HESI RN
HESI Pharmacology Practice Exam
1. When administering hydrochlorothiazide (HydroDIURIL) to a client, the nurse should be aware of which of the following concerns?
- A. Hypouricemia, hyperkalemia
- B. Increased risk of osteoporosis
- C. Hypokalemia, hyperglycemia, sulfa allergy
- D. Hyperkalemia, hypoglycemia, penicillin allergy
Correct answer: C
Rationale: The correct answer is C. Hydrochlorothiazide is a thiazide diuretic, which can lead to hypokalemia and hyperglycemia. It is also associated with hypercalcemia, hyperlipidemia, and hyperuricemia. Being a sulfa-based medication, individuals with a sulfa allergy are at risk for an allergic reaction when taking hydrochlorothiazide. Choice A is incorrect because hydrochlorothiazide can cause hyperkalemia rather than hypouricemia. Choice B is incorrect as there is no direct link between hydrochlorothiazide and an increased risk of osteoporosis. Choice D is incorrect because hypoglycemia and penicillin allergy are not typically associated with hydrochlorothiazide use.
2. The client has a PRN prescription for ondansetron (Zofran). For which condition should this medication be administered to the postoperative client?
- A. Paralytic ileus
- B. Incisional pain
- C. Urinary retention
- D. Nausea and vomiting
Correct answer: D
Rationale: Ondansetron, also known as Zofran, is an antiemetic medication primarily used to treat nausea and vomiting. In the postoperative setting, it is commonly administered to manage postoperative nausea and vomiting, which are frequent occurrences after surgery. Ondansetron works by blocking serotonin, a natural substance in the body that can trigger nausea and vomiting. It is also utilized to manage chemotherapy-induced nausea and vomiting. Therefore, the correct condition for which ondansetron should be administered to the postoperative client is nausea and vomiting.
3. A client receiving nitrofurantoin (Macrodantin) calls the health care provider's office complaining of side effects related to the medication. Which side effect indicates the need to stop treatment with this medication?
- A. Nausea
- B. Diarrhea
- C. Anorexia
- D. Cough and chest pain
Correct answer: D
Rationale: Pulmonary reactions such as cough and chest pain are serious side effects associated with nitrofurantoin that require immediate discontinuation of the medication to prevent potential severe respiratory complications.
4. Prednisone is prescribed for a client with diabetes mellitus who is taking Humulin neutral protamine Hagedorn (NPH) insulin daily. Which of the following prescription changes does the nurse anticipate during therapy with prednisone?
- A. An additional dose of prednisone daily
- B. A decreased amount of daily Humulin NPH insulin
- C. An increased amount of daily Humulin NPH insulin
- D. The addition of an oral hypoglycemic medication daily
Correct answer: C
Rationale: When prednisone is prescribed for a client with diabetes mellitus who is taking Humulin NPH insulin daily, the nurse should anticipate an increased amount of daily Humulin NPH insulin. Prednisone, a glucocorticoid, can elevate blood glucose levels, requiring an increase in insulin dosage to maintain optimal blood sugar control.
5. A client with chronic pain is prescribed transdermal fentanyl (Duragesic) patches. Which instruction should the nurse include in the teaching plan?
- A. Apply the patch to a different site each time.
- B. Avoid using heating pads over the patch.
- C. Change the patch every 72 hours.
- D. Remove the old patch before applying the new one.
Correct answer: B
Rationale: Clients using transdermal fentanyl (Duragesic) patches should avoid using heating pads over the patch as heat can increase the release of the medication, potentially leading to overdose. The patch should be applied to a different site each time, changed every 72 hours, and the old patch should be removed before applying a new one to prevent accidental overdose or excessive drug absorption.
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