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Pharmacology HESI Quiz Correct and Verified Answers Graded A
Nursing Pharmacology Practice Questions
- Following heparin treatment for a pulmonary embolism, a client is being discharged
with a prescription for warfarin (Coumadin). In conducting discharge teaching, the nurse advises the client to have which diagnostic test monitored regularly after discharge?• Perfusion scan • Prothrombin Time (PT/INR) • Activated partial thromboplastin (APTT) • Serum Coumadin level (SCL)
Correct Answer: Prothrombin Time (PT/INR)
Rationale: When used for a client with pulmonary embolus, the therapeutic goal for warfarin therapy is a PT 1 to 2 times greater than the control, or an INR of 2 to 3.
- The healthcare provider prescribes naloxone (Narcan) for a client in the emergency
room. Which assessment data would indicate that the naloxone has been effective?• The client's statement that the chest pain is better • Respiratory rate is 16 breaths/minute • Seizure activity has stopped temporarily • Pupils are constricted bilaterally
Correct Answer: Respiratory rate is 16 breaths/minute
Rationale: Naloxone (Narcan) is a narcotic antagonist that reverses the respiratory depression effects of opiate overdose, so assessment of a normal respiratory rate would indicate that the respiratory depression has been reversed.
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- 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. What action should the nurse take first?• Withhold the scheduled dose • Check the client's apical pulse • Notify the healthcare provider • Repeat the serum potassium level
Correct Answer: Withhold the scheduled dose
Rationale: The nurse should first withhold the scheduled dose of Cozaar because the client is hyperkalemic (normal range 3.5 to 5 mEq/l). Although hypokalemia is usually associated with diuretic therapy in heart failure, hyperkalemia is associated with several heart failure medications, including ARBs. Because hyperkalemia may lead to cardiac dysrhythmias, the nurse should check the apical pulse for rate and rhythm, and the blood pressure.
- 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?• Review the client's hemoglobin results • Notify the healthcare provider • Inquire about the reaction to sulfa • Record the client's vital signs
Correct Answer: Notify the healthcare provider
Rationale: Celebrex contains a sulfur molecule, which can lead to an allergic reaction in individuals who are sensitive to sulfonamides, so the healthcare provider should be notified of the client's allergies.
- Which method of medication administration provides the client with the greatest
first-pass effect?• Oral • Sublingual
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• Intravenous • Subcutaneous
Correct Answer: Oral
Rationale: The first-pass effect is a pharmacokinetic phenomenon that is related to the drug's metabolism in the liver. After oral medications are absorbed from the gastrointestinal tract, the drug is carried directly to the liver via the hepatic portal circulation where hepatic inactivation occurs and reduces the bioavailability of the drug.Alternative method of administration, such as sublingual, IV, and subcutaneous routes, avoid this first-pass effect.
- 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?• Verify both prescriptions with the healthcare provider • Report the medication interactions to the nurse manager • Hold the ACE inhibitor and give the new prescription • Transcribe and send the prescription to the pharmacy
Correct Answer: Verify both prescriptions with the healthcare provider
Rationale: The concomitant use of an angiotensin-converting enzyme (ACE) inhibitor and a potassium-sparing diuretic such as spironolactone, should be given with caution because the two drugs may interact to cause an elevation in serum potassium levels. Although the client is currently receiving an ACE inhibitor, verifying both prescriptions alerts the healthcare provider about the client's medication regimen and provides the safest action before administering the medication.
- A client has myxedema, which results from a deficiency of thyroid hormone
synthesis in adults. The nurse knows that which medication would be contraindicated for this client?• Liothyronine (Cytomel) to replace iodine • Furosemide (Lasix) for relief of fluid retention • Pentobarbital sodium (Nembutal Sodium) for sleep • Nitroglycerin (Nitrostat) for angina pain
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Correct Answer: Pentobarbital sodium (Nembutal Sodium) for sleep
Rationale: Persons with myxedema are dangerously hypersensitive to narcotics,
barbiturates and anesthetics.
- 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?• The expiration date on the morphine syringe in the pump • The rate and depth of the client's respirations • The type of anesthesia used during the surgical procedure • The client's subjective and objective signs of pain
Correct Answer: The rate and depth of the client's respirations
Rationale: A life-threatening side effect of intravenous administration of morphine sulfate, an opiate narcotic, is respiratory depression. Prior to the initiation of the PCA pump, the nurse should assess the client's respirations to obtain a baseline of their respiratory rate and depth. Once the PCA pump is initiated and if the client's respiratory rate falls below 12 breaths per minute, the PCA pump should be stopped and the healthcare provider notified immediately.
- Dobutamine (Dobutrex) is an emergency drug most commonly prescribed for a
client with which condition?• Shock • Asthma • Hypotension • Heart failure
Correct Answer: Heart failure
Rationale: Dobutamine is a beta-1 adrenergic agonist that is indicated for short term use in cardiac decompensation or heart failure related to reduced cardiac contractility due to organic heart disease or cardiac surgical procedures. On the other hand, alpha and beta adrenergic agonists, such as epinephrine and dopamine, are sympathomimetics used in the treatment of shock. Other selective beta-2 adrenergic agonists, such as terbutaline and
