HESI LPN
Pharmacology HESI 55 Questions 2023
1. A client diagnosed with angina has been prescribed nitrate isosorbide dinitrate. Which instruction should the practical nurse reinforce in this client's teaching?
- A. Discontinue the medication if dizziness occurs.
- B. Avoid getting up quickly. Always rise slowly.
- C. Take the medication with or without food.
- D. Increase your intake of potassium-rich foods.
Correct answer: B
Rationale: The correct instruction that the practical nurse should reinforce with a client prescribed nitrate isosorbide dinitrate is to avoid getting up quickly and to rise slowly. Nitrates can cause orthostatic hypotension, a sudden drop in blood pressure when changing positions. By rising slowly, the client can prevent the occurrence of orthostatic hypotension and its associated symptoms. Choices A, C, and D are incorrect because discontinuing the medication without consulting a healthcare provider can be dangerous, taking the medication with or without food does not impact its effectiveness, and increasing potassium intake is not directly related to the use of nitrate isosorbide dinitrate.
2. An adolescent client with a seizure disorder is prescribed the anticonvulsant medication carbamazepine. The nurse should notify the healthcare provider if the client develops which condition?
- A. Experiences dry mouth.
- B. Experiences dizziness.
- C. Develops a sore throat.
- D. Develops gingival hyperplasia.
Correct answer: C
Rationale: The correct answer is C: 'Develops a sore throat.' When a client on carbamazepine develops flu-like symptoms such as pallor, fatigue, sore throat, and fever, it could indicate blood dyscrasias (aplastic anemia, leukopenia, anemia, thrombocytopenia), which are potential adverse effects of the medication. These symptoms warrant immediate notification of the healthcare provider for further evaluation and management to prevent complications. Choices A, B, and D are incorrect because dry mouth, dizziness, and gingival hyperplasia are not commonly associated with carbamazepine use and do not indicate serious adverse effects that require immediate healthcare provider notification.
3. A client with hypertension is prescribed atenolol. The nurse should monitor the client for which potential side effect?
- A. Bradycardia
- B. Tachycardia
- C. Hypotension
- D. Hyperglycemia
Correct answer: A
Rationale: When a client is prescribed atenolol, a beta-blocker medication used to treat hypertension, the nurse should monitor for bradycardia as a potential side effect. Atenolol works by slowing the heart rate, and one common adverse effect is bradycardia, which is a slower than normal heart rate. Monitoring the client's heart rate is essential to detect and manage this potential side effect promptly. Choices B, C, and D are incorrect because atenolol typically does not cause tachycardia, hypotension, or hyperglycemia as primary side effects. Instead, bradycardia is a common concern due to the drug's mechanism of action in reducing heart rate.
4. A client with severe rheumatoid arthritis is prescribed methotrexate. The nurse should monitor the client for which potential adverse effect?
- A. Bone marrow suppression
- B. Increased risk of infection
- C. Liver toxicity
- D. Kidney stones
Correct answer: A
Rationale: The correct answer is A: Bone marrow suppression. Methotrexate, commonly used in rheumatoid arthritis, can lead to bone marrow suppression, reducing the production of blood cells and increasing the risk of infection. Monitoring for signs of anemia, leukopenia, and thrombocytopenia is crucial to detect bone marrow suppression early and prevent complications. Choices B, C, and D are incorrect because while methotrexate can increase the risk of infection, liver toxicity, and kidney issues, the primary concern and most significant adverse effect to monitor for is bone marrow suppression due to its impact on blood cell production.
5. A client is prescribed phenobarbital 100 mg daily for the treatment of seizures. Which statement made by the client indicates an accurate understanding of the medication phenobarbital?
- A. I will take my medicine at 10 PM before retiring to bed.
- B. The medication will turn the color of my urine to a pink color.
- C. I should not eat or drink anything for at least 2 hours before taking my medicine.
- D. In the event a seizure occurs in the middle of the day, I need to take an extra dose of my medicine.
Correct answer: A
Rationale: The correct answer is A. Phenobarbital should be taken at the same time every day to maintain blood levels and enhance compliance. Common side effects of phenobarbital include drowsiness, lethargy, dizziness, and nausea; therefore, it is best to take it before bedtime to minimize these effects and improve sleep quality. Choice B is incorrect because phenobarbital does not affect the color of urine. Choice C is incorrect because there is no need to fast before taking phenobarbital. Choice D is incorrect because taking extra doses without healthcare provider guidance can lead to overdose and adverse effects.
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