HESI PHARMACOLOGY QUESTIONS AND WITH RATIONALE

HESI PHARMACOLOGY QUESTIONS AND WITH RATIONALE

A female client is receiving tamoxifen following surgery for breast cancer. She reports the onset of hot
flashes to the nurse. Which intervention should the nurse implement?
A. Instruct the client that hot flashes are a side effect that often occurs with the use of this medication
B. Encourage the client to verbalize her feelings and fears about the recurrence of her breast cancer
C. Help the client schedule an appointment for evaluation of the need to increase the dose of medication
D. Notify the HCP that the client needs immediate evaluation for medication toxicity - -------- CORRECT
ANSWERS----------Correct Answer: A
Rationale: Tamoxifen is an estrogen receptor blocker used to treat breast carcinoma. Hot flashes are a
common side effect. If the hot flashes become bothersome, the client can be instructed in measures to
reduce the discomfort. Hot flashes are not an indication of option B, C, or D.
The charge nurse is reviewing the admission history and physical data for four clients newly admitted to
the unit. Which client is at greater risk for adverse reactions to medications?
A. 30-year-old man with a fracture
B. 7-year-old child with an ear infection
C. 75-year-old woman with liver disease
D. 50-year-old man with an URI - -------- ----------Correct Answer: C
Rationale: Impaired hepatic metabolic pathways for drug and chemical degradation place option C at
greatest risk for adverse reactions to medications based on advancing age and liver disease. Options A
and D have no predisposing factors, such as genetics, pathophysiologic dysfunction, or drug allergies,
that would increase the risk for cumulative toxicity or ADRs. Option B is at risk for dose-related adverse
reactions but is at less risk than option C.
A client is ordered 22 mg of gentamicin by IM injection. The drug is available in 20 mg/2 mL. How many
milliliters should be administered?
A. 1.8
B. 2.0
C. 2.4
D. 2.2 - -------- ----------Correct Answer: D
Rationale:
(22 mg/20 mg) × (x mL/2 mL) = 22x = 40x = 2.2 mL
A client with metastatic cancer reports severe continuous pain. Which route of administration should the
nurse use to provide the most effective continuous analgesia?
A. Oral
B. Intravenous (IV)
D. Transdermal
D. Intramuscular (IM) - -------- ----------Correct Answer: C
Rationale: Continuous pain is best managed by maintaining a constant serum drug level. Transdermal
drug administration of an analgesic provides around-the-clock, controlled release of the medication that
is absorbed through intact skin into the bloodstream to provide continuous pain relief. Option A is
convenient, but gastrointestinal variables affect the absorption rate of the drug, its onset and intensity,
and duration of response and requires repeated doses around the clock. Option B provides immediate
action because the drug is infused directly into the bloodstream and is quickly metabolized, and
repeated IV doses are required to maintain a continuous blood level. Option D requires repeated
injections at regular intervals, which are uncomfortable, and absorption rates vary between muscle sites.
Minocycline, 50 mg PO every 8 hours, is prescribed for an adolescent girl diagnosed with acne. The nurse
discusses self-care with the client while she is taking the medication. Which teaching points should be
included in the discussion? (Select all that apply.)
A. Report vaginal itching or discharge
B. Take the medication at 0800, 1500, and 2200 hours
C. Protect skin from natural and artificial UV light
D. Avoid drinking until response to medication is known
E. Take with an antacid tablet to prevent nausea
F. use a non-hormonal method of contraception if sexually active - -------- ----------
Correct Answer: A, C, D, F
Rationale: Adverse effects of tetracyclines include superinfections, photosensivity, and decreased
efficacy of oral contraceptives. Therefore, the client should report vaginal itching or discharge (A),
protect the skin from UV light (C), and use a non-hormonal method of contraception (F) while on teh
medication. Minocycline is known to cause dizziness and ataxia, so until the client's response to the
medication is known, driving (D) should be avoided. Tetracyclines should be taken around the clock (B)
but exhibit decreased absorption when taken with antacids, so (E) is contraindicated.
A 3-year-old boy is admitted to the ED after ingesting an unknown amount of phenobarbital elixir
prescribed for his brother's seizure disorder. Which nursing intervention should the nurse implement
first?
A. Administer syrup of ipecac
B. Take the child's vital signs
C. Draw a blood specimen for a phenobarbital level
D. Teach the mother safe medication storage practices - -------- ----------Correct
Answer: B
Rationale: Phenobarbital causes respiratory depression, so the priority intervention is assessment of vital
signs. Options A, C, and D are actions that may be used in the treatment of this child, but they do not
have the priority of option B
Following the administration of sublingual nitroglycerin, which assessment finding indicates that the
medication was effective?
A. Decrease in level of chest pain
B. Clear bilateral breath sounds
C. Increase in blood pressure
D. Increase in urinary output - -------- ----------Correct Answer: A
Rationale: Nitroglycerin reduces myocardial oxygen consumption, which decreases ischemia and reduces
chest pain. Options B, D, and D are not expected outcomes of sublingual nitroglycerin.

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