HESI RN
HESI Pharmacology Practice Exam
1. Bethanechol chloride (Urecholine) is prescribed for a client with urinary retention. Which disorder would be a contraindication to the administration of this medication?
- A. Gastric atony
- B. Urinary strictures
- C. Neurogenic atony
- D. Gastroesophageal reflux
Correct answer: B
Rationale: Bethanechol chloride (Urecholine) should not be administered to clients with urinary strictures as it can contract the bladder and increase pressure within the urinary tract. In individuals with urinary strictures, this elevated pressure may lead to bladder rupture. Therefore, caution is advised when considering the use of Bethanechol chloride in clients with urinary strictures to prevent potential complications. Gastric atony, neurogenic atony, and gastroesophageal reflux are not contraindications for the administration of Bethanechol chloride for urinary retention.
2. A client is receiving intravenous heparin for a deep vein thrombosis. The healthcare provider should monitor the client for which of the following potential complications?
- A. Hypertension
- B. Tachycardia
- C. Bleeding
- D. Hyperkalemia
Correct answer: C
Rationale: Heparin is an anticoagulant, so the primary potential complication is bleeding. The healthcare provider should monitor the client for signs of bleeding, such as bruising, hematuria, and gastrointestinal bleeding. Hypertension, tachycardia, and hyperkalemia are not direct complications of heparin therapy. Therefore, the correct answer is bleeding, as it is the most significant risk associated with heparin administration.
3. A client is diagnosed with pulmonary embolism and is to be treated with streptokinase (Streptase). A nurse would report which priority data collection finding to the registered nurse before initiating this therapy?
- A. Adventitious breath sounds
- B. Temperature of 99.4°F orally
- C. Blood pressure of 198/110 mm Hg
- D. Respiratory rate of 28 breaths/min
Correct answer: C
Rationale: The correct answer is C. Streptokinase therapy is contraindicated in severe uncontrolled hypertension due to the risk of cerebral hemorrhage. A blood pressure of 198/110 mm Hg indicates severe hypertension, which needs to be addressed before initiating streptokinase to prevent potential complications.
4. A client has a prescription to take guaifenesin (Humibid) every 4 hours, as needed. The nurse determines that the client understands the most effective use of this medication if the client states that he or she will:
- A. Watch for irritability as a side effect.
- B. Take the tablet with a full glass of water.
- C. Take an extra dose if the cough is accompanied by fever.
- D. Crush the sustained-release tablet if immediate relief is needed.
Correct answer: B
Rationale: Guaifenesin is an expectorant used to help loosen mucus and make coughs more productive. Taking it with a full glass of water helps decrease the viscosity of secretions, making it easier to expel mucus from the respiratory tract. It is important not to crush sustained-release tablets, as this can alter the intended release of the medication and lead to potential adverse effects.
5. A healthcare professional is monitoring a client who is receiving intravenous amphotericin B. Which of the following should prompt the healthcare professional to notify the healthcare provider immediately?
- A. Fever
- B. Headache
- C. Nausea
- D. Oliguria
Correct answer: D
Rationale: Amphotericin B is known to cause nephrotoxicity, which can lead to kidney damage. Oliguria, which is decreased urine output, is a concerning sign of kidney dysfunction and should be reported promptly to the healthcare provider to prevent further complications. Fever, headache, and nausea are common side effects of amphotericin B but are not as critical as oliguria in indicating potential kidney damage.
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