HESI RN
Pharmacology HESI
1. A client is taking levothyroxine (Synthroid). The nurse instructs the client to notify the health care provider (HCP) if which of the following occurs?
- A. Fatigue
- B. Tremors
- C. Cold intolerance
- D. Excessively dry skin
Correct answer: B
Rationale: Tremors are a sign of excessive doses of levothyroxine, indicating hyperthyroidism. It is important for the client to report tremors to the healthcare provider to prevent complications associated with overdosing on levothyroxine.
2. The camp nurse asks the children preparing to swim in the lake if they have applied sunscreen. The nurse reminds the children that chemical sunscreens are most effective when applied:
- A. Immediately before swimming
- B. 15 minutes before exposure to the sun
- C. Immediately before exposure to the sun
- D. At least 30 minutes before exposure to the sun
Correct answer: D
Rationale: Chemical sunscreens are most effective when applied at least 30 minutes before exposure to the sun to allow them to penetrate the skin and provide optimal protection. Applying sunscreen immediately before swimming (Choice A) or immediately before exposure to the sun (Choice C) may not provide sufficient time for the sunscreen to be absorbed and offer proper protection. Applying sunscreen 15 minutes before sun exposure (Choice B) is also not ideal as it may not allow enough time for the sunscreen to work effectively. Therefore, the correct answer is to apply chemical sunscreen at least 30 minutes before exposure to the sun to ensure it can be absorbed and offer the intended protection. It is important to reapply sunscreen after swimming or sweating to maintain its effectiveness.
3. Colcrys (colchicine) is prescribed for a client with a diagnosis of gout. The nurse reviews the client's medical history in the health record, knowing that the medication would be contraindicated in which disorder?
- A. Myxedema
- B. Renal failure
- C. Hypothyroidism
- D. Diabetes mellitus
Correct answer: B
Rationale: Colchicine is contraindicated in clients with severe gastrointestinal, renal, hepatic, or cardiac disorders, or blood dyscrasias. Renal failure is a condition where the kidneys fail to function adequately, leading to the accumulation of toxins in the body. Since colchicine is contraindicated in clients with renal disorders, including renal failure, it could exacerbate the condition and worsen the client's health. Myxedema, hypothyroidism, and diabetes mellitus are not contraindications for colchicine use. While these conditions may require caution or monitoring when administering colchicine, they are not absolute contraindications like renal failure.
4. A client with severe acne is seen in the clinic, and the healthcare provider prescribes isotretinoin. The nurse reviews the client's medication record and would contact the healthcare provider if the client is taking which medication?
- A. Vitamin A
- B. Digoxin (Lanoxin)
- C. Furosemide (Lasix)
- D. Phenytoin (Dilantin)
Correct answer: A
Rationale: Isotretinoin is a metabolite of vitamin A, which can lead to toxicity when taken together. Therefore, it is crucial to avoid concurrent use of vitamin A supplements with isotretinoin. Contacting the healthcare provider to discuss discontinuing vitamin A supplements is important to prevent potential adverse effects. Choices B, C, and D are incorrect as they are not known to interact significantly with isotretinoin.
5. The healthcare provider is analyzing the laboratory results of a client with leukemia who has received a regimen of chemotherapy. Which laboratory value would the healthcare provider specifically note as a result of the massive cell destruction that occurred from the chemotherapy?
- A. Anemia
- B. Decreased platelets
- C. Increased uric acid level
- D. Decreased leukocyte count
Correct answer: C
Rationale: Following chemotherapy for leukemias and lymphomas, hyperuricemia is common due to the massive cell kill. Chemotherapy leads to the rapid destruction of cancer cells, releasing large amounts of nucleic acids, which are broken down into uric acid. Monitoring and managing uric acid levels are crucial to prevent complications such as renal damage and gout.
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