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HESI PHARMACOLOGY EXIT EXAM LATEST 2024 -2025
COMPLETE 250 ACTUAL EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
GRADED A+
1) A nurse is caring for a client with hyperparathyroidism and notes that the client's serum calcium level is 13 mg/dL. Which medication should the nurse prepare to administer as prescribed to the client?
- Calcium chloride
- Calcium gluconate
- Calcitonin (Miraculin)
- Large doses of vitamin D - Correct Answer - 3. Calcitonin (Miraculin)
Rationale:
The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is experiencing hypercalcemia. Calcium gluconate and calcium chloride are medications used for the treatment of tetany, which occurs as a result of acute hypocalcemia. In hypercalcemia, large doses of vitamin D need to be avoided. Calcitonin, a thyroid hormone, decreases the plasma calcium level by inhibiting bone resorption and lowering the serum calcium concentration.
2.) A nurse is reinforcing discharge instructions to a client receiving Sul isoxazole.Which of the following should be included in the list of instructions?
- Restrict fluid intake.
- Maintain a high fluid intake.
- If the urine turns dark brown, call the health care provider (HCP) immediately.
- Decrease the dosage when symptoms are improving to prevent an allergic response.
- Correct Answer - 2. Maintain a high fluid intake.
Rationale: 1 / 4
pg. 2 Each dose of Sul isoxazole should be administered with a full glass of water, and the client should maintain a high fluid intake. The medication is more soluble in alkaline urine. The client should not be instructed to taper or discontinue the dose. Some forms of Sul isoxazole cause urine to turn dark brown or red. This does not indicate the need to notify the HCP.
3.) Trimethoprim-sulfamethoxazole (TMP-SMZ) is prescribed for a client. A nurse should instruct the client to report which symptom if it developed during the course of this medication therapy?
- Nausea
- Diarrhea
- Headache
- Sore throat - Correct Answer - 4. Sore throat
Rationale:
Clients taking trimethoprim-sulfamethoxazole (TMP-SMZ) should be informed about early signs of blood disorders that can occur from this medication. These include sore throat, fever, and pallor, and the client should be instructed to notify the health care provider if these symptoms occur. The other options do not require health care provider notification.
4.) Phenazopyridine hydrochloride (Pyridium) is prescribed for a client for symptomatic relief of pain resulting from a lower urinary tract infection. The nurse reinforces to the
client:
- To take the medication at bedtime
- To take the medication before meals
- To discontinue the medication if a headache occurs
- That a reddish orange discoloration of the urine may occur - Correct Answer - 4. That
a reddish orange discoloration of the urine may occur
Rationale:
The nurse should instruct the client that a reddish-orange discoloration of urine may occur. The nurse also should instruct the client that this discoloration can stain fabric.The medication should be taken after meals to reduce the possibility of gastrointestinal upset. A headache is an occasional side effect of the medication and does not warrant discontinuation of the medication. 2 / 4
pg. 3 5.) Bethanechol chloride (Urecholine) is prescribed for a client with urinary retention.Which disorder would be a contraindication to the administration of this medication?
- Gastric atony
- Urinary strictures
- Neurogenic atony
- Gastroesophageal reflux - Correct Answer - 2. Urinary strictures
Rationale:
Bethanechol chloride (Urecholine) can be harmful to clients with urinary tract obstruction or weakness of the bladder wall. The medication has the ability to contract the bladder and thereby increase pressure within the urinary tract. Elevation of pressure within the urinary tract could rupture the bladder in clients with these conditions.
6.) A nurse who is administering bethanechol chloride (Urecholine) is monitoring for acute toxicity associated with the medication. The nurse checks the client for which sign of toxicity?
- Dry skin
- Dry mouth
- Bradycardia
- Signs of dehydration - Correct Answer - 3. Bradycardia
Rationale:
Toxicity (overdose) produces manifestations of excessive muscarinic stimulation such as salivation, sweating, involuntary urination and defecation, bradycardia, and severe hypotension. Treatment includes supportive measures and the administration of atropine sulfate subcutaneously or intravenously.
7.) Oxybutynin chloride (Ditropan XL) is prescribed for a client with neurogenic bladder.Which sign would indicate a possible toxic effect related to this medication?
- Pallor
- Drowsiness
- Bradycardia
- Restlessness - Correct Answer - 4. Restlessness
Rationale: 3 / 4
pg. 4 Toxicity (overdosage) of this medication produces central nervous system excitation, such as nervousness, restlessness, hallucinations, and irritability. Other signs of toxicity include hypotension or hypertension, confusion, tachycardia, flushed or red face, and signs of respiratory depression. Drowsiness is a frequent side effect of the medication but does not indicate overdosage.
8.) After kidney transplantation, cyclosporine (Sand immune) is prescribed for a client.Which laboratory result would indicate an adverse effect from the use of this medication?
- Decreased creatinine level
- Decreased hemoglobin level
- Elevated blood urea nitrogen level
- Decreased white blood cell count - Correct Answer - 3. Elevated blood urea nitrogen
level
Rationale:
Nephrotoxicity can occur from the use of cyclosporine (Sand immune). Nephrotoxicity is evaluated by monitoring for elevated blood urea nitrogen (BUN) and serum creatinine levels. Cyclosporine is an immunosuppressant but does not depress the bone marrow.
9.) Cinoxacin (Cino Bac), a urinary antiseptic, is prescribed for the client. The nurse reviews the client's medical record and should contact the health care provider (HCP) regarding which documented finding to verify the prescription? Refer to chart.
- Renal insufficiency
2. Chest x-ray: normal
- Blood glucose, 102 mg/dL
- Folic acid (vitamin B6) 0.5 mg, orally daily - Correct Answer - 1. Renal insufficiency
Rationale:
Cinoxacin should be administered with caution in clients with renal impairment. The dosage should be reduced, and failure to do so could result in accumulation of cinoxacin to toxic levels. Therefore, the nurse would verify the prescription if the client had a documented history of renal insufficiency. The laboratory and diagnostic test results are normal findings. Folic acid (vitamin B6) may be prescribed for a client with renal insufficiency to prevent anemia.
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