Pharm HESI Practice Test

Which side effects should the nurse monitor for a client who is receiving dexamethasone (Decadron) following neurosurgery? (Select all that apply.) 1. Mood swings. 2. Decreased appetite. 3. Increased weight gain. 4. Serum glucose level of 65 mg/dl. 5. Delayed incisional wound healing. 6. Serum hemoglobin level of 9 mg/dl.

1, 3, 5, 6

A client is diagnosed with peptic ulcer disease caused by Helicobacter pylori. Which medications should the nurse anticipate the healthcare provider to prescribe for the client? (Select all that apply.) 1. Clarithromycin (Biaxin). 2. Sulfisoxazole (Gantrisin). 3. Misoprostol (Cytotec). 4. Omeprazole (Prilosec). 5. Metronidazole (Flagyl). 6. Sucralfate (Carafate).

1, 4, 5,

What teaching should the nurse provide a client who has received a new prescription for sildenafil (Viagra)? (Select all that apply.) 1. Frequent use can lead to the development of hypertension. 2. Most effective if taken after at least 6 hours of REM sleep. 3. Take within 30 to 60 minutes of sexual stimulation. 4. Report rebound priapism that occurs for 4 hours or more. 5. Can cause facial flushing and headache.

3, 4, 5,

The mother of a newborn refuses to have her newborn administer the vitamin K injection. Which information should the nurse provide the mother? a. Bacteria that synthesize vitamin K are not present in the newborn's intestinal tract. b. Oral vitamin K impedes the synthesis of clotting factors in the liver. c. The maternal diet is often deficient in vitamin K, so the newborn is deficient in the vitamin K. d. The synthesis of vitamin K is inadequate for 3 to 4 months in the newborn.

a. Bacteria that synthesize vitamin K are not present in the newborn's intestinal tract.

The nurse should withhold which medication if a client reports nausea, vomiting, and diarrhea? a. Colchicine (Mitigare, Colcrys). b. Erythromycin (E-Mycin). c. Naproxen (Aleve, Naprosyn). d. Labetolol (Normodyne).

a. Colchicine (Mitigare, Colcrys).

A client who is receiving chemotherapy is prescribed ondansetron (Zofran). Which side effect should the nurse include in the teaching plan? a. Headache. b. Dry mouth. c. Impaired taste. d. Blurred vision.

a. Headache.

A client diagnosed with multiple sclerosis is experiencing profound weakness, blurry vision, and shooting pains in both legs. Which medication is considered the best course of treatment for the nurse to administer? a. High dose methylprednisolone intravenously. b. Baclofen three times a day. c. Broad spectrum antibiotic coverage orally. d. Immunomodulatory drug therapy periodically.

a. High dose methylprednisolone intravenously.

The nurse is teaching a client who is newly diagnosed with Type 1 diabetes about neutral protamine Hagedor (NPH) insulin. Which statement by the client indicates an understanding of how the medication works? a. It facilitates the transport of glucose into the cells. b. It stimulates the function of beta cells in the pancreas. c. It increases the intracellular receptor site sensitivity. d. It delays the carbohydrate digestion and absorption.

a. It facilitates the transport of glucose into the cells.

A nurse is providing medication education for a client prescribed a beta-blocking agents for treatment of glaucoma. Which statement by the client demonstrates an understanding of the mechanism of the medication? a. It inhibits the aqueous humor production. b. It enhances the aqueous humor outflow. c. It increases the intraocular pressure. d. It prevents extraocular infection.

a. It inhibits the aqueous humor production.

A client newly prescribed esomeprazole for gastroesophageal reflux disease (GERD) asks the nurse how the medication will help. Which is the best explanation to provide the client? a. It will promote rapid tissue healing. b. It will increase gastric emptying. c. It will improve esophageal peristalsis. d. It will neutralize gastric secretions.

a. It will promote rapid tissue healing.

A client experiencing pain from metastatic cancer is prescribed morphine. Which route of administration should the nurse clarify with the healthcare provider prior to administering the medication? a. Oral. b. Buccal. c. Sublingual. d. Intravenous.

a. Oral.

A client prescribed sulfisoxazole for a urinary tract infection (UTI) reports nausea and gastric upset since starting the medication. Which additional assessment finding should the nurse report to the healthcare provider immediately? a. Rash. b. Diarrhea. c. Hematuria. d. Muscle cramping.

a. Rash.

A nurse is planning a teaching session for a client newly prescribed a miotic drug for the treatment of glaucoma. Which information should the nurse include in the teaching session? a. The medication enhances the aqueous humor outflow. b. The medication inhibits the aqueous humor production. c. The medication dilates the pupils. d. The medication prevents extraocular infection.

a. The medication enhances the aqueous humor outflow.

An end-stage terminally ill client being cared for at home is receiving morphine via a patient-controlled pump for intractable cancer pain. When the hospice nurse visits, the client awakens, moans in severe pain, and asks for an increase in the morphine dosage. The client's heart rate is 80 beats/minute, respirations are 10 breaths/minute, and the blood pressure is 102/68 mmHg. Which is the best action for the nurse to implement? a. Titrate the morphine dose upward until the client has adequate pain relief. b. Suggest to the family that they can also give the client ibuprofen, a non-narcotic analgesic. c. Hold additional morphine until the client's respirations are at least 16 per minute. d. Inform the client that an increased dose of morphine increases side effects without additional pain control.

a. Titrate the morphine dose upward until the client has adequate pain relief.

A client who is diagnosed with methillicin-resistant Staphylococcus aureus receives a prescription for vancomycin (Vancocin). Which assessment should the nurse perform to identify a potential adverse effect? a. Whisper test. b. Romberg test. c. Tactile discrimination. d. Skin turgor.

a. Whisper test.

Based on the blood culture and sensitivity results, the healthcare provider prescribes an IV aminoglycoside antibiotic and discontinues the current prescription for another broad spectrum antibiotic. The medication administration record indicates that the client received the broad spectrum antibiotic two hours ago. Which action should the nurse implement? a. Obtain peak and trough serum levels so the aminoglycoside antibiotic can be initiated. b. Administer the initial dose of the aminoglycoside antibiotic as soon as possible. c. Withhold antibiotic administration until the healthcare provider clarifies the prescriptions. d. Schedule the initial dose of the aminoglycoside antibiotic for the following day.

b. Administer the initial dose of the aminoglycoside antibiotic as soon as possible.

A client receives a prescription for sulfamethoxazole-trimethoprim (Septra) for a urinary tract infection (UTI). Which instruction should the nurse provide the client? a. Ingest food prior to taking the antibiotic. b. Drink at least 8 glasses of water a day. c. Take the medication with grapefruit juice. d. Avoid prolonged exposure to sunlight.

b. Drink at least 8 glasses of water a day.

The healthcare provider (HCP) prescribes a medication for an older adult client who is reporting insomnia, and the HCP instructs the client to return in two weeks. The nurse should question which prescription? a. Zolpidem (Ambien) 10 milligrams orally at bedtime. b. Eszopiclone (Lunesta) 10 milligrams orally at bedtime. c. Temazepam (Restoril) 7.5 milligrams orally at bedtime. d. Ramelteon (Rozerem) 8 milligrams orally at bedtime.

b. Eszopiclone (Lunesta) 10 milligrams orally at bedtime.

The healthcare provider prescribes oral antifungal therapy for a client with onychomycosis. Which information should the nurse provide the client? a. A single dose of the oral antifungal agent is usually sufficient to treat the infection. b. The infection is difficult to eradicate and requires prolonged therapy for 3 to 6 months. c. Complete eradicate is important because of the risk of a systemic infection. d. Prolonged therapy provides no benefit and increases the risk of adverse effects.

b. The infection is difficult to eradicate and requires prolonged therapy for 3 to 6 months.

A client at 30-weeks gestation in labor receives two 12 mg doses of betamethasone intramuscularly 12 hours apart. The client asks the nurse why she is receiving the betamethasone. Which explanation should the nurse give the client? a. The medication suppresses uterine contractions. b. The medication stimulates fetal surfactant production. c. The medication reduces maternal and fetal tachycardia. d. The medication maintains adequate maternal respiratory effort.

b. The medication stimulates fetal surfactant production.

A client is beginning therapy with montelukast (Singulair) PO 10 mg once a day in the evening. The client asks the nurse, "When should I begin to feel better?" How should the nurse respond? a. Immediately. b. Within 24 hours. c. In about 12 hours. d. 30 minutes to 1 hour.

b. Within 24 hours.

A client receives a prescription for tetracycline (Sumycin). Which instruction should the nurse include in the client's teaching? a. Take the medication with a glass of orange juice. b. Avoid over-the-counter medications containing alcohol. c. Avoid diary products for 2 hours after taking the medication. d. Do not use teeth whitening agents during the treatment regimen.

c. Avoid diary products for 2 hours after taking the medication.

A client is admitted for atrial fibrillation, and the healthcare provider prescribes disopyramide (Norpace). After explaining the action of this antidysrhythmic agent, which complaint should the nurse instruct the client to report? a. Joint pain. b. Dizziness or muscle weakness. c. Daily weight gain of 2 pounds. d. Dry mouth.

c. Daily weight gain of 2 pounds.

When assessing a client prior to the administration of digoxin (Lanoxin, APO-Digoxin), which data is most important for the nurse to consider? a. Presence of a grade 2 murmur. b. Nailbed capillary refill of 5 seconds. c. Irregular apical pulse with a rate of 87. d. Bilateral lower extremity dependent rubor.

c. Irregular apical pulse with a rate of 87.

A client with chronic gouty arthritis prescribed allopurinol is experiencing an acute attack of gouty arthritis. The healthcare provider prescribes concurrent low-dose colchicine. Which information should the nurse provide the client that best explains the action of the colchicine? a. It acts like aspirin to relieve pain. b. It facilitates the excretion of uric acid. c. It reduces the inflammation at the affected site. d. It prevents the formation of uric acid crystals.

c. It reduces the inflammation at the affected site.

A 38-year-old gravida 2 para 2 is diagnosed with bacterial vaginosis 9-months postpartum. A prescription is written for metronidazole (Flagyl). Which information is most important for the nurse to obtain from the client before initiating treatment? a. Sexual history. b. Use of oral contraceptives. c. Method of infant feeding. d. Possibility of pregnancy.

c. Method of infant feeding.

A client receives a new prescription for an angiotensin-converting enzyme (ACE) inhibitor. Which client history contraindicates its use? a. Asthma. b. Heart failure. c. Renal artery stenosis. d. Coronary artery disease.

c. Renal artery stenosis.

A client prescribed risperidone 10 mg/day for the past three months is being admitted to the hospital. Which physical assessment findings should the nurse report to the healthcare provider? a. Anorexia. b. Drowsiness and lethargy. c. Tremors and muscle twitching. d. Dry mouth, and constipation.

c. Tremors and muscle twitching.

A mother of a child prescribed methylphenidate hydrochloride for attention-deficit hyperactivity disorder (ADHD) informs the school nurse she administers the medication at bedtime. Which instructions should the nurse recommend? a. Continue administering the medication dose at bedtime. b. Give the medication when the child arrives at school. c. The medication should be taken with meals. d. Administer the medication at least six hours before bedtime.

d. Administer the medication at least six hours before bedtime.

The nurse should implement which action to provide analgesic titration for a client in pain? a. Teach the client to increase the time range between doses of pain medication. b. Monitor the effects of continuous intravenous infusion of narcotic analgesics. c. Plan with the client how to use a specific total dose of analgesic over a 24-hour period. d. Determine the optimal analgesic dosage required that causes the least side effects.

d. Determine the optimal analgesic dosage required that causes the least side effects.

A client with Paget's disease is started on calcitonin (Calcimar) 500 mcg subcutaneously daily. During the initial treatment, what is the priority nursing action? a. Assess the injection site for inflammation. b. Evaluate the client's level of pain. c. Monitor the client's alkaline phosphatase levels. d. Observe the client for signs of hypersensitivity.

d. Observe the client for signs of hypersensitivity.

A client receives a new prescription for ciprofloxacin (Cipro), a synthetic quinolone. When teaching about this drug, which information in the client's history requires special emphasis by the nurse? a. Snacks on dairy products such as yogurt or ice cream. b. Previously had a mild allergic reaction to a cephalosporin. c. Consumes alcoholic drinks occasionally on the weekends. d. Works twenty hours a week as a lifeguard at the local pool.

d. Works twenty hours a week as a lifeguard at the local pool.