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. A client is receiving desmopressin acetate (DDAVP), and a healthcare provider is monitoring for adverse effects. Which of the following indicates the presence of an adverse effect?
- A. Insomnia
- B. Drowsiness
- C. Weight loss
- D. Increased urination
Correct answer: B
Rationale: Drowsiness can be a sign of water intoxication or hyponatremia, which are potential adverse effects of desmopressin acetate (DDAVP). It is crucial to monitor for this symptom and promptly address it to prevent complications.
3. A client is receiving instructions from a healthcare provider about intranasal desmopressin acetate (DDAVP). The healthcare provider explains that which of the following is a side effect of the medication?
- A. Headache
- B. Vulval pain
- C. Runny nose
- D. Flushed skin
Correct answer: C
Rationale: Intranasal desmopressin can cause a runny or stuffy nose as a side effect due to its mode of administration through the nasal passages.
4. A client is taking propranolol (Inderal LA). Which data collection finding would indicate a potential serious complication associated with propranolol?
- A. The development of complaints of insomnia
- B. The development of audible expiratory wheezes
- C. A baseline blood pressure of 150/80 mm Hg followed by a blood pressure of 138/72 mm Hg after two doses of the medication
- D. A baseline resting heart rate of 88 beats/min followed by a resting heart rate of 72 beats/min after two doses of the medication
Correct answer: B
Rationale: The development of audible expiratory wheezes may indicate a serious adverse reaction, bronchospasm, associated with propranolol. Beta-blockers can trigger bronchospasm, especially in clients with chronic obstructive pulmonary disease or asthma. This complication can lead to significant respiratory distress and should be addressed promptly to prevent further complications.
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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