HESI LPN
Pharmacology HESI 2023
1. A client with a history of deep vein thrombosis is prescribed rivaroxaban. The nurse should monitor for which potential adverse effect?
- A. Increased risk of bleeding
- B. Decreased risk of bleeding
- C. Increased risk of infection
- D. Decreased risk of infection
Correct answer: A
Rationale: When a client with a history of deep vein thrombosis is prescribed rivaroxaban, the nurse should monitor for signs of bleeding as rivaroxaban increases the risk of bleeding. Common adverse effects of rivaroxaban include bleeding events, such as easy bruising, prolonged bleeding from cuts, or blood in the urine or stool. It is crucial for the nurse to assess for these signs to prevent complications and ensure the client's safety. Choices B, C, and D are incorrect because rivaroxaban does not decrease the risk of bleeding, increase the risk of infection, or decrease the risk of infection. Monitoring for bleeding is essential due to the anticoagulant properties of rivaroxaban.
2. A home health care nurse observes that a client with Parkinson's syndrome is experiencing increased tremors and difficulty in movement. What should the nurse do in response to this finding?
- A. Report the observed finding to the healthcare provider right away
- B. Arrange a medical evaluation so the medication dose can be adjusted
- C. Schedule a return home visit in 2 weeks to monitor
- D. Explain that this is an expected progression of Parkinson's
Correct answer: B
Rationale: In a client with Parkinson's syndrome experiencing increased tremors and movement difficulty, arranging a medical evaluation is crucial to adjust the medication dose. This proactive approach helps in managing the symptoms effectively. Reporting the finding to the healthcare provider may delay necessary adjustments in treatment. Scheduling a return home visit in 2 weeks may not address the immediate need for medication adjustment. Explaining that the progression is expected without taking action does not address the client's worsening symptoms.
3. A client with gastroesophageal reflux disease (GERD) is prescribed omeprazole. The nurse should reinforce which instruction?
- A. Take this medication in the morning before breakfast.
- B. Take this medication with meals.
- C. Avoid taking this medication with antacids.
- D. Take this medication at bedtime.
Correct answer: A
Rationale: The correct instruction for a client with GERD prescribed omeprazole is to take the medication in the morning before breakfast. Omeprazole works best when taken on an empty stomach, approximately 30 minutes before the first meal of the day. This timing maximizes its effectiveness in reducing stomach acid production and helps manage symptoms of GERD more efficiently. Choice B is incorrect because taking omeprazole with meals may reduce its efficacy as it needs an empty stomach for optimal absorption. Choice C is incorrect because omeprazole can be taken with or without food, but it should not be taken with antacids as they can affect its absorption. Choice D is incorrect because taking omeprazole at bedtime is less effective compared to taking it before breakfast due to the circadian rhythm of gastric acid secretion.
4. A client with asthma is prescribed montelukast. The nurse should instruct the client that this medication is used for which purpose?
- A. Immediate relief of acute asthma attacks
- B. Long-term control of asthma symptoms
- C. Treatment of exercise-induced bronchospasm
- D. Immediate relief of allergic rhinitis symptoms
Correct answer: B
Rationale: Montelukast is a leukotriene receptor antagonist used for the long-term control of asthma symptoms by reducing inflammation in the airways. It is not typically used for immediate relief during acute asthma attacks, where short-acting bronchodilators are more appropriate. Montelukast does not specifically target exercise-induced bronchospasm or allergic rhinitis symptoms. Therefore, the correct answer is B. Choice A is incorrect because montelukast is not for immediate relief of acute asthma attacks. Choice C is incorrect as montelukast is not primarily used to treat exercise-induced bronchospasm. Choice D is incorrect because montelukast is not indicated for immediate relief of allergic rhinitis symptoms.
5. A client with hypertension is prescribed amlodipine. The nurse should monitor for which potential adverse effect?
- A. Peripheral edema
- B. Bradycardia
- C. Hypertension
- D. Increased appetite
Correct answer: A
Rationale: Corrected Rationale: Amlodipine is known to cause peripheral edema as a potential adverse effect due to its vasodilatory properties. This can lead to fluid accumulation in the extremities. Monitoring for peripheral edema in patients taking amlodipine is crucial to identify and manage this side effect promptly. Choices B, C, and D are incorrect because amlodipine is not associated with causing bradycardia, hypertension (as the patient already has hypertension), or increased appetite as adverse effects.
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