HESI Compass Pharmacology V1

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Sample questions from HESI Compass Pharmacology V1

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

1. 1.A client taking an oral medication asks why the prescribed dose is different from a friend's dose of the same medication. Which factor most directly affects the amount of drug available to produce an effect?

   • A.The medication's color and tablet shape
   • B.The client's preferred pharmacy
   • C.The client's absorption, distribution, metabolism, and excretion
   • D.The time of day the prescription was written

   Rationale: Pharmacokinetics describes absorption, distribution, metabolism, and excretion, all of which influence drug concentration and response. Tablet appearance and pharmacy do not determine the client's drug handling. Dosing should be individualized rather than compared with another person's prescription.

2. 2.Refer to the client's chart. Which actions should the nurse take before administering the next dose of the prescribed medication? Select all that apply.

   • A.Document the urine output trend and report the decline
   • B.Hold the dose and notify the prescriber about the rising creatinine
   • C.Verify the medication dose against the client's current renal function
   • D.Give the dose with an extra glass of water to accelerate renal clearance
   • E.Assess for sedation and respiratory depression before dosing

   Rationale: The creatinine increase from 0.8 to 2.1 mg/dL and urine output decline suggest impaired renal clearance, so the dose requires review and the prescriber should be notified. Assessing sedation and respirations is prudent because drug accumulation can intensify adverse effects. Extra water does not reliably restore renal clearance and may be unsafe without an order.

3. 3.A client taking warfarin begins a medication that inhibits hepatic drug metabolism. Which outcome should the nurse anticipate?

   • A.No change because metabolism does not affect drug action
   • B.A higher warfarin effect and increased bleeding risk
   • C.A shorter half-life and faster elimination of warfarin
   • D.A lower warfarin effect and reduced bleeding risk

   Rationale: Inhibition of hepatic metabolism can slow warfarin breakdown, increase its concentration, and raise the INR and bleeding risk. A reduced drug effect is more consistent with enzyme induction. The nurse should assess for bleeding and expect closer INR monitoring.

4. 4.A client is prescribed several oral medications, including one with a narrow therapeutic index. Which practices promote safe administration? Select all that apply.

   • A.Crush every tablet when the client reports difficulty swallowing
   • B.Use two client identifiers before giving medications
   • C.Compare the medication label with the medication administration record
   • D.Clarify an order that is incomplete or appears unusually high
   • E.Ask about allergies and the reaction experienced

   Answer and rationale are in the full material.

5. 5.A client prescribed an oral medication with extensive first-pass metabolism asks why the oral dose differs from an injectable dose. Which explanation is accurate?

   • A.Some of the oral drug is metabolized before reaching systemic circulation
   • B.Oral drugs are always absorbed more quickly than injectable drugs
   • C.The injectable form is eliminated only by the lungs
   • D.First-pass metabolism prevents all oral drug absorption

   Answer and rationale are in the full material.