HESI LPN
Pharmacology HESI 55 Questions 2023
1. A client with diabetes mellitus type 2 is prescribed dapagliflozin. The nurse should monitor for which potential adverse effect?
- A. Genital infections
- B. Hypoglycemia
- C. Hyperglycemia
- D. Nausea
Correct answer: A
Rationale: The correct answer is A: Genital infections. Dapagliflozin, a medication used in diabetes mellitus type 2, is associated with an increased risk of genital infections. Its mechanism of action involves promoting glucose excretion through the urine, creating a favorable environment for microbial growth in the genital area. Monitoring for genital infections is crucial when a client is prescribed dapagliflozin. Hypoglycemia (choice B) is not a common adverse effect of dapagliflozin since it does not directly lower blood glucose levels. Hyperglycemia (choice C) is also unlikely as dapagliflozin is intended to help lower blood glucose levels. Nausea (choice D) is a less common side effect of dapagliflozin compared to genital infections.
2. 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.
3. How do you determine if the medication is effective for a client with anemia secondary to chronic kidney disease (CKD)?
- A. Food diary shows increased consumption of iron-rich foods
- B. Reports of increased energy levels and decreased fatigue
- C. Hemoglobin level increased to 12 grams/dL
- D. Takes concurrent iron therapy without adverse effects
Correct answer: C
Rationale: The correct answer is C. To assess the effectiveness of medication for anemia in a client with CKD, monitoring hemoglobin levels is crucial. Hemoglobin levels directly indicate the response to treatment and improvement in the condition. An increase in hemoglobin level to 12 grams/dL suggests that the medication is effectively addressing the anemia associated with CKD. Choices A, B, and D are incorrect because increased consumption of iron-rich foods, reports of increased energy levels and decreased fatigue, and tolerance to concurrent iron therapy without adverse effects are not direct indicators of the medication's effectiveness in treating anemia secondary to CKD.
4. A client with a diagnosis of generalized anxiety disorder is prescribed paroxetine. The nurse should instruct the client that this medication may have which potential side effect?
- A. Drowsiness
- B. Dry mouth
- C. Nausea
- D. Headache
Correct answer: A
Rationale: The correct answer is A: Drowsiness. Paroxetine, used for generalized anxiety disorder, can cause drowsiness. Clients should be advised not to drive or operate heavy machinery until they know how the medication affects them. Dry mouth, nausea, and headache are potential side effects of other medications but are not commonly associated with paroxetine. Drowsiness is a common side effect for paroxetine and can impact a client's ability to perform tasks that require alertness.
5. The client is receiving vancomycin, and the nurse plans to draw blood for a peak and trough to determine... the best timing for these levels?
- A. Midway through administration of the IV dose and 30 minutes before the next
- B. Two hours after completion of the IV dose and 30 minutes before the next
- C. Two hours after completion of the IV dose and one hour before the next
- D. Immediately after completion of the IV dose and 30 minutes before
Correct answer: B
Rationale: To accurately determine peak and trough levels of vancomycin, blood should be drawn two hours after the completion of the IV dose and 30 minutes before the next dose. This timing allows for appropriate assessment of the drug levels in the body, ensuring accurate monitoring of therapeutic and toxic concentrations. Choice A is incorrect as drawing blood midway through administration does not provide an accurate peak level. Choice C is incorrect as drawing blood one hour before the next dose does not represent the trough level. Choice D is incorrect because drawing blood immediately after completion of the IV dose does not allow enough time for the drug to reach peak levels.
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