HESI LPN
Pharmacology HESI 2023
1. The client is being instructed on the correct technique for using... what to provide the client?
- A. Angle the tip of the inhaler upwards while spraying
- B. Hold one nostril closed while spraying the other nostril
- C. Avoid shaking the inhaler immediately before using
- D. Use the inhaler when first awakening in the morning
Correct answer: B
Rationale: The correct technique for using an inhaler for allergic rhinitis involves holding one nostril closed while spraying the other nostril to ensure proper delivery of the medication. This technique helps direct the medication into the nasal passages for optimal effectiveness. Choice A is incorrect as it refers to an incorrect technique for inhaler use. Choice C is incorrect as shaking the inhaler is often necessary to ensure proper mixing of the medication. Choice D is incorrect as the timing of inhaler use is typically based on individual preferences or healthcare provider recommendations, not specifically tied to the morning.
2. A client with diabetes mellitus type 1 is prescribed insulin glargine. When should the nurse instruct the client to administer this medication?
- A. Before meals
- B. After meals
- C. At bedtime
- D. In the morning
Correct answer: C
Rationale: Corrected Rationale: Insulin glargine is a long-acting insulin that provides a consistent level of insulin over 24 hours. Administering it at bedtime helps mimic the body's natural insulin secretion pattern and provides optimal blood glucose control during the night and throughout the day. Choice A (Before meals) is incorrect because insulin glargine is not a rapid-acting insulin meant to cover meals. Choice B (After meals) is incorrect as the timing doesn't align with the insulin's mechanism. Choice D (In the morning) is incorrect as administering insulin glargine in the morning may not provide adequate coverage throughout the night and the following day.
3. A client with chronic heart failure is prescribed spironolactone. The nurse should monitor for which potential side effect?
- A. Hyperkalemia
- B. Hypokalemia
- C. Hypernatremia
- D. Hyponatremia
Correct answer: A
Rationale: The correct answer is A: Hyperkalemia. Spironolactone is a potassium-sparing diuretic that can lead to an excess of potassium in the body, resulting in hyperkalemia. This side effect is important to monitor in clients taking spironolactone, especially those with chronic heart failure, as hyperkalemia can lead to serious cardiac complications.
4. A client with severe depression is prescribed sertraline. Which statement by the client indicates the need for further teaching?
- A. I can stop taking this medication once I feel better.
- B. It may take 1 to 4 weeks to notice improvement in symptoms.
- C. I should avoid alcohol while taking this medication.
- D. I should take this medication in the morning with food.
Correct answer: A
Rationale: The correct answer is A. Clients should not stop taking sertraline abruptly once they feel better without consulting their healthcare provider. It is important to complete the full course of treatment as prescribed to prevent a relapse of symptoms. Stopping the medication suddenly can lead to withdrawal symptoms and may worsen the condition. Choice B is correct because sertraline may take 1 to 4 weeks to show noticeable improvement in symptoms. Choice C is correct as alcohol should be avoided while taking sertraline due to the increased risk of side effects. Choice D is also correct as taking sertraline in the morning with food can help reduce gastrointestinal side effects.
5. A client with diabetes mellitus type 1 is prescribed insulin lispro. When should the nurse instruct the client to administer this medication?
- A. 5-10 minutes before meals
- B. 15 minutes after meals
- C. 30 minutes before meals
- D. 1 hour after meals
Correct answer: A
Rationale: Corrected Rationale: Insulin lispro is a rapid-acting insulin that should be administered 5-10 minutes before meals. This timing helps synchronize the peak action of insulin with the rise in blood glucose levels after eating, effectively managing postprandial hyperglycemia. Choice B, administering 15 minutes after meals, is incorrect because rapid-acting insulins like lispro are meant to act quickly to cover the rise in blood glucose levels after meals. Choices C and D are also incorrect as they do not align with the rapid onset of action required to manage postprandial hyperglycemia in patients with diabetes mellitus type 1.
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