients receiving this

treatment should be monitored for signs of an acid-base imbalance

(hyperventilation). If this occurs, the medication should be discontinued

for 1 to 2 days. Options 3 and 4 describe local rather than systemic

effects. An elevated blood pressure may be expected from the pain that

occurs with a burn injury.

7.) Isotretinoin is prescribed for a client with severe acne. Before the

administration of this medication, the nurse anticipates that which

laboratory test will be prescribed?

1. Platelet count

2. Triglyceride level

3. Complete blood count

4. White blood cell count 2.

Triglyceride level Rationale:

Isotretinoin can elevate triglyceride levels. Blood triglyceride levels

should be measured before treatment and periodically thereafter until

the effect on the triglycerides has been evaluated. Options 1, 3, and 4

do not need to be monitored specifically during this treatment.

8.) A client with severe acne is seen in the clinic and the health care

provider (HCP) prescribes isotretinoin. The nurse reviews the client's

medication record and would contact the (HCP) if the client is taking

which medication?

1. Vitamin A

2. Digoxin (Lanoxin)

3. Furosemide (Lasix)

4. Phenytoin (Dilantin)1. Vitamin

A Rationale:

Isotretinoin is a metabolite of vitamin A and can produce generalized

intensification of isotretinoin toxicity. Because of the potential for

increased toxicity, vitamin A supplements should be discontinued before

isotretinoin therapy. Options 2, 3, and 4 are not contraindicated with the

use of isotretinoin.

9.) The nurse is applying a topical corticosteroid to a client with eczema.

The nurse would monitor for the potential for increased systemic

absorption of the medication if the medication were being applied to

which of the following body areas?

1. Back

2. Axilla

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3. Soles of the feet

4. Palms of the hands 2.

Axilla Rationale:

Topical corticosteroids can be absorbed into the systemic circulation.

Absorption is higher from regions where the skin is especially permeable

(scalp, axilla, face, eyelids, neck, perineum, genitalia), and lower from

regions in which permeability is poor (back, palms, soles).

10.) The clinic nurse is performing an admission assessment on a client.

The nurse notes that the client is taking azelaic acid (Azelex). Because

of the medication prescription, the nurse would suspect that the client is

being treated for:

1. Acne

2. Eczema

3. Hair loss

4. Herpes simplex 1.

Acne Rationale:

Azelaic acid is a topical medication used to treat mild to moderate

acne. The acid appears to work by suppressing the growth of

Propionibacterium acnes and decreasing the proliferation of

keratinocytes. Options 2, 3, and 4 are incorrect.

11.) The health care provider has prescribed silver sulfadiazine

(Silvadene) for the client with a partial-thickness burn, which has

cultured positive for gram-negative bacteria. The nurse is reinforcing

information to the client about the medication. Which statement made

by the client indicates a lack of understanding about the treatments?

1. "The medication is an antibacterial."

2. "The medication will help heal theburn."

3. "The medication will permanently stain my skin."

4. "The medication should be applied directly to the wound." 3. "The

medication will permanently stain my skin."

Rationale:

Silver sulfadiazine (Silvadene) is an antibacterial that has a broad

spectrum of activity against gram-negative bacteria, gram-positive

bacteria, and yeast. It is applied directly to the wound to assist in

healing. It does not stain the skin.

12.) A nurse is caring for a client who is receiving an intravenous (IV)

infusion of an antineoplastic medication. During the infusion, the client

complains of pain at the insertion site. During an inspection of the site,

the nurse notes redness and swelling

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Version 2021
Category HESI
Pages 40
Language English
Comments 0
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