HESI LPN
Pharmacology HESI Practice
1. A client is prescribed verapamil for hypertension. The nurse should monitor the client for which common adverse effect?
- A. Constipation
- B. Headache
- C. Muscle cramping
- D. Fatigue
Correct answer: A
Rationale: Verapamil, a calcium channel blocker commonly used for hypertension, is known to cause constipation as a frequent adverse effect. This occurs due to its effects on smooth muscle relaxation in the gastrointestinal tract, leading to decreased motility. Headache, muscle cramping, and fatigue are not typically associated with verapamil use and are less common side effects. Therefore, the nurse should closely monitor the client for symptoms of constipation when administering verapamil.
2. A client with a diagnosis of schizophrenia is prescribed clozapine. The nurse should monitor the client for which potential side effect?
- A. Agranulocytosis
- B. Dry mouth
- C. Weight gain
- D. Hypersalivation
Correct answer: A
Rationale: The correct answer is Agranulocytosis. Clozapine is known to potentially cause agranulocytosis, a serious condition characterized by a dangerously low white blood cell count. Monitoring white blood cell counts is crucial to detect this side effect early and prevent complications. Choices B, C, and D are incorrect because dry mouth, weight gain, and hypersalivation are not typically associated with clozapine use. While dry mouth can be a common side effect of some antipsychotic medications, it is not specifically linked to clozapine. Weight gain can occur with certain antipsychotics, but clozapine is more commonly associated with metabolic side effects. Hypersalivation is not a common side effect of clozapine.
3. A client admitted with shortness of breath and palpitations currently takes an antiarrhythmic medication, dronedarone. Which action should the nurse take to prevent arrhythmias?
- A. Measure orthostatic blood pressure
- B. Obtain a 12-lead ECG reading daily
- C. Assess the client's apical pulse daily
- D. Provide continuous ECG monitoring
Correct answer: D
Rationale: The correct action to prevent arrhythmias in a client taking an antiarrhythmic medication like dronedarone is to provide continuous ECG monitoring. This is essential because antiarrhythmic drugs can sometimes cause pro-arrhythmic effects, which may lead to dangerous heart rhythm disturbances. Continuous ECG monitoring allows for real-time detection of any abnormal rhythms, enabling prompt intervention. Measuring orthostatic blood pressure, obtaining a 12-lead ECG reading daily, and assessing the client's apical pulse daily are important assessments in general patient care but may not specifically prevent arrhythmias in this scenario.
4. A client with a history of atrial fibrillation is prescribed rivaroxaban. The nurse should monitor for which potential side effect?
- A. Weight gain
- B. Dry mouth
- C. Dizziness
- D. Headache
Correct answer: A
Rationale: The correct answer is weight gain. Rivaroxaban, an anticoagulant, may lead to weight gain as a side effect due to fluid retention. Dry mouth (choice B), dizziness (choice C), and headache (choice D) are not typically associated with rivaroxaban use. Therefore, monitoring for weight gain is crucial to detect and manage this potential side effect in the client.
5. A client who is being discharged to home asks the practical nurse (PN) for a dose of hydrocodone before leaving the hospital. How should the PN respond to this client's request?
- A. Determine if a take-home prescription for hydrocodone was provided and, if so, tell him to take one of them.
- B. Encourage him to wait until he is at home to take a medication that might impair reasoning.
- C. Give him a tablet from the hospital stock and tell him to wait until he is almost home to take it.
- D. Ask him to describe the location and severity of the pain and to rate it on a scale from 1 to 10.
Correct answer: D
Rationale: Hydrocodone is a narcotic analgesic, and the practical nurse should gather more data from the client about the pain he is experiencing before giving the medication. The client's need for pain medication should be addressed, and pain medication should not be withheld because he is going home.
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