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Pharmacology HESI 55 Questions 2023
1. A client with chronic heart failure is prescribed furosemide. The nurse should monitor the client for which potential adverse effect?
- A. Increased blood glucose levels
- B. Electrolyte imbalance
- C. Dehydration
- D. Weight gain
Correct answer: C
Rationale: When a client with chronic heart failure is prescribed furosemide, a diuretic, the nurse should be vigilant for potential adverse effects. Furosemide can lead to excessive fluid loss, resulting in dehydration. Dehydration is a significant concern as it can exacerbate heart failure symptoms. Additionally, furosemide can cause electrolyte imbalances, particularly affecting potassium and sodium levels. Monitoring for signs of dehydration and electrolyte disturbances is crucial to prevent complications and ensure the client's safety and well-being. Increased blood glucose levels and weight gain are not commonly associated with furosemide use in heart failure patients, making choices A and D incorrect.
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 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.
4. 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.
5. 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.
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