HESI LPN
Pharmacology HESI 2023
1. When a client with hepatic encephalopathy is receiving lactulose, which parameter is essential to monitor for a response to the drug?
- A. Serum hepatic enzymes
- B. Fingerstick glucose
- C. Stool color and character
- D. Serum electrolytes and ammonia
Correct answer: D
Rationale: In hepatic encephalopathy, the goal of lactulose therapy is to reduce blood ammonia levels by promoting its excretion in the stool. Therefore, monitoring serum electrolytes and ammonia levels is crucial to assess the effectiveness of lactulose in lowering ammonia levels and improving the client's condition. Options A, B, and C are incorrect because serum hepatic enzymes, fingerstick glucose, and stool color/character are not directly related to monitoring the response to lactulose therapy in hepatic encephalopathy.
2. What class of laxative would the nurse recommend to a patient asking about the best way to prevent constipation?
- A. Stimulant laxatives
- B. Bulk-forming laxatives
- C. Emollient laxatives
- D. Hyperosmotic laxatives
Correct answer: B
Rationale: The correct answer is B: Bulk-forming laxatives. These laxatives are recommended to prevent constipation because they work by absorbing liquid in the intestines, forming a bulky, soft stool that is easier to pass. They are safe and considered the most natural option. Stimulant laxatives (choice A) work by promoting bowel movements through intestinal contractions and are more suitable for treating occasional constipation rather than preventing it. Emollient laxatives (choice C) soften the stool by increasing the incorporation of water into the feces and are more suitable for patients who need to avoid straining during defecation. Hyperosmotic laxatives (choice D) work by drawing water into the intestine through osmosis and are typically used for more severe cases of constipation, not for prevention.
3. When administering medications to a group of clients, which client should the nurse closely monitor for the development of acute kidney injury (AKI)?
- A. Lorazepam
- B. Sucralfate
- C. Digoxin
- D. Vancomycin
Correct answer: D
Rationale: Vancomycin is known to be nephrotoxic, which means it can cause damage to the kidneys. Therefore, clients receiving Vancomycin should be closely monitored for signs and symptoms of acute kidney injury (AKI) to ensure early detection and intervention if necessary. Lorazepam, Sucralfate, and Digoxin do not typically cause acute kidney injury, so they are not the priority for monitoring in this scenario.
4. A client with a diagnosis of schizophrenia is prescribed ziprasidone. The nurse should monitor the client for which potential side effect?
- A. QT prolongation
- B. Weight gain
- C. Dry mouth
- D. Increased appetite
Correct answer: A
Rationale: The correct answer is A: QT prolongation. Ziprasidone is known to cause QT prolongation, which can potentially lead to serious cardiac issues. Monitoring the client's ECG is crucial to detect any changes and prevent adverse effects related to QT interval prolongation. Choices B, C, and D are incorrect because weight gain, dry mouth, and increased appetite are not commonly associated with ziprasidone. While weight gain can be a side effect of some antipsychotic medications, it is not a prominent side effect of ziprasidone. Dry mouth and increased appetite are also not typically linked to ziprasidone use.
5. An older adult with iron deficiency anemia is being discharged with iron supplements, which information should the nurse include in the discharge?
- A. Take the tablet with a daily multivitamin
- B. Crush the tablet and mix it with pudding
- C. Bedtime is the best time to take the tablet
- D. Wait 2 hours after meals to take the tablet
Correct answer: D
Rationale: The correct answer is to wait 2 hours after meals before taking the iron tablet. This is important to ensure better absorption and efficacy of the iron supplement. Taking the tablet with a daily multivitamin (Choice A) may interfere with iron absorption due to interactions with other minerals. Crushing the tablet and mixing it with pudding (Choice B) can alter the effectiveness of the medication. While bedtime (Choice C) may be convenient, waiting after meals is crucial for optimal iron absorption.
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