HESI BSN 315 RN Pharmacology 35504 Proctored Exam

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Sample questions from HESI BSN 315 RN Pharmacology 35504 Proctored Exam

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

1. 1.During a medication review at a community clinic, a client asks why an oral medication has a different dose from the same medication given intravenously. Which pharmacokinetic concept best explains this difference?

   • A.Oral medications may undergo first-pass metabolism in the liver before reaching systemic circulation.
   • B.Oral medications bypass the gastrointestinal tract and enter systemic circulation directly.
   • C.Intravenous medications are subject to greater first-pass metabolism than oral medications.
   • D.Intravenous medications are absorbed more slowly than oral medications.

   Rationale: First-pass metabolism can reduce the amount of an orally administered drug that reaches systemic circulation, so an oral dose may differ from an intravenous dose. Intravenous medications enter the circulation directly and are not absorbed through the gastrointestinal tract. Oral medications do not bypass the gastrointestinal tract, and IV medications do not undergo greater hepatic first-pass metabolism.

2. 2.A client taking a medication with a half-life of 8 hours asks when most of the medication will be eliminated after the last dose. Which response is most accurate?

   • A.About 16 hours, because two half-lives eliminate nearly all of the medication.
   • B.About 8 hours, because the entire dose is eliminated in one half-life.
   • C.About 80 hours, because ten half-lives are required before elimination begins.
   • D.About 40 hours, because approximately five half-lives are generally needed to eliminate most of the medication.

   Rationale: After each half-life, the amount of drug remaining is reduced by half; after about five half-lives, approximately 3% remains, so most of the drug has been eliminated. One half-life does not eliminate the entire dose, and two half-lives leave about 25% remaining. Elimination begins while the medication is being processed, rather than after ten half-lives.

3. 3.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.Verify the prescribed dose and dosing interval in light of the client's changing renal function.
   • B.Increase the dose to compensate for the low urine output.
   • C.Hold the dose and notify the prescriber about the rising creatinine and reduced urine output.
   • D.Assess for signs of medication toxicity, including new confusion and nausea.
   • E.Administer the scheduled dose because the serum concentration is below the listed peak reference range.

   Rationale: The chart shows creatinine increasing from 1.0 to 2.1 mg/dL, urine output falling to 20 mL/hr, and new confusion and nausea, so the nurse should hold the dose, notify the prescriber, and assess for toxicity. Renal impairment can reduce drug clearance, making verification of the dose and interval essential. The listed concentration is a trough, not a peak, and being below a peak reference range does not justify giving the dose; increasing the dose could worsen accumulation.

4. 4.A client receiving an IV antibiotic every 8 hours is due for a trough concentration. When should the nurse obtain the specimen?

   • A.At the midpoint between the current and next doses.
   • B.Immediately before the next scheduled dose.
   • C.Thirty minutes after the next dose is completed.
   • D.Immediately after the current dose is completed.

   Answer and rationale are in the full material.

5. 5.The parent of a 6-year-old asks why the child's medication dose is based on weight rather than the adult dose. Which explanation should the nurse provide?

   • A.Weight-based dosing eliminates the need to verify the maximum recommended dose.
   • B.Children eliminate all medications faster than adults, so their doses must always be larger per kilogram.
   • C.Weight-based dosing helps account for differences in body size and drug distribution in children.
   • D.A child's liver and kidneys are fully mature by age 2, making weight the only factor affecting medication response.

   Answer and rationale are in the full material.