HESI LPN
Pharmacology HESI 55 Questions 2023
1. 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.
2. 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.
3. The healthcare provider is assessing the effectiveness of the drug amiodarone. Which client statement best indicates that the drug has been effective?
- A. I have not had as many spells of angina.
- B. I have not had as much swelling in my ankles lately.
- C. My doctor told me my cholesterol levels were improving with each visit.
- D. I do not notice as many irregular heartbeats as before I started taking this medication.
Correct answer: D
Rationale: The correct answer is option D. The effectiveness of amiodarone is best assessed by a reduction in irregular heartbeats since it is primarily used to treat ventricular dysrhythmias. This drug's main purpose is to control irregular heart rhythms, so a decrease in irregular heartbeats indicates its effectiveness. Options A, B, and C are incorrect because amiodarone is not primarily used to address angina, ankle swelling, or cholesterol levels, so improvements in these areas do not directly reflect the drug's effectiveness.
4. The patient is prescribed cimetidine (Tagamet) orally. What should the nurse consider about administering this drug?
- A. Administer the drug with the first bite of food
- B. Administer the drug immediately after meals
- C. Administer the drug 30 minutes after meals
- D. Administer the drug 30 minutes before meals
Correct answer: D
Rationale: Cimetidine is best absorbed when taken 30 minutes before meals to decrease stomach acid. Administering it before meals allows for optimal absorption and effectiveness of the medication. Choices A, B, and C are incorrect because administering cimetidine with food, immediately after meals, or 30 minutes after meals may not provide the best conditions for absorption. Taking it before meals ensures that the drug is absorbed properly and can exert its intended 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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