HESI HESI Exam RN Pharmacology V3

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Sample questions from HESI HESI Exam RN Pharmacology V3

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.A client taking warfarin is prescribed a new medication. Which prescription should prompt the nurse to contact the provider because it can increase the risk of bleeding?

   • A.Ibuprofen
   • B.Acetaminophen
   • C.Calcium carbonate
   • D.Docusate

   Rationale: Ibuprofen can increase bleeding risk through platelet inhibition and gastrointestinal irritation, which can compound warfarin's anticoagulant effect. Acetaminophen, docusate, and calcium carbonate do not have the same predictable additive bleeding risk at usual doses. Clients taking warfarin should check with a provider before starting over-the-counter medications.

2. 2.During medication reconciliation, which findings can alter how a medication is absorbed or metabolized? Select all that apply.

   • A.Taking a medication by the prescribed intravenous route
   • B.Having a low serum albumin concentration
   • C.Taking a medication with food when its directions specify an empty stomach
   • D.Having severe hepatic impairment
   • E.Taking an antacid at the same time as an oral iron tablet

   Rationale: Antacids can bind or otherwise reduce absorption of oral iron, and food can change absorption when a medication must be taken on an empty stomach. Hepatic impairment can slow metabolism, while low albumin can increase the free fraction of highly protein-bound drugs. Giving a medication by its prescribed intravenous route bypasses gastrointestinal absorption rather than changing it.

3. 3.The provider prescribes digoxin 0.125 mg by mouth daily. Available tablets contain 250 mcg each. How many tablets should the nurse administer?

   • A.0.25 tablet
   • B.0.5 tablet
   • C.1 tablet
   • D.2 tablets

   Rationale: Convert 0.125 mg to 125 mcg, then divide by 250 mcg per tablet: 125/250 = 0.5 tablet. One tablet would provide twice the prescribed dose, and two tablets would provide four times the dose. Verify that the tablet is suitable for splitting before administering a partial tablet.

4. 4.A client reports that a medication causes nausea. Which instruction is appropriate if the medication label does not require administration on an empty stomach?

   • A.Crush the medication and mix it with hot tea.
   • B.Double the next dose if one dose is skipped.
   • C.Stop the medication until the nausea is gone.
   • D.Take the medication with a small meal or snack.

   Answer and rationale are in the full material.

5. 5.A client is being discharged with a new transdermal medication patch. Which instructions should the nurse include? Select all that apply.

   • A.Apply the patch to clean, dry skin at a site allowed by the product instructions.
   • B.Fold the used patch with the sticky sides together before disposal.
   • C.Remove the old patch before applying a new one.
   • D.Cut the patch in half if the prescribed dose seems too strong.
   • E.Use a heating pad over the patch to improve medication absorption.

   Answer and rationale are in the full material.