PHARMACOLOGY HESI FINAL TESTBANK WITH RATIONALE

PHARMACOLOGY HESI FINAL TESTBANK WITH RATIONALE
    
A patient arrives in the emergency department with severe chest pain. The patient reports that the pain has been occurring off and on for a week now. Which assessment finding would indicate the need for cautious use of nitrates and nitrites?
a. Blood pressure of 88/62 mm Hg
b. Apical pulse rate of 110 beats/min
c. History of renal disease
d. History of a myocardial infarction 2 years ago    
Hypotension is a possible contraindication to the use of nitrates because the medications may cause the blood pressure to decrease.

A patient who has received chemotherapy has a critically low platelet count. The nurse
expects which drug or drug class to be used to stimulate platelet cell production?
a. Filgrastim (Neupogen)
b. Interferons
c. Oprelvekin (Neumega)
d. Epoetin alfa (Epogen)    
Oprelvekin (Neumega) stimulates bone marrow cells, specifically megakaryocytes, which
eventually form platelets.

An infant has been hospitalized with a severe lung infection caused by the respiratory syncytial virus (RSV) and will be receiving medication via the inhalation route. The nurse expects which drug to be used?
a. Acyclovir (Zovirax)
b. Ganciclovir (Cytovene)
c. Amantadine (Symmetrel)
d. Ribavirin (Virazole)    
The inhalational form of ribavirin (Virazole) is used primarily in the treatment of hospitalized infants with severe lower respiratory tract infections caused by RSV.

A young adult calls the clinic to ask for a prescription for "that new flu drug." He says he has
had the flu for almost 4 days and just heard about a drug that can reduce the symptoms. What
is the nurse's best response to his request?
a. "Now that you've had the flu, you will need a booster vaccination, not the antiviral
drug."
b. "We will need to do a blood test to verify that you actually have the flu."
c. "Drug therapy should be started within 2 days of symptom onset, not 4 days."
d. "We'll get you a prescription. As long as you start treatment within the next 24
hours, the drug should be effective."    ANS: C
These drugs need to be started within 2 days of influenza symptom onset; they can be used for
prophylaxis and treatment of influenza.

Important monitoring for Clonazepam    Respiratory rate since Clonazepam is a CNS depressant
A 38-year-old man has come into the urgent care center with severe hip pain after falling from a ladder at work. He says he has taken several pain pills over the past few hours but cannot remember how many he has taken. He hands the nurse an empty bottle of acetaminophen (Tylenol). The nurse is aware that the most serious toxic effect of acute acetaminophen overdose is which condition?
a. Tachycardia
b. Central nervous system depression
c. Hepatic necrosis
d. Nephropathy    
Hepatic necrosis is the most serious acute toxic effect of an acute overdose of acetaminophen.

When reviewing the allergy history of a patient, the nurse notes that the patient is allergic to
penicillin. Based on this finding, the nurse would question an order for which class of
antibiotics?
a. Tetracyclines
b. Sulfonamides
c. Cephalosporins
d. Quinolones    
Allergy to penicillin may also result in hypersensitivity to cephalosporins.

The nurse is providing teaching to a patient taking an oral tetracycline antibiotic. Which
statement by the nurse is correct?
a. "Avoid direct sunlight and tanning beds while on this medication."
b. "Milk and cheese products result in increased levels of tetracycline."
c. "Antacids taken with the medication help to reduce gastrointestinal distress."
d. "Take the medication until you are feeling better."    
Drug-related photosensitivity occurs when patients take tetracyclines, and it may continue for
several days after therapy. Milk and cheese products result in decreased levels of tetracycline
when the two are taken together. Antacids also interfere with absorption and should not be
taken with tetracycline. Counsel patients to take the entire course of prescribed antibiotic
drugs, even if they feel that they are no longer ill.

The nurse is monitoring for therapeutic results of antibiotic therapy in a patient with an
infection. Which laboratory value would indicate therapeutic effectiveness of this therapy?
a. Increased red blood cell count
b. Increased hemoglobin level
c. Decreased white blood cell count
d. Decreased platelet count    
Decreased white blood cell counts are an indication of reduction of infection and are a
therapeutic effect of antibiotic therapy.

During a teaching session for a patient on antithyroid drugs, the nurse will discuss which dietary instructions?
a. Using iodized salt when cooking
b. Avoiding foods containing iodine
c. Restricting fluid intake to 2500 mL/day
d. Increasing intake of sodium- and potassium-containing foods    
Patients on antithyroid therapy need to avoid iodine-containing foods. These foods may interfere with the effectiveness of the antithyroid drug.

When reviewing the laboratory values of a patient who is taking antithyroid drugs, the nurse
will monitor for which adverse effect?
a. Decreased glucose levels
b. Decreased white blood cell count
c. Increased red blood cell count
d. Increased platelet count    
Antithyroid drugs may cause bone marrow suppression, resulting in agranulocytosis,
leukopenia, thrombocytopenia, and other problems.