HESI PHARMACOLOGY PRACTICE

HESI PHARMACOLOGY PRACTICE

QUESTIONS FOR FINAL EXAM 2023

A client is receiving clonidine (Catapres) 0.1 mg/24hr via transdermal patch. Which assessment finding indicates that the desired effect of the medication has been achieved?

• Client denies recent episodes of angina.
• Change in peripheral edema from +3 to +1.
• Client denies recent nausea or vomiting.
• Blood pressure has changed from 180/120 to 140/70. Correct - Correct Answer

Catapres acts as a centrally-acting analgesic and antihypertensive agent. (D) indicates a reduction in hypertension. Catapres does not affect (A, B, or C), so these findings do not indicate desired outcomes of Catapres After abdominal surgery, a male client is prescribed low molecular weight heparin (LMWH). During administration of the medication, the client asks the nurse why he is receiving this medication. Which is the best response for the nurse to provide?

• This medication is a blood thinner given to prevent blood clot formation. Correct
• This medication enhances antibiotics to prevent infection.
• This medication dissolves any clots that develop in the legs. Incorrect
• This abdominal injection assists in the healing of the abdominal wound. - Correct

Answer Unfractionated heparin or low molecular weight heparin (LMWH) is an anticoagulant that inhibits thrombin-mediated conversion of fibrinogen to fibrin and is given prophylactically to prevent postoperative venous thrombosis (A) or to treat pulmonary embolism or deep vein thrombosis following knee and abdominal surgeries.Heparin does not dissolve clots but prevents clot extension or further clot formation (C).The anticoagulant heparin does not prevent infection (B) or influence operative wound healing (D).A client with coronary artery disease who is taking digoxin (Lanoxin) receives a new prescription for atorvastatin (Lipitor). Two weeks after initiation of the Lipitor prescription, the nurse assesses the client. Which finding requires the most immediate intervention?

• Heartburn.
• Headache.
• Constipation.
• Vomiting. Correct - Correct Answer Vomiting, anorexia and abdominal pain are early

indications of digitalis toxicity. Since Lipitor increases the risk for digitalis toxicity, this finding requires the most immediate intervention by the nurse (D). (A, B and C) are expected side effects of Lipitor A client with heart failure is prescribed spironolactone (Aldactone). Which information is most important for the nurse to provide to the client about diet modifications?Do not add salt to foods during preparation.Refrain for eating foods high in potassium. Correct 1 / 3

Restrict fluid intake to 1000 ml per day.Increase intake of milk and milk products. - Correct Answer Spironolactone (Aldactone), an aldosterone antagonist, is a potassium-sparing diuretic, so a diet high in potassium should be avoided (B), including potassium salt substitutes, which can lead to hyperkalemia. Although (A) is a common diet modification in heart failure, the risk of hyperkalemia is more important with Aldactone. Restriction of fluids (C) or increasing milk and milk products (D) are not indicated with this prescription.A client with a dysrhythmia is to receive procainamide (Pronestyl) in 4 divided doses over the next 24 hours. What dosing schedule is best for the nurse to implement?q6h. Correct QID.AC and bedtime.PC and bedtime. - Correct Answer Pronestyl is a class 1A antidysrhythmic. It should be taken around-the-clock (A) so that a stable blood level of the drug can be maintained, thereby decreasing the possibility of hypotension (an adverse effect) occurring because of too much of the drug circulating systemically at any particular time of day. (B, C, and

• do not provide an around-the-clock dosing schedule. Pronestyl may be given with

food if GI distress is a problem, but an around-the-clock schedule should still be maintained.A client who was prescribed atorvastatin (Lipitor) one month ago calls the triage nurse at the clinic complaining of muscle pain and weakness in his legs. Which statement reflects the correct drug-specific teaching the nurse should provide to this client?

• Increase consumption of potassium-rich foods since low potassium levels can cause

muscle spasms.

• Have serum electrolytes checked at the next scheduled appointment to assess

hyponatremia, a cause of cramping.

• Make an appointment to see the healthcare provider, because muscle pain may be

an indication of a serious side effect. Correct

• Be sure to consume a low-cholesterol diet while taking the drug to enhance the

effectiveness of the drug. - Correct Answer Myopathy, suggested by the leg pain and weakness, is a serious, and potentially life-threatening, complication of Lipitor, and should be evaluated immediately by the healthcare provider (C). Although electrolyte imbalances such as (A or B) can cause muscle spasms in some cases, this is not the likely cause of leg pain in the client receiving Lipitor, and evaluation by the healthcare provider should not be delayed for any reason. A low-cholesterol diet is recommended 2 / 3

for those taking Lipitor since the drug is used to lower total cholesterol (D), but diet is not related to the leg pain symptom.A category X drug is prescribed for a young adult female client. Which instruction is most important for the nurse to teach this client?

• Use a reliable form of birth control. Correct
• Avoid exposure to ultra violet light.
• Refuse this medication if planning pregnancy.
• Abstain from intercourse while on this drug. - Correct Answer Drugs classified in the

category X place a client who is in the first trimester of pregnancy at risk for teratogenesis, so women in the childbearing years should be counseled to use a reliable form of birth control (A) during drug therapy. (B) is not a specific precaution with Category X drugs. The client should be encouraged to discuss plans for pregnancy with the healthcare provider, so a safer alternative prescription (C) can be provided if pregnancy occurs. Although the risk of birth defects during pregnancy explains the restriction of these drugs during pregnancy, (D) is not indicated.A client receiving Doxorubicin (Adriamycin) intravenously (IV) complains of pain at the insertion site, and the nurse notes edema at the site. Which intervention is most important for the nurse to implement?

• Assess for erythema.
• Administer the antidote.
• Apply warm compresses.
• Discontinue the IV fluids. Correct - Correct Answer Doxorubicin is an antineoplastic

agent that causes inflammation, blistering, and necrosis of tissue upon extravasation.First, all IV fluids should be discontinued at the site (D) to prevent further tissue damage by the vesicant. Erythema is one sign of infiltration and should be noted, but edema and pain at the infusion site require stopping the IV fluids (A). Although an antidote may be available (B), additional fluids contribute to the trauma of the subcutaneous tissues.Depending on the type of vesicant, warm or cold compresses (C) may be prescribed after the infusion is discontinued.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

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