HESI LPN
HESI Pharmacology Exam Test Bank
1. After receiving the third dose of a new oral anticoagulant prescription, which action should the nurse implement? Select all that apply.
- A. Notify the healthcare provider of the finding
- B. Provide a PRN NSAID for gum discomfort
- C. Review the most recent coagulation lab values
- D. Complete a medication variance report
Correct answer: C
Rationale: Reviewing the most recent coagulation lab values is crucial after receiving multiple doses of a new oral anticoagulant to ensure the patient is within the desired therapeutic range and to prevent adverse events related to over or under-anticoagulation. It is essential to monitor these values closely to adjust the dosage if needed. Notifying the healthcare provider of any concerning findings is important, but it may not be the immediate priority after receiving the third dose. Providing a PRN NSAID for gum discomfort is not typically indicated with oral anticoagulant therapy, as it may increase the risk of bleeding. Completing a medication variance report is more relevant in cases of medication errors or discrepancies, which may not apply in this scenario.
2. A client with amyotrophic lateral sclerosis (ALS) has been taking riluzole for two weeks. The nurse notes that the client remains weak with observable muscle atrophy. What action should the nurse take?
- A. Explain that the medication may take time to show improvement in symptoms
- B. Withhold the medication and notify the healthcare provider
- C. Advise the client to undergo liver function tests
- D. Document the assessment findings in the electronic health record
Correct answer: D
Rationale: In this scenario, the nurse's priority is to document the assessment findings in the electronic health record. This action is crucial for maintaining an accurate record of the client's health status and can provide valuable information for the healthcare team. While it is important to monitor the client's response to riluzole, explaining that the medication may take time to show improvement (Choice A) would be more appropriate if the client was expecting immediate results. Withholding the medication and notifying the healthcare provider (Choice B) should not be the initial action without further assessment or guidance. Advising the client to undergo liver function tests (Choice C) is not directly related to the current situation of weakness and muscle atrophy.
3. A client with a diagnosis of generalized anxiety disorder is prescribed fluvoxamine. The nurse should instruct the client that this medication may have which potential side effect?
- A. Drowsiness
- B. Dry mouth
- C. Insomnia
- D. Headache
Correct answer: A
Rationale: The correct answer is A: Drowsiness. Fluvoxamine is known to cause drowsiness as a potential side effect. Patients should be advised to avoid activities like driving that require alertness until they understand how the medication affects them. Dry mouth, insomnia, and headache are potential side effects of other medications used for anxiety disorders but are not typically associated with fluvoxamine.
4. A client who is recovering from an appendectomy is receiving narcotics. Earlier, the nurse witnessed the client's family pushing the pain pump. What should the nurse implement?
- A. Check the client's level of consciousness
- B. Instruct the family not to push the button
- C. Stop the client's basal infusion
- D. Administer a narcotic reversal medication
Correct answer: B
Rationale: Instructing the family not to push the button is necessary to prevent the client from receiving an excessive amount of narcotics, ensuring the safe and appropriate use of the pain pump. Checking the client's level of consciousness may not address the issue of family members pushing the button. Stopping the client's basal infusion is not indicated unless there are specific medical reasons for doing so. Administering a narcotic reversal medication is not necessary at this point as the issue lies with inappropriate use rather than an overdose.
5. A practical nurse is caring for a client with chronic obstructive pulmonary disease (COPD) who is receiving theophylline. Which symptom indicates that the client may be experiencing theophylline toxicity?
- A. Bradycardia
- B. Tremors
- C. Constipation
- D. Hypotension
Correct answer: B
Rationale: Tremors are a common symptom of theophylline toxicity. Other symptoms that may indicate theophylline toxicity include nausea, vomiting, and seizures. Bradycardia, constipation, and hypotension are not typically associated with theophylline toxicity. It is important for the nurse to monitor the client closely for these signs of toxicity and report them promptly to the healthcare provider to prevent further complications.
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