HESI LPN
HESI Pharmacology Exam Test Bank
1. A client with a history of atrial fibrillation is prescribed apixaban. The nurse should monitor for which potential side effect?
- A. Bleeding
- B. Weight gain
- C. Headache
- D. Nausea
Correct answer: A
Rationale: The correct answer is A: Bleeding. Apixaban is an anticoagulant medication that works by decreasing the blood's ability to clot. One of the significant side effects of apixaban is an increased risk of bleeding. Therefore, the nurse should monitor the client for signs of bleeding, such as easy bruising, prolonged bleeding from cuts, blood in the urine or stool, or unusual bleeding or bruising. Monitoring for these signs is crucial to prevent or manage any potential complications associated with the medication. Choices B, C, and D are incorrect because weight gain, headache, and nausea are not typically associated with apixaban use. Therefore, the nurse should primarily focus on monitoring for signs of bleeding in a client prescribed apixaban.
2. A client with a history of atrial fibrillation is prescribed warfarin. The nurse should monitor for which sign of potential bleeding?
- A. Elevated blood pressure
- B. Bruising
- C. Shortness of breath
- D. Nausea and vomiting
Correct answer: B
Rationale: Warfarin is an anticoagulant that increases the risk of bleeding. Bruising is a common sign of potential bleeding in clients taking warfarin. Monitoring for bruising is essential as it can indicate a risk of bleeding that needs further assessment and management. Elevated blood pressure, shortness of breath, nausea, and vomiting are not direct signs of potential bleeding associated with warfarin therapy.
3. A client arrives at the emergency department experiencing diabetic ketoacidosis (DKA). The healthcare provider prescribes an insulin intravenous drip. Which type of insulin should the nurse locate for the registered nurse to mix into the intravenous fluids?
- A. Isophane
- B. Glargine
- C. Regular
- D. Detemir
Correct answer: C
Rationale: The correct insulin type for the nurse to mix into the intravenous fluids is regular insulin. In the scenario of diabetic ketoacidosis (DKA), rapid reduction of blood glucose levels is crucial. Regular insulin has a fast onset of action, making it suitable for intravenous administration to address the high blood sugar levels seen in DKA. Isophane, Glargine, and Detemir are not appropriate choices for intravenous administration in this emergency situation as they are intermediate-acting or long-acting insulins which do not provide the rapid response needed in DKA.
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 a history of atrial fibrillation is prescribed digoxin. The nurse should monitor for which potential side effect?
- A. Bradycardia
- B. Tachycardia
- C. Headache
- D. Hyperglycemia
Correct answer: A
Rationale: The correct answer is A: Bradycardia. Digoxin can lead to bradycardia due to its effect on slowing down the heart rate, which can be dangerous in a client with atrial fibrillation. Monitoring the client's heart rate is essential to detect and manage this potential side effect. Choices B, C, and D are incorrect because digoxin is not known to cause tachycardia, headache, or hyperglycemia as common side effects.
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