HESI LPN
HESI Pharmacology Exam Test Bank
1. A client with chronic kidney disease is prescribed darbepoetin alfa. The nurse should monitor for which potential side effect?
- A. Hypertension
- B. Hypotension
- C. Hyperkalemia
- D. Hyperglycemia
Correct answer: A
Rationale: The correct answer is A: Hypertension. Darbepoetin alfa, used to treat anemia in chronic kidney disease, can lead to hypertension as a side effect. This medication stimulates red blood cell production, which can increase blood pressure. Monitoring blood pressure regularly is crucial to detect and manage this potential adverse effect. Choices B, C, and D are incorrect because hypotension, hyperkalemia, and hyperglycemia are not commonly associated with darbepoetin alfa therapy in chronic kidney disease.
2. A client with type 2 diabetes is prescribed metformin. What instruction should the practical nurse (PN) include in the client's teaching plan?
- A. Take the medication with meals to decrease gastrointestinal upset.
- B. Take the medication with a full glass of water.
- C. Avoid alcohol while taking the medication.
- D. Take the medication with meals to increase absorption.
Correct answer: B
Rationale: The correct instruction for a client prescribed metformin is to take the medication with a full glass of water. This helps ensure proper ingestion and absorption of the medication. While taking metformin with meals can help reduce gastrointestinal side effects, the primary focus should be on adequate hydration and absorption by taking it with water. Avoiding alcohol while taking metformin is also important as alcohol can increase the risk of lactic acidosis when combined with metformin. Taking the medication with meals to increase absorption is incorrect as metformin should be taken with food to reduce gastrointestinal upset, not to increase absorption.
3. A client with diabetes mellitus type 2 is prescribed glipizide. What instruction should the nurse include in the client's teaching plan?
- A. Take this medication with meals.
- B. Avoid alcohol while taking this medication.
- C. Take this medication on an empty stomach.
- D. Report any signs of hypoglycemia to the healthcare provider.
Correct answer: A
Rationale: The correct instruction for a client prescribed glipizide, a sulfonylurea used to lower blood sugar levels, is to take the medication with meals. Taking it with meals helps to minimize the risk of hypoglycemia by ensuring a more balanced effect on blood glucose levels throughout the day. It is important for the client to follow this instruction to maintain stable blood sugar levels and reduce the likelihood of experiencing low blood sugar (hypoglycemia) episodes. Choice B is incorrect because there are no specific contraindications between glipizide and alcohol. Choice C is incorrect as glipizide should not be taken on an empty stomach. Choice D is incorrect as while it is important to report signs of hypoglycemia, the primary focus should be on preventing hypoglycemia by taking the medication with meals.
4. The practical nurse administered 15 units of NPH insulin subcutaneously to a client before they consumed their breakfast at 7:30 AM. At what time is the client at an increased risk for a hypoglycemic reaction?
- A. 8:30 to 11:30 AM
- B. 3:30 to 7:30 PM
- C. 9:30 PM to midnight
- D. 1:00 to 5:00 AM
Correct answer: B
Rationale: NPH insulin, an intermediate-acting type, peaks approximately 8 to 12 hours after subcutaneous administration. Considering this, the client is most likely to experience a hypoglycemic reaction between 3:30 and 7:30 PM, making option B the correct answer. Choices A, C, and D are incorrect because they fall outside the peak time for a hypoglycemic reaction after administering NPH insulin.
5. A client with asthma is prescribed fluticasone. The nurse should instruct the client to use this medication at which time?
- A. During an asthma attack
- B. Twice a day
- C. Once a day
- D. At night before bed
Correct answer: C
Rationale: Fluticasone is a maintenance medication for asthma aimed at controlling symptoms. It should be taken once a day on a regular basis to provide ongoing relief and prevent asthma symptoms, rather than being used to treat acute asthma attacks. Therefore, the correct answer is to use it once a day. Choices A, B, and D are incorrect because using fluticasone during an asthma attack, twice a day, or only at night before bed does not align with the medication's purpose of being a daily maintenance therapy.
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