HESI Pharmacology Questions and Answers

1. 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

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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 life-threatening side effect of intravenous administration of morphine sulfate, an opiate

narcotic, is respiratory depression (B). The PCA pump should be stopped and the healthcare

provider notified if the client's respiratory rate falls below 12 breaths per minute, and the nurse

should anticipate adjustments in the client's dosage before the PCA pump is restarted. (A, C, and

D) provide helpful information, but are not as high a priority as the assessment described in (B).

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6. A medication that is classified as a beta-1 agonist is most commonly prescribed for a client

with which condition?

A) Glaucoma.

B) Hypertension.

C) Heart failure.

D) Asthma.

C) Heart failure.

Beta-1 agonists improve cardiac output by increasing the heart rate and blood pressure and are

indicated in heart failure (C), shock, atrioventricular block dysrhythmias, and cardiac arrest.

Glaucoma (A) is managed using adrenergic agents and beta-adrenergic blocking agents. Beta-1

blocking agents are used in the management of hypertension (B). Medications that stimulate

beta-2 receptors in the bronchi are effective for bronchoconstriction in respiratory disorders, such

as asthma (D).

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7. 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) Take Cytotec 30 minutes prior to Motrin.

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. (B) is not necessary. A common side effect of Cytotec is

diarrhea, so constipation prevention strategies are usually not needed (C). Cytotec and Motrin

should be taken together (D) to provide protective properties against gastrointestinal bleeding.

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8. A client with heart failure is prescribed spironolactone (Aldactone). Which information is

most important for the nurse to provide to the client about diet modifications?

A) Do not add salt to foods during preparation.

B) Refrain for eating foods high in potassium.

C) Restrict fluid intake to 1000 ml per day.

D) Increase intake of milk and milk products.

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