HESI RN
HESI Pharmacology Practice Exam
1. A client is taking lansoprazole (Prevacid) for the chronic management of Zollinger-Ellison syndrome. The nurse advises the client to take which of the following products if needed for a headache?
- A. Naproxen (Aleve)
- B. Ibuprofen (Advil)
- C. Acetaminophen (Tylenol)
- D. Acetylsalicylic acid (aspirin)
Correct answer: C
Rationale: Acetaminophen is the preferred choice for pain relief in individuals taking lansoprazole for Zollinger-Ellison syndrome due to its lower risk of stomach irritation compared to NSAIDs like ibuprofen and aspirin. Naproxen, ibuprofen, and aspirin are NSAIDs that can increase the risk of stomach irritation and bleeding, which is why they are not recommended for individuals with Zollinger-Ellison syndrome who are already on lansoprazole to reduce stomach acid production.
2. The client has reinforced instructions for taking cholestyramine (Questran). Which statement indicates a need for further instructions?
- A. I will continue taking vitamin supplements.
- B. This medication will help lower my cholesterol.
- C. This medication should only be taken with water.
- D. A high-fiber diet is important while taking this medication.
Correct answer: C
Rationale: The correct answer is C because cholestyramine should not only be taken with water. Flavored products or fruit juices can improve the taste. Choices A, B, and D are all correct statements. It is important for the client to continue taking vitamin supplements, understand that cholestyramine helps lower cholesterol, and maintain a high-fiber diet while taking this medication to enhance its effectiveness.
3. The healthcare provider should anticipate that the most likely medication to be prescribed prophylactically for a child with spina bifida (myelomeningocele) who has a neurogenic bladder would be:
- A. Prednisone
- B. Sulfisoxazole
- C. Furosemide (Lasix)
- D. Intravenous immune globulin (IVIG)
Correct answer: B
Rationale: Children with spina bifida, especially those with a neurogenic bladder, are at an increased risk of urinary tract infections. Sulfisoxazole, an antibiotic, is commonly prescribed prophylactically to prevent UTIs in this population. Prednisone (Choice A) is a corticosteroid and is not typically used for prophylaxis in this scenario. Furosemide (Lasix) (Choice C) is a diuretic used to treat fluid retention and hypertension, not for preventing UTIs. Intravenous immune globulin (IVIG) (Choice D) is used to boost the immune system, not for UTI prophylaxis in this case.
4. A client is being monitored while receiving bethanechol chloride (Urecholine) for urinary retention. Which of the following indicates a therapeutic effect of this medication?
- A. Increased heart rate
- B. Increased peristalsis
- C. Passage of flatus
- D. Urinary output of 50 mL per hour
Correct answer: D
Rationale: Bethanechol chloride (Urecholine) is administered to stimulate the bladder and treat urinary retention. The therapeutic effect is indicated by an increased urinary output, as it demonstrates the medication's ability to prompt the bladder to empty. Increased heart rate and passage of flatus are unrelated to the therapeutic effects of bethanechol. Although bethanechol can increase peristalsis, the primary therapeutic goal is to address urinary retention.
5. A client is being taught about the use of enoxaparin (Lovenox) for the prevention of deep vein thrombosis. Which instruction should the nurse include in the teaching plan?
- A. Inject the medication subcutaneously.
- B. Avoid massaging the injection site after administration.
- C. Administer the medication at the same time each day.
- D. Do not expel the air bubble from the syringe before injection.
Correct answer: C
Rationale: Enoxaparin (Lovenox) is administered subcutaneously at the same time each day to maintain consistent blood levels. Injecting the medication into the muscle is incorrect, as it should be given subcutaneously. Massaging the injection site should be avoided to prevent bruising. The air bubble in the prefilled syringe should not be expelled, as it ensures the full dose is administered.
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