Download HESI PHARM 315 Exam Questions with Complete Solution and more Exams Pharmacology in PDF only on Docsity!
1 / 51
HESI PHARM 315 Exam Questions with
Complete Solution
1. A client taking atorvastatin develops an increased serum creatine phospho-
kinase (CK) level. The nurse should assess the client for the onset of which problem?
A. Muscle tenderness.
B. Nausea and vomiting.
C. Excessive bruising.
D. Peripheral edema.: A. Muscle tenderness.
2. An increase in which serum laboratory value indicates to the nurse that a
prescription for atorvastatin is having the desired effect for a client at risk for coronary artery disease?
A. LDL (Low-density lipoprotein)
B. Triglycerides (Type of fat)
C. HDL (High-density lipoprotein)
D. VLDL (Very low-density lipoprotein): C. HDL (High-density lipoprotein)
3. NGN - Patient Data
2 / 51 History and Physical: The client is a 36-year-old female with moderate persistent asthma. She takes fluticasone/salmeterol 250 mcg/50 mcg 1 inhalation twice daily and albuterol 90 mcg/inhalation 2 inhalations every 4-6 hours as needed. Nurses notes: The client states that she has had more severe asthma symptoms than usual in the past week. Her forced expiratory volume has been 60-65% even with multiple doses of albuterol for several days in a row. She came to the hospital feeling dizzy, lightheaded, and complaining of "heart palpitations". Upon assessment, no wheezes were found. Her oxygen saturation is 99%. Review H and P, and nurse's note. Identify from the choices below which condition the client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client's progress.: Potential Condition: Methemoglobinemia Actions to Take:
1. Draw blood for a complete blood count
2. Administer methylene blue
4 / 51
D. Evaluate ongoing sleep patterns: C. Determine presence of abdominal pain
6. The nurse administers risedrineate to a client with osteoporosis at 0700. The client
asks for a glass of milk to drink with the medication. Which action should the nurse take?
A. Instruct the client that it is necessary to take nothing but water with the
medication.
B. Assign an unlicensed assistive personnel (UAP) to bring the client a glass of low
fat milk.
C. Withhold the medication until the client's breakfast tray is available on the
unit.
D. Consult with a pharmacist about scheduling the dose one hour after the client
eats.: A. Instruct the client that it is necessary to take nothing but water with the medication.
7. Which action should the nurse implement to assess the effectiveness of
calcium channel blocker amlodipine?
A. Note the clients serum calcium levels
B. Monitor the clients serum electrolytes
C. Review the clients intake and output
D. Measure the clients blood pressure: D. Measure the clients blood pressure
5 / 51
8. A client is receiving tamsulosin an alpha adrenergic - blocking agent for the
management of urinary retention due to benign prostatic hyperplasia (BPH). Which instruction is most important for the nurse to provide?
A. Use a twice a week dosing schedule
B. Stand and sit up slowly
C. Take the medication early in the day
D. Reduce daily fluid intake: B. Stand and sit up slowly
9. A client with chemotherapy induced nausea receives a prescription for meto-
clopramide. Which adverse effect is most important for the nurse to report?
A. Nausea
B. Involuntary movements
C. Diarrhea
D. Unusual irritability: B. Involuntary movements
10. A client is receiving orlistat as part of a weight management program.
Which ongoing assessment should be included in the plan of care to deter-mine the effectiveness of the medication?
A. Body mass index
B. Depression screening
7 / 51 400 mg 1 hr 400
13. Before administering a laxative to a bed fast client, it is most important
for the nurse to perform which assessment?
A. Determine the frequency and consistency of bowel movements
B. Observe the skin integrity of the clients rectal and sacral areas
C. Assess the clients strength in moving and turning the bed
D. Evaluate the clients ability to recognize the urge to defecate: A. Determine the
frequency and consistency of bowel movements
14. The nurse is caring for a client who takes methotrexate for
rheumatoid arthritis and is now prescribed adalimumab. Which instructions should the nurse provide the client?
A. Have a chest x-ray prior to your first dose
B. Avoid crowds and people who are sick
C. Obtain routine vaccinations as scheduled
D. Undergo annual eye examinations: A. Have a chest x-ray prior to your first dose
15. The nurse is reviewing the history and physical examination of a client
who will be receiving asparaginase (Elspar), an antineoplastic agent. The nurse
8 / 51 consults with the registered nurse regarding the administration of the medication if which of the following is documented in the client's history?
A. Pancreatitis
B. Diabetes mellitus
C. Myocardial infarction
D. Chronic obstructive pulmonary disease: A. Pancreatitis
16. Hormone replacement therapy with levothyroxine sodium is prescribed for a
client with hypothyroidism. The nurse should instruct the client to report which symptom because it indicates that the client is taking too much of the hormonal agent, levothyroxine?
A. Intolerance to cold
B. Constipation
C. Restlessness
D. Decreased appetite: C. Restlessness
17. A client with peptic ulcer disease receives a new prescription for cimetidine.
Which statement provided by the client requires additional instruction by the nurse?
A. Take the medication an hour after antacids.
10 / 51
20. Before administering a newly prescribed dose of terbinafine HCL to a client
with a fungal toenail infection, which assessment finding is most important for the nurse to address? A: Employed as a construction worker. B: Reported history of alcoholism. C: White blood cell count of 8,500/mm3 (8.5 x 10^9/L). D: Toenails appear thick and yellow.: B: Reported history of alcoholism.
21. A client is diagnosed with myasthenia gravis receives a prescription for the
anticholinesterase medication pyridostigmine. Which intervention should the nurse implement when preparing to administer this medication?: Administer the medication thirty minutes prior to meals.
22. A client with benign prostatic hyperplasia receives a new prescription
of tamsulosin. Which intervention should the nurse perform to monitor for an adverse reaction? A: Perform a bladder scan. B: Assess urine output. C: Measure blood pressure. D: Monitor daily weights.: C: Measure blood pressure.
23. After administering oral doses of calcitriol and calcium carbonate to a client
11 / 51 with hypoparathyroidism, the nurse notes that the client's total calcium level is 14 mg/dL (3.5 mmol/L). Which action should the nurse implement? A: Administer both prescribed medications as scheduled. B: Hold the calcium carbonate, but administer the calcitriol as scheduled. C: Hold both medications until contacting the healthcare provider. D: Hold the calcitriol, but administer the calcium carbonate as scheduled.: C: Hold both medications until contacting the healthcare provider.
24. Rivastigmine, a cholinesterase inhibitor, is prescribed for a female client
with early stage Alzheimer's disease. The client's daughter tells the nurse that she plans to start administering the drug when her mother's symptoms are no longer manageable, in hopes that her mother will not have to go to a nursing home. How should the nurse respond? A: Confirm that the daughter is aware of the progressive nature of the dis-ease. B: Affirm the decision to use the medication when the symptoms start to worsen. C: Explain that the drug should be used early in the course of the disease process. D: Assess the client's current mental status before deciding to support the decision.: C: Explain that the drug should be used early in the course of the disease process.
25. A client with psychosis who is receiving an antipsychotic medication is
13 / 51 D: Ensure the client knows to stop baclofen before using other antispasmod-ics.: A: Advise the client to move slowly and cautiously when rising and walking.
28. A client with atrial fibrillation receives a new prescription for
dabigatran. Which instruction should the nurse include in this client's teaching plan? A: Eliminate spinach and other green vegetables in the diet. B: Continue obtaining scheduled laboratory bleeding tests. C: Keep an antidote available in the event of hemorrhage. D: Avoid use of nonsteroidal anti-inflammatory drugs (NSAIDs).: D: Avoid use of nonsteroidal anti-inflammatory drugs (NSAIDs).
29. A client taking atorvastatin develops an increased serum creatine phospho-
kinase (CK) level. The nurse should assess the client for the onset of which problem? A: Muscle tenderness. B: Nausea and vomiting. C: Excessive bruising. D: Peripheral edema.: A: Muscle tenderness.
30. The nurse is planning care for a client with major depression who is receiv-
ing a new prescription for duloxetine. Which information is most important for the nurse to obtain?
14 / 51 A: Weight change in the last month. B: Liver function laboratory results. C: Recent use of other antidepressants. D: Family history of mental illness.: C: Recent use of other antidepressants.
31. A client with Parkinson's disease who is taking carbidopa/levodopa reports
the urine appears to be darker in color. Which action should the nurse take? A: Measure the client's urinary output. B: Explain the color change is normal. C: Obtain a specimen for a urine culture. D: Encourage an increase in oral intake.: B: Explain the color change is normal.
32. Before administering a newly prescribed dose of terbinafine HCL to a client
with a fungal toenail infection, which assessment finding is most important for the nurse to address? A: Employed as a construction worker. B: Reported history of alcoholism. C: White blood cell count of 8,500/mm3 (8.5 x 10^9/L). D: Toenails appear thick and yellow: B: Reported history of alcoholism.
33. Prior to administering the evening dose of carbamazepine, the nurse notes
that the client's morning carbamazepine level was 84 mcg/L (35.6 mmol/L). Which
16 / 51 Administer the dose and monitor the client's BP regularly. C: Apply a telemetry monitor before administering the dose. D: Withhold the scheduled dose and notify the health care provider.: D: Withhold the scheduled dose and notify the health care provider.
36. A client is receiving intravenous (IV) vancomycin and the nurse plans to
draw blood for a peak and trough to determine the serum level of the medica- tion. Which of the following collection times provide the best determination of these levels? A: Thirty minutes into the administration of the IV dose and 30 minutes before the next administration of the medication. B: One hour after completion of the IV dose and one hour before the next administration of the medication. C: Two hours after completion of the IV dose and two hours before the next administration of the medication. D: Immediately after completion of the IV dose and 30 minutes before the next administration of the medication.: B: One hour after completion of the IV dose and one hour before the next administration of the medication.
37. After taking orlistat for one week, a female client tells the home health
nurse that she is experiencing increasingly frequent oily stools and flatus. Which action should the nurse take?
17 / 51 A: Instruct the client to increase her intake of saturated fats over the next week. B: Advise the client to stop taking the drug and contact her healthcare provider. C: Obtain a stool specimen to evaluate for occult blood and fat content. D: Ask the client to describe her dietary intake history for the last several days.: D: Ask the client to describe her dietary intake history for the last several days.
38. A client with heart failure (HF) develops hyperaldosteronism and spirono-
lactone is prescribed. Which instruction should the nurse include in this client's plan of care? A: Replace salt with a salt substitute. B: Monitor skin for excessive bruising. C: Cover your skin before going outside. D: Limit intake of high-potassium foods.: D: Limit intake of high-potassium foods.
19 / 51 a prescription to wear a subcutaneous morphine sulfate patch for pain. The client is short of breath and difficult to arouse. While performing a head to toe assessment, the nurse discovers four patches on the client's body. Which action should the nurse take first? A: Apply oxygen face mask. B: Remove the morphine patches. C: Administer a narcotic reversal drug. D: Monitor blood pressure.: B: Remove the morphine patches.
42. An older adult with iron deficiency anemia is being discharged with a
prescription for ferrous sulfate enteric-coated tablets. To promote best ab- sorption of the medication, which information should the nurse include in the discharge instructions? A: Take the tablet with a daily multivitamin. B: Bedtime is the best time to take the tablet. C: Wait 2 hours after meals to take the tablet. D: Crush the tablets and mix with pudding.: C: Wait 2 hours after meals to take the tablet.
43. A client in the surgical recovery area asks the nurse to bring the largest
possible dose of pain medication available. Which action should the nurse implement first?
20 / 51 A: Determine when the last dose was administered. B: Encourage the client to use diversional thoughts to manage pain. C: Review the history for a past use of recreational drugs. D: Ask the client to rate the current level of pain using a pain scale.: D: Ask the client to rate the current level of pain using a pain scale.
44. The nurse is caring for a client who is taking diclofenac, a nonsteroidal
anti-inflammatory (NSAID) drug for rheumatoid arthritis. During a clinic visit, the client appears pale and reports increasing fatigue. Which of the client's serum laboratory values is most important for the nurse to review? A: Glucose. B: Total protein. C: Sodium. D: Hemoglobin.: D: Hemoglobin.
45. Which nursing action has the highest priority when administering a dose
of codeine with acetaminophen to a client? A: Instruct the client to request assistance when ambulating to the bathroom. B: Administer a stool softener/laxative at the same time as the analgesic. C: Advise the client that the medication should start to work in about 30 minutes.
