Hesi Rn 301 pharmacology Exam
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Free Hesi Rn 301 pharmacology Exam Questions
he nurse is caring for a client who has a finger stick blood glucose level of 130 mg/dL (7.21 mmol/L). Prior to administering the scheduled dose of acarbose, the nurse is informed that morning meal trays will be 30 minutes late. Which action should the nurse take
Reference Range:
Glucose [74 to 106 mg/dL (4.1 to 5.9 mmol/L)]
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Administer the medication.
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Notify the healthcare provider.
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Hold the medication until the meal trays arrive.
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Obtain another finger stick blood glucose level.
Explanation
Correct Answer C. Hold the medication until the meal trays arrive.
Explanation:
Acarbose is an alpha-glucosidase inhibitor that works in the intestine to delay carbohydrate absorption, lowering postprandial blood glucose levels. It must be taken with the first bite of a meal to be effective and to avoid the risk of hypoglycemia if combined with other agents. Administering it without food present can cause adverse effects and reduce therapeutic benefit. Holding the medication until the trays arrive ensures proper timing and safety.
Why Other Options Are Wrong:
A. Administer the medication.
Giving acarbose without immediate food intake defeats its purpose and increases the risk of low blood sugar in combination therapy. It is not designed to work on fasting glucose levels and requires carbohydrate ingestion to be effective.
B. Notify the healthcare provider.
This situation is a common nursing consideration that can be managed within nursing scope by adjusting medication timing. There is no urgent need to contact the provider unless the delay will be prolonged or the patient’s condition changes significantly.
D. Obtain another finger stick blood glucose level.
Rechecking blood glucose would not address the main concern, which is medication timing with meals. The current glucose level is already known, and the issue at hand is ensuring the drug is given with food, not confirming another measurement.
During a regular follow-up visit, Jane points out a sore that has developed on her mouth. She is diagnosed with herpes simplex. Which medication does the nurse anticipate Jane will receive?
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miconazole (Monistat)
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acyclovir (Zovirax)
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clotrimazole (Lotrimin)
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anthralin (Anthra-Derm)
Explanation
Correct Answer:
B. acyclovir (Zovirax)
Explanation:
Acyclovir is an antiviral medication specifically indicated for the treatment of herpes simplex virus infections, including oral herpes (cold sores). It works by inhibiting viral DNA synthesis, thereby reducing viral replication. Early initiation of acyclovir can help shorten symptom duration, reduce lesion severity, and decrease viral shedding. It may be administered orally or topically depending on severity. Nursing teaching includes taking the medication as prescribed, maintaining hydration, and understanding that while it reduces outbreaks, it does not cure herpes simplex.
Why Other Options Are Incorrect:
A. miconazole (Monistat)
An antifungal medication used to treat yeast infections and other fungal infections. It is not effective against viral infections like herpes simplex.
C. clotrimazole (Lotrimin)
Also an antifungal agent used to treat tinea and candidiasis. It has no role in the treatment of herpes simplex virus.
D. anthralin (Anthra-Derm)
A topical medication used primarily to treat psoriasis by slowing skin cell growth. It is not used for viral infections.
A client at an outpatient clinic is ordered to receive ampicillin (Omnipen) for an infection. Which nursing intervention related to penicillins would the nurse question
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Verify that the client is not allergic to penicillin.
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Obtain culture before administering the first dose of medication.
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Instruct client to discontinue penicillin when temperature is normal.
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Encourage the client to increase fluid intake.
Explanation
Correct Answer C. Instruct client to discontinue penicillin when temperature is normal.
Explanation:
Stopping penicillin therapy when the fever resolves is unsafe. Even if symptoms improve, the infection may still be present, and early discontinuation increases the risk of recurrence and antibiotic resistance. The patient must complete the full prescribed course to ensure eradication of the pathogen and to prevent the development of resistant bacterial strains.
Why Other Options Are Incorrect:
A. Verify that the client is not allergic to penicillin
This is a critical first step before administration because penicillin allergies can cause severe, potentially life-threatening reactions such as anaphylaxis.
B. Obtain culture before administering the first dose of medication
Cultures should be collected prior to starting antibiotics to ensure accurate identification of the organism and appropriate selection of therapy.
D. Encourage the client to increase fluid intake
Adequate hydrtion asupports optimal drug distribution and helps flush bacteria and toxins from the body during infection treatment.
A 42-year-old client is prescribed metronidazole for treatment of bacterial vaginosis. The nurse provides discharge teaching to prevent adverse reactions and ensure the medication is taken safely. Which instruction should be included for metronidazole therapy?
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Avoid grapefruit juice
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Avoid alcohol during therapy and for 48–72 hours after
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Avoid potassium-rich foods
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Take with milk to prevent GI upset
Explanation
Correct Answer:
Avoid alcohol during therapy and for 48–72 hours after
Explanation:
Metronidazole can cause a disulfiram-like reaction when combined with alcohol, leading to flushing, severe nausea and vomiting, headache, abdominal cramps, and hypotension. Clients must avoid all alcohol-containing products (including cough syrups and mouthwashes) during therapy and for at least 48–72 hours after the last dose.
Why Other Options Are Incorrect:
Avoid grapefruit juice
Grapefruit juice does not interact significantly with metronidazole; this restriction applies to certain other drugs like statins and calcium channel blockers.
Avoid potassium-rich foods
There is no need to restrict potassium with metronidazole; this is more relevant for potassium-sparing diuretics or ACE inhibitors.
Take with milk to prevent GI upset
Milk is not contraindicated, but it does not specifically prevent GI upset with metronidazole. Taking it with food (not dairy-specific) may help reduce nausea.
A male client with dementia is admitted to the emergency department (ED) because he accidentally self-administered several doses of diltiazem. Which intervention is most important for the nurse to implement
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Frequently assess the patient's blood pressure.
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Observe the client for signs of gastric irritation.
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Monitor electrocardiogram (ECG) continuously.
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Assess for changes in level of consciousness.
Explanation
Correct Answer C. Monitor electrocardiogram (ECG) continuously.
Explanation:
Diltiazem is a calcium channel blocker that can cause serious cardiac effects in overdose, including bradycardia, AV block, and other conduction abnormalities. Continuous ECG monitoring is the priority because it allows for rapid detection and intervention if life-threatening arrhythmias occur. Early recognition of cardiac conduction changes is essential to prevent cardiac arrest.
Why Other Options Are Wrong:
A. Frequently assess the patient's blood pressure.
While blood pressure monitoring is important with calcium channel blocker use, ECG monitoring takes priority in overdose situations due to the immediate risk of severe arrhythmias that can be fatal if not promptly recognized.
B. Observe the client for signs of gastric irritation.
Gastric irritation is not a primary concern with diltiazem toxicity. The main risks are cardiovascular in nature, making gastrointestinal observation a lower priority in this context.
D. Assess for changes in level of consciousness.
Although changes in mental status can occur with hypotension or hypoperfusion, they are secondary to the primary cardiac risks. Continuous ECG monitoring addresses the root cause by detecting early cardiac disturbances that could lead to altered consciousness.
A nurse is preparing to administer subcutaneous enoxaparin. What is the correct administration site
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Abdomen at least 2 inches from the umbilicus
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Deltoid muscle
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Anterolateral thigh intramuscularly
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Forearm intradermally
Explanation
Correct Answer A. Abdomen at least 2 inches from the umbilicus
Explanation:
Enoxaparin is a low–molecular-weight heparin given subcutaneously in the abdomen at least 2 inches from the umbilicus. The site should be rotated to minimize tissue irritation. The injection is given at a 90-degree angle into a skin fold, and the air bubble in the prefilled syringe is not expelled before administration.
Why Other Options Are Incorrect:
B. Deltoid muscle
Used for IM injections, not LMWH.
C. Anterolateral thigh intramuscularly
IM route increases bleeding risk with anticoagulants.
D. Forearm intradermally
Used for TB tests, not anticoagulants.
A 42-year-old client is diagnosed with latent tuberculosis and started on a daily dose of an antitubercular medication. To prevent peripheral neuropathy, the nurse educates the client about the need for concurrent vitamin B6 (pyridoxine) supplementation. Which drug requires this co-administration
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Isoniazid
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Rifampin
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Ethambutol
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Pyrazinamide
Explanation
Correct Answer A. Isoniazid
Explanation:
Isoniazid interferes with pyridoxine (vitamin B6) metabolism, which can lead to a deficiency and subsequent peripheral neuropathy. Supplementation with vitamin B6 during isoniazid therapy prevents nerve damage, especially in individuals with risk factors such as diabetes, malnutrition, HIV infection, alcoholism, or pregnancy. This preventive measure allows continued TB treatment without compromising nerve function, and it is standard practice in TB protocols worldwide.
Why Other Options Are Incorrect:
A. Rifampin
Does not interfere with vitamin B6 metabolism; its major adverse effects include hepatotoxicity, gastrointestinal upset, and orange discoloration of body fluids.
C. Ethambutol
Primarily associated with optic neuritis and requires baseline and periodic vision testing, not vitamin B6 supplementation.
D. Pyrazinamide
Can cause hepatotoxicity and hyperuricemia leading to gout but does not affect vitamin B6 metabolism or cause neuropathy.
A patient with mitral valve prolapse is admitted for a scheduled cystoscopy. The physician has ordered gentamicin to be taken before the procedure. What is the rationale for this?
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Prevent bacterial endocarditis
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Prevent inflammation of the urethra
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Avoid antibiotic use during the procedure
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Decrease need for surgical asepsis
Explanation
Correct Answer:
Prevent bacterial endocarditis
Explanation:
Clients with mitral valve prolapse, especially if they have associated regurgitation or other structural valve abnormalities, are at increased risk for bacterial endocarditis when undergoing invasive procedures that may introduce bacteria into the bloodstream, such as cystoscopy. Administering gentamicin beforehand provides prophylactic antibiotic coverage against likely pathogens, reducing the chance of bacteria seeding the heart valves and causing endocarditis.
Why Other Options Are Incorrect:
Prevent inflammation of the urethra
While cystoscopy can cause temporary urethral irritation, gentamicin is not prescribed to prevent this minor inflammation; its role is to prevent systemic infection.
Avoid antibiotic use during the procedure
The purpose of giving gentamicin pre-procedure is not to avoid intra-procedural antibiotics but to ensure therapeutic blood levels before potential bacterial entry.
Decrease need for surgical asepsis
Antibiotic prophylaxis does not replace sterile technique during cystoscopy. Surgical asepsis remains essential to prevent infections from local or systemic sources.
Which antifungal drug can be given intravenously to treat severe yeast infections as well as a one-time oral dose to treat vaginal yeast infections?
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Nystatin (Mycostatin)
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Caspofungin (Cancidas)
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Fluconazole (Diflucan)
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Voriconazole (Vfend)
Explanation
Correct Answer:
C. Fluconazole (Diflucan)
Explanation:
Fluconazole (Diflucan) is a systemic antifungal in the azole class that can be administered both orally and intravenously. It is effective against a variety of fungal infections, including severe systemic yeast infections such as candidemia. A single 150 mg oral dose is commonly prescribed for uncomplicated vaginal yeast infections, making it versatile for both acute and systemic treatment. It is well absorbed orally and penetrates body tissues effectively, including cerebrospinal fluid.
Why Other Options Are Incorrect:
A. Nystatin (Mycostatin)
Primarily used topically or as an oral suspension for superficial Candida infections of the skin, mouth, and GI tract. It is not given IV and is ineffective for systemic infections.
B. Caspofungin (Cancidas)
An echinocandin antifungal used intravenously for serious systemic Candida and Aspergillus infections. It is not given orally and is not a one-time treatment for vaginal yeast infections.
D. Voriconazole (Vfend)
A broad-spectrum triazole antifungal used for serious systemic fungal infections, particularly invasive aspergillosis. It is not used as a single-dose oral treatment for vaginal yeast infections.
A 62-year-old client is receiving IV vancomycin for methicillin-resistant Staphylococcus aureus (MRSA) pneumonia. Fifteen minutes into the infusion, the client develops flushing of the face and neck, pruritus, and hypotension. What is the priority action if a client on IV vancomycin develops flushing and hypotension
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Stop the infusion immediately
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Increase the infusion rate
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Notify the provider after completion
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Give an antihistamine and continue
Explanation
Correct Answer A. Stop the infusion immediately
Explanation:
Flushing, hypotension, and pruritus during vancomycin infusion suggest "Red man syndrome," a rate-related infusion reaction caused by rapid administration. The priority is to stop the infusion to prevent worsening hypotension or cardiovascular collapse. After symptoms resolve, the provider may order the drug to be restarted at a slower rate, often over at least 60 minutes.
Why Other Options Are Incorrect:
B. Increase the infusion rate
This would worsen the reaction by delivering the drug more quickly, intensifying histamine release and hypotension.
C. Notify the provider after completion
Waiting until completion is unsafe because symptoms may progress to severe hypotension or shock if the infusion continues.
D. Give an antihistamine and continue
While antihistamines can help treat symptoms, the infusion must first be stopped to halt the reaction. Continuing without interruption is unsafe.
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