BSN HESI 315 Pharmacology Exam v1

(New 2026/ 2027 Update) over 200

Questions and Answers |100 out of 100|
Grade A- Nightingale

What hormone stimulates the release of the follicle-stimulating hormone (FSH) from both male
and female glands?

A)Growth hormone-releasing hormone (GHRH)

B)Thyrotropin-releasing hormone (TRH)
C)Gonadotropin-releasing hormone (GnRH)

D)Prolactin-releasing hormone (PRH)

The male and female glands respond to luteinizing hormone (LH) and FSH, which are released
from the anterior pituitary in response to stimulation from GnRH that is released from the
hypothalamus. GHRH stimulates the release of the growth hormone, which targets cell growth.
TRH stimulates the thyroid-stimulating hormone, which targets the thyroid gland. PRH
stimulates the release of prolactin, which is necessary for milk production.

A nurse is providing patient education to a patient as part of her work in a fertility clinic. The
nurse explains possible reasons for infertility. When explaining how the ovaries are involved in
conception, what will the nurse stress?

A)Ova quickly degenerate and most are absorbed in the body before the age of 12.

B)The ovaries at birth contain all of the ova that a woman will have.

C)Ova aggregate, causing millions to be contained in a storage site called a follicle.

D)Follicles produce only estrogen; the uterus produces progesterone.

b
 BSN HESI 315 Pharmacology Exam v1
(New 2026/ 2027 Update) over 200
Questions and Answers |100 out of 100|
Grade A- Nightingale
It would be important to explain that the woman's ova do not increase or decrease from birth to
childbearing years. The nurse will stress that all the ova that a woman will have will be present at
birth. The patient should understand that if she does not ovulate 1 month or for several months, it
is not because she has done something to her body to cause this. Ova slowly degenerate over a
lifetime or they are released once a month until menopause is complete. Each ovum is contained
in a storage site called a follicle, which produces the female sex hormones, estrogen and
progesterone.

The nursing instructor is discussing the physiology of pregnancy with her clinical group. What
hormone, produced during pregnancy, would the instructor tell the students helps to maintain the
pregnancy until birth of the fetus?

A)High levels of estrogen only

B)High levels of estrogen, low levels of progesterone

C)Low levels of estrogen, high levels of progesterone

D)High levels of estrogen and progesterone

Feedback:

In a pregnant woman, both estrogen and progesterone hormones have specific functions. High
levels of both hormones are needed for the maintenance of pregnancy.

The nursing instructor is talking with her class of students about the female reproductive system.
A student is trying to understand the role of progesterone in the body. What nonreproductive
affect does progesterone have on the body?
A)Decreased body temperature B)Decreased appetite C)Anti-insulinD)Increased uterine motility
 BSN HESI 315 Pharmacology Exam v1
(New 2026/ 2027 Update) over 200
Questions and Answers |100 out of 100|
Grade A- Nightingale
C

Feedback:

Progesterone has an anti-insulin effect to generate a higher blood glucose concentration to allow
for rapid diffusion of glucose to the developing embryo. Body temperature and appetite are
increased by progesterone. Uterine motility is decreased to provide increased chance that
implantation can occur.

What hormone causes ovulation to occur? A)Adrenocorticotropic hormone (ACTH)

B)Luteinizing hormone (LH)

C)Prolactin
D)Follicle-stimulating hormone (FSH)

Feedback:

When the circulating estrogen level rises high enough, it stimulates a massive release of LH from
the anterior pituitary causing one of the developing follicles to burst and release the ovum with
its stored hormones into the system. ACTH targets the adrenal corticosteroid hormone, which
helps prepare the body for the "fight or flight" response. Prolactin is responsible for milk
production and FSH in combination with LH stimulate follicles on the outer surface of the uterus
to grow and develop and also stimulates the release of estrogen and progesterone.

A 16-year-old girl comes to the clinic complaining of severe menstrual cramps. The girl is
concerned about the pain and worried that "something is wrong." The nurse explains to the
patient that she has cramping during her menstrual period because of what?

A)An increase in the levels of estrogen and progesterone, which cause uterine contractions
 BSN HESI 315 Pharmacology Exam v1
(New 2026/ 2027 Update) over 200
Questions and Answers |100 out of 100|
Grade A- Nightingale
B)Low levels of plasminogen in the uterus that cause the shedding of the lining of the uterus

C)Prostaglandins in the uterus, which stimulate uterine contractions to clamp off vessels as the
lining of her uterus sheds

D)An increase in progesterone and a decrease of estrogen cause the lining of the uterus to slough
away

C Feedback:

Prostaglandins in the uterus stimulate uterine contractions to clamp off vessels in the lining of
the uterus, which is the cause of the cramping. The decrease of estrogen and progesterone after
the involution of the corpus luteum triggers the release of follicle- stimulating hormone (FSH)
and luteinizing hormone (LH). The decreased levels of FSH and LH cause the inner lining of the
uterus to slough off because the vascular system is no longer being stimulated. High, not low,
levels of plasminogen in the uterus prevent clotting of the lining as the vessels shear off.

What drug would the nurse expect to administer if beta-specific adrenergic agonist effects are
desired to prevent bronchospasm during anesthesia?
A)Dobutamine (Dobutrex) B)Ephedrine (generic) C)Isoproterenol (Isuprel) D)Phenylephrine
(Neo-Synephrine)
C

Isoproterenol is a beta-specific adrenergic agonist used to prevent bronchospasm during

anesthesia. Phenylephrine is an alpha-specific adrenergic agonist. Both dobutamine and
ephedrine are alpha- and beta-adrenergic agonists.

The nurse is preparing discharge teaching for four patients. Which patient should be advised by
the nurse that over-the-counter cold and allergy preparations contain phenylephrine and should
be avoided?

A)A 47-year-old woman with hypertensionB)A 52-year-old man with adult onset diabetes
 BSN HESI 315 Pharmacology Exam v1
(New 2026/ 2027 Update) over 200
Questions and Answers |100 out of 100|
Grade A- Nightingale
C)A 17-year-old girl with symptoms of an upper respiratory infection

D)A 62-year-old man with gout

Feedback:
Phenylephrine, a potent vasoconstrictor and alpha1-agonist with little or no effect on the heart or
bronchi, is used in many combination cold and allergy products. Patients with hypertension
should avoid these drugs because serious increases in blood pressure could occur. Use of this
drug in patients with diabetes and gout are not contraindicated. An upper respiratory infection
may be an indication for the drug.

The nurse is writing a plan of care for a patient receiving an alpha-specific adrenergic agonist.
What should this plan of care include?

A)Monitoring the patient for diarrhea

B)Monitoring blood pressure and heart rate every 2 to 4 hours

C)Assessing skin turgor for dehydration D)Assessing for fatigue and lethargy

Sympathetic stimulation will cause hypertension and increased heart rate so it is important these
be monitored. Sympathetic stimulation will also result in increased sweating, decreased
gastrointestinal activity, and a sense of anxiety and heightened awareness. Diarrhea, dehydration,
fatigue, and lethargy would not be expected.

A nurse receives an order for clonidine (Catapres) for a 25-year-old pregnant woman. What is the
nurse's priority action?
 BSN HESI 315 Pharmacology Exam v1
(New 2026/ 2027 Update) over 200
Questions and Answers |100 out of 100|
Grade A- Nightingale
A)Weigh the patient to obtain correct dose/kg/day.

B)Have a second nurse check the dose before administering the drug.

C)Consult with the physician about the order.

D)Make sure the patient is wearing a fetal monitor.

Ans:C

Feedback:

The nurse would consult with the physician to ensure awareness of the pregnancy and desire to
administer this drug. There are no adequate studies about use during pregnancy and lactation, so
use should be reserved for situations in which the benefit to the mother outweighs any potential
risk to the fetus or neonate. The nurse should question the prescriber regarding this order. It
would not be necessary to implement the other options.

The nursing students are studying sympathomimetic drugs. How do these drugs act on the body?
A)Stimulate beta receptors and block alpha- receptors

B)Stimulate alpha-receptors and block beta- receptors

C)Block adrenergic receptorsD)Stimulate both alpha and beta-receptors

Ans:D

Drugs that are generally sympathomimetic are called alpha-agonists (stimulate alpha- receptors)
and beta-agonists (stimulate beta- receptors). These agonists stimulate all of the adrenergic
receptors; that is they affect both alpha and beta-receptors.

How does ephedrine act on the body?

A)Stimulates the release of norepinephrine
 BSN HESI 315 Pharmacology Exam v1
(New 2026/ 2027 Update) over 200
Questions and Answers |100 out of 100|
Grade A- Nightingale
B)Acts indirectly on beta-adrenergic receptor sites

C)Stimulates the release of dopamine

D)Acts indirectly on alpha-adrenergic receptor sites

Ans:A Feedback:
Ephedrine stimulates the release of norepinephrine from nerve endings and acts directly on
adrenergic receptor sites. Therefore, the other options are incorrect.

In what age group are adrenergic agonists contraindicated?

A)Older adults B)Adolescents C)Children D)No age group

Ans:D Feedback:

The use of adrenergic agonists varies from ophthalmic preparations for dilating pupils to
systemic preparations used to support patients experiencing shock. They are used in patients of
all ages. Therefore, the other options are incorrect responses.

A patient in shock is receiving an infusion of dopamine when it is discovered that an

extravasation has occurred. What drug should be on standby for this occurrence?

A)Phenylephrine B)Propranolol C)Phenylalanine D)Phentolamine

Ans:D Feedback:

Maintain phentolamine on standby in case extravasation occurs; infiltration of the site with 10
mL of saline containing 5 to 10 mg of phentolamine is usually effective in saving the area.
Phenylephrine, propranolol, and phenylalanine are not indicated for use when extravasation
occurs.
 BSN HESI 315 Pharmacology Exam v1
(New 2026/ 2027 Update) over 200
Questions and Answers |100 out of 100|
Grade A- Nightingale
The pharmacology instructor is discussing adrenergic agonists with the nursing class. Which
drugs would the instructor tell the nursing students are generally indicated for the treatment of
shock, bronchospasm, and some types of asthma?

A)Sympathomimetic drugs B)Beta-blocking drugs C)Parasympathetic stimulating drugs

D)Anticatecholamine drugs

Ans:A Feedback:

These drugs generally are indicated for the treatment of hypotensive states or shock,
bronchospasm, and some types of asthma. Beta-blocking drugs, parasympathetic stimulating
drugs, and anticatecholamine drugs are not the drugs of choice in these situations.

When studying for a pharmacology exam, a student asks her peers which agents affect both
alpha- and beta-receptor sites. What would be an appropriate response to this student? (Select all
that apply.)
A)Dobutamine (Dobutrex)

B)Epinephrine (Adrenalin, Sus-Phrine) C)Dopamine (Intropin)D)Clonidine

(Catapres)E)Albuterol (Proventil)

Ans:A, B, C Feedback:

Agents that affect both alpha- and beta- receptor sites include dobutamine, dopamine, ephedrine,
epinephrine, and norepinephrine. Clonidine is an alpha-specific adrenergic agonist; albuterol is a
beta-specific adrenergic agonist.

The nurse is admitting a mental health patient and collects the medication history. The patient
says he takes Haldol, midodrine, hydrochlorothiazide, acetaminophen, and Cymbalta. The nurse
will call the provider to discuss what dangerous drug combination?
A)Haldol and midodrine B)Hydrochlorothiazide and midodrine C)Cymbalta and midodrine
D)Acetaminophen and midodrine
 BSN HESI 315 Pharmacology Exam v1
(New 2026/ 2027 Update) over 200
Questions and Answers |100 out of 100|
Grade A- Nightingale
Ans:AFeedback:

Midodrine can precipitate increased drug effects of digoxin, beta-blockers, and many
antipsychotics. Such combinations should be avoided. The other drug combinations do not pose
any immediate concerns.

A 4-year-old is admitted to the emergency department in shock after a motor vehicle accident.
The patient weighs 12.5 kg. What would be the minimum safe dose of adrenalin if the pediatric
dose is 0.005 to 0.01 mg/kg IV?

A)0.0625 mg B)0.075 mg C)0.08 mg D)0.085 mg

Ans:A Feedback:

To calculate the minimum dosage, multiply the child's weight in kg by the lower dosage range;
12.5 × 0.005 = 0.0625 mg.

When giving beta-specific adrenergic agonists, at what age is an adult dose given?
A)10 years B)11 years C)12 years D)13 years

Ans:C Feedback:

Adult doses are given to children who are 12 years and older (see dosages in Table 30.3, page
497.) Therefore, the other options are incorrect.

The home health nurse is caring for a 77- year-old male patient who has just been discharged
from the hospital. The patient is receiving an infusion of dobutamine (Dobutrex) to treat
congestive heart failure. What is the priority nursing assessment?
 BSN HESI 315 Pharmacology Exam v1
(New 2026/ 2027 Update) over 200
Questions and Answers |100 out of 100|
Grade A- Nightingale
A)Capillary refill time and vital signs B)Effectiveness of comfort measures C)Dietary intake and
hydration D)Compliance with treatment plan

Feedback:

Dobutamine, although it acts at both receptor sites, has a slight preference for beta1- receptor
sites. It is used in the treatment of heart failure because it can increase myocardial contractility
without much change in rate and does not increase the oxygen demand of the cardiac muscle, an
advantage over all of the other sympathomimetic drugs. Assessing capillary refill time and vital
signs will allow the nurse to assess perfusion as an

indicator of the effectiveness of the infusing drug. Dietary intake, compliance with treatment
plan, and effectiveness of comfort measures are all important assessments but the priority
assessment is perfusion.

A 66-year-old female patient is on long-term oral glucocorticoid therapy to treat chronic

obstructive pulmonary disease. When providing drug teaching, the nurse will inform this patient
that she is at particular risk for what?

A)HyponatremiaB)Spontaneous fractures C)Respiratory depression D)Ineffective temperature

regulation

Ans:BFeedback:

Only spontaneous fractures are considered an adverse effect of glucocorticoids; this patient
would be at increased risk because her age and gender put her at higher risk for osteoporosis,
which also has the adverse effect of spontaneous fractures. Long-term glucocorticoid therapy is
not associated with hyponatremia, respiratory depression, or ineffective temperature regulation.

The nurse provides teaching to a patient with chronic obstructive pulmonary disease who has
been prescribed budesonide (Pulmicort) two puffs and fluticasone (Flovent) three puffs t.i.d. The
nurse evaluates that further teaching is needed when the patient makes what statement?
 BSN HESI 315 Pharmacology Exam v1
(New 2026/ 2027 Update) over 200
Questions and Answers |100 out of 100|
Grade A- Nightingale
A)"Take all five puffs as quickly as possible." B)"Replace the inhalers before they run out."

C)"Rinse the mouth after taking the medication."

D)"Continue medication even when symptoms start to subside."

Ans:A
Feedback:

The nurse needs to review how to administer the drug via inhalation because the patient must
hold the medication in the airways as long as possible before exhaling and should not try to rush
the treatment. The other statements are correct and would not require clarification.

The home health nurse provides patient teaching to his or her patient who is taking oral
prednisolone. The nurse provides what instruction to reduce the occurrence of nausea?

A)"Take with a meal."B)"Take 1 hour before meals."C)"Take before bedtime."D)"Split the dose
into two equal doses."
Feedback:

Steroids, taken on an empty stomach, would exacerbate the nausea. If the patient takes only one
dose per day, it should be taken immediately after breakfast. If spaced throughout the day, eating
something before taking the pill will reduce risk of nausea. Timing is dictated by frequency of
administration, and if only taken once daily, the medication should be taken in the morning (so
bedtime is inappropriate). Splitting the dose would decrease effectiveness and would be
inappropriate for the nurse to suggest because it is outside the scope of nursing practice. Taking
the medication before meals would mean it was being taken on an empty stomach.

What would be important for the nurse to teach the parents of a pediatric patient about the use of
topical corticosteroids?
 BSN HESI 315 Pharmacology Exam v1
(New 2026/ 2027 Update) over 200
Questions and Answers |100 out of 100|
Grade A- Nightingale
A)"Apply the medication sparingly." B)"Apply directly to open lesions." C)"After applying
cover with a bandage."

D)"Reapply as often as needed to keep the rash coated with the medication."

Ans:A Feedback:

Topical use of corticosteroids should be limited in children, because their body surface area is
comparatively large, so that the amount of the drug absorbed in relation to weight is greater than
in an adult. Apply sparingly and do not use in the presence of open lesions. Do not occlude
treated areas with dressings or diapers, which may increase the risk of systemic absorption.

The nurse is teaching the patient who will require long-term corticosteroid therapy how to reduce
the risk of infection. What suggestions will the nurse include?

A)"Avoid large crowds of people tightly packed together."

B)"Avoid working in areas with other people." C)"Avoid exercising to reduce risk of injury."

D)"Avoid touching other people who may carry germs."

Ans:A Feedback:
With long-term therapy, the importance of avoiding exposure to infection—crowded areas,
people with colds or the flu, activities associated with injury—should be stressed. If an injury or
infection should occur, the patient should be encouraged to seek medical care. These patients do
not need to avoid work, exercise, or touching others but they should use good hand hygiene to
avoid infection from these sources.

The nurse is caring for an African American patient who received a kidney transplant and
receives methylprednisolone for immunosuppression. What is the nurse's priority assessment
specific to this patient?
A)Assessing capillary refill time
 BSN HESI 315 Pharmacology Exam v1
(New 2026/ 2027 Update) over 200
Questions and Answers |100 out of 100|
Grade A- Nightingale
B)Assessing cardiac rhythm

C)Assessing white blood cell count

D)Assessing blood glucose levels

Ans:
DFeedback:

African Americans develop increased toxicity to the corticosteroid methylprednisolone—

particularly when it is used for immunosuppression after renal transplantation. This toxicity can
include severe steroid-induced diabetes mellitus. A priority intervention with this patient is
monitoring blood glucose levels. Assessment of capillary refill time and cardiac rhythm would
not be indicated by the data supplied about this patient. White blood cell counts should be
monitored on any patient receiving long-term corticosteroids but is not specific to this patient.

The nurse is caring for a patient who is diagnosed with protein-deficient malnutrition. Why
would an order to administer androgens to this patient be appropriate?

A)Androgens reduce the body's requirement for protein.

B)Androgens increase the body's absorption of protein from the bowel.
C)Androgens stimulate protein production and decrease protein breakdown.

D)Androgens reduce carbohydrate metabolism and promote lipid absorption.

Ans:C

Feedback:

Androgens are a form of the male sex hormone called testosterone. They affect electrolytes,
stimulate protein production, and decrease protein breakdown, which will help to reverse the
patient's protein malnutrition in addition to a high-protein diet. They do not reduce the body's
need for protein, increase protein absorption from the bowel, or impact carbohydrate and lipid
metabolism.
 BSN HESI 315 Pharmacology Exam v1
(New 2026/ 2027 Update) over 200
Questions and Answers |100 out of 100|
Grade A- Nightingale

The nurse is caring for a patient who works night shift from 2200 (10 pm) to 0600 (6 am) and
normally sleeps from 0800 (8 am) until 1600 (4 pm) each day. The nurse would teach this patient
to take his or her corticosteroid at what time of the day?

A)06:00 (6 am) B)08:00 (8 am) C)16:00 (4 pm) D)22:00 (10 pm)

Ans:C Feedback:

If a person works all night and goes to bed at 8 am, arising at 4 pm to carry on the day's activities
before going to work at 10 pm, the hypothalamus will release corticotropin- releasing hormone at
about 4 pm in accordance with the new sleep-wake cycle. It usually takes 2 or 3 days for the
hypothalamus to readjust. A patient on this schedule who is taking replacement corticosteroids
would then need to take them at 4 pm, or on arising. All other options would not be optimal.

For what reason might a nurse administer androgen injections to a 9-year-old boy?

A)Ovarian atrophy B)Dwarfism C)Acromegaly D)Hypogonadism

Ans:D
Feedback:
Androgens are used pharmacologically to treat hypogonadism or to increase protein growth and
red blood cell production. Androgens are not used in a male to treat ovarian atrophy. Androgens
are not used to treat dwarfism or acromegaly.

A patient is taking low-dose corticosteroids on a long-term basis for chronic obstructive

pulmonary disease. The nurse assesses this patient knowing prolonged use of corticosteroids puts
the patient at risk for what?

A)Adrenal stormB)Adrenal atrophyC)Stunted growth D)Hypothalamic insufficiency

 BSN HESI 315 Pharmacology Exam v1
(New 2026/ 2027 Update) over 200
Questions and Answers |100 out of 100|
Grade A- Nightingale
Ans:B

Feedback:

Prolonged use of corticosteroids suppresses the normal hypothalamic-pituitary axis and leads to
adrenal atrophy from lack of stimulation. The other options are all distracters for this question
with no connection to long-term use of corticosteroids.

The nurse administers prednisone orally at 8 am. When would the nurse expect the drug to reach
peak effect?

A)9 to 10 am B)12 to 1 pm C)8:30 to 9:00 am D)4 to 6 pm

Ans:AFeedback:
Prednisone's peak effect occurs 1 to 2 hours after administering the drug. If given at 8 am, the
expected peak would occur between 9 and 10 am.

32.

Nursing care for the postoperative patient requiring long-term glucocorticoid therapy will be
directed at overcoming what adverse effect of the drug?

A)Poor wound healing B)Inflammation C)Autoimmune response

D)Lack of mobility

Ans:AFeedback:

Patients taking long-term glucocorticoid therapy will have impaired wound healing so nursing
care is directed toward promoting healing. The drug has an anti-inflammatory effect so that
would not need to be overcome. There is no autoimmune response or lack of mobility so these do
not have to be overcome.
 BSN HESI 315 Pharmacology Exam v1
(New 2026/ 2027 Update) over 200
Questions and Answers |100 out of 100|
Grade A- Nightingale

The nurse is teaching a class for his or her peers about glucocorticoids. What will the nurse say is
initially blocked, resulting in the drug's anti-inflammatory action?

A)Arachidonic acid B)Phagocytes C)Lymphocytes D)Antibodies

Ans:A
Feedback:

Glucocorticoids block the actions of arachidonic acid, which leads to a decrease in the formation
of prostaglandins and leukotrienes. They also impair the ability of phagocytes to leave the
bloodstream and move to injured tissues; they inhibit the ability of lymphocytes to act within the
immune system, including blocking the production of antibodies. Blocking arachidonic acid is,
however, the initial action.

What hormones does the adrenal medulla secrete?

A)Renin and erythropoietin B)Norepinephrine and epinephrine C)Epinephrine and dopamine
D)Dopamine and serotonin
Ans:B

Feedback:The adrenal medulla is actually part of the sympathetic nervous system (SNS). It is a
ganglion of neurons that releases the neurotransmitters norepinephrine and epinephrine into
circulation when the SNS is stimulated.

The adrenal cortex responds to adrenocorticotropic hormone (ACTH), which responds to

corticotropin-releasing hormone (CRH) from the hypothalamus in a daily pattern called what?
 BSN HESI 315 Pharmacology Exam v1
(New 2026/ 2027 Update) over 200
Questions and Answers |100 out of 100|
Grade A- Nightingale
A)Pituitary rhythm B)hypothalamic-pituitary axis C)Diurnal rhythm D)Circadian rhythm

Feedback:

The adrenal cortex responds to ACTH released from the anterior pituitary. ACTH, in turn,
responds to CRH released from the hypothalamus. This happens regularly during a normal day in
what is called "diurnal rhythm." Pituitary rhythm is a distracter; the term does not exist. The
hypothalamic- pituitary axis involves the interaction between the two glands. Circadian rhythm
involves when people prefer to be most active, such as people who say they are "morning
people."

A 9-year-old boy is taking testosterone injections for treatment of hypogonadism. What should
be measured every 6 months on this child?

A)Liver function test (LFT) B)Cholesterol levelC)VisionD)hand and wrist radiographs

Ans:DFeedback:

Because of the effects of these hormones on epiphyseal closure, children should be closely
monitored with hand and wrist radiographs before treatment and every 6 months after treatment.
It would not be necessary to measure LFTs, cholesterol levels, or the child's vision.

The nurse assesses the patient taking anabolic steroids for what serious adverse effects?

A)Elevated blood urea nitrogen (BUN) B)Elevated blood glucose level

C)BradycardiaD)Jaundice

Ans:D Feedback:

Anabolic steroids all have black box warnings as alerts to the potentially serious effects of liver
tumors, hepatitis, and blood lipid level changes that might be associated with increased risk of
coronary artery disease. As a result, the nurse should assess for jaundice that could be an early
indication of liver dysfunction. Elevated BUN, blood glucose levels, and bradycardia are not
commonly reported adverse effects.
 BSN HESI 315 Pharmacology Exam v1
(New 2026/ 2027 Update) over 200
Questions and Answers |100 out of 100|
Grade A- Nightingale

What therapeutic effect will the nurse assess for in the male patient taking anabolic steroids?

A)Thinning of the skin B)Body hair loss

C)Increase in red blood cells (RBCs) and hemoglobin

D)Gynecomastia

Ans C:

Feedback:

Therapeutic effects include promotion of body tissue-building processes, reverse catabolic or

tissue-destroying processes, and increased hemoglobin and red blood cell mass. Thinning of the
skin and body hair loss are not associated effects of anabolic steroids. Gynecomastia is an
adverse effect and would not be a therapeutic effect for which the drug was administered.

An woman is prescribed androgens. The nurse teaches the patient to anticipate what effect from
the drug?

A)Atrophy of breasts B)Rapid bone growth C)Loss of pubic hair D)Nervousness

Ans:D

Feedback:

Antiestrogen effects—flushing, sweating, vaginitis, nervousness, and emotional lability—can be

anticipated when these drugs are used in women. When androgens are administered to women
you would not expect the results to include atrophy of the breasts, rapid bone growth, or loss of
pubic hair.
 BSN HESI 315 Pharmacology Exam v1
(New 2026/ 2027 Update) over 200
Questions and Answers |100 out of 100|
Grade A- Nightingale
The nurse is caring for a patient who has been taking androgens and has been admitted to the
ICU following a car accident. What lab results will the nurse interpret as more indicative of
androgen therapy than actual disease states? (Select all that apply.)

A)Decreased thyroid functionB)Increased creatinine levelsC)Increased creatinine clearance

D)Elevated liver enzymesE)Increased white blood cell (WBC) count

Ans:A, B, C Feedback:

While a patient is taking androgens, thyroid function may be decreased, as well as increased
creatinine and creatinine clearance, results that are not associated with disease states. These
effects can last up to 2 weeks after the discontinuation of therapy. Elevated liver enzymes may
indicate a potentially life- threatening effect that has been documented is hepatocellular cancer.
Increased WBC count would indicate an infection. Increased liver enzymes and WBC are not
associated with androgen therapy but instead indicate a disease state.

The 63-year-old male patient receives a prescription for androgens. The nurse evaluates that the
patient understood drug teaching when he makes what statement?

A)"If I experience acne, I will contact my physician immediately."

B)"If I experience flushing, sweating, nervousness, or emotional lability I'll know it's the drug."
C)"I will report any difficulty urinating such as trouble starting my flow."

D)"These pills may make my skin turn yellow but it will go away when the drug is stopped."

Ans:B Feedback:

Benign prostatic hypertrophy, a common problem in older men, may be aggravated by

androgenic effects that may enlarge the prostate further, leading to urinary difficulties and
increased risk of prostate cancer. Nurses should teach these men the signs and symptoms of
prostatic enlargement and the importance of reporting these manifestations immediately to
prevent worsening of symptoms. Acne need not be reported immediately. Flushing, sweating,
nervousness, and emotional lability are more usually experienced by women. Yellowing of the
skin may be an indication of liver disease, which should be reported immediately
 BSN HESI 315 Pharmacology Exam v1
(New 2026/ 2027 Update) over 200
Questions and Answers |100 out of 100|
Grade A- Nightingale

A female athlete is using high doses of anabolic steroids to enhance her performance. The nurse
warns this patient that such use of anabolic steroids is likely to result in what?

A)Masculinization B)Immobility of joints C)Obesity D)Hypotension

Ans: A
Feedback:

Adverse effects in women include masculinization effects, hirsutism, and deepening of the voice.
A woman using anabolic steroids would not expect it to result in joint immobility, obesity, or
hypotension.

The nurse attributes what assessment finding to the use of androgens by the male patient?

A)Testicular atrophy B)Increased fertility C)Increased urination D)Hoarseness

Ans:A Feedback:

In adult men, adverse effects include inhibition of testicular function, gynecomastia, testicular
atrophy, priapism, baldness, and change in libido. Increased fertility, increased urination, and
hoarseness would not be expected assessment findings.

The nurse administers danazol (Danocrine) be a woman for what purpose?

A)Reverse folic acid deficiencies B)Increase hair growth

C)Decrease symptoms of endometriosis D)Prevent toxic shock syndrome.

Ans:CFeedback:
 BSN HESI 315 Pharmacology Exam v1
(New 2026/ 2027 Update) over 200
Questions and Answers |100 out of 100|
Grade A- Nightingale
Danazol may be used in women to prevent or treat endometriosis or fibrocystic breast disease.
Danazol is not prescribed for increased hair growth, to reverse folic acid deficiencies, or to
prevent toxic shock syndrome.

The nurse assesses the young adult athlete who has been taking anabolic steroids to enhance his
performance. What findings would the nurse associate with this practice? (Select all that apply.)

A)Personality changes B)Sexual dysfunction C)Increased serum lipid levels D)Cardiomyopathy

E)Weight loss

Ans:A, B, C, D Feedback:

Cardiomyopathy, hepatic carcinoma, personality changes, and sexual dysfunction are all
associated with the excessive and off- label use of anabolic steroids for athletic performance
enhancement. Adverse effects associated with prescription use include inhibition of testicular
function, gynecomastia, testicular atrophy, priapism, baldness, change in libido, serum
electrolyte changes, liver dysfunction, insomnia, and weight gain, not weight loss.

The nurse learns a patient receiving a new prescription for oxandrolone takes a lipid- lowering
medication daily. What will the nurse tell the patient about this drug interaction?

A)Lipid-lowering drug becomes much less effective.

combination

Ans:A Feedback:

Anabolic steroids may alter lipid metabolism and cause a lack of effectiveness for lipid- lowering
agents. Lipid-lowering medications do not impact anabolic steroids and there is no increased risk
for toxicity of either drug.
 BSN HESI 315 Pharmacology Exam v1
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Questions and Answers |100 out of 100|
Grade A- Nightingale
What supplement would be safest for a diabetic female athlete wishing to improve athletic
performance?

A)Bee pollen B)Damiana C)Wild yam D)Spirulina

Ans:C Feedback:

Wild yam is an estrogen-like herb used to increase athletic performance, slow the aging process,
and improve energy and stamina. It can be toxic to the liver and may cause breast pain but is the
safest of these supplements. Bee pollen is associated with serious allergic reactions and random
studies have found wide variety of ingredients in each product. Damiana interferes with
antidiabetic agents so it would not be appropriate for this patient. Spirulina may contain toxic
metals and can cause serious reactions in children and pets. It interferes with vitamin
B12absorption and there are no studies to prove it is effective in the claims it makes.

When a 5-year-old patient is prescribed oxandrolone (Oxandrin) to promote weight

gain, how would the nurse expect the drug to be administered?

A)Long-term B)Short-term C)Continuous D)Intermittent

Ans:D Feedback:

Oxandrin is given intermittently to pediatric patients and should not be used on a daily basis for
short, long, or continuous therapy.

The nurse gives a class at the local high school on the use of anabolic steroids. The nurse
explains that one of the most serious and all too common side effects of using these drugs
without a prescription and medical follow-up is what?

A)Renal stonesB)DeathC)CirrhosisD)Malignant hyperthermia

Ans:B

Feedback:
 BSN HESI 315 Pharmacology Exam v1
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Questions and Answers |100 out of 100|
Grade A- Nightingale
Prolonged use of high doses may cause potentially life-threatening conditions, placing the patient
at risk of death. Conditions such as peliosis hepatis, hepatic neoplasms, and hepatocellular
carcinoma are often seen with high-dose street use of these drugs. Renal stones, cirrhosis, and
malignant hyperthermia are not associated with the use of anabolic steroids.

When fluoxymesterone (Androxy) is administered to a 14-year-old boy for hypogonadism, what

is the expected result?

A)Enlarged sex organs B)Decreased skin thickness

C)Increased protein metabolism D)Increased sperm production

Ans:AFeedback:

In prepubertal boys, administration of male sex hormone-like drugs will stimulate development
of masculine characteristics and cause development of the male sexual organs. Production of
sperm will occur when the boy enters puberty. These drugs are not administered to decrease skin
thickness or increase protein metabolism.

A 69-year-old man is prescribed testosterone. The patient is found to have hypertension and a
history of congestive failure after assessment by the nurse. What is this patient at increased risk
for?

A)Fluid retention B)Impotence C)Liver failure D)Kidney failure

Ans:A

Feedback:

Older adults often have hypertension and other cardiovascular disorders that may be aggravated
by sodium and water retention associated with androgens and anabolic steroids. Testosterone
would not increase the risk of impotence. Liver and kidney failure could be exacerbated by the
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Grade A- Nightingale
drug if they were preexisting conditions but since that is not indicated by the question, this would
be a lower risk than fluid retention.

The nurse is caring for a patient with cryptorchidism who is 28 years old and taking testosterone
to treat his condition. What statement by this patient would lead the nurse to believe that he has
understood the teaching provided about the drug?

A)"My body hair may increase."

B)"My sexual desire may increase." C)"My voice may become higher." D)"My skin may become
clear and soft."

Ans:A

Feedback:

Androgenic effects include acne, edema, hirsutism (increased hair distribution), deepening of the
voice, oily skin and hair, weight gain, decrease in breast size, and testicular atrophy. Testosterone
does not make the skin clear and soft, it does not make the voice higher, and the testicular
atrophy is more likely to decrease rather than increase libido.

A 16-year-old boy is diagnosed with delayed onset of puberty and the physician has ordered
testosterone, intramuscular (IM), once every 2 weeks. What nursing intervention would be
important to the patient?

A)Discuss changes that will occur in his body.

B)Have patient fast before injection.

C)Have patient reduce protein intake.

D)Decrease exercise while on this hormonal treatment.

Ans:A
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Grade A- Nightingale
Feedback:

It is important for this patient to understand what will happen and the changes he will see to
reduce the anxiety that could occur if he didn't understand. Discuss the development of
masculine characteristics as well as common adverse effects such as acne. Having the patient fast
before the injection would not be necessary, nor would decreasing exercise or reducing protein
intake.

A patient has been prescribed sildenafil citrate. What should the nurse teach the patient about this
medication?

A)Take the medication with a glass of grapefruit juice.

B)The drug should be taken 1 hour before attempting intercourse.

C)Facial flushing or headache should be reported to the physician immediately.

D)A dose exceeding 80 mg will result in a change of vision, making everything appear blue.

Ans:B Feedback:

The drug should be taken approximately 1 hour before intercourse to allow adequate time for
absorption and therapeutic effects to occur. Facial flushing, mild headache, indigestion, and
running nose are common side effects of sildenafil citrate and do not need to be reported unless
they become acute. The "blue haze" that occurs with the 100-mg dosage is transient (it lasts
about 1 hour). Grapefruit juice should be avoided 2 days before until 2 days after taking the
medication because it prolongs the drugs metabolism and excretion.

A 55-year-old man presents at the clinic complaining of erectile dysfunction. The patient has a
history of diabetes mellitus. The physician orders tadalafil (Cialis) to be taken 1 hour before
sexual intercourse. The nurse reviews the patient's history before instructing the patient on the
use of this medication. What disorder (or condition) would contraindicate the use of tadalafil
(Cialis)?
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Grade A- Nightingale
A)Cataracts B)Penile implant C)Hypotension D)Lung cancer

Ans:B Feedback:

Patients with a penile implant should not take tadalafil. Patients with cataracts, hypotension, or
lung cancer may take tadalafil if needed but

should do so with caution and should be carefully monitored for adverse effects.

56.For what reason might the nurse administer sildenafil to a woman?

A)Pulmonary arterial hypertension B)Sexual dysfunctionC)Breast cancerD)Endometriosis

Ans:A

Feedback:

Sildenafil is used to treat erectile dysfunction in the presence of sexual stimulation in men and to
treat pulmonary arterial hypertension in women. It is not used for sexual dysfunction, breast
cancer, or endometriosis in women.

A 68-year-old male patient tells the nurse that he has been unable to get an erection for the past 6
months and he guesses his sex life is over. The provider orders diagnostic testing to determine
whether sildenafil (Viagra) is appropriate for the patient. What is the most correct nursing
diagnosis for this patient?

A)Sexual dysfunctionB)Disturbed body imageC)Ineffective sexuality pattern D)Disturbed tactile

sensory perception

Ans:A

Feedback:
The patient is experiencing sexual dysfunction so that would be the most appropriate nursing
diagnosis. The patient did not discuss feeling let down by or unhappy with his body so disturbed
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Grade A- Nightingale
body image is incorrect. The effectiveness of sexual pattern is not known. No problem with
sensory perception is indicated by this question.

The 22-year-old patient tells the nurse he doesn't have trouble obtaining and maintaining an
erection but wonders if taking Viagra would improve the sexual experience anyway. What is the
nurse's best response?

A)"The only thing Viagra does is improve blood flow to the penis to make it erect."

B)"Viagra improves stamina and sensation, making the sexual experience better."

C)"Viagra has its greatest effect if both the man and woman take it at the same time."

D)"Viagra does nothing to improve the sexual experience."

Ans:A Feedback:

Viagra improves blood flow into the penis and that is its only effect. It does not improve stamina
or sensation. Research has indicated it has no effect on women's sexual response. To say only
that Viagra does nothing would not provide adequate information for the patient.

The patient is prescribed oxandrolone 2.5 mg twice a day and is told to increase the dosage to
gain weight to a maximum of 20 mg/d. If each tablet contains 2.5 mg, how many tablets would
the nurse tell the patient he may take per day to avoid exceeding the 20 mg/d maximum?

A)4B)6C)8D)10
Ans:C Feedback:

Calculate the number of tablets required to administer 20 mg by dividing 20 mg by 2.5 mg.

20/2.5 = 8 tablets
 BSN HESI 315 Pharmacology Exam v1
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Questions and Answers |100 out of 100|
Grade A- Nightingale

The patient is prescribed sildenafil 25 mg PO one hour before sexual intercourse is planned. The
patient returns for follow-up care and says that 25 mg did not produce an erection so he
increased the dosage. How much of an increase would be enough to concern a nurse?

A)50 mg B)75 mg C)100 mg D)25 mg

Ans:C Feedback:

Normal dosage range is 25 to 100 mg so the nurse should not be concerned unless the dosage
exceeded 100 mg.

Why would the nurse expect the patient with liver disease to receive a smaller dose of
benzodiazepines?

A)Excretion of the drug relies on liver function.

B)The drugs are metabolized extensively in the liver.

C)They are lipid soluble and well distributed throughout the body.

D)The drugs are well absorbed from the gastrointestinal tract.

Ans:B Feedback:

The benzodiazepines are metabolized extensively in the liver. Patients with liver disease must
receive a smaller dose and be monitored closely. Excretion is primarily through the urine. All of
the answer options are true, but only the fact that the benzodiazepines are metabolized in the
liver explains why a patient with liver disease would require smaller dosages.

When compared with benzodiazepines, buspirone (BuSpar) stands out as unique

among antianxiety drugs because of what factor?

A)Increases the central nervous system (CNS) depression of alcohol and other drugs.
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Grade A- Nightingale
B)Lacks muscle relaxant and anticonvulsant effects.

C)Causes significant physical and psychological dependence.

D)Rapidly absorbed from the gastrointestinal (GI) tract and metabolized in the liver.

Ans:B Feedback:
Buspirone, a newer antianxiety agent, has no sedative, anticonvulsant, or muscle-relaxant
properties, and its mechanism of action is unknown. However, it reduces the signs and symptoms
of anxiety without many of the central nervous system effects and severe adverse effects
associated with other anxiolytic drugs. Most of the antianxiety drugs are rapidly absorbed from
the GI tract, metabolized in the liver, have a significant drug-drug interaction with alcohol and
other drugs, and can result in psychological dependence.

What would the nurse assess for when benzodiazepines are abruptly stopped?

A)Urinary retention and change in sexual functioning

B)Dry mouth, constipation, nausea, and vomiting

C)Nausea, headache, vertigo, malaise, and nightmares

D)In most cases nothing significant

Ans:CFeedback:

Abrupt cessation of these drugs may lead to a withdrawal syndrome characterized by nausea,
headache, vertigo, malaise, and nightmares. When benzodiazepines are stopped abruptly the
likelihood of withdrawal
symptoms increases with the length of time the patient took the medication. Urinary retention,
change in sexual functioning, dry mouth, constipation, nausea, and vomiting are all common
adverse effects of the medications classified as benzodiazepines.
 BSN HESI 315 Pharmacology Exam v1
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Questions and Answers |100 out of 100|
Grade A- Nightingale
The nurse is caring for a patient in intensive care unit receiving IV lorazepam (Ativan) to reduce
anxiety related to mechanical ventilation. While injecting the medication the nurse notes a
decrease in blood pressure and bradycardia. What is the nurse's priority action?

A)Discontinue drug administration. B)Give the IV drug more slowly.C)Notify the patient's
health care provider. D)Document the reaction to the drug.

Ans:B

Feedback:

The nurse's priority action is to slow the rate of injection because rapid injection of
benzodiazepines can result in hypotension and bradycardia and can lead to cardiac arrest.

For what purpose would the nurse choose to administer a hypnotic instead of another
classification of antianxiety drug?

A)Treating insomniaB)Treating seizure disorder C)Treating panic attachD)Treating confusion

and agitation

Ans:DFeedback:

Hypnotics are used to help people fall asleep by causing sedation. Drugs that are effective
hypnotics act on the reticular activating system (RAS) and block the brain's response to
incoming stimuli. Hypnotics would not be the most effective drugs to treat seizure disorders,
panic attack, or confusion with agitation.

The nurse assesses the patient who had an abrupt withdrawal of benzodiazepines for withdrawal
syndrome and would recognize what symptoms as part of the syndrome? (Select all that apply.)

A)Headache B)Nightmares C)Malaise D)Bradycardia E)Hypotension

Ans:A, B, C Feedback:
 BSN HESI 315 Pharmacology Exam v1
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Questions and Answers |100 out of 100|
Grade A- Nightingale
Abrupt cessation of benzodiazepines may lead to a withdrawal syndrome characterized by
nausea, headache, vertigo, malaise, and nightmares. Withdrawal symptoms may be caused by the
abrupt separation of benzodiazepine molecules from their receptor sites and the resulting acute
decrease in gamma-aminobutyric acid (GABA) neurotransmission. Because GABA is an
inhibitory neurotransmitter, less GABA may produce a less inhibited central nervous system
(CNS) and therefore symptoms of hyperarousal or CNS stimulation. The nurse would not
categorize hypotension or bradycardia as indicating benzodiazepine withdrawal.

A 75-year-old patient is brought to the emergency department by his family. The family relates
that the patient is complaining of confusion, seizures, and abnormal perception of movement.
The nurse reviews all of the medication bottles found in the house and suspects the patient
overdosed on what medication?

A)Benzodiazepine B)Antihypertensive C)Sedative

D)Analgesic

Ans:A Feedback:

Common manifestations of benzodiazepine toxicity include increased anxiety, psychomotor

agitation, insomnia, irritability, headache, tremor, and palpitations. Less common but more
serious manifestations include confusion, abnormal perception of movement, depersonalization,
psychosis, and seizures. These symptoms are not found in association with options B, C, or D.

The nurse is caring for a patient who experiences anxiety and insomnia and is prescribed
benzodiazepines. When developing the plan of care, what would be an appropriate nursing
diagnosis related to potential adverse effects of the drug?

A)Provide patient teaching about drug therapy.

B)Anxiety related to drug therapy.

C)Risk for injury related to central nervous system (CNS) effects.
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Grade A- Nightingale
D)Avoid preventable adverse effects, including abuse and dependence.

Ans:C Feedback:

The most appropriate nursing diagnosis related to adverse effects of the drug is risk for injury
related to CNS effects because benzodiazepines can have many CNS adverse effects. Anxiety is
the condition for which drug therapy is prescribed not related to drug therapy. Patient teaching
and avoiding adverse effects are interventions and not nursing diagnoses.

A patient is being discharged home from the hospital after receiving treatment for pneumonia.
The patient is going home and continuing to take the same drugs he or she was taking before he
or she was hospitalized. These drugs include an antianxiety medication and a medication for
insomnia. The home care nurse is following this patient. On the initial visit what is the nurse's
priority teaching point?

A)The names and purposes of medications prescribed

B)How to contact the provider if needed

C)The importance of taking medications for insomnia only occasionally

D)Warning signs that may indicate serious adverse effects

Ans:D

Feedback:

The home care nurse should provide thorough patient teaching, with a priority teaching point
being the warning signs the patient may experience that indicate a serious adverse effect.
Although this may have been discussed by the discharging nurse in the hospital, this is essential
information for the patient to thoroughly understand. By the time the home care nurse visits, the
patient should already have filled the prescriptions and know the names and purposes of the
medications prescribed from the hospital nurse but it is a good idea to review this information,
although it is not a priority. Medications for insomnia should be taken as prescribed. The patient
should have received the provider's contact information when leaving the hospital but the home
care nurse may need to review this, even though it is not the priority teaching point.
 BSN HESI 315 Pharmacology Exam v1
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Grade A- Nightingale

Hypnotic drugs are used to aid people in falling asleep. What physiological system does a
hypnotic act on to be effective in helping a patient to sleep?

A)Limbic system B)Sympathetic nervous system C)Reticular activating system D)Lymph system
Ans:C
Feedback:

Hypnotics are used to help people fall asleep by causing sedation. Drugs that are effective
hypnotics act on the reticular activating system and block the brain's response to incoming
stimuli. Hypnosis, therefore, is the extreme state of sedation, in which the person no longer
senses or reacts to incoming stimuli. The other options are incorrect.

A patient presents at the emergency department with respiratory depression and excessive
sedation. The family tells the nurse that the patient has been taking medication throughout the
evening and gives the nurse an almost empty bottle of benzodiazepines. What other adverse
effects would the nurse assess this patient for?

A)Seizures B)Tachycardia C)Headache D)Coma

Ans:D Feedback:

Toxic effects of benzodiazepines include excessive sedation, respiratory depression, and coma.
Flumazenil (Anexate) is a specific antidote that competes with benzodiazepines for
benzodiazepine receptors and reverses toxicity. Seizures, tachycardia, and headache would not
normally be associated with benzodiazepine toxicity.

A patient presents at the free clinic complaining of nervousness, worrying about everything, and
feeling very tense. What diagnose would the nurse suspect?
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Grade A- Nightingale
A)Neurosis B)Psychosis C)Anxiety

D)Depression

A patient presents at the free clinic complaining of nervousness, worrying about everything, and
feeling very tense. What diagnose would the nurse suspect?

A)Neurosis B)Psychosis C)Anxiety

D)Depression Ans:C

The nurse is caring for a patient who is taking a benzodiazepine. The nurse knows that caution
should be used when administering a benzodiazepine to the elderly because of what possible
adverse effect?
A)Acute renal failure B)Unpredictable reactions C)Paranoia D)Hallucinations

Ans:B Feedback:

Use benzodiazepines with caution in elderly or debilitated patients because of the possibility of
unpredictable reactions and in patients with renal or hepatic dysfunction, which may alter the
metabolism and excretion of these drugs, resulting in direct toxicity. Dosage adjustments usually
are needed for such patients. Acute renal failure, paranoia, and hallucinations are not commonly
related to therapy with these medications in the elderly.

A 72-year-old patient presents at the emergency department with respiratory depression and
excessive sedation. The family tells the nurse that the patient has been taking medication
throughout the evening. The nurse suspects benzodiazepine overdose and would expect what
drug to be ordered?

A)Valium B)Phenergan C)Hydroxyzine

D)Flumazenil

Ans:D Feedback:
 BSN HESI 315 Pharmacology Exam v1
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Questions and Answers |100 out of 100|
Grade A- Nightingale
Toxic effects of benzodiazepines include excessive sedation, respiratory depression, and coma.
Flumazenil is an antidote for the benzodiazepines. Hydroxyzine is an antihistamine with
anticholinergic effects and would not be appropriate for this patient. Valium would enhance the
effects of benzodiazepines. Phenergan is not indicated for this patient; it is similar in actions to
hydroxyzine.

The nurse is caring for a patient who has not been able to sleep. The physician orders a
barbiturate medication for this patient. What adverse effect should the nurse teach the patient
about?

A)Double vision B)ParanoiaC)TinnitusD)Thinking abnormalities

Ans:D

Feedback:

The most common adverse effects are related to general central nervous system (CNS)
depression. CNS effects may include drowsiness, somnolence, lethargy, ataxia, vertigo, a
resembling a "hangover," thinking abnormalities, paradoxical excitement, anxiety, and
hallucinations. Barbiturate drugs generally do not cause double vision, paranoia, or tinnitus.

An older adult African American patient comes to the clinic and is diagnosed with generalized
anxiety disorder (GAD). The physician orders oral flurazepam 30 mg. What is the nurse's
priority action?

A)Teach the patient about the prescribed medication.

B)Administer the first dose of medication.

C)Tell patient to take first dosage after driving home.

D)Talk to the physician about the dosage.

Ans:DFeedback:
 BSN HESI 315 Pharmacology Exam v1
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Questions and Answers |100 out of 100|
Grade A- Nightingale
If an anxiolytic or hypnotic agent is the drug of choice for an African American patient, the
smallest possible dose should be used, and the patient should be monitored very closely during
the first week of treatment. Dosage adjustments are necessary to achieve the most effective dose
with the fewest adverse effects. In addition, older adults also require careful titration of dosage.
Older patients may be more susceptible to the adverse effects of these drugs, from unanticipated
central nervous system (CNS) adverse effects including increased sedation, dizziness, and even
hallucinations. Dosages of all of these drugs should be reduced and the patient should be
monitored very closely for toxic effects and to provide safety measures if CNS effects do occur.
As a result, the priority action is to talk to the physician about the dosage. The other actions may
be appropriate after a proper dosage is ordered.

The nurse is caring for a patient who has a sedative hypnotic ordered. The nurse would consider
this drug contraindicated if the patient had what disorder?
A)Neurological diseases B)Liver failure C)Endocrine disorders D)Heart disease

Ans:B Feedback:

Benzodiazepines undergo extensive hepatic metabolism. In the presence of liver disease, the
metabolism of most benzodiazepines is slowed, with resultant accumulation and increased risk of
adverse effects. Neurological

disorders, endocrine disorders, and heart disease are not contraindications for the use of
benzodiazepines.

The nurse evaluates teaching as effective when a patient taking a benzodiazepine states,

A)"I should always take the medication with meals."

B)"I should not stop taking this drug without talking to my health care provider first."

C)"I cannot take aspirin with this medication."

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Grade A- Nightingale
D)"I will have to take this medication for the rest of my life."

Ans:B Feedback:

The patient makes a correct statement when saying the drug should not be stopped without
talking to the health care provider first because withdrawal of benzodiazepines require careful
monitoring and should be gradually withdrawn. Medications do not have to be taken with food,
aspirin is not contraindicated, and the medication need only be taken while the condition being
treated continues. Patients with anxiety may only need the medication for a few weeks whereas
those with a seizure disorder may take it for longer periods of time.

The nurse is caring for a patient treated with flumazenil (Anexate) for benzodiazepine toxicity.
After administering flumazenil what will the nurse carefully assess for?

A)Agitation, confusion, and seizures

B)Cerebral hemorrhage and dystonia

C)Hypertension and renal insufficiency

D)Hypotension, dysrhythmias, and cardiac arrest

Ans:A
Feedback:
Administration of flumazenil blocks the action of benzodiazepines. If the patient has been taking
these medications for an extended period of time, the blockage of the drug's effects could
precipitate an acute benzodiazepine withdrawal syndrome with symptoms including agitation,
confusion, and seizures. Anexate does not cause cerebral hemorrhage and dystonia, hypertension,
renal insufficiency, hypotension, dysrhythmias, and cardiac arrest.

The nurse administers promethazine (Phenergan) to the patient before sending the patient to the
preoperative holding area. What is the rationale for administration of this drug?
 BSN HESI 315 Pharmacology Exam v1
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Grade A- Nightingale
A)SedationB)Oral secretions C)Hypotension and bradycardia D)Confusion

Ans:AFeedback:

Antihistamines (promethazine, diphenhydramine [Benadryl]) can be very sedating in some

people. They are used as preoperative medications and postoperatively to decrease the need for
narcotics. Promethazine is not given for hypotension, bradycardia, confusion, or oral secretions.

What reasons can the nurse give for why barbiturates are no longer considered the mainstay for
treatment of anxiety? (Select all that apply.)

A)Adverse effects are more severe.

B)There is an increased risk of physical tolerance.

C)There is an increased risk of psychological dependence.

D)The most common adverse effects are related to cardiac arrhythmias.

E)Hypersensitivity reactions can sometimes be fatal.

Ans:A, B, C, E Feedback:

The adverse effects caused by barbiturates are more severe than those associated with other,
newer sedatives/hypnotics. For this reason, barbiturates are no longer considered the mainstay
for the treatment of anxiety. In addition, the development of physical tolerance and psychological
dependence is more likely with the barbiturates than with other anxiolytics. The most common
adverse effects are related to central nervous system (CNS) depression. Hypersensitivity
reactions to barbiturates are sometimes fatal.

The nurse is teaching a class for nurses working in prenatal clinics about the danger associated
with use of benzodiazepines during pregnancy and explains that what fetal anomalies result from
maternal use of benzodiazepines during the first trimester of pregnancy? (Select all that apply.)

A)Cleft lip or palate B)Inguinal hernia C)Cardiac defects D)Microencephaly E)Gastroschises

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Grade A- Nightingale
Ans:A, B, C, D Feedback:

Benzodiazepines are contraindicated in pregnancy because a predictable syndrome of cleft lip or

palate, inguinal hernia, cardiac defects, microcephaly, or pyloric stenosis occurs when they are
taken in the first trimester. Gastroschises, when the abdominal organs are found outside the
abdominal cavity, is not associated with use of benzodiazepine use in the first trimester.

The nurse is caring for a newborn who was delivered from a woman who took

benzodiazepines for anxiety during the last 2 months of her pregnancy after her husband was
killed in war. What will the nurse assess for in this newborn?

A)Newborn withdrawal syndrome B)Hepatic dysfunctionC)Failure to thriveD)Learning

deficiencies

Ans:A Feedback:

Neonatal withdrawal syndrome may result in a baby born to a mother who was taking
benzodiazepines in the final weeks of pregnancy. The neonate may be given very small doses of
benzodiazepines that are withdrawn gradually to prevent symptoms. Hepatic dysfunction in the
neonate is not associated with use of benzodiazepines. Failure to thrive and learning deficiencies
would be long-term problems and are not assessed during the neonatal period.

The nurse is caring for a patient who received a new diagnosis of cancer. The patient exhibits
signs of a sympathetic stressreaction. What signs and symptoms will the nurse assess in this
patient consistent with an acute reaction to stress? (Select all that apply.)
A)Profuse sweatingB)Fast heart rateC)Rapid breathing D)HypotensionE)Inability to interact
with others

Ans:A, B, C
Feedback:
 BSN HESI 315 Pharmacology Exam v1
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Questions and Answers |100 out of 100|
Grade A- Nightingale
Anxiety is often accompanied by signs and symptoms of the sympathetic stress reaction that may
include sweating, fast heart rate, rapid breathing, and elevated blood pressure. Chronically
anxious people may be afraid to

interact with other people but this is not usually seen in an acute stress reaction.

The nurse is caring for an older adult in the long-term care facility who has begun to display
signs of anxiety and insomnia. What is the priority nursing action?

A)Assess the patient for physical problems.

B)Call the provider and request an antianxiety drug order.

C)Increase the patient's social time, encouraging interaction with others.

D)Suggest the family visit more often to reduce the resident's stress level.

Ans:A Feedback:

The patient should be screened for physical problems, neurological deterioration, or depression,
which could contribute to the insomnia or anxiety. Only after physical problems are ruled out
would the nurse consider nondrug measures such as increased socialization with other residents
or family members. If nothing else is effective, pharmacological intervention may be necessary.

The pharmacology instructor is explaining to their class the difference between the "typical" and
the "atypical" groups of antipsychotic drugs. What medication would the instructor explain to the
students has fewer extrapyramidal effects and greater effectiveness than older antipsychotic
drugs in relieving negative symptoms of schizophrenia?

A)Chlorpromazine (Thorazine) B)Clozapine (Clozaril) C)Thiothixene (Navane) D)Haloperidol

(Haldol)
Ans:B Feedback:Advantages of clozapine include improvement of negative symptoms without
causing the extrapyramidal effects associated with older antipsychotic drugs. Chlorpromazine is
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a typical antipsychotic, one of the older drugs, which does cause the extrapyramidal effects.
Navane is part of the thioxanthene group of typical antipsychotics. This group of drugs has low
sedative and hypotensive effects but can cause extrapyramidal effects. Haloperidol is a
butyrophenone group drug used in psychiatric disorders. Usually, it produces a relatively low
incidence of hypotension and sedation and a high incidence of extrapyramidal effects.

The nurse, providing teaching about a typical antipsychotic newly prescribed for the patient,
cautions against use of alcohol with the drug by explaining it will have what effect?
A)Prolonged QT interval

B)Increased central nervous system (CNS) depression

C)Increased anticholinergic effects

D)Increased gastrointestinal (GI) adverse effects

Ans:B Feedback:

Antipsychotic-alcohol combinations combinations result in an increased risk of CNS depression,

and antipsychotic- anticholinergic combinations lead to increased anticholinergic effects, so
dosage adjustments are necessary. Patients should not take thioridazine or ziprasidone with any
other drug associated with prolongation of the QT interval. Increase in GI adverse effects is not
associated with concurrent use of alcohol.

The nurse is caring for four patients. Which patient would the nurse know that clozapine
(Clozaril) is contraindicated for?

A)17-year-old adolescent B)23-year-old with diabetes insipidus

C)32-year-old with osteoarthritis D)45-year-old with bone marrow depression

Ans:DFeedback:
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Clozapine is associated with bone marrow suppression, a life-threatening decrease in white blood
cells. Because of their wide- ranging adverse effects, antipsychotic drugs may cause or aggravate
various conditions. They should be used very cautiously in patients with liver damage, coronary
artery disease, cerebrovascular disease, Parkinsonism, bone marrow depression, severe
hypotension or hypertension, coma, or severely depressed states. Options A, B, and C are
incorrect.

The physician has ordered olanzapine (Zyprexa) for a new patient. What laboratory test should
be done before administration of olanzapine?

A)Blood glucoseB)Urine specific gravity C)CholesterolD)Hemoglobin and hematocrit

Ans:AFeedback:

Olanzapine has been associated with weight gain, hyperglycemia, and initiation or aggravation of
diabetes mellitus. Other options are not necessary for patients taking olanzapine unless a
secondary diagnosis indicates a need.

Parents bring a 15-year-old boy into the clinic. The parents tell the nurse that there is a family
history of schizophrenia and they fear their son has developed the disease. What symptoms, if
described by the family, would support their conclusion?

A)"He hears and interacts with voices no one else can hear."
B)"He is overactive and always so excitable." C)"He falls asleep in the middle of a sentence."

D)"He cannot concentrate and his grades are suffering."

Ans:A Feedback:

Characteristics of schizophrenia include hallucinations, paranoia, delusions, speech

abnormalities, and affective problems. Overactivity and excitement are associated with mania.
Falling asleep suddenly describes narcolepsy. Difficulty concentrating and failing grades is
associated with attention deficient disorders.
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The nurse admits a patient newly diagnosed with schizophrenia to the inpatient mental health
unit. What is the priority reason for why the nurse includes the family when collecting the
nursing history?

A)The patient may not be able to provide a coherent history.

B)The patient may not be able to speak due to reduced level of consciousness.

C)The family will feel better if they are included in the process.

D)The patient will be less anxious if the family listens while he answers questions.
Ans:A

Feedback:

Schizophrenia, the most common psychosis, is characterized by delusions, hallucinations, and

inappropriate responses to stimuli. As a result, the patient may be unable to provide a coherent
history and may be unaware of his behaviors considered dysfunctional. There is no reason to
suspect the patient cannot speak and reducing anxiety is not the priority rationale for including
family. While family is included in treatment, the goal is to treat the patient and not make the
family feel better if actions were not in the patient's best interests.

The nurse is teaching the soon-to-be- discharged patient, diagnosed with schizophrenia, about his
medications. What is a priority teaching point for this patient?

A)The patient must eat three nutritious meals daily.

B)Over-the-counter medications may be taken with antipsychotic drugs.

C)Cough medicines potentiate the actions of antipsychotic drugs.

D)Alcohol consumption should be avoided.

Ans:DFeedback:
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Alcohol consumption should be avoided because it increases the central nervous system (CNS)
effects of the drug and may cause excessive drowsiness and decreased awareness of safety
hazards in the environment. Some patients may find it easier and more effective to eat five small
meals rather than three nutritious meals. While promoting good nutrition is good practice, it is
not the priority. Drug-drug interactions with antipsychotic drugs are common so the nurse would
teach the patient not to take any medication without consulting with the doctor or a pharmacist to
make sure it is safe.

What antiepileptic medication might the nurse administer to treat bipolar disorder?

A)Apriprazole (Abilify) B)Cyclobenzaprine (Flexeril) C)Lamotrigine (Lamictal) D)Temazepam

(Restoril)

Ans:C

Feedback:
Lamotrigine is an antiepileptic agent used for long-term maintenance of patients with bipolar
disorders because it decreases occurrence of acute mood episodes.
Apriprazole is an atypical antipsychotic and is not an antiepileptic medication. Flexeril is a
muscle relaxant and Temazepam is a hypnotic agent. None of these medications are indicated for
the treatment of bipolar disorder.

A patient, who is 77 years old, is admitted with a diagnosis of dementia. Haloperidol (Haldol)
has been ordered for this patient. What nursing considerations would govern the nurse's actions?
(Select all that apply.)

A)It is classed as an atypical antipsychotic.

B)A lowered dosage is indicated for older adult.

C)It often has a hyperactive effect on patients.
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D)It should not be used to control behavior with dementia.

E)It should only be given every other day.

Ans:B, DFeedback:

Haloperidol is classified as a typical antipsychotic with a high risk of extrapyramidal effects and
lower risk for hypotension and sedation. Older patients may be more susceptible to the adverse
effects of antipsychotic drugs. All dosages need to be reduced and patients monitored very
closely for toxic effects and to provide safety measures if central nervous system effects do
occur. They should not be used to control behavior with dementia. Haloperidol does not have a
hyperactive effect on patients; it should not be given on an every-other-day schedule.

Which drug does not have a recommended pediatric dose?

A)Pimozide (Orap) B)Lithium salts (Lithotabs) C)Haloperidol (Haldol) D)Risperidone

(Risperdal)

Ans:B

Feedback:

Lithium does not have a recommended pediatric dose; the drug should not be administered to
children younger than 12 years old. Pimozide, haloperidol, and risperidone all have
recommended pediatric doses.

The mother of a child diagnosed with attention-deficit syndrome receives a prescription for a
central nervous system (CNS) stimulant to treat her child. The mother asks the nurse, "I don't
understand why we're giving a stimulant to calm him down?" What is the nurse's best response to
this mother?

A)"It helps the reticular activating system (RAS), a part of the brain, to be more selective in
response to incoming stimuli."
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B)"It helps energize the child so they use up all of their available energy and then they can focus
on quieter stimuli."

C)"No one truly understands why it works but it has been demonstrated to be very effective in
treating ADHD."

D)"The drugs work really well and you will see a tremendous change in your child within a few
weeks without any other treatment."

Ans:A Feedback:

The paradoxical effect of calming hyperexcitability through CNS stimulation seen in attention-
deficit syndrome is believed to be related to increased stimulation of an immature RAS, which
leads to the ability to be more selective in response to incoming stimuli. CNS stimulants do not
cause the child to use all his energy, the effect is thought to be understood, and telling the mother
the drug just works without any explanation is not appropriate and may result in noncompliance
with pharmacology therapy if the mother does not understand why the drug is given.

The nurse is teaching the mother of a child diagnosed with attention-deficit hyperactivity
disorder how to administer methylphenidate (Ritalin). When would the nurse instruct the mother
to administer this drug?

A)"Administer at lunch every day." B)"Administer at breakfast every day." C)"Administer at

dinner every day." D)"Administer at bedtime."

Ans:B Feedback:

Several long-acting formulations of methylphenidate have become available that allow the drug
to be given only once a day. It should always be given in the morning because administration at
dinnertime or bedtime could result in insomnia.
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A child was diagnosed with attention-deficit hyperactivity disorder and methylphenidate was
prescribed for treatment to be taken once a day in a sustained release form. On future visits what
is a priority nursing assessment for this child?

A)Weight and height

B)Breath sounds and respiratory rate

C)Urine output and kidney function

D)Electrocardiogram (ECG) and echocardiogram

Ans:A

Feedback:
The nurse needs to carefully track this child's weight and height because the drug can cause
weight loss, anorexia, and nausea that could result in slowed or absent growth. There would be
no need to monitor breath sounds, respiratory rate, urine output, and kidney function. Although
arrhythmias may occur as an adverse effect necessitating an ECG, there is no need to perform
echocardiograms.

The nurse is preparing to administer methylphenidate to the child admitted to the pediatric unit
after breaking a leg when jumping off the garage roof at home. Where will the nurse find the
medication?

A)In the patient's drawerB)In the refrigeratorC)At the patient's bedsideD)In the controlled
substance cabinet

Ans:D

Feedback:

Methylphenidate is a controlled medication due to risk for physical and psychological

dependence. As a result, the drug would be found in the controlled substance cabinet.
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The nurse is caring for a child receiving a central nervous system (CNS) stimulant who was
admitted to the pediatric intensive care unit following repeated seizures after a closed head
injury. The physician orders phenytoin to control seizures and lorazepam to be administered
every time the child has a seizure. What is the nurse's priority action?

A)Call the doctor and question the administration of phenytoin.

B)Call the doctor and question the administration of lorazepam.

C)Wait 24 hours before beginning to administer phenytoin.

D)Wait 24 hours before beginning to administer lorazepam.

Ans:A Feedback:

The combination of CNS stimulants with phenytoin leads to a risk of increased drug levels.
Patients who receive such a combination should be monitored for toxicity. There is no
contraindication for use of lorazepam.

A 20-year-old female patient has been diagnosed with multiple sclerosis. What drug will most
likely be prescribed?
A)Baclofen (Lioresal) B)Cyclobenzaprine (Flexeril) C)Metaxalone (Skelaxin) D)Orphenadrine
(Banflex)

Ans:A
Feedback:

Baclofen is used for treatment of muscle spasticity associated with neuromuscular diseases such
as multiple sclerosis. Cyclobenzaprine, metaxalone, and orphenadrine are used for relief of
discomfort associated with painful, acute musculoskeletal conditions.
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The nurse is caring for four patients. Which patient would have the highest risk for
hepatotoxicity from dantrolene (Dantrium)?

A)An 87-year-old man who is taking a cardiac glycosideh

B)A 32-year-old man who is taking an antipsychotic drug
C)A 65-year-old woman who is on hormone replacement therapy

D)A 48-year-old woman who is taking an antihypertensive agent

Ans:C Feedback:

If dantrolene is combined with estrogen, the incidence of hepatocellular toxicity is increased.

This combination should be avoided. Nothing indicates that patients taking a cardiac glycoside,
an antipsychotic drug, and an antihypertensive would have serious adverse effects when
combined with dantrolene therapy.

The nurse alerts the patient to what adverse effect of tizanidine (Zanaflex) that could cause
injury?

A)Constipation B)Dry mouth C)Fatigue D)Hypotension

Ans:D Feedback:

Tizanidine has been associated with hypotension, which could be a safety risk especially if the
patient is also taking an antihypertensive drug. Constipation, dry mouth, and fatigue are common
adverse effects that do not pose a safety risk.

A young woman attends a "Botox Party" and is injected with botulinum toxin type A to decrease
"frown lines" between her eyebrows. Later that evening the patient is admitted to the emergency
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department and is hysterical, because she cannot move her eyebrows. The nurse explains that
that toxin causes what?

A)"The toxin causes muscle death, which smoothes wrinkles in the area."

B)"The toxin causes muscle paralysis, preventing movement and relieving wrinkles."

C)"The drug is a toxin to nerves in the area."

D)"The drug is a permanent muscle relaxant and the muscles will never move again."
Ans:B Feedback:

Botulinum toxin types A and B bind directly to the receptor sites of motor nerve terminals and
inhibit the release of acetylcholine, leading to local muscle paralysis. These two drugs are
injected locally and used to paralyze or prevent the contractions of specific muscle groups. The
action smoothes wrinkles in the area, but does not cause muscle death. The effect is temporary
and does not cause nerve death. The other options are false statements.

A patient has stepped on a rusty nail and is exhibiting signs of muscle rigidity and contractions.
The patient's wife called the

emergency department (ED) and the triage nurse told her to bring him in. The ED nurse will
have which drug available for administration when the patient arrives?

A)Carisoprodol (Soma) B)Cyclobenzaprine (Flexeril) C)Metaxalone (Skelaxin)

D)Methocarbamol (Robaxin)

Ans:D

Feedback:

The patient is exhibiting signs of tetanus and methocarbamol (Robaxin) is indicated for
treatment. Carisoprodol, cyclobenzaprine, and metaxalone are not used to treat tetanus.
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The nurse assesses a newly admitted patient and finds the muscle tone in his left leg has
sustained muscle contraction. How will the nurse document this finding?

A)Tonus B)Flaccid C)Atonic D)Spastic

Ans:D Feedback:

Muscle spasticity is defined as a sustained muscle contraction. Soft and flabby muscle tone is
defined as atonic. A limp muscle without tone is described as flaccid. The state of readiness,
known as muscle tone (tonus), is produced by the maintenance of some of the muscle fibers in a
contracted state.

A patient comes to the clinic to receive a Botox injection in her forehead. The patient has adult
acne across her forehead. What is the nurse's priority action?

A)Hold the injection and consult the health care provider.

B)Cleanse the area well with an antibacterial soap.

C)Apply a topical antibiotic after administering the Botox.

D)Provide patient information about post- Botox injection care.

Ans:A Feedback:

Botulinum toxins should not be injected into any area with an active infection because of the risk
of exacerbation of the infection. As a result, the nurse would hold the injection and consult with
the physician, with the expectation the medication would be held until the acne resolved.
Cleansing the area well, applying a topical antibiotic, and providing information about
postinjection care would not resolve the problem and are not indicated.

The patient presents to the emergency department with muscle spasms in the back. What types of
injury would the nurse recognize can result in muscle spasm? (Select all that apply.)
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A)Overstretching a muscle B)Wrenching a jointC)Tearing a tendon or ligament D)Breaking a
bone E)Exercising too vigorously.

Ans:A, B, C

Feedback:

Muscle spasms often result from injury to the musculoskeletal system (e.g., overstretching a
muscle, wrenching a joint, tearing a tendon or ligament). These injuries can cause violent and
painful involuntary muscle contractions. Breaking a bone or exercising would not cause muscle
spasms unless one of the other options was involved.

The nurse is giving discharge instructions to a patient who just had Botox A injections around her
eyes. What adverse effects would

the nurse include in her discharge instructions? (Select all that apply.)

A)Respiratory infections B)Flu-like syndrome C)Droopy eyelids D)Cough

E)Diarrhea
Ans:A, B, C Feedback:

Adverse effects associated with use of botulinum toxin type A for cosmetic purposes include
headache, respiratory infections, flu- like syndrome, and droopy eyelids in severe cases. Adverse
effects do not include cough or diarrhea.

A patient with severe spasticity sees his physician. The physician orders dantrolene. In what
circumstances is the drug dantrolene contraindicated?
A)Spasticity that contributes to upright position
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B)Spasticity that involves both legs

C)Spasticity that involves the arm and the leg on the same side

D)Spasticity that contributes to mobility

Ans:AFeedback:
Dantrolene is contraindicated in the presence of any known allergy to the drug. It is also
contraindicated in the following conditions: spasticity that contributes to locomotion, upright
position, or increased function, which would be lost if that spasticity was blocked; active hepatic
disease, which might interfere with metabolism of the drug and because of known liver toxicity;
and lactation because the drug may cross into breast milk and cause adverse effects in the infant.
The other options would not contraindicate the medication.

Which muscle relaxant was found to be embryotoxic in animal studies?

A)Carisoprodol (Soma) B)Botulinum toxin A (Botox) C)Cyclobenzaprine (Flexeril)

D)Dantrolene (Dantrium)

Ans:D

Feedback:
Dantrolene crosses the placenta and was found to be embryotoxic in animal studies. Botulinum
toxin A, carisoprodol, and cyclobenzaprine are not known to be embryotoxic.

When spinal reflexes involve synapses with interneurons within the spinal cord, what
physiological adjustments are made?
A)Coordinate movement and position B)Adjust response and recovery C)Adjust to upright
position D)Coordinate balance
Ans:A Feedback:
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Other spinal reflexes may involve synapses with interneurons within the spinal cord, which
adjust movement and response based on information from higher brain centers to coordinate
movement and position. Spinal reflexes do not adjust response and recovery, adjust the body to
the upright position, or coordinate balance.

What are the simplest nerve pathways in the body?

A)Arc reflexesB)Spinal reflexes C)Afferent nerve reflexes D)Spindle gamma loop

Ans:B Feedback:

The spinal reflexes are the simplest nerve pathways that monitor movement and posture. Arc
reflexes and afferent nerve reflexes are distracters for this question. Spindle gamma loops
respond to stretch receptors.

The anatomy and physiology instructor is discussing reflex systems with the prenursing class.
What system would the instructor say causes a muscle fiber contraction that relieves the stretch?
A)Arch reflex systemB)Spinal reflex system C)Spindle gamma loop system D)Stretch receptor
system

Ans:CFeedback:

A spindle gamma loop system responds to stretch receptors or spindles on muscle fibers to cause
a muscle fiber contraction that relieves the stretch. In this system, nerves from stretch receptors
form a synapse with gamma nerves in the spinal cord, which send an impulse to the stretched
muscle fibers to stimulate their contraction. These reflexes are responsible for maintaining
muscle tone and keeping an upright position against the pull of gravity and are important in
helping venous return when the contracting muscle fibers massage veins to help move the blood
toward the heart. The arch reflex system and the stretch receptor system are distracters for this
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question. The spinal reflex system is not the reflex systems that respond to stretch receptors in
the body.

A 3-year-old girl with a diagnosis of spasticity caused by cerebral palsy has been admitted to the
unit. The physician has ordered dantrolene to see if it relieves the spasticity in the child's arms
and hands. The nurse would

schedule this child for what routine screenings?

A)Central nervous system and gastrointestinal (GI) function

B)Respiratory and cardiovascular (CV) function

C)Growth and development D)Renal and hepatic function

Ans:AFeedback:

Children prescribed dantrolene should be routinely and regularly screened for central nervous
system and gastrointestinal (including hepatic) toxicity. Growth and development should be
routinely screened in all children. Renal, respiratory, and CV screening is not indicated.

According to the sliding filament theory, what is the initial action in a muscle contraction?

A)Troponin is freed and prevents actin and myosin from reacting with each other.

B)Calcium binds to troponin, which causes the release of actin and myosin binding sites.

C)Actin and myosin molecules react with each other sliding along the filament and making it
shorter.

D)Muscle filament relaxes or slides back to the resting position.

Ans:C Feedback:
Actin and myosin molecules react with each other again and again, sliding along the filament and
making it shorter. This is a contraction of the muscle fiber according to the sliding filament
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theory. As the calcium is removed from the cell during repolarization of the muscle membrane,
the troponin is freed and once again prevents the actin and myosin from reacting with each other.
The muscle filament then relaxes or slides back to the resting position. Muscle tone results from
a dynamic balance between excitatory and inhibitory impulses to the muscle.

When causing depolarization of the muscle membranes, what neurotransmitter interacts with the
nicotinic cholinergic receptors leading to the release of calcium ions?

A)AcetylcholineB)SerotoninC)D-gluconamidoethyl methacrylate (GAMA) D)Epinephrine

Ans:AFeedback:

At the acetylcholine receptor site on the effector's side of the synapse, the acetylcholine interacts
with the nicotinic cholinergic receptors causing the depolarization. Serotonin, GAMA, and
epinephrine are not part of muscle contraction and relaxation.

The nurse, working in the preoperative holding area, is caring for a 70-year-old patient who is
scheduled to receive succinylcholine as part of general anesthesia. When collecting the nursing
history, what condition would require the nurse to notify the anesthesiologist of the need for
caution?

A)Bone fracture B)MalnutritionC)Fluid volume overload D)Narrow-angle glaucoma

E)Pregnancy
Ans:A, B, DFeedback:

Succinylcholine should be used with caution in patients with fractures because the muscle
contractions it causes might lead to additional trauma; in patients with narrow-angle glaucoma or
penetrating eye injuries because intraocular pressure increases. Extreme

caution is necessary in the presence of genetic or disease-related conditions causing low plasma
cholinesterase levels (e.g., cirrhosis, metabolic disorders, carcinoma, burns, dehydration,
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malnutrition, hyperpyrexia, thyroid toxicosis, collagen diseases, exposure to neurotoxic
insecticides).

The nurse is caring for a patient who received succinylcholine during surgery. The nurse would
expect the patient to spend more time in the postanesthesia care unit due to prolonged paralysis
and inability to breathe if the patient was from what ethnic group?

A)American Japanese B)Alaskan Eskimos C)Native Americans D)Hawaiian natives

Ans:B

Feedback:

Alaskan Eskimos belong to a genetic group that is predisposed to low plasma cholinesterase
levels, making them susceptible to prolonged paralysis after succinylcholine use. The other
ethnic groups do not have this genetic predisposition.

A patient scheduled for surgery is to have a nondepolarizing neuromuscular junction (NMJ)

blocker as adjunctive anesthesia. The nurse will have cause for concern about prolonged
paralysis if the patient has been taking what medication?

A)An aminoglycoside B)AminophyllineC)A barbiturate anesthetic D)A cephalosporin

Feedback:

Combining nondepolarizing NMJ blockers with aminoglycosides can result in prolonged

paralysis, and this combination should be avoided. This interaction does not occur with
barbiturate anesthetics, cephalosporins, or aminophylline.

A patient is having outpatient surgery that should last only 45 minutes. The patient is planning to
go home immediately after the surgery is complete. What nondepolarizing neuromuscular
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junction blocker will most likely be used as an adjunct therapy to general anesthesia for this
patient?

A)Atracurium (Tracrium) B)Cisatracurium (Nimbex) C)Pancuronium (Pavulon) D)Rocuronium

(Zemuron)

Ans:D

Fedback:

Rocuronium has a rapid onset of action and a short duration, making it a drug of choice for
outpatient surgical procedures when the patient will be leaving to go home and will need to be
awake, alert, and mobile. Atracurium, cisatracurium, and pancuronium are associated with longer
paralysis and recovery.

A patient is taking aminophylline for their chronic obstructive pulmonary disease. The patient is
about to undergo emergency surgery and will receive an neuromuscular junction (NMJ) blocker
as part of the procedure. It is important for the nurse to take what action?

A)Make sure the patient receives the aminophylline on a regular schedule to maintain therapeutic
levels.

B)Monitor the patient very closely for signs of early arousal and return of muscle function.

C)Carefully explain all that is going on because the patient will be unable to talk.

D)Switch the patient to theophyllines before the procedure begins.

Ans:B Feedback:

Aminophylline can cause a decreased effectiveness of NMJ blockers, leading to reduced

paralysis and early return of movement. If a patient has emergency surgery and has been taking
aminophylline, the patient should be carefully monitored for early arousal and return of
movement. The patient will not be awake during surgery using an NMJ blocker and will be
intubated to ensure respirations. Aminophylline and other xanthine derivatives like the
theophyllines will have the same effect.
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The nurse is caring for a patient who is being maintained on mechanical ventilation. Atracurium
is administered to limit the resistance to mechanical ventilation. What is the nurse's priority
assessment?

A)Hypotension B)Tachycardia C)Bradycardia D)Increased secretions

Ans:C

Feedback:

Bradycardia is a common adverse effect associated with atracurium. The nurse should monitor
the patient regularly to avoid serious adverse effects. Increased secretions and hypotension are
common with tubocurarine. Option B is a distracter.

The nurse is preparing a patient for surgery who will receive a neuromuscular junction blocker
during the procedure. It is important for the nurse to review the patient's medication history for
concurrent use of what?

A)Angiotensin-converting enzyme (ACE) inhibitors

B)Beta blockers
C)Calcium channel blockers
D)Montelukast

Ans:C

Feedback:

When calcium channel blockers are used concurrently with neuromuscular junction blockers, the
patient is at increased risk of prolonged paralysis. The dose of the neuromuscular junction
blocker should be lowered if this combination cannot be avoided and the patient should be
monitored closely. There is no anticipated drug-drug interaction with ACE inhibitors, beta
blockers, or montelukast.
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Questions and Answers |100 out of 100|
Grade A- Nightingale

An elderly patient has received a neuromuscular junction blocker during surgery. What would be
an appropriate nursing diagnosis for this patient?

A)Excess fluid volumeB)Risk for impaired skin integrity C)Deficient fluid volume D)Chronic
confusion

Ans:BFeedback:

An elderly or frail patient will need extra nursing care to prevent skin breakdown during the
period of paralysis because skin tends to be thinner and more susceptible to breakdown.
Therefore, risk of impaired skin integrity would be an appropriate nursing diagnosis. Fluid
excess or deficit should not be a concern and the patient may be acutely confused when
awakening, but there is no reason to think he or she would remain chronically confused if he was
not before surgery.

What are the primary uses of neuromuscular junction blockers (NMJ) blockers? (Select all that
apply.)
A)To facilitate endotracheal intubation

B)To sedate patient for general anesthesia

C)To prevent injury during electroconvulsive therapy

D)To provide greater ease in extubating patient

E)To facilitate mechanical ventilation

Ans:A, C, EFeedback:

NMJ blockers are primarily used as adjuncts to general anesthesia, to facilitate endotracheal
intubation, to facilitate mechanical ventilation, and to prevent injury during electroconvulsive
therapy. NMJ blockers do not sedate the patient who will be paralyzed after administration but
will remain alert unless another medication is given. These medications would not be given
before extubation because respiratory muscles would be paralyzed, resulting in the inability to
breathe.
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Grade A- Nightingale

The pharmacology instructor is discussing nondepolarizing neuromuscular junction blockers

(NMJ) blockers with the nursing class. How would the instructor explain the action of
nondepolarizing NMJ blockers?

A)Blocks acetylcholine (ACh) from acting B)Acts like ACh then prevents repolarization

C)Takes the place of ACh in the depolarizing/repolarizing process

D)Stops depolarization in the axion

Ans:BFeedback:
Depolarizing NMJ blockers cause muscle paralysis by acting like ACh. They excite (depolarize)
the muscle and prevent repolarization and further stimulation. Options A, C, and D are incorrect.

A patient is to have surgery and it is planned that atracurium (Tracrium) is to be used as an

adjunct to general anesthesia. How will the atracurium work?

A)Act as agonist to acetylcholine B)Stops depolarization in the axion C)Act as antagonist to

acetylcholine D)Stops repolarization in the axion

Ans:C

Feedback:

Nondepolarizing neuromuscular junction blockers compete with acetylcholine (ACh) for the
ACh receptor site and after they occupy the site, stimulation cannot occur. This results in
paralysis because the muscle cannot respond. Other options are incorrect.
 BSN HESI 315 Pharmacology Exam v1
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Grade A- Nightingale
The nurse is caring for a patient who is receiving pancuronium (Pavulon) to facilitate mechanical
ventilation. The patient is also receiving a barbiturate. How will the nurse administer these two
medications?

A)They can be mixed and given in the same syringe.

B)Administer IM quickly after mixing the two drugs.

C)Shake vigorously when mixed in one syringe.

D)If given together, a precipitate may form.

Ans:DFeedback:

Do not mix this drug with any alkaline solutions such as barbiturates because a precipitate may
form, making it inappropriate for use. Pancuronium is only given IV. Shaking does not prevent
precipitation.

The nurse is caring for a patient who is scheduled for abdominal surgery in the morning and is
scheduled to receive rocuronium (Zemuron). The patient asks the nurse to describe the adverse
effects of

rocuronium. What would the nurse describe for the patient?

A)"This drug is associated with pulmonary hypertension."
B)"This drug contains benzyl alcohol." C)"This drug is associated with bradycardia."

D)"This drug is associated with an increased heart rate."

Ans:A Feedback:

Rocuronium may be associated with pulmonary hypertension. Cisatracurium (Nimbex) contains

benzyl alcohol; Atracurium (Tracrium) is associated with bradycardia; and Pancuronium
(Pavulon) is associated with an increased heart rate.
 BSN HESI 315 Pharmacology Exam v1
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Grade A- Nightingale
The nurse is discussing the endocrine system with a class of nursing students. What substance
would the nurse label as a hormone?

A)Acetylcholine B)Norepinephrine C)Nucleic acid D)Serotonin

Ans:B

Feedback:
A hormone is secreted directly into the bloodstream and travels from the site of production to
react with specific receptor sites to cause an action. Norepinephrine, which is a neurotransmitter,
is a hormone when it is produced in the adrenal medulla, secreted into circulation, and travels to
norepinephrine receptor sites to cause an effect. Acetylcholine and serotonin are
neurotransmitters, but are not hormones. Nucleic acid is used to build deoxyribonucleic acid and
ribonucleic acid.

What organ should the nurse recognize as the coordinating center for the nervous and endocrine
responses to internal and external stimuli?

A)Hypothalamus B)Pituitary gland C)Thyroid gland D)Parathyroid gland

Ans:A

Feedback:

The hypothalamus is the coordinating center for the nervous and endocrine responses to internal
and external stimuli. The pituitary, thyroid, and parathyroid glands all play an important role in
maintaining homeostasis, but they do not connect the nervous and endocrine systems.

What criteria can the nurse use to describe all hormones?

A)They are produced in very large amounts.

B)They circulate until they are used by receptor cells.
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C)They are secreted directly into the tissue where they react.

D)They travel in the blood to specific receptor sites.

Ans:D Feedback:

Hormones are chemicals that are produced in the body and meet specific criteria. All hormones
are produced in very small amounts and are secreted directly into the bloodstream. They travel in
the blood to specific receptor sites throughout the body and are immediately broken down.

The nurse is caring for a patient with abnormal calcium levels. What thyroid hormone does the
nurse expect this will impact?

A)Aldosterone B)Calcitonin C)Erythropoietin D)Insulin

Ans:B Feedback:

Calcitonin is produced and secreted by the thyroid gland in direct response to serum calcium
levels. Aldosterone is an adrenocorticoid hormone that is released in response to
adrenocorticotropic hormone. Erythropoietin is released by the juxtaglomerular cells in the
kidney in response to decreased pressure or decreased oxygenation of the blood flowing into the
glomerulus. Insulin is produced by the pancreas in response to varying blood glucose levels.

The nurse explains the end result of the hypothalamus in regulating the central nervous system
(CNS), autonomic nervous system (ANS), and endocrine system is what?

A)Regulation of the negative feedback system

B)Creation of a diurnal rhythm

C)Maintenance of homeostasis

D)Production of prolactin-inhibiting factor (PIF)

Ans:C Feedback:
 BSN HESI 315 Pharmacology Exam v1
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Grade A- Nightingale
The hypothalamus maintains internal homeostasis by sensing blood chemistries and by
stimulating or suppressing endocrine, autonomic, and CNS activity. In essence, it can turn the
ANS and its effects on or off. The negative feedback system is one way homeostasis is
maintained. When the hypothalamus senses a need for a particular hormone, it secretes a
releasing factor directly into an area such as the anterior pituitary. This causes the area to produce
a hormone. When the hypothalamus senses a rising level of the hormone it stops secreting the
releasing factor, which decreases the hormone production. When this occurs the hypothalamus
senses the falling hormone level and the releasing factor is secreted again. This process is how
the hormone level is maintained. Diurnal rhythm refers to the release of hormones at various
times of the day. PIF, produced by the hypothalamus, acts as a regulator to shut off production of
hormones when levels become too high.

While caring for a diabetic patient, the nurse explains that normally insulin is produced by the
pancreas and does what when reacting with the human cell?

A)Metabolizes glucose B)Allows water to enter the cell

C)Alters cellular messenger ribonucleic acid (RNA)

D)Changes the cell permeability to glucose

Ans:DFeedback:

Insulin reacts with specific receptor sites on the cell membrane to change the cell's permeability
to glucose to allow glucose to enter the cell. It does not affect water transport or messenger RNA.
Insulin does not metabolize glucose but rather helps it move into the cell where it supplies
energy for cellular activity.

What hormone enters the cell and reacts with a receptor inside the cell to change messenger
ribonucleic acid and affect the cell's function?
A)EstrogenB)InsulinC)Calcitonin D)Thyroid-stimulating hormone
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Grade A- Nightingale
Ans:A

Feedback:

Estrogen enters the cell and reacts with a receptor site inside of the cell to make changes and
produce an action. This does not happen quickly, and it may take months to years to produce the
changes. Estrogen, calcitonin, and thyroid-stimulating hormone react with specific receptor sites
on the cell membrane to stimulate change and action within the cell.

The patient's body modulates pain perception as a result of the production of what in the
intermediate lobe of the pituitary gland?

A)Antidiuretic hormone (ADH) B)EndorphinsC)Adrenocorticotropic hormone (ACTH)

D)Oxytocin

Ans:B Feedback:

Endorphins and enkephalins are produced by the intermediate lobe of the pituitary gland.
Oxytocin and ADH are produced by the posterior pituitary gland, and ACTH is produced by the
anterior pituitary gland.

The nurse explains the purpose of the negative feedback system used by the endocrine system is
what?

A)To change the environment of the pituitary gland

B)To regulate hormone release

C)To maintain hormone concentration at a certain level

D)To control the action of hormones

Ans:CFeedback:
 BSN HESI 315 Pharmacology Exam v1
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Grade A- Nightingale
The negative feedback system is a control system in which increasing levels of a hormone lead to
decreased levels of releasing and stimulating hormones, leading to decreased hormone levels,
which stimulates the release of releasing and stimulating hormones; it allows tight control of the
endocrine system. It does not involve changing the environment or control the action of
hormones.

Melanocyte-stimulating hormone (MSH) released from the anterior pituitary is important in

humans because of its suspected ability to do what?

A)Block the perception of pain

B)Change the color of skin in some environments

C)Stimulate fat mobilizationD)Stimulate nerve growth and development

Ans:DFeedback:

MSH might be important for nerve growth and development in humans. Animals use MSH to
change skin color as part of protective camouflage, but it does not have this effect in humans.
Lipotropins stimulate fat mobilization. Endorphins and enkephalins are hormones that block the
perception of pain.

The nurse is caring for a patient diagnosed with a condition resulting in inadequate production of
cholecystokinin. What would the nurse expect to find when assessing this patient?

A)Elevated serum sodium and reduced serum potassium levels

B)Decreased bowel sounds C)Increased numbers of red blood cells D)Increased serum calcium
levels
Ans:BFeedback:
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Grade A- Nightingale
Cholecystokinin is secreted by the intestine and decreases gastric movement resulting in
diminished bowel sounds as well as stimulation of bile and pancreatic juice secretion.
Aldosterone causes sodium

retention and potassium excretion. Erythropoietin increases red blood cell production.
Parathyroid hormone causes an increase in serum calcium levels.

A group of nursing students are developing a presentation on hormones. What hormone will the
students' presentation identify as regulating the metabolic rate and influencing the growth and
development of the body?

A)Parathyroid hormone or parathormone B)Thyroid hormoneC)CortisolD)Insulin

Ans:B Feedback:

Thyroid hormone regulates the metabolic rate of the body and greatly influence growth and
development. Parathormone, cortisol, and insulin do not regulate the metabolic rate or influence
growth and development.

The patient's anterior pituitary hormone secretion is impacted by time of day and activity level,
which the nurse assesses as what?

A)Diurnal rhythm B)Physiological rhythm C)Circadian rhythm D)Biannual rhythm

Ans:A

Feedback:
The anterior pituitary hormones are released in a rhythmic manner into the bloodstream. Their
secretion varies with time of day (often referred to as diurnal rhythm) or with physiological
conditions, such as exercise or sleep. A biannual rhythm would be twice a year. Circadian rhythm
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Grade A- Nightingale
is indicated by when the patient prefers to sleep or wake, such as those who describe themselves
as "morning people." There is no such thing as a physiological rhythm.

Some hormones react with specific receptor sites on a cell membrane and stimulate what?
A)MeiosisB)Cyclic adenosine monophosphate (cAMP) C)Increase in hormonal inactivity
D)Decrease in hormonal activity

Ans:BFeedback:

Some hormones react with specific receptor sites on a cell membrane to stimulate the nucleotide
cAMP within the cell to elicit an effect. Hormones that react with specific receptor sites do not
stimulate miosis, or a change in amount of hormonal activity, either an increase or decrease,
which would be regulated by a negative feedback mechanism.

Estrogen enters the cell and reacts with a receptor site. What is the final result of this reaction?

A)Deoxyribonucleic acid (DNA) is affected. B)Ribonucleic acid enters the cell nucleus.
C)Alteration in cellular function D)Changes messenger RNA
Ans:C Feedback:
Estrogen enters the cell and reacts with a receptor site inside the cell to change messenger RNA,
which enters the cell nucleus to affect cellular DNA, and the final result is an alteration in the
cell's function.

The nurse is preparing a class on the endocrine system for students. What benefit is served by the
positioning of the hypothalamus in the brain? (Select all that apply.)
A)Close to other important areas of the brain
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B)Able to influence and be influenced by emotions and thoughts

C)Poorly protected by the blood-brain barrier D)Floats within ventricles of the brain E)Protected
from the limbic system

Ans:A, B, C

Feedback:
Situated at the base of the forebrain, the hypothalamus receives input from virtually all other
areas of the brain, including the limbic system, cerebral cortex and the special senses that are
controlled by the cranial nerves: smell, sight, touch, taste, hearing. Because of its positioning, the
hypothalamus is able to influence, and be influenced by, emotions and thoughts. The
hypothalamus also is located in an area of the brain that is poorly protected by the blood-brain
barrier, so it is able to act as a sensor to various electrolytes, chemicals, and hormones that are in
circulation and do not affect other areas of the brain. It does not float within the ventricles of the
brain, and it is located to allow input from the limbic system.

The nurse is caring for a pregnant patient. What hormone must be secreted to cause uterine
contractions?

A)Oxytocin B)ADHD C)Estrogen D)Enkephalins

Ans:A Feedback:

The pituitary is made up of three lobes: anterior, intermediate, and posterior. The posterior lobe
stores two hormones produced by the hypothalamus, ADH and oxytocin. Oxytocin stimulates
uterine smooth muscle contraction in late phases of pregnancy and also causes milk release or
"let down" reflex in lactating women. The posterior lobe does not store estrogen or enkephalins.
ADHD (i.e., attention deficit hyperactivity disorder is a disease process, not a hormone.

What receptors in the body stimulate the hypothalamus to release antidiuretic hormone (ADH)?

A)Diuretic receptors B)Osmoreceptors C)Alpha receptors D)Nicotinic receptors

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Grade A- Nightingale
Ans:B

Feedback:

The osmoreceptors in the hypothalamus stimulate the release of ADH. There is no such thing as a
diuretic receptor. Alpha receptors are associated with the sympathetic nervous system and
nicotinic receptors are associated with the parasympathetic nervous system.

A researcher is studying chromosomal disorders. What part of the human cell would the
researcher be interested in studying?

A)Cytoplasm B)Membrane C)Nucleus D)Organelles

Ans:C Feedback:
The nucleus of a cell contains all of the genetic material that is necessary for cell reproduction.
The nucleus also contains genes or sequences of deoxyribonucleic acid (DNA). Genes are
responsible for the formation of messenger ribonucleic acid (mRNA) and transcription RNA,
which are involved in production of proteins unique to the cells.

This is the area where chromosomal disorders originate. The cell cytoplasm lies within the cell
membrane and is the site of activities of cellular metabolism and special cellular

functions. The organelles are contained within the cytoplasm and are structures with specific
functions. They include the mitochondria, endoplasmic reticulum, free ribosomes, Golgi
apparatus, and lysosomes. The membrane is a thin barrier, which separates the intracellular fluid
from the extracellular fluid and is essential for cellular integrity; it also maintains cell
homeostasis.

Which of these body cells has the greatest number of mitochondria?

A)Tibia bone cells B)Breast tissue C)Cardiac muscle D)Subcutaneous skin

Ans:C
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Feedback:

Mitochondria are very abundant in cells that consume energy. The cardiac muscle cells, which
must work continually to keep the heart contracting, contain a great number of mitochondria.
Milk-producing cells in breast tissue, which are normally dormant, contain very few. Cells of
bone and of subcutaneous tissue do not consume a great deal of energy; therefore, they have
smaller numbers of mitochondria than cardiac muscle.

When hormones, formed within the cell, move across the cell membrane, the process is called
what?

A)Endocytosis B)Exocytosis C)Phagocytosis D)Pinocytosis

Ans:B Feedback:

Exocytosis is the movement of substances such as waste products, hormones, and

neurotransmitters out of the cell. Pinocytosis is the movement of nutrients and needed substances
into the cell through specific receptors on the cell surface. Phagocytosis involves the destruction
of engulfed proteins or bacteria. Endocytosis involves incorporation of material into the cell.

What substances move freely in and out of a cell by diffusion?

A)Electrolytes B)Enzymes C)Hormones D)Proteins

Ans:A Feedback:

Sodium, potassium, calcium, carbonate, oxygen, bicarbonate, and water move freely in and out
of cells. These substances move through channels or pores in the cell membrane through
movement from a region of higher concentration to a region of lower concentration. Hormones,
enzymes, and proteins are considered carriers. If a substance cannot move freely on its own, it
may attach itself to another carrier to be diffused.
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Grade A- Nightingale

There can be interference with cancer chemotherapy in what phase of the cell cycle?
A)G0 phase B)G1 phase C)G2 phase D)S phase

Ans:A Feedback:

During the G0 phase, the cell is stable. Cells in this phase can interfere with cancer
chemotherapy because these drugs usually work on actively dividing cells, leaving resting cells
mostly untouched. When the resting cells are stimulated to become active and
regenerate, the cancer can return. This is the reason that cancer chemotherapy regimens are
complicated and extended over a period of time. In the G1 phase, a cell is stimulated to emerge
from its resting phase. During this time, the cell synthesizes the substances needed for DNA
formation. The S phase involves the actual synthesis of DNA, and during the G2 phase, the cell
produces all the substances that are required for the manufacture of the mitotic spindles.

The pharmacology instructor is discussing the histocompatibility of the cell. What is the
importance of a cell's histocompatibility antigen?

A)It reproduces cells when other cells die.

B)It recognizes cells as self-cells that belong in the body.

C)The antigen produces antibodies to viral invaders.

D)The antigen stimulates the production of white blood cells.

Ans:B Feedback:

The histocompatibility antigens are proteins that are seen on the top of the cell membrane. T cells
use these antigens as the identifying proteins that identify a cell as a self-cell. If these antigens
are not present on a cell membrane, the T cells will destroy that cell, determining that it is
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foreign. The histocompatibility antigens are not involved in reproduction. They do not produce
antibodies nor do they stimulate white blood cell production.

A patient on the unit has a deep decubitus ulcer. The family asks why the nurse debrides the ulcer
and removes the dead cells. What is the nurse's best response to explain to the family why
debridement is performed?

A)The lysosomes released by the dead cells in the area continue to kill other cells, destroying
more tissue.

B)The dead cells no longer contain histocompatible antigens causing a greater inflammatory
response.

C)Removing dead tissue forces oxygen to enter the damaged cells to regenerate them and to
promote healing.

D)The doctor ordered the procedure to be performed so it is done the way it is ordered because
orders are always followed.

Ans:A

Feedback:

When a cell dies, its cell membrane ruptures and the lysosomes release lysozymes, which
dissolve protein. When many cells die, lysozymes accumulate and dissolve the proteins that the
dead cells leave behind, but the lysozymes also destroy the cell membrane of healthy cells in the
area. Those cells then die, releasing lysozymes, which destroy more cells, and a vicious cycle
occurs. A decubitus ulcer is an area of many dead cells, which are killing healthy cells. The area
needs to be scraped clean to remove the dead cells so that the lysozymes will stop destroying
healthy cells and allow oxygen to return to the area through the capillary bed, which allows
healing to occur. Many treatments exist for decubitus ulcers, all of which depend on the return of
blood flow to the area and removal of the dead tissue. No procedure should ever be performed
only because it was ordered. The nurse should understand why each procedure is needed.
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Grade A- Nightingale

A patient is extremely dehydrated from vomiting and diarrhea causing his or her blood to
become hypertonic. What effect does the nurse expect this will have on the red blood cells?

A)They will swell and eventually rupture.

B)Red blood cells will migrate to the bone narrow.

C)The cells will shrink and shrivel, decreasing their oxygen-carrying ability.
D)The red cells will precipitate out of circulation.

Ans:C

Feedback:

A hypertonic solution will draw the water out of the red blood cell, causing it to shrink and
shrivel, decreasing the oxygen carrying ability of the red blood cell. A hypotonic solution would
result in water moving into the red blood cell, causing it to swell and burst. Red blood cells will
not migrate back to the bone marrow or precipitate out of circulation.

The nurse is caring for four patients. Which patient would the nurse expect to have a faster
recovery period based only on the process of mitosis?

A)A 32-year-old female patient who had surgery for ulcerated colitis

B)A 72-year-old man who had surgery for colon cancer

C)A 28-year-old woman who had breast reduction surgery

D)A 65-year-old man who had surgery for breast cancer

Ans:A

Feedback:
Cells lining the GI tract reproduce very quickly (72 hours) compared with breast tissue, which
takes 2 to 3 months to reproduce. The older the person is, the longer it will take for recovery due
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to the aging process that reduces rate of circulation of blood cells carrying oxygen to and from
cells.

When chemotherapeutic agents interfere with cellular physiology, it results in what?

A)Cellular death or alterations B)DiffusionC)EndocytosisD)Homeostasis
Ans:A Feedback:

Drugs may alter the cell membrane, causing the cell to rupture and die or they may deprive the
cell of certain nutrients, altering the proteins that the cell produces. This could interfere with
normal cell functioning and cell division. Diffusion is the movement of a substance from a
region of higher concentration to a region of lower concentration. Endocytosis involves
gathering of material into a cell. Homeostasis refers to keeping the cytoplasm stable within the
cell membrane. Diffusion, endocytosis, and homeostasis are not the result of chemotherapeutic
agents but may be impacted by the agent.

What is the function of the mitochondria within the cell?

A)Convert small substances into energy B)Convert hormones into secretory substances

C)Produce energy in the form of adenosine triphosphate (ATP)

D)Move electrolytes into and out of a cell

Ans:CFeedback:
Mitochondria are rod-shaped organelles that produce energy in the form of ATP for use by cells.
They do not convert small substances into energy; they do not convert hormones into secretory
substances; and they do not move electrolytes into and out of a cell.
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Two types of ribosomes exist within a cell. Ribosomes that are not bound to the endoplasmic
reticulum exist throughout the

cytoplasm of the cell and produce proteins with what purpose?

A)Bind themselves to the Golgi apparatus B)Bind to produce the endoplasmic reticulum

C)Denature unnecessary enzymes within the cell

D)Contribute to the structure of the cell
Ans:DFeedback:

Ribosomes that are not bound to the surface of the endoplasmic reticulum exist throughout the
cytoplasm. These free-floating ribosomes produce proteins that are important to the structure of
the cell and some of the enzymes that are necessary for cellular activity. Free- floating ribosomes
do not bind themselves to Golgi apparatus; produce endoplasmic reticulum; or denature any part
of the cell or its contents.

When a cell uses energy to move ions against an electrical or chemical gradient, what is the
process called?

A)Passive transport B)Neutral transport C)Cotransport D)Active transport

Ans:D
Feedback:

Active transport is what happens when cells use energy to move ions against an electrical or
chemical gradient. Passive transport is another term for diffusion. There is no such thing as
neutral transport. Cotransport is when the sodium ion and the solute are transported in the same
direction.

When making a presentation on the cell, what would the students say are the main parts of the
cell? (Select all that apply.)
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A)The nucleusB)The cytoplasm C)The cell membrane D)The mitochondria E)The organelles

Ans:A, B, C Feedback:

The cell is composed of a nucleus, which contains genetic material and controls the production
of proteins by the cell; a cell membrane, which separates the inside of the cell from the outside
environment; and cytoplasm, which contains various organelles important to cell function. The
mitochondria and the organelles are units within the cytoplasm but are not main parts of the cell.

The cell membrane has embedded within it a series of peripheral proteins that function in several
ways. One of these proteins is known as a receptor site. What does this receptor site do?

A)Maintains contact with outside proteins to prevent lysis of the cell wall

B)Maintains contact with inside proteins to prevent lysis of the cell wall

C)Reacts with specific chemicals inside the cell to stimulate a reaction outside the cell

D)Reacts with specific chemicals outside the cell to stimulate a reaction within a cell
Ans:D

Feedback:

Embedded in the cell membrane are a series of peripheral proteins with several functions. One
type of protein located on the cell membrane is known as a receptor site. This protein reacts with
specific chemicals outside the cell to stimulate a reaction within a cell. Receptor sites do not
prevent lysis of the cell wall nor do they stimulate a reaction outside of the cell.

A 32-year-old female patient is admitted to the floor with a superinfection. Her orders read
tigecycline (Tygacil) 100 mg IV followed by 50 mg IV every 12 hours infused over 30 to 60
minutes for 5 days. What would be important for the nurse to educate this patient about?
A)Analgesics B)Antihistamines C)Contraceptives D)Decongestants
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Ans:C

Feedback:

Many antibiotics interfere with the effectiveness of oral contraceptives and unplanned
pregnancies can occur. Women should be advised to use a barrier form of contraceptives when
taking this drug. No known serious drug-drug interactions involve analgesics, antihistamines, or
decongestants.

A patient with a gram-negative infection is being treated with an aminoglycoside. What system
should the nurse expect to monitor closely while the patient is taking this medication?

A)Respiratory system B)Ophthalmic system C)Renal system D)Musculoskeletal system

Ans:C

Feedback:
Renal function should be tested daily because aminoglycosides depend on the kidney for
excretion and if the glomerular filtration rate (GFR) is abnormal it may be toxic to the kidney.
The results of the renal function testing could change the daily dosage. Aminoglycosides do not
usually adversely affect respiratory, hepatic, or musculoskeletal function, although baseline data
concerning these systems is always needed.

How would the nurse describe selective toxicity?

A)Selective toxicity interferes with a biochemical reaction common to many different organisms.
B)Selective toxicity will decrease invading bacteria by interfering with the pathogens' ability to
reproduce.
C)Selective toxicity will eliminate bacteria by interrupting protein synthesis and damaging the
pathogen's cell wall.
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Grade A- Nightingale
D)Selective toxicity is the ability of the drug to kill foreign cells without causing harm to one's
own body cells.

Ans:D Feedback:

The choice of antibiotics in a clinical situation is determined by assessing which drug will affect
the causative organism and lead to the fewest adverse effects. Selective toxicity is the ability of
the drug to kill foreign cells without causing harm to the human body cells. How the antibiotic
works to kill bacteria varies by drug type and may reduce the ability to reproduce, damage the
cell wall, or interfere with a biochemical reaction, but this is a description of how the antibiotic
works and does not describe selective toxicity

A local bioterrorism medical team is learning about germ warfare. The team is instructed that a
fluoroquinolone may be used to prevent an outbreak of anthrax infection. What fluoroquinolone
would the nurse be most likely to administer for this purpose?

A)Ciprofloxacin (Cipro) B)Gemifloxacin (Factive) C)Norfloxacin (Noroxin) D)Sparfloxacin

(Zagam)

Ans:A Feedback:

Ciprofloxacin (Cipro) is the most widely used fluoroquinolone and is indicated for the
prevention of anthrax infection. Gemifloxacin and sparfloxacin are most useful in treating acute
episodes of chronic bronchitis and community-acquired pneumonia. Norfloxacin is
recommended only for certain types of urinary tract infections.

A clinic nurse is caring for a 66-pound child who has acute otitis media. The physician has
ordered ceftibuten (Cedax) 9 mg/kg per day PO for 10 days. The drug comes in an oral
suspension of 90 mg/5 mL. How many mL will the nurse administer?
A)5 mL B)10 mL C)15 mL D)20 mL
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Grade A- Nightingale
Ans:C Feedback:

First, using the formula: 2.2 lb/1 kg = 66 lb/X kg, determine the child's weight in kg (66/2.2 = 30
kg). Next, determine the desired dose by using the formula: amount of prescribed drug times
weight in kg (9 mg/kg times 30 kg = 270 mg). To determine the volume of medication to
administer, use the formula: amount of drug available/volume available = amount of drug
prescribed/volume to administer (90 mg/5 mL = 270 mg/X mL, 90mg/(X) = 1,350 mg/mL, X =
15 mL).

A 78-year-old woman, who lives alone and is forgetful, is being seen by her home health nurse.
In reviewing the patient's medication, the nurse discovers that the patient is taking Azithromycin
(Zithromax) for urethritis. Why would this be a good choice of antibiotics for this patient?

A)The half-life of the drug is 3 to 7 hours.

B)It is taken only once a day. C)It has very few adverse effects.

D)It can be given without consideration to drug-drug interactions.

Ans:B Feedback:

Given that the patient is "forgetful" and lives alone, a daily dose would likely promote improved
compliance. Azithromycin can be administered once daily because the half-life is 68 hours.
Azithromycin is associated with GI adverse effects and can cause pseudomembranous colitis;
neurological symptoms can occur as well. Azithromycin (Zithromax) may adversely interact with
cardiac glycosides, oral anticoagulants, theophyllines, carbamazepine, and corticosteroids to
name a few agents.

A 12-year-old patient with a complicated skin infection has been admitted to the pediatric unit.
The physician has ordered Ertapenem (Invanz). What is the nursing priority?

A)Transcribe the order to the medication administration record (MAR).

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Grade A- Nightingale
B)Perform hand hygiene before preparing the medication.

C)Assess the patient's renal and hepatic functions.

D)Question the order by calling the physician who prescribed it.

Ans:D Feedback:
The nurse should call the physician and question the order Because this drug is not
recommended for children younger than 18 years of age. Following clarification of the order, the
drug would be transcribed and listed in the MAR. The nurse would then wash her hands before
preparing the drug for administration. Assessment of renal and hepatic function is good practice
before

administering any medication but is not the nursing priority.

A 22-year-old female is diagnosed with mycobacterial tuberculosis. The physician orders

rifampin (Rifadin) 600 mg PO daily. What should the nurse question the patient about?

A)Her dietB)Sun exposureC)Type of exercise she does D)Use of contact lenses

Ans:DFeedback:
Some antimycobacterial drugs can cause discoloration of body fluids. The orange tinged
discoloration can cause permanent stain to contact lenses. The patient should avoid wearing them
while on the antimycobacterial therapy. With antimycobacterial drugs there is not a concern is
warranted about photosensitivity or exercise. However, due to the GI adverse effects, the nurse
may want to discuss an appropriate diet if the patient experiences GI upset after beginning
treatment.

The nurse is providing discharge teaching to a patient who is being sent home on oral
tetracycline (Sumycin). What instructions should the nurse include?
A)Take the medication only once a day.
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Grade A- Nightingale
B)Check pulse rate and hold the drug if lower than 60 beats per minute (bpm).

C)Take the drug on an empty stomach. D)Take the medication with 2 ounces of water.

Ans:CFeedback:

Tetracycline should be taken on an empty stomach 1 hour before or 2 hours after meals with a
full 8 ounces of water to ensure full absorption. Tetracycline is usually taken at least once every
12 hours. Checking the pulse and holding the dose if below 60 bpm is an action specific to the
use of cardiac glycosides.

A 28-year-old patient has been prescribed penicillin for the first time. What nursing diagnosis
would be most appropriate for this patient?

A)Acute pain related to gastrointestinal (GI) effects of the drug

B)Deficient knowledge regarding drug therapy

C)Imbalance nutrition: less than body requirements related to multiple GI effects of the drug
D)Constipation

Ans:B Feedback:

Because this is the first time the patient has taken penicillin, she is likely to have limited
knowledge about the drug. She may not understand the importance of taking the medication as
ordered to increase effectiveness of the drug or to report adverse effects. because the patient has
not started the drug yet, there is no way to know what adverse effects, if any, she will experience.
Only if she develops acute pain related to GI effects of the drug would this be appropriate. If GI
symptoms develop it may lead to imbalanced nutrition, but that remains to be seen. No indication
about constipation exists.
 BSN HESI 315 Pharmacology Exam v1
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Questions and Answers |100 out of 100|
Grade A- Nightingale
The pharmacology instructor is discussing antimicrobials with the nursing class. What would the
instructor tell the students about the mechanism of action of antimicrobials? (Select all that
apply).

A)Preventing cell division B)Causing cell death C)Inhibiting cell wall synthesis

D)Causing leakage of cell wall allowing fluid to leak in

E)Inhibiting synthesis of ribonucleic acid (RNA)

Ans:A, B, C Feedback:

Sites of cellular action of carbapenems, ketolides, lincosamides, aztreonam, penicillins,

sulfonamides, tetracyclines, and antimycobacterials. Carbapenems, ketolides, and lincosamides
change protein function and prevent cell division or cause cell death. Aztreonam alters cell
membranes to allow leakage of intracellular substances and causes cell death; it does not cause
leakage of fluid into the cell. Penicillins prevent bacteria from building their cells during
division. Sulfonamides inhibit folic acid synthesis for RNA and deoxyribonucleic acid
production but does not inhibit RNA synthesis

The nurse is preparing to contact the physician for an antibiotic order for the patient's infection.
What information will the nurse be prepared to provide for the physician to choose the proper
antibiotic?

A)First day of infection symptoms B)Culture and sensitivity test results

C)The patient's intake and output for past 2 days

D)Results of complete blood count with differential

Ans:B Feedback:

Antibiotics are best selected based on culture results that identify the type of organism causing
the infection and sensitivity testing that shows what antibiotics are most effective in eliminating
the bacteria. First day of symptoms of infection is likely already known if culture and sensitivity
testing has been performed. Although measurement of intake and output is one indicator of renal
function, a blood-urea-nitrogen test and assessment of creatinine levels would be better ways of
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Grade A- Nightingale
assessing renal function, which will be used to determine dose of medication but not for selection
of the correct antibiotic. The white blood cell count and differential would indicate the possibility
of an infection but are not needed in choosing the proper antibiotic.

A nursing student asks the pharmacology instructor for ways to minimize the emergence of drug-
resistant microbial agents. What would be an appropriate response by the instructor? (Select all
that apply.)

A)Avoid the use of broad-spectrum antibacterial drugs when treating trivial or viral infections.

B)Use narrow-spectrum agents if they are thought to be effective.

C)Do not use vancomycin unnecessarily.

D)Prescribe antibiotics when the patient believes they are warranted.

E)Start the antibiotics, do culture and sensitivity tests, and provide patient education.
Ans:A, B, C

Feedback:

To prevent or contain the growing threat of drug-resistant strains of bacteria, it is very important
to use antibiotics cautiously, to complete the full course of an antibiotic prescription, and to
avoid saving antibiotics for self-medication in the future. You would not give antibiotics every
time the patient wants them, nor would you do a culture and sensitivity test after starting
antibiotics. Therefore, Options D and E are incorrect.

A student asks the pharmacology instructor if there is a way to increase the benefits and decrease
the risks of antibiotic therapy. What would be an appropriate response by the instructor?
A)Taking drugs not prescribed for the particular illness tends to maximize risks and minimize
benefits.
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Grade A- Nightingale
B)Never use antibiotics in combination with other prescriptions or in combination with other
antibiotics.

C)Maximize antibiotic drug therapy by administering the full dose when the patient has a fever.

D)Use antibiotics cautiously and teach patients to complete the full course of an antibiotic
prescription.

Ans:D

Feedback:

To prevent or contain the growing threat of drug-resistant strains of bacteria, it is very important
to use antibiotics cautiously, to complete the full course of an antibiotic prescription, and to
avoid saving antibiotics for self-medication in the future. A patient and family teaching program
should address these issues, as well as the proper dosing procedure for the drug (even if the
patient feels better) and the importance of keeping a record of any reactions to antibiotics. Thus,
taking drugs not prescribed for the particular illness tends to maximize risks and minimize
benefits. Also, if the infection is viral, antibacterial drugs are ineffective and should not be used.

What is the priority reason for the nurse to consider questioning an order for tetracycline in a
child younger than 8 years of age?
A)Children younger than 8 years of age cannot take tetracyclines.

B)Weight-bearing joints have been impaired in young animals given the drugs.

C)Tetracyclines can damage developing teeth and bone in children younger than 8 years of age.

D)Liver and kidney function may be damaged when it is given to children under 8 years of age.

Ans:C Feedback:Use tetracyclines with caution in children younger than 8 years of age because
they can potentially damage developing bones and teeth. Although the drug does not cause
damage to liver and kidneys, it may be contraindicated in patients with hepatic or renal
dysfunction because it is concentrated in the bile and excreted in the urine. Fluoroquinolones, not
tetracyclines, are generally contraindicated for use in children (i.e., those younger than 18 years
of age) because weight-bearing joints have been impaired in young animals given the drugs.
 BSN HESI 315 Pharmacology Exam v1
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Questions and Answers |100 out of 100|
Grade A- Nightingale
Clindamycin (Dalacin C) warrants monitoring hepatic and renal function when it is given to
neonates and infants. Trimethoprim- sulfamethoxazole (Nu-Cotrimox) is used in children,
although children younger than 2 months of age have not been evaluated. Children under 8 years
of age can take tetracycline, but it should be used with caution.

A 17-year-old male patient with athlete's foot is extremely upset that he cannot get rid of it. He
calls the clinic and asks the nurse whether the doctor can give him an antibiotic to "cure the
infection." What should the nurse include in the explanation of treatment for fungal infections?
A)"Fungi differ from bacteria in that the fungus has flexible cell walls that allow for free transfer
into and out of the cell."
B)"Protective layers contain sterols, which change the membrane permeability."

C)"The composition of the protective layers of the fungal cell makes the organism resistant to
antibiotics."
D)"Fungi cell walls contain Candida, which makes the cells rigid.

Ans:C

Feedback:

The nurse should tell the patient that the composition of the protective layers of the fungal cell
makes the organism resistant to antibiotics so that antibiotics would not have

any positive effect. Fungi do differ from bacteria, but the fungus has rigid cell walls that allow
for free transfer in and out of the cell. The protective layers contain ergosterol, not Candida, that
helps keep the cell wall rigid, not permeable.

The nurse admits a 1-year-old child to the pediatric intensive care unit (ICU) with cryptococcal
meningitis. What drug will the nurse anticipate receiving an order for to treat this child?
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Grade A- Nightingale
A)Amphotericin B (Fungizone) B)Fluconazole (Diflucan) C)Griseofulvin (Fulvicin)
D)Ketoconazole (Nizoral)

Ans:B

Feedback:

Fluconazole is used in the treatment of cryptococcal meningitis and is safe to use in a 1-year-old
child. Amphotericin B has many unpleasant adverse effects and is very potent, so it would not be
the first or best medication to administer initially but would be reserved for use if fluconazole
was not effective. Griseofulvin is given to treat tinea pedis and tinea unguium in children.
Ketoconazole is not given to children younger than 2 years because safety has not been
established.

The nurse is teaching the patient about a newly prescribed systemic antifungal drug. What sign
or symptom will the nurse instruct the patient to report to the provider immediately?
A)Unusual bruising and bleeding B)Constipation or diarrheaC)Red and dry eyesD)Increased
appetite with weight gain
Ans:A

Feedback:Unusual bruising and bleeding can be an indication of hepatic toxicity, which should
be reported immediately. Yellowing of the eyes, not redness, and tearing are also indicative of
hepatic toxicity. Usually GI symptoms include nausea and vomiting with antiviral drugs, which
could cause decreased appetite and weight loss. These symptoms should be reported if they
persist but are not emergency symptoms to report immediately.

A patient who has a tinea infection calls the clinic and complains of intense local burning and
irritation with use of a topical antifungal drug. Even before asking the patient, the nurse suspects
he or she is applying what medication?
 BSN HESI 315 Pharmacology Exam v1
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Grade A- Nightingale
A)Butoconazole (Gynazole I) B)Ciclopirox (Loprox) C)Econazole (Spectazole) D)Haloprogin
(Halotex)

Ans:C

Feedback:

Econazole can cause intense local burning and irritation in treatment of tinea infections.
Butoconazole is used to treat vaginal Candida infections. Ciclopirox is used to treat toenail and
fingernail tinea infections and does not produce intense burning and irritation. Haloprogin is used
to treat athlete's foot, jock itch, and ringworm infections and is not associated with burning or
irritation.

A patient asks the nurse if he or she should use a topical antifungal. The nurse is aware that the
most important contraindication to topical antifungals is what?

A)Hepatic impairmentB)Renal impairmentC)Congestive heart failureD)Known allergy to any of

the antifungal drugs

Ans:D

Feedback:

Topical antifungals are not absorbed systemically so they are not metabolized and excreted. As a
result, the only contraindication would be an allergy to the drug. Hepatic and renal impairment
and congestive heart failure would not be a contraindication because these drugs do not enter the
bloodstream and impact these organ systems.

A patient with high cholesterol is taking lovastatin (Mevacor). What drug would the nurse
question if it was ordered for this patient?

A)Nifedipine (Procardia) B)Ciprofloxacin (Cipro) C)Itraconazole (Sporanox) D)Oxazepam

(Serax)
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Grade A- Nightingale
Ans:C

Feedback:

Itraconazole is an azole antifungal drug that has been associated with severe cardiovascular
events when taken with lovastatin. Nifedipine, ciprofloxacin, and oxazepam have no drug
interactions with lovastatin. Nifedipine is an antihypertensive drug whose effects can be
increased when taken with cimetidine. The effects of ciprofloxacin are altered when taken with
antacids and theophyllines. Oxazepam is an antianxiety drug that should not be taken with
alcohol or theophyllines.

An 85-year-old man who is a resident in an extended-care facility has athlete's foot. After
applying an antifungal cream, what is the nurse's next action?

A)Wipe away excess medication from the affected area.

B)Wrap a sterile kling dressing around both feet.

C)Elevate the feet for 30 minutes.

D)Apply clean dry socks.

Ans:DFeedback:
Clean dry socks should be applied when treating athlete's foot to help eradicate the infection
because they will keep the feet dry as well as prevent the cream from being wiped away. A kling
dressing is not necessary as it would bind the feet and interfere with mobility and increase the
risk of systemic absorption. Medication should not be removed once applied, and there is no
need to elevate the feet unless another medical condition warrants this action.
 BSN HESI 315 Pharmacology Exam v1
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Grade A- Nightingale
A patient comes to the clinic and is diagnosed with a vaginal fungal infection. The nurse provides
patient information for self- administration of a vaginal antifungal medication. What will the
nurse include in the instructions?

A)"Insert low into the opening of the vagina." B)"Discontinue use during menstruation."

C)"Remain recumbent for at least 15 minutes after insertion."

D)"Rub the cream into the vaginal wall after insertion."

Ans:C Feedback:

The patient should remain recumbent at least 10 to 15 minutes after the medication is deposited
high in the vagina so that leakage will not occur and absorption will take place. The effectiveness
of the medication is determined by the consistent application for each specified dose for maximal
results. The nurse would instruct the patient to continue the medication during menstruation.
Stopping the drug and restarting it later can lead to the development of resistant strains of the
drug. The cream need not be rubbed into the vaginal wall as it will coat the wall naturally after
insertion.

A patient who is using a topical antifungal agent to treat mycosis calls the clinic to report a
severe rash that is accompanied by blisters. What will the nurse instruct the patient to do?
A)"Continue the drug as the prescription indicates."

B)"Scrub the rash with soap and water." C)"Stop using the drug immediately."

D)"Decrease the amount of the medication used."

Ans:C

Feedback:

The patient should stop using the drug. The rash could indicate sensitivity to the drug or
worsening of the condition being treated. Scrubbing the rash could cause further irritation and
increase the risk for other infections. Continuing the drug could cause further complications.
Decreasing the medication would be ineffective in treating the infection while continuing to risk
further complications.
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Grade A- Nightingale

The nurse admitted a 25-year-old woman to the unit. What would be the most important thing for
the nurse to assess before administering ketoconazole?

A)Complete blood count (CBC) and blood glucose

B)Eating and sleeping habits C)Height and weightD)Renal and hepatic function
Ans:D

Feedback:

It would be important for the nurse to know the patient's CBC, blood glucose level, eating and
sleeping habits, and height and weight. All of these factors could help determine a specific
dosage. However, the most important factor would be the patient's renal and hepatic function
because hepatic or renal toxicity could occur quickly if the organs are not functioning properly.

What drug would the nurse administer orally without the need to question when treating
infections caused by Candida albicans?
A)Amphotericin B (Abelcet) B)Tolnaftate (Tinactin) C)Griseofulvin (Fulvicin) D)Fluconazole
(Diflucan)
Ans:D

Feedback:

Fluconazole is available for oral use and is effective in treating C. albicans. Amphotericin B is
reserved for severe and potentially fatal infections, so it would not be used for a C.
albicansinfection. Tolnaftate is used to treat athlete's foot and is applied topically, not given
orally. Griseofulvin is applied topically and is used to treat tinea, not C. albicans.
 BSN HESI 315 Pharmacology Exam v1
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Grade A- Nightingale
When administering a topical antifungal via the vaginal route, what action would the nurse take?

A)Place the patient in left lateral Sims' position.

B)Applied using sterile technique C)Administered high into the vagina. D)Insert a tampon after
insertion.

Ans:C
Feedback:
Vaginal antifungals should be administered high into the vagina. The patient should be placed in
a recumbent position for insertion. Clean technique (not sterile) should be used. Inserting a
tampon after administration is not necessary.

By what route would the nurse administer amphotericin B?

A)Intravenously B)Intramuscularly C)Orally D)Topically

Ans:A Feedback:

Amphotericin B is only administered by the IV route. It cannot be given intramuscularly, orally,

or topically.

What classification of medication will the nurse administer concurrently with amphotericin B
(Fungizone) to help minimize the adverse reactions to this medication?

A)SedativesB)Antipyretics C)Beta-adrenergic blockers D)Diuretics

Ans:BFeedback:

Amphotericin B is often given with antipyretics to improve patient comfort and to minimize
adverse reactions. Sedatives, beta- adrenergic blockers, and diuretics are not indicated for use
with amphotericin B unless the patient has a coexisting diagnosis that would indicate a need for
these drugs.
 BSN HESI 315 Pharmacology Exam v1
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Questions and Answers |100 out of 100|
Grade A- Nightingale

The nurse provides teaching about amphotericin B (Fungizone) for an 82-year-old patient. The
nurse evaluates the patient understood teaching when he says he could develop what condition?

A)Diabetes B)Liver necrosis C)Kidney damage D)Pancreatitis

Ans:C
Feedback: Amphotericin B is nephrotoxic so the patient needs to understand the risk of kidney
damage. Other risks of amphotericin B include bone marrow suppression; GI irritation with
nausea, vomiting, and potentially severe diarrhea; anorexia and weight loss; and pain at the
injection site with the possibility of phlebitis or thrombophlebitis, but it does not cause diabetes,
liver necrosis, or pancreatitis.

A public health nurse is speaking to parents of first graders. When discussing worm infection, the
nurse will explain that the most common type found in U.S. school-aged children is what?

A)Pinworms B)Roundworms C)Threadworms D)Whipworms

Ans:A Feedback:
The most common worm infection encountered in U.S. school-aged children is pinworms. These
worms are endogenous to the area and easily spread. Roundworms, whipworms, and
threadworms are not as common.

A mother of a 3-year-old child brings her child to the clinic. The child is diagnosed with
pinworms. What drug would be the best choice for the patient?
A)Pyrantel (Pin-Rid) B)Ivermectin (Stromectol) C)Mebendazole (Vermox) D)Albendazole
(Albenza)
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Grade A- Nightingale
Ans:C

Feedback:

Mebendazole is the most commonly used anthelmintic for pinworms because it is

available in a chewable tablet. This is a good choice for the 3-year-old patient. Pyrantel is also
prescribed for pinworms but is not available in a chewable form. Ivermectin is prescribed for
treatment of threadworm disease and albendazole is given to treat active lesions caused by pork
tapeworm and cystic disease of the liver, lungs, and peritoneum caused by dog tapeworm.

A nurse is teaching a young mother about administering pyrantel (Pin-Rid, others) to her 5-year-
old child. What will the nurse emphasize about how the agent is given?

A)In 3 doses as a 1-day treatment

B)In a morning dose and an evening dose for 3 days

C)B.I.D. for 10 days D)Give only once

Ans:DFeedback:

Pyrantel is administered orally as a single dose. Albendazole is prescribed for hydatid disease
and is given twice a day for 8 to 30 days of treatment. Mebendazole is used in the treatment of
diseases caused by pinworms, roundworms, whipworms, and hookworms and is given in a
morning and evening dose for 3 days. Praziquantel is used to treat schistosomes and is taken in
three doses as a 1-day treatment.

A patient has been diagnosed with roundworms and is to be treated with albendazole. A priority
nursing assessment of this patient would be to determine if the patient is taking what?

A)Cimetidine (Tagamet) B)Pioglitazone (Actos) C)Alprazolam (Xanax) D)Loperamide

(Imodium)

Ans:A
 BSN HESI 315 Pharmacology Exam v1
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Grade A- Nightingale
Feedback:

The adverse effects of albendazole, which are already severe, may increase if the drug is
combined with dexamethasone, praziquantel, or cimetidine. These combinations should be
avoided if at all possible; if they are necessary, patients should be monitored closely for the
occurrence of adverse effects. Pioglitazone is an oral antidiabetic agent that could be taken with
albendazole. Loperamide is an antidiarrheal drug that may be used for treatment of diarrhea as a
result of the mebendazole and pyrantel. Alprazolam should not be a concern.

What would be a priority nursing action related to the care of a patient taking albendazole
(Albenza)?
A)Check blood pressure, pulse, and respirations

B)Weigh the patientC)Monitor renal function D)Encourage small, frequent meals

Ans:CFeedback:

It is important that the patient's kidney function be monitored because a serious adverse effect of
this drug is renal failure. Even though vital signs, weight, and nutrition are important and should
be monitored, if the patient exhibits any signs of renal failure the drug should be stopped
immediately.

A mother brings her child to the clinic where the child is diagnosed with hookworms. The
mother asks how the child got hookworms. What would the nurse tell the mother is the route of
entry for hookworm?
A)InhalationB)Contact with skinC)Ingestion of undercooked foods D)Blood-borne exposure

Ans:B

Feedback:
 BSN HESI 315 Pharmacology Exam v1
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Grade A- Nightingale
The larvae penetrate the skin and then enter the blood and within about a week, reach the
intestine. Inhalation, ingestion, and blood- borne exposure are incorrect.

A patient is diagnosed with an ascaris infection. The patient asks what the best way is to prevent
ascaris infections. What is the nurse's best response?

A)"Wash hands before eating."B)"Do not share hairbrushes or hats."

C)"Wash fresh fruits and vegetables before eating."

D)"Avoid heavily populated areas."

Ans:CFeedback:

Ascaris infection occurs where sanitation is poor. Eggs in the soil are ingested with vegetables or
other improperly washed foods containing the worm. The patients may be unaware until a worm
in their stool is seen or the patient becomes quite ill. Teaching patients the importance of washing
fresh fruit and vegetables will help them reduce risk of infection. Washing hands, avoiding
sharing hairbrushes or hats, and being aware in populated areas will reduce the risk of other
infections but do not relate to ascaris.

What is an appropriate nursing diagnosis for a patient with tapeworm?

A)Imbalanced nutrition: less than body requirements

B)Chronic pain C)Constipation D)Impaired mobility

Ans:A

Feedback:Tapeworm affects the body's ability to absorb food products and weight loss and
malnutrition often follow unless treatment is received promptly. As a result, the best nursing
diagnosis is imbalanced nutrition: less than body requirements. Patients with tapeworm are often
symptom-free but may experience some abdominal discomfort and distention as well as weight
loss so they do not have chronic pain, constipation, or impaired mobility.
 BSN HESI 315 Pharmacology Exam v1
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Grade A- Nightingale

Why is it important for a nurse to inquire about any foreign travel of a patient with a suspected
lymphatic or hematologic disorder?

A)To determine the varied sexual history of the patient, if any

B)To determine the potential exposure to infectious agents
C)To determine whether the patient has had any blood transfusions

D)To determine whether the patient adopted any specific dietary habits

Ans:B Feedback:

Knowledge of recent travel can help the nurse to pinpoint potential exposure to helminths,
parasites, or other infection exposure common in the area visited. The nurse should specifically
ask about foreign travel to countries where malaria or parasitic roundworms are common. Sexual
history, dietary habits, or any blood transfusions that the patient may have had before would not
be adequately explored by questioning travel history.

What helmintic infestation occurs in tropical areas and is carried by snails?

A)Schistosomiasis B)Platyhelminths C)Trichinosis D)Filariasis

Ans:A Feedback:

Schistosomiasis is a common problem in many tropical areas where the snail that is necessary in
the life cycle of the fluke lives. Trichinosis is caused by eating undercooked pork and can occur
in any part of the world. Filariasis and platyhelminths are not restricted to tropical areas.

The nursing instructor is discussing helmintic infections with the nursing students. How would
the instructor explain the action of anthelmintic drugs?
 BSN HESI 315 Pharmacology Exam v1
(New 2026/ 2027 Update) over 200
Questions and Answers |100 out of 100|
Grade A- Nightingale
A)Destroy the nervous system of the invading worm

B)Act on metabolic pathways that are present in the invading worm

C)Interfere in the reproductive cycle of the invading worm

D)Cause fatal mutations in the deoxyribonucleic acid of the invading worm

Ans:B Feedback:

The anthelmintic drugs act on metabolic pathways that are present in the invading worm, but that
are absent or significantly different in the human host. Other options are incorrect descriptions of
how anthelmintic drugs work.

What anthelmintics would the nurse expect will be readily absorbed from the gastrointestinal
(GI) tract? (Select all that apply.)

A)Mebendazole B)Pyrantel C)Albendazole D)Praziquantel E)Ivermectin

Ans:D, E

Feedback:

Praziquantel and ivermectin are readily absorbed from the GI tract. Mebendazole, pyrantel, and
albendazole are not.