HESI LPN
Pharmacology HESI 2023
1. A client with diabetes mellitus type 1 is prescribed insulin glargine. When should the nurse instruct the client to administer this medication?
- A. Before meals
- B. After meals
- C. At bedtime
- D. In the morning
Correct answer: C
Rationale: Corrected Rationale: Insulin glargine is a long-acting insulin that provides a consistent level of insulin over 24 hours. Administering it at bedtime helps mimic the body's natural insulin secretion pattern and provides optimal blood glucose control during the night and throughout the day. Choice A (Before meals) is incorrect because insulin glargine is not a rapid-acting insulin meant to cover meals. Choice B (After meals) is incorrect as the timing doesn't align with the insulin's mechanism. Choice D (In the morning) is incorrect as administering insulin glargine in the morning may not provide adequate coverage throughout the night and the following day.
2. A 6-month-old infant is prescribed digoxin for the treatment of congestive heart failure. Which observation by the practical nurse (PN) warrants immediate intervention for signs of digoxin toxicity?
- A. Apical heart rate of 60 beats/min
- B. Sweating across the forehead
- C. Poor sucking effort
- D. Respiratory rate of 30 breaths/min
Correct answer: A
Rationale: A heart rate of 60 beats/min for a 6-month-old infant warrants immediate intervention as it falls below the normal range. The normal heart rate for a 6-month-old is 80 to 150 beats/min when awake, and a rate of 70 beats/min while sleeping is considered within normal limits. Bradycardia (heart rate <60 beats/min) in infants can be a sign of digoxin toxicity, necessitating prompt evaluation and intervention to prevent adverse effects. Sweating across the forehead (Choice B) is a non-specific symptom and may not directly indicate digoxin toxicity. Poor sucking effort (Choice C) and a respiratory rate of 30 breaths/min (Choice D) are not typically associated with digoxin toxicity and do not require immediate intervention in the context of this question.
3. A client with chronic kidney disease is prescribed ferric citrate. The nurse should monitor for which potential side effect?
- A. Constipation
- B. Diarrhea
- C. Nausea
- D. Hyperphosphatemia
Correct answer: A
Rationale: When a client with chronic kidney disease is prescribed ferric citrate, the nurse should monitor for constipation as a potential side effect. Ferric citrate can lead to constipation due to its effects on the gastrointestinal system, causing a decrease in bowel movements. It is essential for the nurse to assess and manage constipation promptly to prevent complications and ensure the client's comfort and well-being. Monitoring bowel movements, providing adequate hydration, and recommending dietary interventions can help alleviate constipation in clients taking ferric citrate. Diarrhea, nausea, and hyperphosphatemia are not typically associated with the use of ferric citrate in clients with chronic kidney disease.
4. The client is being instructed on the correct technique for using... what to provide the client?
- A. Angle the tip of the inhaler upwards while spraying
- B. Hold one nostril closed while spraying the other nostril
- C. Avoid shaking the inhaler immediately before using
- D. Use the inhaler when first awakening in the morning
Correct answer: B
Rationale: The correct technique for using an inhaler for allergic rhinitis involves holding one nostril closed while spraying the other nostril to ensure proper delivery of the medication. This technique helps direct the medication into the nasal passages for optimal effectiveness. Choice A is incorrect as it refers to an incorrect technique for inhaler use. Choice C is incorrect as shaking the inhaler is often necessary to ensure proper mixing of the medication. Choice D is incorrect as the timing of inhaler use is typically based on individual preferences or healthcare provider recommendations, not specifically tied to the morning.
5. How should the healthcare provider schedule the administering of propylthiouracil (PTU)?
- A. Offer both drugs together with a meal
- B. Give parental dose once every 24 hours
- C. Schedule both medications at bedtime
- D. Administer iodine one hour before PTU
Correct answer: D
Rationale: Administering iodine one hour before PTU is crucial to ensure proper absorption and effectiveness of PTU. This timing helps optimize the therapeutic benefits of PTU by allowing it to be absorbed efficiently without interference from iodine, ultimately leading to better treatment outcomes for the patient. Choices A, B, and C are incorrect because offering both drugs together with a meal, giving parental dose once every 24 hours, and scheduling both medications at bedtime do not address the specific timing requirement of administering iodine before PTU for optimal absorption.
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