HESI RN
HESI Pharmacology Practice Exam
1. A client is prescribed nitroglycerin (Nitro-Dur) transdermal patch for angina. Which instruction should the nurse include in the client's teaching plan?
- A. Apply the patch to a hairless area of skin.
- B. Leave the patch on for 24 hours.
- C. Apply the patch at the same time each day.
- D. You can keep the patch on while taking a shower.
Correct answer: C
Rationale: The correct instruction for the nurse to include in the client's teaching plan is to apply the nitroglycerin (Nitro-Dur) transdermal patch at the same time each day. This consistency helps maintain steady blood levels of the medication. While it is important to apply the patch to a hairless area of the skin for proper absorption, it does not necessarily have to be left on for 24 hours; typically, it is worn for 12-14 hours to allow for a nitrate-free period and reduce tolerance. Additionally, the patch can generally be kept on while taking a shower, as water exposure does not typically affect its efficacy.
2. Oxybutynin chloride (Ditropan XL) is prescribed for a client with neurogenic bladder. Which sign would indicate a possible toxic effect related to this medication?
- A. Pallor
- B. Drowsiness
- C. Bradycardia
- D. Restlessness
Correct answer: D
Rationale: Signs of toxicity related to oxybutynin chloride (Ditropan XL) include central nervous system excitation, such as nervousness, restlessness, hallucinations, and irritability. Other signs of toxicity may include hypotension or hypertension, confusion, tachycardia, a flushed or red face, and signs of respiratory depression. Restlessness is a sign of central nervous system excitation, which can indicate a possible toxic effect of this medication.
3. A client has been prescribed cyclosporine (Sandimmune). Which food item should the client avoid based on the medication's interaction?
- A. Red meats
- B. Orange juice
- C. Grapefruit juice
- D. Green, leafy vegetables
Correct answer: C
Rationale: Grapefruit juice should be avoided when taking cyclosporine because it inhibits the metabolism of the medication, leading to increased blood levels and a higher risk of toxicity. It is important for the client to follow this dietary instruction to ensure the safe and effective use of cyclosporine.
4. A nurse is providing instructions to an adolescent who has a history of seizures and is taking an anticonvulsant medication. Which of the following statements indicates that the client understands the instructions?
- A. I will never be able to drive a car.
- B. My anticonvulsant medication will clear up my skin.
- C. I can't drink alcohol while I am taking my medication.
- D. If I forget my morning medication, I can take two pills at bedtime.
Correct answer: C
Rationale: The correct answer is C: 'I can't drink alcohol while I am taking my medication.' Alcohol can lower the seizure threshold and should be avoided by individuals taking anticonvulsants. Choice A is incorrect because it is an extreme statement and not necessary for someone taking anticonvulsants. Choice B is incorrect as anticonvulsant medications are not used to clear skin conditions. Choice D is incorrect because doubling up medication doses can be harmful and should not be done without healthcare provider approval.
5. The nurse provides medication instructions to an older hypertensive client who is taking 20 mg of lisinopril (Prinivil, Zestril) orally daily. The nurse evaluates the need for further teaching when the client states which of the following?
- A. I can skip a dose once a week.
- B. I need to change my position slowly.
- C. I take the pill after breakfast each day.
- D. If I get a bad headache, I should call my doctor immediately.
Correct answer: A
Rationale: Lisinopril should be taken daily as prescribed and not skipped. Skipping doses can lead to ineffective treatment.
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