Pharm Hesi Exam Study Guide

Phenytoin (Dilantin), 100 mg orally three times, has been prescribed for a client for seizure control. The nurse reinforces instructions regarding the medication to the client. Which statement by the client indicates an understanding of the instructions? 1. "I will use a soft toothbrush to brush my teeth." 2. "It's all right to break the capsules to make it easier for me to swallow them." 3. "If I forge to take my medication, I can wait until the next dose and eliminate that dose." 4. "If my throat becomes sore, it's a normal effect of the medication and it's nothing to be concerned about."

1. "I will use a soft toothbrush to brush my teeth."

A nurse has a prescription to give a client albuterol (Proventil HFA) (two puffs) and beclomethasone dipropionate (Qvar) (nasal inhalation, two puffs), by meter dose inhaler. The nurse administers the medication by giving the: 1. Albuterol first and then the beclomethasone dipropionate 2. Beclomethasone dipropionate first and then the albuterol 3. alternating a single puff of each, beginning with the albuterol 4. alternating a single puff of each, beginning with the beclomethasone dipropionate

1. Albuterol first and then the beclomethasone dipropionate

A histamine (H2)- receptor antagonist will be prescribed for a client. The nurse understands that which medications are H2-receptor antagonists? SATA 1. Nizatidine (Axid) 2. Ranitidine (Zantac) 3. Famotidine (Pepcid) 4. Cimetidine (Tagamet) 5. Esomeprazole (Nexium) 6. Lansoprazole (Prevacid)

1. Nizatidine (Axid) 2. Ranitidine (Zantac) 3. Famotidine (Pepcid) 4. Cimetidine (Tagamet)

Glimepiride (Amarly) is prescribed for a client with diabetes mellitus. A nurse reinforces instructions for the client and tells the client to avoid which of the following while taking this medication? 1. alcohol 2. organ meats 3. whole-grain cereals 4. carbonated beverages

1. alcohol

Desmopressin acetate (DDAVP) is prescribed for the treatment of diabetes insipidus. The nurse monitors the client after medication administration for which therapeutic response? 1. decreased urinary output 2. decreased blood pressure 3. decreased peripheral edema 4. decreased blood glucose level

1. decreased urinary output

A nurse is collecting data from a client and the client's reports that the client is taking donepezil hydrochloride (Aricept). Which disorder would the nurse suspect that this client may have based on the use of this medication? 1. dementia 2. schizophrenia 3. seizure-disorder 4. obsessive-compulsive disorder

1. dementia

A hospitalized client is started on phenelzine sulfate (Nardil) for the treatment of depression. The nurse instructs the client to avoid consuming which foods while taking this medication? SATA 1. figs 2. yogurt 3. crackers 4. aged cheese 5. tossed salad 6. oatmeal cookies

1. figs 2. yogurt 4. aged cheese

Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse monitors the clients, knowing that which of the following would indicate the presence of systemic toxicity from this medication? 1. tinnitus 2. diarrhea 3. constipation 4. decreased respirations

1. tinnitus

A client taking lithium carbonate reports vomiting, abdominal pain, diarrhea, blurred vision, tinnitus and tremors. The lithium level is checked as part of the routine follow-up and the level is 3.0 mEq/L. The nurse knows that this level is: 1. toxic 2. normal 3. slightly above normal 4. excessively below normal

1. toxic

A client with severe acne is seen in the clinic and the health care provider (HCP) prescribes isotretinoin. The nurse reviews the client's medication record and would contact the (HCP) if the client is taking which medication? 1. vitamin A 2. Digoxin (Lanoxin) 3. Furosemide (Lasix) 4. Phenytoin (Dilantin)

1. vitamin A

Ibuprofen (Advil) is prescribed for a client. The nurse tells the client to take the medication: 1. with 8 oz of milk 2. in the morning after arising 3. 60 minutes before breakfast 4. at bedtime on an empty stomach

1. with 8 oz of milk

A nurse is reinforcing teaching for a client regarding how to mix regular insulin and NPH insulin in the same syringe. Which of the following actions, if performed by the client, indicates the need for further teaching? 1. withdraws the NPH insulin first 2. withdraws the regular insulin first 3. injects air into NPH insulin vial first 4. injects an amount of air equal to the desired dose of insulin into the vial

1. withdraws the NPH insulin first

A client who is receiving digoxin (Lanoxin) daily has a serum potassium level of 3.0 mEq/L and is complaining of anorexia. A health care provider prescribes a digoxin level to rule out digoxin toxicity. A nurse checks the results knowing that which of the following is the therapeutic serum level (range) for digoxin? 1. 3-5 ng/mL 2. 0.5-2 ng/mL 3. 1.2-2.58 ng/mL 4. 3.5-5.5 ng/mL

2. 0.5-2 ng/mL

A client is taking phenytoin (Dilantin) for seizure control and a sample for a serum drug level is drawn. Which of the following indicates a therapeutic serum drug range? 1. 5-10 mcg/mL 2. 10-20 mcg/mL 3. 20-30 mcg/mL 4. 30-40 mcg/mL

2. 10-20 mcg/mL

A client is taking Humulin NPH insulin daily every morning. The nurse reinforces instructions for the client and tells that the most likely time for a hypoglycemic reaction to occur is: 1. 2-4 hours after administration 2. 4-12 hours after administration 3. 16-18 hours after administration 4. 18-24 hours after administration

2. 4-12 hours after administration

A client has been taking isoniazid (INH) for 2 months. The client complains to a nurse about numbness, paresthesias, and tingling in the extremities. The nurse interprets that the client is experiencing: 1. Hypercalcemia 2. Peripheral neuritis 3. small blood vessel spasm 4. impaired peripheral circulation

2. Peripheral neuritis

A nurse is reinforcing discharge instructions to a client receiving baclofen. Which of the following would the nurse include in the instructions? 1. restrict fluid intake 2. avoid the use of alcohol 3. stop the medication if diarrhea occurs 4. notify the health care provider if fatigue occurs

2. avoid the use of alcohol

After kidney transplantation, cyclosporine (Sand immune) is prescribed for a client. Which laboratory result would indicate an adverse effect from the use of this medication? 1. decreased creatinine level 2. decreased hemoglobin level 3. elevated blood urea nitrogen level 4. decreased white blood cell count

2. decreased hemoglobin level

Baclofen is prescribed for the client with multiple sclerosis. The nurse assists in planning care, knowing that the primary therapeutic effect of this medication is which of the following? 1. increased muscle tone 2. decreased muscle spasm 3. increased range of motion 4. decrease local pain and tenderness

2. decreased muscle spasm

A nurse performs an admission assessment on a client who visits a health care clinic for the first time. The client tells the nurse that propylthiouracil (PTU) is taken daily. The nurse continues to collect data from the client, suspecting that the client has a history of: 1. myxedema 2. graves' disease 3. addison's disease 4. cushing's syndrome

2. graves' disease

Ketoconazole is prescribed for a client with a diagnosis of candidiasis. Select the interventions that the nurse includes when administering this medication. SATA 1. restrict fluid intake 2. instruct the client to avoid alcohol 3. monitor hepatic and liver function studies 4. administer the medication with an antacid 5. instruct the client to avoid exposure to the sun 6. administer the medication on an empty stomach

2. instruct the client to avoid alcohol 3. monitor hepatic and liver function studies 5. instruct the client to avoid exposure to the sun

A nurse is reinforcing discharge instructions to a client receiving sulfisoxazole. Which of the following should be included in the list of instructions? 1. restrict fluid intake 2. maintain a high fluid intake 3. if the urine turns dark brown, call the health care provider (HCP) immediately 4. decrease the dosage when symptoms are improving to prevent an allergic response

2. maintain a high fluid intake

A client who has been newly diagnosed with diabetes mellitus has been stabilized with daily insulin injections. Which information should the nurse teach when carrying out plans for discharge? 1. keep insulin vials refrigerated at all times 2. rotate the insulin injection sites systematically 3. increase the amount of insulin before unusual exercise 4. monitor the urine acetone level to determine the insulin dosage

2. rotate the insulin injection sites systematically

A nurse reinforces medication instructions to a client who is taking levothyroxine (Synthroid). The nurse instructs the client to notify the health care provider (HCP) if which of the following occurs? 1. fatigue 2. tremors 3. cold intolerance 4. excessive dry skin

2. tremors

The client has a PRN prescription for loperamide hydrochloride (Imodium). The nurse understands that this medication is used for which condition? 1. constipation 2. abdominal pain 3. an episode of diarrhea 4. hematest-positive nasogastric tube drainage

3. an episode of diarrhea

Prednisone is prescribed for a client with diabetes mellitus who is taking (NPH) insulin daily. Which of the following prescription changes does the nurse anticipate during therapy with the prednisone? 1. an additional dose of prednisone daily 2. a decreased amount of daily Humulin NPH insulin 3. an increased amount of daily Humulin NPH insulin 4. the addition of an oral hypoglycemic medication daily

3. an increased amount of daily Humulin NPH insulin

A nurse is caring for a client with hyperparathyroidism and notes that the client's serum calcium level is 13 mg/dL. Which medication should the nurse prepare to administer as prescribed to the client? 1. calcium chloride 2. calcium gluconate 3. calcitonin (Miacalcin) 4. large dose of vitamin D

3. calcitonin (Miacalcin)

A client complaining of not feeling well is seen in a clinic. The client is taking several medications for the control of heart disease and hypertension. These medications include a B-blocker, digoxin (Lanoxin), and a diuretic. A tentative diagnosis of digoxin toxicity is made. Which of the following assessment data would support this diagnosis? 1. dyspnea, edema, and palpitations 2. chest pain, hypotension, and paresthesia 3. double vision, green and yellow halos, and nausea 4. constipation, dry mouth, and sleep disorder

3. double vision, green and yellow halos, and nausea

A client is receiving meperidine hydrochloride (Demerol) for pain. Which of the following are side effects of this medication. SATA 1. diarrhea 2. tremors 3. drowsiness 4. hypotension 5. urinary frequency 6. increased respiratory rate

3. drowsiness 4. hypotension

A nurse is caring for a client who has been prescribed furosemide (Lasix) and is monitoring for adverse effect associated with this medication. which of the following should the nurse recognize as a potential adverse effects SATA 1. nausea 2. tinnitus 3. hypotension 4. hypokalemia 5. photosensitivity 6. increased urinary frequency

3. hypotension 4. hypokalemia

Manfenide acetate (Sulfamylon) is prescribed for the client with a burn injury. When applying the medication, the client complains of local discomfort and burning. Which of the following is the most appropriate nursing action? 1. notifying the registered nurse 2. discontinuing the medication 3. informing the client that this is normal 4. apply a thinner film than prescribed to the burn site

3. informing the client that this is normal

A client with tuberculosis is being started on antituberculosis therapy with isoniazid (INH). Before giving the client the first dose, a nurse ensures that which of the following baseline studies has been completed? 1. electrolyte levels 2. coagulation times 3. liver enzyme levels 4. serum creatinine level

3. liver enzyme levels

A client is diagnosed with an acute myocardial infraction and is receiving tissue plasminogen activator, alterplase (Activase, tPA). Which action is a priority nursing intervention? 1. monitor for renal failure 2. monitor psychosocial status 3. monitor for signs of bleeding 4. have heparin sodium available

3. monitor for signs of bleeding

The client has begun medication therapy with pancrelipase (Pancrease MT). The that the medication is having the optimal intended benefits if which effect is observed? 1. weight loss 2. relief of heartburn 3. reduction of steatorrhea 4. absence of abdominal pain

3. reduction of steatorrhea

A postoperative client has received a dose of naloxone hydrochloride for respiratory depression shortly after transfer to the nursing unit from the postanesthesia care unit. After administration of the medication, the nurse checks the client for: 1. pupillary changes 2. scattered lung wheezes 3. sudden increase in pain 4. sudden episodes of diarrhea

3. sudden increase in pain

A nurse is caring for a client after thyroidectomy and notes that calcium gluconate is prescribed for the client. The nurse determines that this medication has been prescribed to: 1. treat thyroid storm 2. prevent cardiac irritability 3. treat hypocalcemic tetany 4. stimulate the release of parathyroid hormone

3. treat hypocalcemic tetany

Sildenafil (Viagra) is prescribed to treat a client with erectile dysfunction. A nurse reviews the client's medical record and would question the prescription if which of the following is noted in the client's history? 1. neuralgia 2. insomnia 3. use of nitroglycerin 4. use of multivitamins

3. use of nitroglycerin

A client with trigeminal neuralgia is being treated with carbamazepine (Tegretol). Which laboratory results would indicate that the client is experiencing an adverse reaction to the medication? 1. sodium level, 140 mEq/L 2. uric acid level, 5.0 mg/dL 3. white blood cell count, 3000 cells/mm3 4. blood urea nitrogen (BUN) level, 15 mg/dL3

3. white blood cell count, 3000 cells/mm3

A client with coronary artery disease complains of substernal chest pain. After checking the client's heart rate and blood pressure, a nurse administers nitroglycerin, 0.4 mg, sublingually. After 5 minutes, the client states, "My chest still hurts." Select the appropriate actions that the nurse should take. SATA 1. call a code blue 2. contact the registered nurse 3. contact the client's family 4. assess the client's pain level 5. check the client's blood pressure 6. administer a second nitroglycerin, 0.4 mg, sublingually

4. assess the client's pain level 5. check the client's blood pressure 6. administer a second nitroglycerin, 0.4 mg, sublingually

A client with chronic renal failure is receiving ferrous sulfate (Feosol). The nurse monitors the client for which common side effect associated with this medication? 1. diarrhea 2. weakness 3. headache 4. constipation

4. constipation

Oral iron supplements are prescribed for a 6-year-old child with iron deficiency anemia. The nurse instructs the mother to administer the iron with which best food item? 1. milk 2. water 3. apple juice 4. grapefruit juice

4. grapefruit juice

A client with myasthenia gravis is suspected of having cholinergic crisis. Which of the following indicate that this crisis exists? 1. ataxia 2. mouth sores 3. hypotension 4. hypertension

4. hypertension

The client has a PRN prescription for ondansetron (Zofran). FOr which condition should this medication be administered to the postoperative client? 1. paralytic ileus 2. incisional pain 3. urinary retention 4. nausea and vomiting

4. nausea and vomiting

The client with a gastric ulcer has a prescription for sucralfate (Carafate), 1 g by mouth four times daily. The nurse schedules the medications for which times? 1. with meals and at bedtime 2. every 6 hours around the clock 3. one hour after meals and at bedtime 4. one hour before meals and at bedtime

4. one hour before meals and at bedtime

Phenazopyridine hydrochloride (Pyridium) is prescribed for a client for symptomatic relief of pain resulting from a lower urinary tract infection. The nurse reinforces to the client: 1. to take the medication at bedtime 2. to take the medication before meals 3. to discontinue the medication if a headache occurs 4. that a reddish orange discoloration of the urine may occur

4. that a reddish orange discoloration of the urine may occur