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. A healthcare professional is preparing to administer an intramuscular dose of penicillin to a client with a history of anaphylactic reactions to penicillin. Which action should the healthcare professional take first?
- A. Check the medication order for accuracy.
- B. Have an epinephrine injection available.
- C. Administer a test dose to check for a reaction.
- D. Ask the client about any allergies.
Correct answer: B
Rationale: When dealing with a client who has a history of anaphylactic reactions to penicillin, the priority action for the healthcare professional is to have an epinephrine injection readily available in case of a severe allergic reaction. In such cases, the immediate focus is on being prepared to manage a potentially life-threatening situation. While checking the medication order for accuracy, administering a test dose, and asking the client about allergies are essential steps in medication administration, the first priority is ensuring the availability of epinephrine to address a severe allergic reaction promptly.
3. The home health care nurse is visiting a client who was recently diagnosed with type 2 diabetes mellitus. The client is prescribed repaglinide (Prandin) and metformin (Glucophage) and asks the nurse to explain these medications. The nurse should reinforce which instructions to the client? Select one that doesn't apply.
- A. Diarrhea can occur secondary to the metformin.
- B. The repaglinide is not taken if a meal is skipped.
- C. The repaglinide is taken 30 minutes before eating.
- D. Nausea and vomiting
Correct answer: D
Rationale: Repaglinide is a rapid-acting oral hypoglycemic that should be taken before meals and withheld if the client does not eat. Hypoglycemia is a side effect of repaglinide, so carrying a simple sugar is essential. Metformin decreases hepatic glucose production and can cause diarrhea. Muscle pain may occur as an adverse effect and should be reported to the HCP.
4. A community health nurse visits a client at home. Prednisone 10 mg orally daily has been prescribed for the client. The nurse reinforces teaching for the client about the medication. Which statement, if made by the client, indicates that further teaching is necessary?
- A. I can take aspirin or my antihistamine if I need it.
- B. I need to take the medication every day at the same time.
- C. I need to avoid coffee, tea, cola, and chocolate in my diet.
- D. If I gain more than 5 pounds a week, I will call my doctor.
Correct answer: A
Rationale: Aspirin and other over-the-counter medications should not be taken without consulting the health care provider (HCP). The client needs to take the medication at the same time every day and avoid caffeine-containing foods and fluids to prevent steroid-ulcer development.
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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