HESI LPN
Pharmacology HESI 2023
1. A client is prescribed nitroglycerin sublingual tablets. The practical nurse should reinforce which instruction?
- A. Store the tablets in a cool, dry place.
- B. Take one tablet every 5 minutes until pain is relieved, up to three tablets.
- C. Swallow the tablets whole.
- D. Chew the tablets for faster relief.
Correct answer: A
Rationale: Nitroglycerin sublingual tablets are sensitive to heat and moisture, so they should be stored in a cool, dry place to maintain their efficacy. Storing them in a cool, dry place helps prevent degradation of the medication. Choice B is incorrect because nitroglycerin tablets should be taken as directed by the healthcare provider to avoid potential overdose or adverse effects. Choice C is incorrect because sublingual tablets should be placed under the tongue to dissolve and be absorbed, not swallowed, to ensure their quick action. Choice D is incorrect because sublingual tablets should not be chewed; they are meant to be absorbed through the tissues under the tongue, and chewing them may alter their effectiveness.
2. A client is prescribed an antacid for the treatment of peptic ulcer disease. What is the action of this medication that is effective in treating the client's ulcer?
- A. Decrease in the production of gastric secretions
- B. Production of an adherent barrier over the ulcer
- C. Maintenance of a gastric pH of 3.5 or above
- D. Decrease in the gastric motor activity
Correct answer: C
Rationale: The correct answer is C. Antacids work by neutralizing gastric acids and maintaining a gastric pH of 3.5 or above. This pH level is crucial to prevent the activation of pepsinogen, a precursor to pepsin, which can further damage the ulcer. Choice A is incorrect because antacids do not directly decrease the production of gastric secretions; they neutralize existing acid. Choice B is incorrect as antacids do not form a physical barrier over the ulcer but rather neutralize the acid around it. Choice D is also incorrect as antacids do not affect gastric motor activity but focus on reducing acidity in the stomach.
3. What instruction should the nurse include in the teaching plan for a client with diabetes mellitus type 2 prescribed alogliptin?
- A. Report any signs of pancreatitis to the healthcare provider.
- B. Take this medication with meals.
- C. Avoid alcohol while taking this medication.
- D. Report any signs of heart failure to the healthcare provider.
Correct answer: A
Rationale: The correct answer is A: Report any signs of pancreatitis to the healthcare provider. Alogliptin is associated with an increased risk of pancreatitis. Therefore, clients should be instructed to report any signs of pancreatitis, such as severe abdominal pain, to their healthcare provider promptly. This is essential for early detection and management of this serious adverse effect. Choices B, C, and D are incorrect because they do not address the specific side effect associated with alogliptin.
4. A client with angina pectoris has been prescribed nitroglycerin tablets prn for chest pain. Which statement by the client causes the practical nurse (PN) to clarify instructions for this client?
- A. I will take one tablet every 5 minutes, up to three tablets.
- B. I should take one tablet at the onset of angina and stop activity.
- C. I need to replace nitroglycerin tablets every 3 to 6 months to maintain freshness.
- D. I should ensure that I chew the pill completely before swallowing it.
Correct answer: D
Rationale: Nitroglycerin tablets should be taken at the onset of angina, and the client should stop activity and rest. One tablet should be placed under the tongue (sublingually), not chewed or swallowed. One tablet can be taken every 5 minutes, up to three doses. If pain relief not achieved after taking three pills, seek medical attention immediately. Nitroglycerin should be replaced every 3 to 6 months. Nitroglycerin pain relief should occur in 5 minutes and duration should last 30 minutes.
5. A client with a diagnosis of schizophrenia is prescribed olanzapine. The nurse should monitor for which potential side effect?
- A. Weight gain
- B. Insomnia
- C. Dry mouth
- D. Headache
Correct answer: A
Rationale: When a client with schizophrenia is prescribed olanzapine, the nurse should monitor for weight gain as a potential side effect. Olanzapine is known to cause metabolic changes that can lead to weight gain, making it crucial for the nurse to closely monitor the client's weight during treatment. This side effect is significant as it can impact the client's overall health and well-being, so early detection and intervention are essential to manage it effectively.
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