nalidixic acid neggram is prescribed for a client with a urinary tract infection on review of the clients record the nurse notes that the client is ta
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Nursing Elites

HESI RN

HESI Pharmacology Practice Exam

1. Nalidixic acid (NegGram) is prescribed for a client with a urinary tract infection. On review of the client's record, the nurse notes that the client is taking warfarin sodium (Coumadin) daily. Which prescription should the nurse anticipate for this client?

Correct answer: B

Rationale: Nalidixic acid can intensify the effects of oral anticoagulants by displacing these agents from binding sites on plasma proteins. When an oral anticoagulant, like warfarin sodium (Coumadin), is combined with nalidixic acid, a decrease in the anticoagulant dosage may be necessary to avoid excessive anticoagulation and potential bleeding risks. Therefore, the correct action for the nurse to anticipate in this situation is a decrease in the warfarin sodium (Coumadin) dosage. Choice A is incorrect because discontinuing warfarin sodium abruptly can lead to thrombosis or embolism. Choice C is incorrect as increasing the warfarin sodium dosage can potentiate the anticoagulant effect, leading to bleeding complications. Choice D is incorrect as reducing the dose of nalidixic acid would not directly address the interaction with warfarin sodium.

2. The client with non-Hodgkin's lymphoma is receiving daunorubicin (DaunoXome). Which of the following would indicate to the nurse that the client is experiencing a toxic effect related to the medication?

Correct answer: D

Rationale: Crackles on auscultation of the lungs would indicate a toxic effect related to daunorubicin, known to cause cardiotoxicity. Cardiotoxicity can manifest as heart failure, abnormal ECG findings, or cardiomyopathy. It is crucial for the nurse to monitor for signs of cardiotoxicity to ensure timely intervention and prevent further complications. Fever, diarrhea, and complaints of nausea and vomiting are common side effects of daunorubicin but do not specifically indicate a toxic effect like cardiotoxicity.

3. The client with small cell lung cancer is being treated with etoposide (VePesid). The nurse assisting in caring for the client during its administration understands that which side effect is specifically associated with this medication?

Correct answer: D

Rationale: The correct answer is 'D: Orthostatic hypotension.' Etoposide is associated with orthostatic hypotension, a sudden drop in blood pressure that can occur when transitioning from lying down to standing up. It is important for the nurse to monitor the client's blood pressure during the infusion to detect and manage this potential side effect.

4. After the initial dose, which of the following is the priority assessment for a client being treated for acute congestive heart failure with intravenously administered bumetanide?

Correct answer: C

Rationale: The correct answer is monitoring blood pressure. Bumetanide is a loop diuretic, and monitoring blood pressure is crucial as hypotension is a common side effect. Hypotension can further worsen the condition of a patient with congestive heart failure, so assessing and managing blood pressure is a priority after administering bumetanide.

5. An older client recently has been taking cimetidine (Tagamet). The nurse monitors the client for which most frequent central nervous system side effect of this medication?

Correct answer: C

Rationale: Older clients are particularly vulnerable to central nervous system side effects of cimetidine. The most frequent side effect is confusion. It is crucial for nurses to be vigilant in monitoring for confusion as it can impact the client's safety and well-being. While tremors, dizziness, and hallucinations are possible side effects, confusion is the most common in older clients taking cimetidine.

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