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. What is the primary nursing intervention that the practical nurse should perform before administering ampicillin to a client diagnosed with a urinary tract infection?
- A. Obtain a clean-catch urine specimen.
- B. Assess the urine pH for acidity.
- C. Insert an indwelling catheter.
- D. Assess for complaints of dysuria.
Correct answer: A
Rationale: The correct answer is to obtain a clean-catch urine specimen. Before administering ampicillin to a client with a urinary tract infection, it is crucial to collect a urine specimen to determine the causative organism and evaluate the effectiveness of pharmacological therapy. Assessing the urine pH for acidity (choice B) is not the primary intervention needed before administering ampicillin. Inserting an indwelling catheter (choice C) is invasive and not necessary unless indicated for specific reasons. Assessing for complaints of dysuria (choice D) is important but does not take precedence over obtaining a urine specimen for proper diagnosis and treatment.
3. A client with chronic kidney disease is prescribed lanthanum carbonate. The nurse should monitor for which potential side effect?
- A. Hypercalcemia
- B. Hypocalcemia
- C. Hyperkalemia
- D. Hypokalemia
Correct answer: A
Rationale: Lanthanum carbonate is prescribed in chronic kidney disease to bind dietary phosphorus in the gastrointestinal tract. This action can lead to decreased phosphorus absorption and potential hypercalcemia due to the increased serum calcium levels. Therefore, the nurse should monitor the client for signs and symptoms of hypercalcemia, such as confusion, fatigue, and muscle weakness. Choices B, C, and D are incorrect as lanthanum carbonate's mechanism of action does not lead to hypocalcemia, hyperkalemia, or hypokalemia.
4. A client with a history of hypertension is prescribed hydrochlorothiazide. The practical nurse should monitor the client for which potential adverse effect?
- A. Hyperkalemia
- B. Hypokalemia
- C. Hypernatremia
- D. Hyponatremia
Correct answer: B
Rationale: Corrected Rationale: Hydrochlorothiazide is a diuretic that can lead to potassium loss, resulting in hypokalemia. Monitoring for hypokalemia is essential because it can cause various complications such as cardiac dysrhythmias. Therefore, the practical nurse should closely watch for signs and symptoms of low potassium levels in clients taking hydrochlorothiazide. Incorrect Rationale for Other Choices: A. Hyperkalemia is not typically associated with hydrochlorothiazide use; instead, it is more commonly linked to medications like ACE inhibitors or potassium-sparing diuretics. C. Hypernatremia is unlikely with hydrochlorothiazide use as it tends to cause sodium loss. D. Hyponatremia is more commonly associated with conditions where there is excessive water intake or syndrome of inappropriate antidiuretic hormone secretion (SIADH), rather than with hydrochlorothiazide use.
5. What side effect is a male client likely to experience while receiving furosemide 40mg by mouth?
- A. Difficulty starting urination
- B. Nosebleeds
- C. Muscle cramps
- D. Visual disturbances
Correct answer: C
Rationale: Muscle cramps are a common side effect of furosemide due to its impact on electrolyte levels, especially potassium. Furosemide is a loop diuretic that can lead to potassium depletion, resulting in muscle cramps as one of the manifestations of electrolyte imbalances. Therefore, choices A, B, and D are incorrect. Difficulty starting urination is not a common side effect of furosemide; nosebleeds and visual disturbances are not typically associated with this medication.
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