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HESI Adaptive Quiz Pharmacology Exam 2024/2025 Questions With Completed & Verified Solutions.
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HESI Adaptive Quiz Pharmacology Exam 2024/2025 Questions With Completed & Verified Solutions.
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HESI Adaptive Quiz PharmacologyA client with a partial occlusion of the left common carotid artery is to be discharged while still
receiving warfarin. Which clinical adverse effect should the nurse identify as a reason for the
client to seek medical consultation? Select all that apply.
A. Presence of blood in urine (hematuria).
B. Bruising noted at various stages of healing.
C. Delayed clotting from minor cuts and scrapes.
D. Bleeding from gums when brushing teeth.
E. Vomiting coffee-ground emesis. - ANS ANSWER: A, E
[Presence of blood in urine (hematuria).
Vomiting coffee-ground emesis.]
Rationale
Warfarin causes an increase in the prothrombin time and international normalized ratio (INR)
level, leading to an increased risk for bleeding. Any abnormal or prolonged bleeding must be
reported, because it may indicate an excessive level of the drug. Common side effects including
bruising, delayed clotting and bleeding gums do not require immediate intervention. However,
hematuria and hemoptysis are evidence of more serious bleeding and require immediate
attention. Coffee-ground emesis is a sign of gastric bleeding. Even though the emesis is not
bright red, it still requires immediate attention by a healthcare provider.
What should the nurse keep in mind when administering a benzodiazepine to a client?
A. The medication can cause rebound insomnia if it is discontinued abruptly.
B. The medication should be administered cautiously for infants less than 6 months old.
C. The medication should be administered in higher dosage if the client becomes incontinent.
D. The medication can cause fewer problems with dependence and abuse than does a
nonbenzodiazepine. - ANS ANSWER: A [The medication can cause rebound insomnia if it is
discontinued abruptly.]
Rationale
Benzodiazepine often leads to tolerance and withdrawal; therefore, it can cause rebound
insomnia when discontinued abruptly. Benzodiazepine is contraindicated for infants less than 6
months old. Benzodiazepine should be discontinued if the client becomes incontinent.
Nonbenzodiazepines cause fewer problems with dependence and abuse than do
benzodiazepines.
,Which medication requires the nurse to monitor the client for signs of hyperkalemia?
A. Furosemide
B. Metolazone
C. Spironolactone
D. Hydrochlorothiazide - ANS ANSWER: C [Spironolactone]
Rationale
Spironolactone is a potassium-sparing diuretic; hyperkalemia is an adverse effect. Furosemide,
metolazone, and hydrochlorothiazide generally cause hypokalemia.
A client is taking lithium sodium. The nurse should notify the healthcare provider for which
laboratory value?
A. Negative protein in the urine
B. Prothrombin of 12.0 seconds
C. Blood urea nitrogen (BUN) of 20 mg/dL (7.1 mmol/L)
D. White blood cell (WBC) count of 15,000 mm 3 (15 X 10 9/L) - ANS ANSWER: D [White blood
cell (WBC) count of 15,000 mm 3 (15 X 10 9/L)]
Rationale
White cell counts can increase with this drug. The expected range of the WBC count is 5000 to
10,000 mm 3 (5-10 X 10 9/L) for a healthy adult. Urinalysis, BUN, and prothrombin are not
necessary, and these are normal values.
A client with an intractable infection is receiving vancomycin. Which laboratory blood test result
should the nurse report?
A. Hematocrit: 45%
B. Calcium: 9.0 mg/dL (2.25 mmol/L)
C. White blood cells (WBC): 10,000 mm 3 (10 X 10 9/L)
D. Blood urea nitrogen (BUN): 30 mg/dL (10.2 mmol/L) - ANS ANSWER: D [Blood urea nitrogen
(BUN): 30 mg/dL (10.2 mmol/L)]
Rationale
Vancomycin is a nephrotoxic medication. An elevated BUN can be an early sign of toxicity. The
BUN of a healthy adult is 10 to 20 mg/dL (3.6-7.1 mmol/L). This hematocrit is expected in a
healthy adult; the range is from 40 to 52. The expected range of the WBC count is 5,000 to
10,000 mm 3 (5-10 X 10 9/L) for a healthy adult. This calcium level is within the expected range
of 9.0 to 10.5 (2.25-2.75 mmol/L) for a healthy adult.
, When reviewing a drug to be administered, the nurse identifies that the package insert indicates
that the Z-track injection technique should be used. Under what circumstance does the nurse
expect that this technique will be necessary?
A. Volume of medication to be administered is large.
B. Medication is irritating to subcutaneous tissue and skin.
C. Injection site must be massaged after it is administered.
D. Procedure requires an air bubble to be drawn into the syringe. - ANS ANSWER: B
[Medication is irritating to subcutaneous tissue and skin.]
Rationale
The Z-track method seals the puncture at the intramuscular level, preventing seepage of
injected medication up the needle track and thereby avoiding injury to subcutaneous tissue and
skin. The Z-track technique is unrelated to the volume of medication to be administered. When
the volume of medication is large, it should be administered into a large muscle or divided into
two syringes. Massage is avoided with the Z-track technique to help prevent the injected
medication from flowing back up the needle track. Administration of a small air bubble at the
completion of injection of medication into a muscle (air-lock technique) is no longer
recommended because it does not increase the likelihood that medication will remain in the
muscle without flowing back up the needle track.
What effect of povidone-iodine does a nurse consider when using it on the client's skin before
obtaining a specimen for a blood culture?
A. Avoids drying the skin
B. Makes the skin more supple
C. Eliminates surface bacteria that may contaminate the culture
D. Provides a cooling agent to diminish the feeling from the puncture wound - ANS ANSWER: C
[Eliminates surface bacteria that may contaminate the culture]
Rationale
Povidone-iodine exerts bactericidal action that helps eliminate surface bacteria that will
contaminate culture results. Povidone-iodine does not make the skin more supple. It does dry
the skin. Although povidone-iodine may provide a cool feeling, this is not a reason for its use.
An older client develops hypokalemia, and an intravenous infusion containing 40 mEq of
potassium is instituted. The client tells the nurse that the IV stings a little. What is the nurse's
best reply?
A. "I'll restart the IV in a different vein. This may help to relieve the pain."
B. "Try to imagine a sunny beach with gentle waves, and soon you won't notice the discomfort."
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