HESI PHARMACOLOGY (QUESTIONS AND ANSWERS)

1. A healthcare provider prescribes cephalexin monohydrate (Keflex) for a client with a
postoperative infection. It is most important for the nurse to assess for what additional drug
allergy before administering this prescription?
A) Penicillins.
B) Aminoglycosides.
C) Erythromycins.
D) Sulfonamides.
A) Penicillins.
Cross-allergies exist between penicillins (A) and cephalosporins, such as cephalexin
monohydrate (Keflex), so checking for penicillin allergy is a wise precaution before administering
this drug.
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2. Which nursing intervention is most important when caring for a client receiving the
antimetabolite cytosine arabinoside (Arc-C) for chemotherapy?
A) Hydrate the client with IV fluids before and after infusion.
B) Assess the client for numbness and tingling of extremities.
C) Inspect the client's oral mucosa for ulcerations.
D) Monitor the client's urine pH for increased acidity.
C) Inspect the client's oral mucosa for ulcerations.
Cytosine arabinoside (Arc-C) affects the rapidly growing cells of the body, therefore stomatitis
and mucosal ulcerations are key signs of antimetabolite toxicity (C). (A, B, and D) are not typical
interventions associated with the administration of antimetabolites.
3. When assessing an adolescent who recently overdosed on acetaminophen (Tylenol), it is
most important for the nurse to assess for pain in which area of the body?
A) Flank.
B) Abdomen.
C) Chest.
D) Head.
B) Abdomen.
Acetaminophen toxicity can result in liver damage; therefore, it is especially important for the
nurse to assess for pain in the right upper quadrant of the abdomen (B), which might indicate
liver damage. (A, C, and D) are not areas where pain would be anticipated.
4. An adult client is given a prescription for a scopolamine patch (Transderm Scop) to prevent
motion sickness while on a cruise. Which information should the nurse provide to the client?
A) Apply the patch at least 4 hours prior to departure.
B) Change the patch every other day while on the cruise.
C) Place the patch on a hairless area at the base of the skull.
D) Drink no more than 2 alcoholic drinks during the cruise.
A) Apply the patch at least 4 hours prior to departure.
Scopolamine, an anticholinergic agent, is used to prevent motion sickness and has a peak onset
in 6 hours, so the client should be instructed to apply the patch at least 4 hours before
departure (A) on the cruise ship. The duration of the transdermal patch is 72 hours, so (B) is not
needed. Scolopamine blocks muscarinic receptors in the inner ear and to the vomiting center, so
the best application site of the patch is behind the ear, not at the base of the skull (C).
Anticholinergic medications are CNS depressants, so the client should be instructed to avoid
alcohol (D) while using the patch.