PHARMACOLOGY HESI TEST ASSESSMENT ACTUAL EXAM WITH DETAILED VERIFIED ANSWERS

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PHARMACOLOGY HESI TEST ASSESSMENT ACTUAL EXAM WITH DETAILED VERIFIED

ANSWERS WITH RATIONALES

In evaluating the effects of lactulose (Cephulac), which outcome would indicate that the drug is performing as intended?An increase in urine output.Two or three soft stools per day.Watery, diarrhea stools.Increased serum bilirubin.Rationale The medication lactulose can be administered for either chronic constipation or for portal-systemic encephalopathy in clients with hepatic disease. Two to three stools a day indicate that lactulose is performing as intended for chronic constipation. This would also indicate it should be effective for the clients with encephalopathy because the lactulose's action prevents absorption of ammonia in the colon as it increases water absorption and softens the stool. The efficacy of the use for ammonia absorption would have to be verified by a serum ammonia level and observation of clearing of the client's mental status.A 43-year-old female client is receiving thyroid replacement hormone following a thyroidectomy. What adverse effects associated with thyroid hormone toxicity should the nurse instruct the client to report promptly to the healthcare provider?Tinnitus and dizziness.Tachycardia and chest pain.Dry skin and intolerance to cold.Weight gain and increased appetite.

lOMoARcPSD|5422489 Downloaded by Clinton Bundi (clinyclinton@gmail.com) Rationale Thyroid replacement hormone increases the metabolic rate of all tissues, so common signs and symptoms of toxicity include tachycardia and chest pain.A client with hyperlipidemia receives a prescription for niacin (Niaspan). Which client teaching is most important for the nurse to provide?Expected duration of flushing.Symptoms of hyperglycemia.Diets that minimize GI irritation.Comfort measures for pruritis.Rationale Flushing of the face and neck, lasting up to an hour, is a frequent reason for discontinuing niacin.Inclusion of this effect in client teaching may promote compliance in taking the medication. While nutrition tips and managing pruritis are worthwhile instructions to help clients minimize or cope with normal side effects associated with niacin (Niaspan), flushing is intense and causes the most concern for the client.A client is being treated for hyperthyroidism with propylthiouracil (PTU). The nurse knows that the action of this drug is to decrease the amount of thyroid-stimulating hormone circulating in the blood. increase the amount of thyroid-stimulating hormone circulating in the blood.increase the amount of T4 and decrease the amount of T3 produced by the thyroid.

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Downloaded by Clinton Bundi (clinyclinton@gmail.com) inhibit synthesis of T3 and T4 by the thyroid gland.Rationale PTU is an adjunct therapy used to control hyperthyroidism by inhibiting production of thyroid hormones.It is often prescribed in preparation for thyroidectomy or radioactive iodine therapy.A client is admitted to the hospital for diagnostic testing for possible myasthenia gravis. The nurse prepares for intravenous administration of edrophonium chloride (Tensilon). What is the expected outcome for this client following administration of this pharmacologic agent?Progressive difficulty with swallowing.Decreased respiratory effort.Improvement in generalized fatigue.Decreased muscle weakness.Rationale Administration of edrophonium chloride (Tensilon), a cholinergic agent, will temporarily reduce muscle weakness, the most common complaint of newly-diagnosed clients with myasthenia gravis. This medication is used to diagnose myasthenia gravis due to its short duration of action. This drug would temporarily reverse difficulty in swallowing and respiratory effort.A postoperative client has been receiving a continuous IV infusion of meperidine (Demerol) 35 mg/hr for four days. The client has a PRN prescription for Demerol 100 mg PO q3h. The nurse notes that the client has become increasingly restless, irritable and confused, stating that there are bugs all over the walls. What action should the nurse take first?

lOMoARcPSD|5422489 Downloaded by Clinton Bundi (clinyclinton@gmail.com) Administer a PRN dose of the PO meperidine (Demerol).Administer naloxone (Narcan) IV per PRN protocol.Decrease the IV infusion rate of the meperidine (Demerol) per protocol.Notify the healthcare provider of the client's confusion and hallucinations.Rationale The client is exhibiting symptoms of Demerol toxicity which is consistent with the large doses of Demerol received over four days. Decreasing the infusion rate of the Demerol as per protocol is the most effective action to immediately decrease the amount of serum Demerol. The next nursing action is for the nurse to notify the healthcare provider.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.This medication enhances antibiotics to prevent infection.This medication dissolves any clots that develop in the legs.This abdominal injection assists in the healing of the abdominal wound.Rationale 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 in order to prevent pulmonary embolism or deep vein thrombosis following knee and abdominal surgeries.