HESI LPN
Pharmacology HESI 2023
1. A client with a history of atrial fibrillation is prescribed digoxin. The nurse should monitor for which sign of digoxin toxicity?
- A. Bradycardia
- B. Tachycardia
- C. Nausea
- D. Vomiting
Correct answer: A
Rationale: Bradycardia is a common sign of digoxin toxicity. Digoxin, a medication used to treat atrial fibrillation, can lead to toxicity manifesting as various cardiac dysrhythmias, with bradycardia being a notable indicator. Monitoring for bradycardia is crucial as it can indicate the need for dosage adjustment or discontinuation of digoxin to prevent adverse effects. Tachycardia, nausea, and vomiting are not typically associated with digoxin toxicity, making them incorrect choices for monitoring in a client receiving this medication.
2. A client with heart failure develops hyperaldosteronism. What dietary recommendation is essential for managing this condition?
- A. Limit intake of high potassium foods
- B. Replace salt with salt substitute
- C. Monitor skin for excessive bruising
- D. Cover your skin before going outside
Correct answer: A
Rationale: Hyperaldosteronism can lead to increased potassium retention, which can be problematic for individuals with heart failure. Limiting intake of high potassium foods is crucial to prevent hyperkalemia, a condition that can worsen heart failure. Therefore, advising the client to limit high potassium foods is essential in managing hyperaldosteronism in the setting of heart failure.
3. A client with diabetes mellitus type 1 is prescribed insulin lispro. When should the nurse instruct the client to administer this medication?
- A. 5-10 minutes before meals
- B. 15 minutes after meals
- C. 30 minutes before meals
- D. 1 hour after meals
Correct answer: A
Rationale: Corrected Rationale: Insulin lispro is a rapid-acting insulin that should be administered 5-10 minutes before meals. This timing helps synchronize the peak action of insulin with the rise in blood glucose levels after eating, effectively managing postprandial hyperglycemia. Choice B, administering 15 minutes after meals, is incorrect because rapid-acting insulins like lispro are meant to act quickly to cover the rise in blood glucose levels after meals. Choices C and D are also incorrect as they do not align with the rapid onset of action required to manage postprandial hyperglycemia in patients with diabetes mellitus type 1.
4. A client with a diagnosis of schizophrenia is prescribed risperidone. The nurse should monitor for which potential side effect?
- A. Weight gain
- B. Tremors
- C. Insomnia
- D. Hyperglycemia
Correct answer: A
Rationale: The correct answer is A: Weight gain. When a client is prescribed risperidone, monitoring weight is crucial due to the potential side effect of weight gain associated with this medication. This side effect can be significant as it may lead to other health issues. Choice B, Tremors, is not typically associated with risperidone use. Choice C, Insomnia, is less likely to be a direct side effect of risperidone compared to weight gain. Choice D, Hyperglycemia, is a possible side effect of some antipsychotic medications, but it is not commonly associated with risperidone.
5. During a home visit, a client with a history of angina reports frequent headaches. The client recently started a new prescription for diltiazem, a calcium channel blocker. What action should the nurse take?
- A. Explain the importance of obtaining a blood sample promptly to test for medication toxicity
- B. Consult with the healthcare provider regarding the necessity of an opioid analgesic for pain relief
- C. Recommend the client to discontinue the medication until contacting the healthcare provider
- D. Instruct the client on the use of acetaminophen every 4-6 hours as needed for headaches
Correct answer: D
Rationale: The correct action for the nurse to take is to instruct the client to use acetaminophen for headaches. Acetaminophen is a suitable and safer option for managing headaches associated with calcium channel blockers like diltiazem. It is essential to avoid medications that can interact negatively with diltiazem, such as opioid analgesics. Discontinuing the medication abruptly without consulting the healthcare provider is not recommended. Monitoring for medication toxicity through blood samples is not typically indicated for managing headaches in this scenario.
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