HESI PHARM Practice Test

Which medication prescription should the practical nurse administer for a client who is having an asthmatic episode? A) Propranolol (Inderal). B) Enalapril (Vasotec). C) Isosorbide mononitrate (Imdur). D) Albuterol (Proventil).

D) Albuterol (Proventil).

A client with Parkinson's disease has been taking antiparkinsonian medications for 3 months. Which client finding should the practical nurse (PN) identify as a therapeutic response? A) Decreased appetite. B) Gradual development of cogwheel rigidity. C) Occurrence of confusion. D) Improved ability to perform activities.

D) Improved ability to perform activities.

The practical nurse (PN) is reviewing the laboratory results for a client who is taking sulfasalazine (Azulfidine) for an exacerbation of inflammatory bowel disease (IBD). Before administering the next dose, which laboratory results warrant further action by the PN? A) Blood urea nitrogen (BUN) is 30 mg/dL and creatinine is 1.5 mg/dL. B) White blood cells (WBC) are 14,000 mm3 and neutrophils are 86%. C) Hemoglobin is 12.5 grams and hematocrit is 40%. D) Serum potassium is 3.2 mEq/L and sodium is 145 mEq/L.

A) Blood urea nitrogen (BUN) is 30 mg/dL and creatinine is 1.5 mg/dL.

Dietary trays usually arrive on the hospital unit at 7:30 AM. When should the practical nurse (PN) plan to administer NPH insulin 40 units subcutaneously to a client with diabetes mellitus? A) 6:30 and 7:00 AM. B) 7:00 and 7:30 AM. C) 7:30 and 8:00 AM. D) 8:00 and 8:30 AM

A) 6:30 and 7:00 AM.

A client returns to the postoperative unit with prescriptions for morphine 5 mg IM q4 hours PRN pain and morphine 10 mg IM q4 hours PRN pain. At 1300, the practical nurse (PN) administers morphine 5 mg IM for the client's rated pain of "8" on a 0 to 10 scale. At 1500, the client rates the pain at "7." Which intervention should the PN implement? A) Administer morphine 5 mg IM now. B) Wait to administer morphine 10 mg IM at 1700. C) Request an order for an adjunct medication. D) Give morphine 2.5 mg IM at 1700.

A) Administer morphine 5 mg IM now.

A client is receiving a nitroglycerin transdermal patch daily. Which assessment finding indicates that the practical nurse (PN) should withhold the next dose? A) Blood pressure 90/60 mmHg. B) Apical heart rate 60 beats/minute. C) Bilateral crackles noted in the lung bases. D) Redness at the previous application site.

A) Blood pressure 90/60 mmHg.

The practical nurse (PN) is administering a daily dose of nifedipine (Procardia) 60 mg extended release to a client with angina pectoris. Which finding should the PN consider withholding the medication? A) Blood pressure of 96/52. B) Apical heart rate of 60. C) Temperature is 100.4 F. D) Respiratory rate of 24.

A) Blood pressure of 96/52.

The practical nurse (PN) should recommend that oral contraceptives be avoided in which group of women? A) Women who smoke. B) Multigravidous women. C) Monogamous women. D) Women with an intrauterine device.

A) Women who smoke.

Forty minutes after a client with pulmonary edema receives furosemide (Lasix) 40 mg, 50 ml of concentrated dark amber urine is in the indwelling urinary catheter's bedside drainage bag. What action should the practical nurse (PN) implement first? A) Check the urinary drainage system for kinks. B) Record the findings on the client's record. C) Notify the healthcare provider of client status. D) Encourage an intake of high potassium foods.

A) Check the urinary drainage system for kinks.

A client receives a prescription for an oral opioid analgesic for post-operative pain. Which adverse effect should the practical nurse (PN) monitor for in the client? A) Constipation. B) Photosensitivity. C) Decreased heart rate. D) Frequent urination.

A) Constipation.

A client with Attention Deficit Disorder (ADD) is prescribed amphetamine (Adderall). Which side effect should the practical nurse (PN) explain is commonly experienced? A) Difficulty sleeping. B) Increased fatigue. C) Improved appetite. D) Decreased heart rate.

A) Difficulty sleeping.

Which action should the practical nurse (PN) implement for a client who is recently diagnosed with myasthenia gravis? A) Give neostigmine bromide (Prostigmin) before meals. B) Administer prednisone (Deltasone) on an empty stomach. C) Protect the extremities from trauma. D) Schedule the client for an eye exam.

A) Give neostigmine bromide (Prostigmin) before meals.

An older client who takes risperidone (Risperdal), an antipsychotic, is complaining of constipation. Which dietary changes should the practical nurse (PN) recommend? A) Increase daily green vegetables and bran. B) Take a laxative and stool softener daily. C) Eat liver and turnips once a week. D) Use a retention enema every four days.

A) Increase daily green vegetables and bran.

Which client statement indicates to the practical nurse (PN) that a client understands discharge instructions about a new prescription for digoxin (Lanoxin)? A) "I should double the dose if one is missed." B) "I will take my pulse for one-minute every day." C) "I should take an antacid to minimize stomach upset." D) "I will alternate my dose between morning and afternoon."

B) "I will take my pulse for one-minute every day."

A male client whose postoperative patient-controlled analgesia (PCA) pump is discontinued receives a prescription for hydrocordone bitartrate with acetaminophen (Vicodin) 2 tablets PO every 4 hours for pain. One hour after receiving the prescribed dose of Vicodin, the client states he is having pain rated as "11" on a 0 to 10 pain scale. Which action should the practical nurse (PN) implement? A) Inform the charge nurse about the client's status. B) Review with the client that the pain scale is only 0 to 10. C) Demonstrate use of relaxation breathing technique. D) Review client's medical record for a history of drug abuse.

A) Inform the charge nurse about the client's status.

The practical nurse (PN) is unable to arouse a client who is receiving meperidine (Demerol) for postoperative pain. The client is stuporous, has constricted pupils, and a respiratory rate of 8 breaths/minute. Which PRN prescription should the PN give the client? A) Naloxone (Narcan). B) Promethazine (Phenergan). C) Metoclopramide (Reglan). D) Bethanechol (Urecholine).

A) Naloxone (Narcan).

What criterion provides the best indication to the practical nurse that albuterol (Ventolin) nebulizing treatment is effective for a client with asthma? A) No wheezing is audible or auscultated. B) Respiratory rate is 22 breaths/minute. C) Pulse oximetry is 93% with supplemental oxygen. D) Chest x-ray report indicates no evidence of atelectasis.

A) No wheezing is audible or auscultated.

A client with gastroesophageal reflux disease (GERD) is having symptoms of reflux despite taking omeprazole (Prilosec) 20 mg daily. What action should the practical nurse (PN) implement? A) Notify the healthcare provider about the symptoms. B) Obtain vital signs every 30 minutes until symptoms are alleviated. C) Instruct the client to stop taking the medication. D) Tell the client to take an antacid in addition to the omeprazole.

A) Notify the healthcare provider about the symptoms.

Which action should the practical nurse implement prior to administering furosemide (Lasix) 60 mg and hydrochlorothiazide (HydroDIURIL) 25 mg to a client? A) Obtain the client's heart rate and blood pressure. B) Verify that the serum potassium level is below 5 mEq/L. C) Determine if the client illicit a positive Trousseau's sign. D) Check that the client's serum sodium level is above 135 mEq/L.

A) Obtain the client's heart rate and blood pressure.

The practical nurse (PN) is caring for a client who is receiving hydromorphone (Dilaudid) per patient-controlled analgesia (PCA) pump at 1 mg/hour basal rate for postoperative pain. The PCA pump is programmed for a 0.1 mg bolus dose and the lock out time is 6 minutes. Which finding should the PN report to the charge nurse? A) Pain rating of 9 on a 0 to 10 pain scale. B) Blood pressure is 129/81 mmHg. C) Respiratory rate of 16 breaths/minute. D) Oral temperature is 100.1oF.

A) Pain rating of 9 on a 0 to 10 pain scale.

When caring for a client receiving warfarin (Coumadin), what action should the practical nurse implement? A) Recommend the use of a soft toothbrush. B) Monitor for signs of thrombocytopenia. C) Instruct to avoid dairy foods. D) Watch for signs of hypokalemia.

A) Recommend the use of a soft toothbrush.

A client is hospitalized with an asthma exacerbation and is being treated with methylprednisolone (Solu-Medrol) 125 mg q6 hours. Which laboratory value should the practical nurse (PN) to monitor? A) Serum blood glucose. B) Red blood cell count. C) Urine specific gravity. D) Blood urea nitrogen.

A) Serum blood glucose.

A female client tells the practical nurse (PN) that she started taking an over-the-counter herbal supplement, St. John's Wort (Hypericum perforatum), last week. Which question should the PN ask the client? A) "Have you noticed an improved memory?" B) "Have you felt sad or depressed lately?" C) "Have you told your healthcare provider?" D) "Have you experienced facial flushing?"

B) "Have you felt sad or depressed lately?"

The practical nurse (PN) discusses antihypertensive drug therapy with several clients diagnosed with high blood pressure. To improve client understanding, the PN should emphasize that which medication preserves renal function in a client with diabetes? A) Verapamil (Calan). B) Captopril (Capoten). C) Clonidine (Catapres). D) Nifedipine (Procardia).

B) Captopril (Capoten).

Which prescription should the practical nurse (PN) administer for a client who is experiencing an anaphylactic reaction to an antibiotic? A) Ephedra (ma-huang). B) Epinephrine (Adrenalin). C) Phenylephrin (Neo-Synephrine). D) Fexofenadine with pseudoephedrine (Allegra D).

B) Epinephrine (Adrenalin).

An older adult client receives a prescription for hydrochlorothiazide (HydroDIURIL), a thiazide diuretic for the treatment of heart failure. Which side effect(s) should the practical nurse reinforce with the client? (Select all that apply.) A) Constipation. B) Fatigue. C) Edema. D) Nausea. E) Dehydration. F) Blurred vision.

B) Fatigue. E) Dehydration.

A client with increased intracranial pressure (ICP) is receiving an infusion of mannitol 25% (Osmitrol). Which finding indicates to the practical nurse (PN) that the medication is effective? A) Urinary output of 1000 ml clear, yellow urine in 8 hours. B) Glasgow Coma Scale (GCS) score of 15. C) No complaints of headache. D) Oral temperature of 99 F (37.2 C).

B) Glasgow Coma Scale (GCS) score of 15.

A female client with recurring headaches tells the practical nurse (PN) that she has been taking at least 4 grams of acetaminophen a day. Which laboratory studies should the PN review for this client? A) Creatinine clearance. B) Hepatic enzymes. C) Coagulation values. D) Arterial blood gases.

B) Hepatic enzymes.

A client who is receiving an antibiotic suddenly develops hives. The practical nurse should report that the client is most likely experiencing which type of drug response? A) Adverse response. B) Hypersensitivity reaction. C) Idiosyncratic reaction. D) Multiple drug interaction.

B) Hypersensitivity reaction.

The practical nurse (PN) is caring for a client who is receiving dexamethasone (Decadron) after abdominal surgery. Which finding should the PN report to the charge nurse? A) Weight loss. B) Impaired healing. C) Bradycardia. D) Hyperkalemia.

B) Impaired healing.

The practical nurse (PN) is reinforcing medication teaching to a client who receives a prescription for lovastatin (Mevacor). Which symptom should the PN tell the client to report immediately? A) Constipation. B) Muscle aching. C) Joint stiffness. D) Hacking cough.

B) Muscle aching.

A client who is admitted with diabetic ketoacidosis (DKA) and an initial serum glucose level of 300 mg/dl has a prescription of IV insulin per sliding scale. The nurse asks the practical nurse (PN) to retrieve the insulin from the automated medication dispensing system. Which insulin vial should the PN obtain? A) NPH insulin (Humulin N). B) Regular insulin (Humulin R). C) Neutral protamine lispro and lispro (Humalog 75/25). D) Glargine insulin (Lantus).

B) Regular insulin (Humulin R). Rationale: The only preparation of insulin that should be administered IV is regular insulin (B). (A, B, and C) are for subcutaneous administration only.

The practical nurse (PN) is caring for a client who has been taking prednisone (Deltasone) daily for a year. Which adverse effect should the PN document in the client's record? A) Photosensitvity. B) Weight gain. C) Loss of hair. D) Pale skin color.

B) Weight gain.

The practical nurse (PN) is preparing the next secondary infusion of gentamicin IV q18 hours for an older client. The PN reviews the client's serum values for gentamicin, which is 14 ug/ml (therapeutic range is 4-10 ug/ml.) Which action should the practical nurse take? A) Administer the next gentamicin dose at a slower rate. B) Withhold the dose and report findings to the charge nurse. C) Add additional diluent in the next dose of gentamicin. D) Determine the client's last 24 hour urine output.

B) Withhold the dose and report findings to the charge nurse.

Which client situation requires a response from the practical nurse? A) A client who takes niacin (Niaspan) is having facial flushing. B) A client's heart rate is 112/minute after albuterol (Ventolin) nebulizing treatment. C) A client who takes metformin (Glucophage) is scheduled for a test using iodine dye. D) A client who is receiving ampicillin (Principen) reports loose stool.

C) A client who takes metformin (Glucophage) is scheduled for a test using iodine dye.

An older client with a broken humerus received an IV dose of morphine in the emergent care center. Thirty minutes later, the client complained of feeling lightheaded and vomits once. The practical nurse (PN) understands which process is most likely the cause for these symptoms? A) Hypoglycemia. B) A drug-drug interaction. C) A side-effect. D) An allergic reaction.

C) A side-effect.

A client who is admitted for bradycardia receives a prescription for atropine. Which client information should the practical nurse report to the healthcare provider? A) Recurrent streptococcal pharyngitis. B) Cataract extraction and lens implants. C) Chronic constipation and diverticulosis. D) Renal colic related to renal lithiasis.

C) Chronic constipation and diverticulosis.

Which therapeutic action should the practical nurse (PN) base an explanation to a client who is receiving a cardiac glycoside? A) Decrease cardiac output. B) Increased renal perfusion. C) Decreased rate of contraction. D) Increased blood volume.

C) Decreased rate of contraction.

The practical nurse (PN) is giving medications to a client with hyperlipidemia who receives a new prescription for cholestyramine (Questran). Which information should the PN reinforce with the client? A) Increase intake of green leafy vegetables. B) Check apical pulse before taking medication. C) Take before meals and apart from other drugs. D) Provide the client with a low residue diet.

C) Take before meals and apart from other drugs.

A client who has been taking phenazopyridine (Pyridium) for symptoms of urethritis and cystitis comes to the clinic because her urine is reddish-orange. Which question should the practical nurse ask to determine if the medication has been effective? A) How much water have you been drinking each day? B) Does the urine color stain your toilet bowel or undergarments? C) Have you had any relief from urinary pain, burning, or urgency? D) Did your urine appear cloudy or have a foul odor on voiding?

C) Have you had any relief from urinary pain, burning, or urgency?

Which adverse effect should the practical nurse monitor for in a client who is taking amikacin (Amikin)? A) Irritability. B) Constipation. C) Hearing loss. D) Insomnia.

C) Hearing loss.

Which co-morbidity of a client who is starting thyroid replacement should the practical nurse report to the healthcare provider? A) Penicillin allergy. B) Scheduled dental work. C) History of dysrhythmias. D) History of peptic ulcer.

C) History of dysrhythmias.

The practical nurse (PN) administers isoproterenol (Isuprel) to a client with heart block. The PN should evaluate the client for which physiological response? A) Thirst and dry mucous membranes. B) Decrease in gastric motility. C) Increased heart rate. D) Bronchoconstriction.

C) Increased heart rate.

A client with type 1 diabetes mellitus received an early AM dose of regular insulin per sliding scale. At 1000, the practical nurse (PN) should report which signs indicative of hypoglycemia? A) Urticaria and rash. B) Nausea and diarrhea. C) Irritability and confusion. D) Fruity, acetone odor to the breath.

C) Irritability and confusion.

After an albuterol (Ventolin) nebulizer treatment is given to a client with asthma, what finding by the practical nurse indicates that the treatment was effective? A) Arterial blood gas (ABG) pH is 7.30. B) Incentive spirometer reading is 500 ml of air. C) Peak flow reading is raised to 80% of personal best. D) Bilevel positive airway pressure (BiPAP) is 5 ml.

C) Peak flow reading is raised to 80% of personal best.

The practical nurse (PN) should reinforce what time frame with a client about self-administration of lispro insulin (Humalog)? A) Take after a meal is completed. B) Take once daily at the midday meal. C) Take within 15 minutes of beginning a meal. D) Take only before bedtime with an evening snack.

C) Take within 15 minutes of beginning a meal.

An adult male arrives in the clinic requesting a prescription for sildenafil (Viagra). Which client history should the practical nurse (PN) report to the healthcare provider? A) Hypogonadism. B) Fluid retention. C) The use of nitrates. D) Benign prostatic hypertrophy

C) The use of nitrates.

What assessment is most important for the practical nurse (PN) to obtain prior to initiating medication therapy with phenelzine (Nardil) for a client with depression? A) Activity level. B) Mood and affect. C) Understanding of diet modification. D) The client's support system.

C) Understanding of diet modification.

Which information should the practical nurse (PN) reinforce with a client who is self-administering insulin injections? A) Shake the vial of insulin to mix the contents before administration. B) Store opened vials of insulin in a refrigerator no more than 30 days. C) Use a different syringe to prepare and inject each type of insulin. D) Aspirate regular insulin in the syringe first when mixing insulins.

D) Aspirate regular insulin in the syringe first when mixing insulins.

A client who sustains a severe blunt head trauma during a motor vehicle collision receives a prescription for phenytoin (Dilantin). Which therapeutic response should the practical nurse (PN) observe in the client? A) Systolic blood pressure between 100 -120 mmHg. B) Lungs are clear with regular respirations. C) Urinary output for 8 hours averages 65 ml/hour. D) Seizure free during the last 24 hours.

D) Seizure free during the last 24 hours.