HESI LPN
Pharmacology HESI 55 Questions 2023
1. A client with a diagnosis of bipolar disorder is prescribed topiramate. The nurse should monitor for which potential adverse effect?
- A. Cognitive impairment
- B. Weight gain
- C. Liver toxicity
- D. Weight loss
Correct answer: A
Rationale: Correct. Topiramate is associated with cognitive impairment as an adverse effect. It is important for the nurse to monitor the client's cognitive function while on this medication to assess for any signs of cognitive decline or impairment. Choice B, weight gain, is incorrect as topiramate is actually associated with weight loss rather than weight gain. Choice C, liver toxicity, is also incorrect as topiramate is not known to cause liver toxicity. Choice D, weight loss, is not the correct answer as topiramate is not associated with weight gain.
2. A client taking long-term steroids also has ranitidine prescribed. The nurse provides which explanation as to why these drugs are given together?
- A. Ranitidine reduces the risk of ulcers associated with steroids.
- B. Ranitidine decreases the risk of infection associated with steroids.
- C. Ranitidine decreases blood sugar elevations associated with steroids.
- D. Ranitidine reduces sodium retention associated with steroid usage.
Correct answer: A
Rationale: The correct answer is A. Ranitidine is prescribed with long-term steroids to reduce the risk of ulcers associated with steroid therapy. Although steroids can increase the risk of ulcers due to their effect on the gastrointestinal system, ranitidine works by reducing stomach acid production, thus helping to prevent ulcer formation. Choices B, C, and D are incorrect as ranitidine is not given to decrease the risk of infection, reduce blood sugar elevations, or reduce sodium retention associated with steroid usage.
3. A 67-year-old client is discharged from the hospital with a prescription for digoxin 0.25 mg daily. Which instruction by the practical nurse (PN) is correct?
- A. Take the medication in the morning before getting out of bed.
- B. Do not take the medication if the heartbeat is irregular or slow.
- C. Expect some vision changes due to the medication.
- D. Increase intake of foods rich in potassium.
Correct answer: B
Rationale: The correct instruction for a client taking digoxin is not to take the medication if the heartbeat is irregular or slow. Digoxin can affect the heart rhythm, so it is crucial to monitor the pulse rate. In case of irregular or slow heartbeats, the medication should be withheld, and the healthcare provider should be consulted. This step is necessary to prevent potential complications associated with digoxin therapy. Choices A, C, and D are incorrect. Taking digoxin in the morning before getting out of bed is not a specific requirement. Vision changes are not a common side effect of digoxin. While digoxin can affect potassium levels, it is not advised to increase potassium intake without healthcare provider guidance.
4. 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.
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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