2024 HESI PHARMACOLOGY
PRACTICE EXAM WITH CORRECT
ANSWERS
When assessing an adolescent who recently overdosed on acetaminophen
(tylonel), it is most important for the nurse to assess for pain in which area of
the body
a. flank
b. abdomen
c. chest
d. head - CORRECT-ANSWERSB. acetaminophen toxicisty an result in liver
damage; therefore, it is especially important for the nurse to assess for pain
in the right upper quadrant of the abdomen (which might indicated liver
damage)
An older client with a decreased percentage of lean body mass is likely to
receive a prescription that is adjusted based on which pharmacokinetic
process?
A) Absorption.
B) Metabolism.
C) Elimination.
D) Distribution. - CORRECT-ANSWERSD.
A decreased lean body mass in an older adult affects the distribution of
drugs (D), which affects the pharmacokinetics of drugs. Decreased gastric
pH, delayed gastric emptying, decreased splanchnic blood flow, decreased
gastrointestinal absorption surface areas and motility affect (A) in the older
adult population. Decreased hepatic blood flow, decreased hepatic mass,
and decreased activity of hepatic enzymes affect (B) in older adults.
Decreased renal blood flow, decreased glomerular filtration rate, decreased
tubular secretion, and decreased number of nephrons affects (C) in an older
adult.
Which symptoms are serious adverse effects of beta-adrenergic blockers
such as propranolol (Inderal)?
A) Headache, hypertension, and blurred vision.
B) Wheezing, hypotension, and AV block.
C) Vomiting, dilated pupils, and papilledema.
,D) Tinnitus, muscle weakness, and tachypnea. - CORRECT-ANSWERSB.
(B) represents the most serious adverse effects of beta-blocking agents. AV
block is generally associated with bradycardia and results in potentially life-
threatening decreases in cardiac output. Additionally, wheezing secondary to
bronchospasm and hypotension represent life-threatening respiratory and
cardiac disorders. (A, C, and D) are not associated with beta-blockers.
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?
A) Withhold the scheduled dose.
B) Check the client's apical pulse.
C) Notify the healthcare provider.
D) Repeat the serum potassium level. - CORRECT-ANSWERSA.
The nurse should first withhold the scheduled dose of Cozaar (A) 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 (B), and the blood pressure. Before
repeating the serum study (D), the nurse should notify the healthcare
provider (C) of the findings.
A client is receiving digoxin for the onset of supraventricular tachycardia
(SVT). Which laboratory findings should the nurse identify that places this
client at risk?
A) Hypokalemia.
B) Hyponatremia.
C) Hypercalcemia.
D) Low uric acid levels. - CORRECT-ANSWERSA.
Hypokalemia affects myocardial contractility, so (A) places this client at
greatest risk for dysrhythmias that may be unresponsive to drug therapy.
Although an imbalance of serum electrolytes, (B and C), can effect cardiac
rhythm, the greatest risk for the client receiving digoxin is (A). (D) does not
cause any interactions related to digoxin therapy for supraventricular
tachycardia (SVT).
Following the administration of sublingual nitroglycerin to a client
experiencing an acute anginal attack, which assessment finding indicates to
the nurse that the desired effect has been achieved?
A. Client states chest pain is relieved
B. Client's pulse decreases from 120 to 90
, C. Client's systolic blood pressure decreases from 180 to 90
D. Clients SaO2 level increases from 92% to 96% - CORRECT-ANSWERSA.
nitroglycerin reduces mycocardial oxygen consumption which decreases
ischemia and reduces chest pain
A client with hyperlipidemia recieves a prescription for niacin (niaspan).
which client teaching is most important for the nurse to provide
a. expected duration of flushing
b. symptoms of hyperglycemia
c. diets that minimize gi irritation
d. comfort measure for pruritis - CORRECT-ANSWERSA. flushing of the face
and neck, lasting up to an hour, is a frequent reason for discontinuing niacin.
inclusion of this effect in clietn teaching may promote compliance in taking
the med.
A client is admitted to the coronary care unit with a medical diagnosis of
acute myocardial infarction. which medication prescription decreases both
preload and afterload
a. nitroglycerin
b. propranolol
c. propranolol
d. captopril - CORRECT-ANSWERSA. nitroglycerin is a nitrate that causes
peripheral vasodilation and decreases contractility, thereby decreasing both
preload and afterload
A client is being treated for hyperthyroidism with propylthiouracil (PTU). The
nurse knows that the action of this drug is to
A. decrease the amount of the thyroid-stimulating hormone circulating in the
blood
B. increase the amount of thyroid-stimulating hormone circulating in the
blood
C. increase the amount of T4 and decrease the amount of T3 produced by
the thyroid
D. inhibit synthesis of T3 and T4 by the thyroid gland - CORRECT-ANSWERSD.
PTU is an adjunct therapy used to control hyperthyroidism by inhibiting
production of thyroid hormones. It is often prescribed in prep for
thyroidectomy or radioactive iodine therapy
Which change in data indicates to the nurse the desired effect of the
angiotensin II receptor antagonist has been achieved
A. Dependent edema reduced form +3 to +1
B. Serum HDL increased from 35 to 55mg/dl
C. PUlse rate reduced from 150 to 90 beats/min
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