HESI Wgu Pharmacology D441

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Sample questions from HESI Wgu Pharmacology D441

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

1. 1.During a pharmacology review, an instructor asks how oral medications may be affected before reaching systemic circulation. Which process can reduce the amount of an orally administered drug that reaches the bloodstream?

   • A.Distribution from plasma into tissues
   • B.First-pass metabolism in the liver
   • C.Binding of the drug to a receptor
   • D.Renal filtration after systemic absorption

   Rationale: First-pass metabolism occurs when an absorbed oral drug travels through the portal circulation and is metabolized in the liver before reaching systemic circulation, reducing its bioavailability. Tissue distribution occurs after a drug enters systemic circulation, while renal filtration removes drug from the blood later. Receptor binding describes a drug action, not a presystemic process.

2. 2.Refer to the client's chart. Which actions are appropriate before the next gentamicin dose? Select all that apply.

   • A.Administer the dose now because the temperature remains elevated.
   • B.Assess urine output and review the dosing plan with the provider.
   • C.Hold the dose and notify the provider about the rising creatinine.
   • D.Verify whether the 1000 gentamicin level was drawn immediately before the scheduled dose.
   • E.Give an additional dose to compensate for the elevated level.

   Rationale: Holding the dose and notifying the provider is appropriate because the creatinine rose from 0.8 to 1.4 mg/dL and the reported level is above the listed reference range. A gentamicin trough should be drawn immediately before the next dose, so its timing must be verified before interpreting it. Assessing urine output and reviewing the dosing plan help identify impaired renal clearance; fever alone does not justify giving a dose despite possible accumulation, and an extra dose would increase toxicity risk.

3. 3.The provider prescribes 15 mg/kg/day of an oral medication in three equal doses for a child who weighs 18 kg. The available liquid contains 90 mg per 5 mL. How many milliliters should the nurse administer per dose?

   • A.10 mL
   • B.15 mL
   • C.1.7 mL
   • D.5 mL

   Rationale: The total daily dose is 15 mg/kg x 18 kg = 270 mg, and each of three doses is 90 mg. The concentration is 18 mg/mL, so 90 mg requires 5 mL. Giving 15 mL would deliver the full daily volume in one dose, while 1.7 mL and 10 mL do not match the prescribed dose.

4. 4.During a home visit, an adult client says, "I put my new nitroglycerin patch on this morning, but I left yesterday's patch on too." Which instruction should the nurse give first?

   • A.Place the new patch over the old one so the medication is absorbed evenly.
   • B.Leave both patches on until the next scheduled change.
   • C.Remove the old patch and keep only the newly prescribed patch in place.
   • D.Cut the older patch in half to reduce the amount of medication absorbed.

   Answer and rationale are in the full material.

5. 5.A client taking an extended-release medication has difficulty swallowing tablets. Which action is safest for the nurse to take?

   • A.Check the specific product information and contact the pharmacist or prescriber for an appropriate formulation.
   • B.Crush the tablet and mix it with applesauce.
   • C.Dissolve the tablet in warm water before administration.
   • D.Split the tablet and administer both halves.

   Answer and rationale are in the full material.