HESI LPN
Pharmacology HESI 55 Questions 2023
1. A client receiving enalapril reports a persistent dry cough. The nurse should explain that this side effect is related to which medication action?
- A. It reduces the production of angiotensin II.
- B. It increases the production of angiotensin II.
- C. It causes increased production of bradykinin.
- D. It increases the production of aldosterone.
Correct answer: C
Rationale: The correct answer is C. Enalapril, an ACE inhibitor, inhibits the conversion of angiotensin I to angiotensin II, leading to increased levels of bradykinin. The accumulation of bradykinin is responsible for the persistent dry cough associated with ACE inhibitors like enalapril. Choices A, B, and D are incorrect because enalapril does not directly affect the production of angiotensin II or aldosterone. Instead, it primarily impacts the renin-angiotensin-aldosterone system by inhibiting the conversion of angiotensin I to angiotensin II, leading to bradykinin accumulation.
2. 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.
3. A client with chronic obstructive pulmonary disease (COPD) is prescribed ipratropium. The nurse should assess the client for which potential side effect?
- A. Nausea
- B. Dry mouth
- C. Cough
- D. Palpitations
Correct answer: B
Rationale: The correct answer is B: Dry mouth. Ipratropium can cause dry mouth as a common side effect due to its anticholinergic effects. Anticholinergic medications like ipratropium can lead to decreased salivary flow, resulting in dry mouth. Choices A, C, and D are incorrect because nausea, cough, and palpitations are not commonly associated with ipratropium use.
4. A client with hypertension is prescribed lisinopril. The nurse should monitor the client for which potential side effect?
- A. Cough
- B. Dizziness
- C. Hyperkalemia
- D. Hyponatremia
Correct answer: A
Rationale: The correct answer is A: Cough. Lisinopril is known to cause a persistent dry cough as a side effect. It is essential for the nurse to monitor the client for this adverse reaction as it may lead to discontinuation of the medication. Dizziness, hyperkalemia, and hyponatremia are not typically associated with lisinopril use. Dizziness is more commonly seen with antihypertensives that cause orthostatic hypotension. Hyperkalemia and hyponatremia are not usually linked to lisinopril use.
5. A client who takes metformin for diabetes mellitus type 2 is nothing by mouth (NPO) for surgery. What pre-op prescription should the practical nurse (PN) anticipate for this client's glucose management?
- A. NPO except for metformin and regular snacks
- B. NPO except for oral antidiabetic agent
- C. Novolin-N insulin subcutaneously twice daily
- D. Regular insulin subcutaneously per sliding scale
Correct answer: D
Rationale: When a client taking metformin for diabetes mellitus type 2 is NPO for surgery, it is crucial to manage their glucose levels effectively. The best approach in this situation is to prescribe regular insulin subcutaneously according to a sliding scale based on the client's blood glucose levels. This method allows for precise adjustment of insulin doses to maintain blood glucose within the target range while the client is unable to take oral medications. Choices A and B are incorrect because metformin is typically held when a client is NPO, and oral antidiabetic agents may not provide sufficient glucose control. Choice C is incorrect as Novolin-N insulin given twice daily may not offer the flexibility needed for glucose management in a surgical setting where the client's intake is restricted.
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