Pharm II HESI Practice - FFHUGFDDHTJ YTJ UY GJUDRRRD T DGDFHG TYJYU 18. A client, who had a myocardial PDF

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FFHUGFDDHTJ YTJ UY GJUDRRRD T DGDFHG TYJYU 18. A client, who had a myocardial infarction last year, has a daily prescription for aspirin 325 mg by mouth. Which assessment finding should alert the nurse to withhold this medication?...

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1.

HESI Practice Test: Pharmacology 1. ID: 20127756676

The nurse is caring for a client who has taken atenolol for 2 years. The healthcare provider recently changed the medication to enalapril to manage the client's blood pressure. Which instruction should the nurse provide the client regarding the new medication? A.

Take the medication at bedtime.

B.

Report presence of increased bruising.

C. Check pulse before taking medication. D. Rise slowly when getting out of bed or chair. Correct 2. ID: 20127756673

A female client calls the clinic and talks with the nurse to inquire about a possible reaction after taking amoxicillin for 5 days. She reports having vaginal discomfort, itching, and a white discharge. The nurse should discuss which action with the client? A.

Discontinue the antibiotic because original symptoms have subsided.

B.

Continue taking medication until finished until the symptoms subside.

C. Consult with healthcare provider about another treatment for this effect. Correct D. Use an over-the-counter (OTC) vaginal wash to flush out the secretions. 3. ID: 20127756670

The nurse is making early morning rounds on a group of clients when a client begins exhibiting symptoms of an acute asthma attack. The nurse administers a PRN prescription for a Beta 2 receptor agonist agent. Which client response should the nurse expect? A.

Tachycardia.

B.

Increased blood pressure.

C. Rapid resolution of wheezing. Correct D. Improved pulse oximetry values. Correct E.

Reduce fever airway inflammation. 4.

ID: 20127756667

A client prescribed atenolol has a blood pressure of 120/68 mmHg, displaying a sinus bradycardia with a rate of 58 beats/minute, and a P-R interval of 0.24. Which action should the nurse take? A.

Lower the head of the bed and assess the client for orthostatic vital sign changes.

B.

Give the medication as prescribed and continue to monitor the client. Correct

C. Prepare to administer atropine sulfate IV push. D. Hold the prescribed dose and contact the healthcare provider. 5. ID: 20127756664

The nurse is preparing the 0900 dose of losartan (Cozaar), an angiotensin II receptor blocker (ARB), for a client with hypertension and heart failure. The nurse reviews the client's laboratory results and notes that the client's serum potassium level is 5.9 mEq/L. Which action should the nurse take first? A.

Withhold the scheduled dose. Correct

B.

Check the client's apical pulse.

C. Notify the healthcare provider. D. Repeat the serum potassium level. 6. ID: 20127756656

Upon admission to the emergency center, an adult client with acute status asthmaticus is prescribed this series of medications. In which order should the nurse administer the prescribed medications? (Arrange from first to last.) Correct A. Albuterol (Proventil) puffs. B. Salmeterol (Serevent Diskus). C. Prednisone (Deltasone) orally. D. Gentamicin (Garamycin) IM. 7. ID: 20127756653

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. Correct

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. 8. ID: 20127756650

A client with giardiasis is taking metronidazole (Flagyl) 2 grams PO. Which information should the nurse include in the client's instruction? A.

Notify the clinic of any changes in the color of urine.

B.

Avoid overexposure to the sun.

C. Stop the medication after the diarrhea resolves. D. Take the medication with food. Correct 9. ID: 20127756647

A female client with rheumatoid arthritis takes 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. Correct

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. 10. ID: 20127756644

A client with osteoarthritis receives a new prescription for celecoxib (Celebrex) orally for symptom management. The nurse notes the client is allergic to sulfa. Which action is most important for the nurse to implement prior to administering the first dose? A.

Review the client's hemoglobin results.

B.

Notify the healthcare provider. Correct

C. Inquire about the reaction to sulfa. D. Record the client's vital signs. 11. ID: 20127756641

A client is admitted to the hospital for a new onset of supraventricular tachycardia (SVT) and is prescribed digoxin. For which laboratory finding should the nurse notify the healthcare provider immediately?

A.

Potassium level of 3.1 mEq/L. Correct

B.

Sodium level of 132 mEq/L.

C. Calcium level of 8.6 mg/dL. D. Magnesium level of 1.2 mEq/L. 12. ID: 20127756637

The nurse is transcribing a new prescription for spironolactone (Aldactone) for a client who receives an angiotensin-converting enzyme (ACE) inhibitor. Which action should the nurse implement? A.

Verify both prescriptions with the healthcare provider. Correct

B.

Report the medication interactions to the nurse manager.

C. Hold the ACE inhibitor and give the new prescription. D. Transcribe and send the prescription to the pharmacy. 13. ID: 20127756634

The nurse admits a client with tumor-induced spinal cord compression. Which medication should the nurse anticipate to be prescribed to offer the best palliative treatment for this client? A.

Morphine sulfate.

B.

Ibuprofen.

C.

Amitriptyline.

D. Dexamethasone. Correct 14. ID: 20127756631

The nurse is preparing an education session for a client prescribed opioids for intractable cancer pain. The nurse should include strategies to help prevent which common side effect associated with long-term use of opioids?

A.

Sedation.

B.

Constipation. Correct

C. Urinary retention. D. Respiratory depression.

15. ID: 20127756628

A client is prescribed controlled-release oxycodone. Which dosing schedule is best for the nurse to teach the client?

A.

As needed.

B.

Every 12 hours. Correct

C. Every 24 hours. D. Every 4 to 6 hours. 16. ID: 20127756625

Which client should the nurse identify as being at highest risk for complications during the use of an opioid analgesic? A.

An older client with Type 2 diabetes mellitus.

B.

A client with chronic rheumatoid arthritis.

C. A client with a open compound fracture. D. A young adult with inflammatory bowel disease. Correct 17. ID: 20127756622

Which medications should the nurse caution the client about taking while receiving an opioid analgesic? A.

Antacids.

B.

Benzodiazepines. Correct

C.

Antihypertensives.

D. Oral antidiabetics. 18. ID: 20127756619

A client is prescribed 1 mcg/kg/min of dobutamine hydrochloride via IV infusion. Which client's condition would benefit the most from an administration of dobutamine hydrochloride? A.

Shock.

B.

Asthma.

C.

Hypotension.

D. Heart failure. Correct 19.

ID: 20127756616

A client is experiencing anaphylaxis from an insect sting. Which medication should the nurse administer? A.

Dopamine.

B.

Ephedrine.

C. Epinephrine. Correct D.

Diphenhydramine. 20.

ID: 20127756613

The healthcare provider prescribes a beta-1 agonist medication to be administered. The nurse should anticipate the medication to be prescribed for a client diagnosed with which condition? A.

Glaucoma.

B.

Hypertension.

C. Heart failure. Correct D.

Asthma. 21.

ID: 20127756610

An older client with a decreased percentage of lean body mass is admitted to the hospital. Which pharmacokinetic process is affected and should be considered in the client's dosing of medication? A.

Absorption.

B.

Metabolism.

C.

Elimination.

D. Distribution. Correct 22. ID: 20127756607

A Category X drug is prescribed for a young adult female client. Which instruction is most important for the nurse to teach this client? A.

Use a reliable form of birth control. Correct

B.

Avoid exposure to ultra violet light.

C. Refuse this medication if planning pregnancy. D. Abstain from intercourse while on this drug. 23. ID: 20127756604

A client being discharged home is prescribed an antibiotic with a dosage three times higher than it was administered when the client was in the hospital. Which

route of administration should the nurse anticipate will be prescribed for the greatest first-pass effect? A.

Oral. Correct

B.

Sublingual.

C.

Intravenous.

D.

Subcutaneous. 24.

ID: 20127756601

The healthcare provider prescribes naproxen (Naproxen) twice daily for a client with osteoarthritis of the hands. The client tells the nurse that the drug does not seem to be effective after three weeks. Which is the best response for the nurse to provide? A.

The frequency of the dosing is necessary to increase the effectiveness.

B.

Therapeutic blood levels of this drug are reached in 4 to 6 weeks.

C. Another type of nonsteroidal antiinflammatory drug may be indicated. Correct D. Systemic corticosteroids are the next drugs of choice for pain relief. 25. ID: 20127755997

After abdominal surgery, a client is prescribed low molecular weight heparin (LMWH). During administration of the medication, the client asks the nurse the reason for the medication. Which is the best response for the nurse to provide the client? A.

This medication is given to prevent blood clot formation. Correct

B.

This medication enhances antibiotics to prevent infection.

C. This medication dissolves clots that develop in the legs. D. This medication enhances the healing of wounds. 26. ID: 20127755994

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. Correct

C. Restrict fluid intake to 1000 ml per day.

D. Increase intake of milk and milk products. 27. ID: 20127755990

A client receiving doxorubicin (Adriamycin) intravenously (IV) complains of pain at the insertion site, and the nurse notes edema at the site. Which intervention is most important for the nurse to implement? A.

Assess for erythema.

B.

Administer the antidote.

C. Apply warm compresses. D. Discontinue the IV fluids. Correct 28. ID: 20127755987

A client with acute myocardial infarction is admitted to the coronary care unit. Which medication should the nurse administer to lessen the workload of the heart by decreasing the cardiac preload and afterload?

A.

Nitroglycerin. Correct

B.

Propranolol (Inderal).

C.

Morphine.

D. Captopril (Capoten). 29. ID: 20127755984

Which instruction) should the nurse give to a female client who just received a prescription for oral metronidazole (Flagyl) for treatment of trichomonas vaginalis? (Select all that apply.) A.

Increase fluid intake, especially cranberry juice. Correct

B.

Do not abruptly discontinue the medication; taper use.

C. Check blood pressure daily to detect hypertension. D. Avoid drinking alcohol while taking this medication. Correct E.

Use condoms until treatment is completed. Correct

F.

Ensure that all sexual partners are treated at the same time. Correct 30.

ID: 20127755981

A client with hyperlipidemia receives a prescription for niacin (Niaspan). Which client teaching is most important for the nurse to provide? A.

Expected duration of flushing. Correct

B.

Symptoms of hyperglycemia.

C. Diets that minimize GI irritation. D. Comfort measures for pruritus. 31. ID: 20127755978

The nurse is planning discharge instructions for a client prescribed cyclosporine following a liver transplant. Which adverse reactions should the nurse instruct the client to report to the healthcare provider? A.

Changes in urine color.

B.

Presence of hand tremors. Correct

C. Increasing body hirsutism. D. Nausea and vomiting. 32. ID: 20127755975

A client is taking hydromorphone (Dilaudid) PO every 4 hours at home. Following surgery, Dilaudid IV every 4 hours PRN and butorphanol tartrate (Stadol) IV every 4 hours PRN are prescribed for pain. The client received a dose of the Dilaudid IV four hours ago, and is again requesting pain medication. Which intervention should the nurse implement? A.

Alternate the two medications every 4 hours PRN for pain.

B.

Alternate the two medications every 2 hours PRN for pain.

C. Administer only the Dilaudid every 4 hours PRN for pain. Correct D. Administer only the Stadol every 4 hours PRN for pain. 33. ID: 20127755972

Which change in data indicates to the nurse that the desired effect of the angiotensin II receptor antagonist valsartan has been achieved? A.

Dependent edema reduced from +3 to +1.

B.

Serum HDL increased from 35 to 55 mg/dL.

C. Pulse rate reduced from 150 to 90 beats/minute. D. Blood pressure reduced from 160/90 mmHg to 130/80 mmHg. Correct

34. ID: 20127755969

A client with coronary artery disease who is taking digoxin (Lanoxin) receives a new prescription for atorvastatin (Lipitor). Two weeks after initiation of the Lipitor prescription, the nurse assesses the client. Which finding requires the most immediate intervention?

A.

Heartburn.

B.

Headache.

C.

Constipation.

D. Vomiting. Correct 35. ID: 20127755966

The nitrate isosorbide dinitrate is prescribed for a client with angina. Which instruction should the nurse include in this client's discharge teaching plan? A.

Quit taking the medication if dizziness occurs.

B.

Do not get up quickly. Always rise slowly. Correct

C. Take the medication with food only. D. Increase your intake of potassium-rich foods. 36. ID: 20127755963

The nurse is reviewing admission prescriptions for a client with myxedema. The nurse should clarify with the healthcare provider which prescription for the client? A.

Liothyronine to replace iodine.

B.

Furosemid for relief of fluid retention.

C. Pentobarbital sodium for sleep. Correct D. Nitroglycerin for angina pain. 37. ID: 20127755960

The nurse is providing care for a client prescribed propranolol. Which symptoms should the nurse report to the healthcare provider immediately? A.

Headache, hypertension, and blurred vision.

B.

Wheezing, hypotension, and AV block. Correct

C. Vomiting, dilated pupils, and papilledema. D. Tinnitus, muscle weakness, and tachypnea. 38. ID: 20127755954

A client asks the nurse if glipizide (Glucotrol) is an oral insulin. Which response should the nurse provide? A.

"Yes, it is an oral insulin and has the same actions and properties as intermediate insulin."

B.

"Yes, it is an oral insulin and is distributed, metabolized, and excreted in the same manner as insulin."

C. "No, it is not an oral insulin and can be used only when some beta cell function is present." Correct D. "No, it is not an oral insulin, but it is effective for those who are resistant to injectable insulins." 39. ID: 20127755957

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. Correct D. Monitor the client's urine pH for increased acidity. 40. ID: 20127755951

A 43-year-old female client is prescribed thyroid replacement hormone following a thyroidectomy. Which adverse effects should the nurse instruct the client to report immediately to the healthcare provider? A.

Tinnitus and dizziness.

B.

Tachycardia and chest pain. Correct

C. Dry skin and intolerance to cold. D. Weight gain and increased appetite. 41. ID: 20127755948

A client prescribed albuterol tablets reports nausea every evening with the 9:00 p.m. dose. Which action should the nurse perform to alleviate this side effect? A.

Change the time of the dose.

B.

Hold the 9 p.m. dose.

C. Administer the dose with a snack. Correct D. Offer an antiemetic with the dose. 42. ID: 20127755945

A peak and trough level is prescribed for a client receiving antibiotic therapy. When should the nurse should obtain the trough level? A.

Sixty minutes after the antibiotic dose is administered.

B.

Immediately before the next antibiotic dose is given. Correct

C. Upon completion of the prescribed antibiotic regime.

D. An hour before the next antibiotic dose is given. 43. ID: 20127755942

A client is prescribed ampicillin sodium (Omnipen) for a sinus infection. The nurse should instruct the client to notify the healthcare provider immediately if which symptom occurs? A.

Rash. Correct

B.

Nausea.

C.

Headache.

D.

Dizziness. 44.

ID: 20127755939

While taking a medical history, the client states, "I am allergic to penicillin." What related allergy to another type of antiinfective agent should the nurse ask the client about when taking the nursing history? A.

Aminoglycosides.

B.

Cephalosporins. Correct

C.

Sulfonamides.

D.

Tetracyclines. 45.

ID: 20127755936

A client receives a new prescription for sustained release levodopa/carbidopa PO BID for the treatment of Parkinson's disease. The client's previous prescr...