HESI RN PHARMACOLOGY EXAM
1. The health care provider prescribes carbamazepine for a child whose tonic-clonic
seizures have been poorly controlled. The nurse informs the mother that the child
must have blood tests every week. The mother asks why so many blood tests are
necessary. Which complica...
hesi rn pharmacology exam 1 the health care provider prescribes carbamazepine for a child whose tonic clonic seizures have been poorly controlled the nurse informs the mother that the child must hav
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HESI RN PHARMACOLOGY EXAM
1. The health care provider prescribes carbamazepine for a child whose tonic-clonic
seizures have been poorly controlled. The nurse informs the mother that the child
must have blood tests every week. The mother asks why so many blood tests are
necessary. Which complication is assessed through frequent laboratory testing that
the nurse should explain to this mother?
Myelosuppression
Rationale:
Myelosuppression is the highest priority complication that can potentially affect clients
managed with carbamazepine therapy. The client requires close monitoring for this
condition by weekly laboratory testing. Hepatic function may be altered, but this
complication does not have as great a potential for occurrence as Myelosupression
2. A client is prescribed a cholinesterase inhibitor, and a family member asks the nurse
how this medication works. Which pharmacophysiologic explanation should the
nurse use to describe this class of drug?
Improves nerve impulse transmission
Rationale:
Cholinesterase inhibitors work to increase the availability of acetylcholine at cholinergic
synapses, which aids in neuronal transmission and assists in memory formation.
3. A client is ordered 22 mg of gentamicin by IM injection. The drug is available in 20
mg/2 mL. How many milliliters should be administered?
2.2 mL
Rationale:
(22 mg/20 mg) × (x mL/2 mL) = 22x = 40
x = 2.2 mL
4. In addition to nitrate therapy, a client is receiving nifedipine, 10 mg PO every 6 hours.
The nurse should plan to observe for which common side effect of this treatment
regimen?
,Hypotension
Rationale:
Nifedipine reduces peripheral vascular resistance and nitrates produce vasodilation, so
concurrent use of nitrates with nifedipine can cause hypotension with the initial
administration of these agents.
5. Which response best supports the observations that the nurse identifies in a client
who is experiencing a placebo effect?
Psychological response to inert medication
Rationale:
The placebo effect is a response in the client that is caused by the psychological impact of
taking an inert drug that has no biochemical properties. A placebo effect can be
therapeutic, negative, or ineffective but provides no cure or benefit to the client's
progress. The placebo effect may evoke behavioral changes but does not affect
neurochemical psychotropic changes. Malingering and drug seeking are behaviors that a
client exhibits to obtain treatment for nonexistent disorders or obtain prescription
medications.
6. A 42-year-old client is admitted to the emergency department after taking an
overdose of amitriptyline in a suicide attempt. Which drug should the nurse plan to
administer to reverse the cardiac and central nervous system effects of amitriptyline?
Sodium bicarbonate
Rationale:
Sodium bicarbonate is an effective treatment for an overdose of tricyclic antidepressants
such as amitriptyline to reverse QRS prolongation.
7. A 67-year-old client is discharged from the hospital with a prescription for digoxin,
0.25 mg daily. Which instruction should the nurse include in this client's discharge
teaching plan?
Take and record radial pulse rate daily.
Rationale:
,Monitoring pulse rate is very important when taking digoxin. The client should be
further instructed to report pulse rates <60 or >110 beats/min and to withhold the
dosage until consulting with the health care provider in such a case. Vision change is
an indication of drug toxicity, and the client should be instructed to report this
immediately.
8. A 55-year-old client was diagnosed with schizophrenia 5 years earlier. Numerous
hospitalizations have occurred since the diagnosis because of noncompliance with the
prescribed medication regimen. Which drug might work best for this particular
client?
Fluphenazine decanoate
Rationale:
Fluphenazine, an antipsychotic drug that can be given IM, has a rapid onset (1 to 2
hours) and a long duration of action (up to 3 or 4 weeks), so it would be the drug of
choice for a noncompliant psychotic client. Chlorpromazine HCl is an antipsychotic drug
used to treat schizophrenia and is usually administered PO (IM doses are short-acting).
The client must be compliant in taking this drug for it to be effective. Lithium carbonate is
most effective with manic and depressive bipolar affective disorders. Diazepam is an
anti-anxiety drug and would not be effective for a psychotic disorder.
9. A client is being discharged with a prescription for sulfasalazine to treat ulcerative
colitis. Which instruction should the nurse provide to this client prior to discharge?
Drink at least eight glasses of fluid a day
Rationale:
Adequate hydration is important for all sulfa drugs because they can crystallize in the
urine. If possible, the drug should be taken after eating to provide longer intestinal
transit time. Maintaining good oral hygiene is important for other medications, such as
phenytoin, because of the incidence of gingival hyperplasia, Discontinue use of the
drug gradually is important for steroid administration.
10. Amoxicillin, 500 mg PO every 8 hours, is prescribed for a client with an infection.
The drug is available in a suspension of 125 mg/5 mL. How many milliliters should
the nurse administer with each dose?
20 mL
Rationale:
500 mg/x mL = 125
, mg/5 mL 125x = 2500
x = 20 mL
11. A client with acute lymphocytic leukemia is to begin chemotherapy today. The health
care provider's prescription specifies that ondansetron is to be administered IV 30
minutes prior to the infusion of cisplatin. What is the rationale for administering
Zofran prior to the chemotherapy induction?
Reduction or elimination of nausea and vomiting
Rationale:
Ondansetron is a type 3 receptor (5-HT3) antagonist that is recognized for improved
control of acute nausea and vomiting associated with chemotherapy. 5-HT3 antagonists
are most effective when administered IV prior to the induction of the chemotherapeutic
agent(s).
12. A client with chronic gouty arthritis is talking allopurinol, 100 mg PO daily. Which
laboratory serum level should the nurse report to the health care provider to
determine the therapeutic outcome?
Uric acid level
Rationale:
The primary therapeutic outcome associated with allopurinol therapy is reduced serum
uric acid levels with a lower frequency of acute gouty attacks, so uric acid level should be
reported to the health care provider.
13. The nurse is reviewing prescribed medications with a female client who is preparing
for discharge. The client asks the nurse why the oral dose of an opioid analgesic is
higher than the IV dose that she received during hospitalization. Which response is
best for the nurse to provide?
Oral forms of drugs must pass through the liver first, where more of the dose is
metabolized.
Rationale:
Oral doses of medication are usually larger than parenteral doses to compensate for the
first-pass effect in the liver after oral administration, which metabolizes more of the
drug's dose before affecting its therapeutic response. Although recommended dose
ranges for adults should be individualized, a client's pain should be controlled at
discharge.
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