Hesi Rn 301 pharmacology Exam
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Free Hesi Rn 301 pharmacology Exam Questions
A 27-year-old client who is 6 weeks pregnant comes for her first prenatal visit. She mentions she has severe acne and asks if she can continue her current prescription medication. Which drug should be avoided in pregnancy due to fetal harm risk
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Isotretinoin
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Penicillin
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Acetaminophen
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Amoxicillin
Explanation
Correct Answer A. Isotretinoin
Explanation:
Isotretinoin is a potent teratogen and is strictly contraindicated during pregnancy due to its high risk of causing severe birth defects, including craniofacial, cardiac, and central nervous system abnormalities. Women of childbearing age on isotretinoin must use strict contraceptive measures.
Why Other Options Are Incorrect:
B. Penicillin
Penicillin is generally safe during pregnancy and is often used to treat infections in pregnant clients.
C. Acetaminophen
Acetaminophen is considered safe for use in pregnancy at recommended doses for pain or fever management.
D. Amoxicillin
Amoxicillin is a commonly prescribed antibiotic that is considered safe during pregnancy.
A client receiving long-term anticoagulation therapy asks about taking over-the-counter ibuprofen for joint pain. Which drug requires avoiding concurrent NSAID use due to an increased risk of bleeding?
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Warfarin
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Metformin
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Furosemide
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Digoxin
Explanation
Correct Answer:
Warfarin
Explanation:
Warfarin is an anticoagulant that reduces blood clot formation by inhibiting vitamin K–dependent clotting factors. NSAIDs increase bleeding risk through platelet inhibition and gastrointestinal irritation. Taking NSAIDs with warfarin can cause serious internal bleeding, so they should be avoided unless prescribed and closely monitored by a healthcare provider.
Why Other Options Are Incorrect:
Metformin
An oral hypoglycemic that does not significantly increase bleeding risk when combined with NSAIDs.
Furosemide
A loop diuretic where NSAIDs may reduce diuretic effectiveness but not cause dangerous bleeding.
Digoxin
A cardiac glycoside that has no significant bleeding interaction with NSAIDs.
The nurse is administering SUBQ enoxaparin to a client following knee replacement surgery to prevent a deep vein thrombosis. Which laboratory result requires immediate action by the nurse
Reference Range:
Hematocrit [42% to 52% (0.42 to 0.52 volume fraction)]
Platelets [150,000 to 400,000/mm³ (150 to 400 x 10⁹/L)]
Creatinine [0.5 to 1.1 mg/dL (44 to 97 µmol/L)]
Blood Urea Nitrogen (BUN) [10 to 20 mg/dL (3.6 to 7.1 mmol/L)]
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Platelet count of 100,000/mm³ (100 x 10⁹/L)
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Blood urea nitrogen (BUN) 20 mg/dL (7.1 mmol/L)
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Hematocrit 45% (0.45 volume fraction)
Explanation
Correct Answer A. Platelet count of 100,000/mm³ (100 x 10⁹/L)
Explanation:
Enoxaparin, a low molecular weight heparin, carries a risk of heparin-induced thrombocytopenia (HIT), a potentially life-threatening immune reaction that reduces platelet count and increases clotting risk. A platelet count of 100,000/mm³ is significantly below the normal range and requires immediate action, including holding the medication and notifying the healthcare provider. Early recognition is essential to prevent thrombotic complications.
Why Other Options Are Wrong:
B. Blood urea nitrogen (BUN) 20 mg/dL (7.1 mmol/L)
This value is at the upper limit of normal and does not indicate an acute problem requiring immediate action in the context of enoxaparin administration.
C. Hematocrit 45% (0.45 volume fraction)
This hematocrit value is within the normal range for adults and does not require intervention. It indicates stable red cell concentration without signs of acute blood loss or anemia.
A 52-year-old client with newly diagnosed type 2 diabetes is prescribed metformin. During medication teaching, the nurse emphasizes lifestyle and dietary precautions to prevent complications. A nurse should instruct a client taking metformin to avoid:
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Alcohol
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High-protein diet
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Low-fat foods
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Green leafy vegetables
Explanation
Correct Answer:
Alcohol
Explanation:
Alcohol should be avoided while taking metformin because it increases the risk of lactic acidosis, a rare but potentially fatal complication. Alcohol can also cause unpredictable changes in blood glucose levels, increasing the risk of hypoglycemia, especially in clients on additional glucose-lowering drugs.
Why Other Options Are Incorrect:
High-protein diet
A high-protein diet does not specifically interact with metformin, though balanced nutrition is encouraged for diabetes management.
Low-fat foods
Low-fat foods are not contraindicated and can be part of a healthy diabetic diet.
Green leafy vegetables
Green leafy vegetables are encouraged for their fiber, vitamins, and minerals, and do not cause adverse effects with metformin.
A nurse is preparing to administer IV potassium chloride. Which action is correct?
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Dilute in 50–100 mL and infuse slowly
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Give undiluted as a bolus
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Administer via IM route if IV access is unavailable
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Mix with dextrose-containing solution only
Explanation
Correct Answer:
Dilute in 50–100 mL and infuse slowly
Explanation:
IV potassium must be diluted and infused slowly to prevent cardiac arrest. Never give IV push. Usual rates are ≤10 mEq/hr peripherally and ≤20 mEq/hr centrally. Continuous cardiac monitoring may be needed for higher doses.
Why Other Options Are Incorrect:
Give undiluted as a bolus
Causes fatal arrhythmias.
Administer via IM route if IV access is unavailable
Potassium is not given IM due to tissue damage risk.
Mix with dextrose-containing solution only
Dextrose can worsen hypokalemia in some cases.
A 72-year-old client with Parkinson’s disease is starting levodopa/carbidopa therapy. The nurse is providing dietary teaching to optimize medication effectiveness and reduce fluctuations in symptom control. Which instruction is essential for this client
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Avoid high-protein meals
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Avoid vitamin C
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Avoid caffeine
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Take at bedtime only
Explanation
Correct Answer A. Avoid high-protein meals
Explanation:
High-protein meals can interfere with the absorption of levodopa in the small intestine and compete with the drug for transport across the blood-brain barrier. This can reduce the medication’s effectiveness and worsen Parkinson’s symptoms. Clients are advised to take levodopa/carbidopa with low-protein meals or spread protein intake evenly throughout the day to prevent “off” periods.
Why Other Options Are Incorrect:
B. Avoid vitamin C
There is no clinical evidence that vitamin C interferes with levodopa/carbidopa absorption or effectiveness, so routine avoidance is unnecessary.
C. Avoid caffeine
Caffeine does not interact with levodopa/carbidopa in a harmful way. In some cases, caffeine may even improve alertness in Parkinson’s patients.
D. Take at bedtime only
Levodopa/carbidopa must be taken at scheduled intervals during waking hours to maintain stable dopamine levels and control symptoms; bedtime-only dosing is ineffective.
The nurse is providing teaching to a patient who will begin taking a cephalosporin to treat an infection. Which statement by the patient indicates a need for further teaching?
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I may stop taking the medication if my symptoms clear up.
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I should eat yogurt while taking this medication.
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I should stop taking the drug and call my provider if I develop a rash.
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I will not consume alcohol while taking this medication.
Explanation
Correct Answer:
I may stop taking the medication if my symptoms clear up.
Explanation:
Stopping an antibiotic prematurely, even if symptoms improve, can lead to incomplete eradication of the infection, recurrence, and the development of antibiotic resistance. The full prescribed course must be completed to ensure effectiveness and prevent resistant bacterial strains. Cephalosporins are generally well tolerated, but adherence to the treatment regimen is essential for optimal outcomes.
Why Other Options Are Incorrect:
I should eat yogurt while taking this medication.
Consuming yogurt with live cultures can help restore healthy gut flora and reduce the risk of antibiotic-associated diarrhea, so this is a beneficial practice.
I should stop taking the drug and call my provider if I develop a rash.
A rash can indicate an allergic reaction to cephalosporins, especially in those with penicillin allergies, so this statement reflects appropriate safety awareness.
I will not consume alcohol while taking this medication.
Some cephalosporins can cause a disulfiram-like reaction with alcohol, leading to flushing, headache, nausea, and hypotension, so avoiding alcohol is correct.
While monitoring a patient, the nurse knows that a therapeutic response to antitubercular drugs would be:
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The patient states that he or she is feeling much better.
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The patient's laboratory test results show a lower white blood cell count.
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The patient reports a decrease in cough and night sweats.
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There is a decrease in symptoms, along with improved chest radiograph and sputum culture results.
Explanation
Correct Answer D. There is a decrease in symptoms, along with improved chest radiograph and sputum culture results.
Explanation:
D. There is a decrease in symptoms, along with improved chest radiograph and sputum culture results
A true therapeutic response to TB treatment is confirmed by both clinical improvement (fewer symptoms) and objective findings—negative sputum cultures and improved chest X-ray results. This combination ensures that the infection is resolving, not just masked.
Why the other options are incorrect:
A. The patient states that he or she is feeling much better
Symptom improvement alone is not reliable, as TB symptoms can fluctuate, and subjective feelings do not confirm bacterial eradication.
B. The patient's laboratory test results show a lower white blood cell count
WBC count is not a specific measure of TB treatment effectiveness and may not accurately reflect the infection’s status.
C. The patient reports a decrease in cough and night sweats
While this indicates clinical improvement, confirmation requires microbiological and radiological evidence to verify that the infection is under control.
A 62-year-old client is admitted with a complicated urinary tract infection. The provider prescribes gentamicin 80 mg IV every 8 hours. The nurse reviews the client’s history, noting stage 2 chronic kidney disease. Baseline labs are drawn, and the client is placed on the medication. Two days later, the client reports a new ringing sound in the ears and mild difficulty hearing. The nurse also notes a slight increase in serum creatinine from baseline. A client receiving gentamicin should be monitored for which toxicities?
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Ototoxicity and nephrotoxicity
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Neurotoxicity and hepatotoxicity
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Cardiotoxicity and retinopathy
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Pulmonary toxicity and neuropathy
Explanation
Correct Answer:
Ototoxicity and nephrotoxicity
Explanation:
Gentamicin is an aminoglycoside antibiotic with well-known risks of ototoxicity (damage to the inner ear) and nephrotoxicity (kidney injury). Ototoxicity can present as tinnitus, hearing loss, or balance problems and may be irreversible. Nephrotoxicity is due to accumulation of the drug in renal tubular cells, leading to rising creatinine and decreased kidney function. The risks increase with prolonged therapy, high trough levels, preexisting renal impairment, or concurrent use of other nephrotoxic drugs. The nurse should monitor hearing changes, vestibular symptoms, urine output, and renal function tests (BUN, creatinine), and notify the provider promptly if signs of toxicity appear.
Why Other Options Are Incorrect:
Neurotoxicity and hepatotoxicity
Gentamicin is not commonly associated with neurotoxicity or liver injury; these are not primary concerns with this drug.
Cardiotoxicity and retinopathy
These are not known adverse effects of gentamicin; cardiotoxicity is more linked to certain chemotherapy agents, and retinopathy is associated with drugs like hydroxychloroquine.
Pulmonary toxicity and neuropathy
These are associated with drugs like amiodarone (pulmonary) and chemotherapy agents (neuropathy), not aminoglycosides.
A client who has dysphagia after a cerebral vascular accident (CVA) receives a new prescription for lansoprazole capsules via nasogastric tube (NGT). Which action should the nurse implement prior to administering the medication
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Open the capsule to crush the granules.
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Sprinkle the granules in applesauce.
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Request the pharmacist to provide tablets.
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Contact the pharmacist for a liquid formulation of lansoprazole that is safe for administration via nasogastric tube.
Explanation
Correct Answer D. Contact the pharmacist for a liquid formulation of lansoprazole that is safe for administration via nasogastric tube.
Explanation:
Lansoprazole capsules contain enteric-coated granules that must remain intact to ensure the medication reaches the small intestine for absorption. Crushing them destroys the coating and reduces efficacy. For a client with an NGT, the safest approach is to request a liquid or suspension specifically designed for tube administration. This ensures proper drug delivery, maintains therapeutic effect, and prevents tube obstruction.
Why Other Options Are Wrong:
A. Open the capsule to crush the granules.
Crushing the granules destroys the enteric coating, causing premature drug release in the stomach and reducing therapeutic benefit.
B. Sprinkle the granules in applesauce.
This is an option for patients who can swallow, not for those requiring NG administration. Applesauce can clog the tube and is unsuitable for this route.
C. Request the pharmacist to provide tablets.
Tablets may not be available in an NG-compatible form and crushing enteric-coated or extended-release tablets has the same risks as crushing granules. Liquid formulations are the recommended option.
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