HESI LPN
HESI Practice Test Pharmacology
1. A client with rheumatoid arthritis is prescribed adalimumab. What instruction should the nurse include in the client's teaching plan?
- A. Avoid live vaccines while taking this medication.
- B. Take this medication with food to decrease gastrointestinal upset.
- C. Report any signs of infection to the healthcare provider.
- D. Avoid sunlight exposure while taking this medication.
Correct answer: A
Rationale: The correct instruction for a client prescribed adalimumab, which is an immunosuppressant medication, is to avoid live vaccines. Adalimumab can weaken the immune system, making live vaccines potentially harmful. It is essential to educate the client on this to prevent complications and ensure the effectiveness of the treatment.
2. A client prescribed glipizide asked why they had to take their insulin orally. How should the practical nurse respond?
- A. Glipizide is not an oral form of insulin and can be used only when some beta cell function is present.
- B. Glipizide is an oral form of insulin and is distributed, metabolized, and excreted in the same manner as insulin.
- C. Glipizide is an oral form of insulin and has the same actions and properties as intermediate insulin.
- D. Glipizide is not an oral form of insulin, but it is effective for those who are resistant to injectable insulins.
Correct answer: A
Rationale: The practical nurse should explain to the client that glipizide is not an oral form of insulin but an oral hypoglycemic agent. Glipizide works by enhancing pancreatic production of insulin when some beta cell function is present. It is not a replacement for insulin but helps the body produce more insulin. Therefore, it can be used when there is still some beta cell function present, unlike insulin which is used when there is a deficiency of endogenous insulin production.
3. A client with severe rheumatoid arthritis is prescribed adalimumab. The nurse should monitor for which potential adverse effect?
- A. Increased risk of infection
- B. Bone marrow suppression
- C. Hair loss
- D. Hyperglycemia
Correct answer: A
Rationale: The correct answer is A: Increased risk of infection. Adalimumab is known to increase the risk of infection due to its immunosuppressive effects. Patients on adalimumab should be closely monitored for signs and symptoms of infection, such as fever, chills, and malaise, and should promptly report any such symptoms to their healthcare provider for further evaluation and management. Monitoring for infection is crucial to prevent serious complications in patients receiving adalimumab therapy.
4. A client has a prescription for heparin 1,000 units IV STAT. Several pre-filled syringes of low molecular weight heparin are available in the client's medication drawer. Which action should the nurse implement?
- A. Dilute the available heparin in 250ml of normal saline solution prior to IV administration
- B. Advise the pharmacy on the need to deliver a vial of heparin to the nursing unit immediately
- C. Calculate and administer the equivalent dose of the available low molecular weight heparin
- D. Request a prescription to change the route of administration and use the available heparin
Correct answer: B
Rationale: In this scenario, the nurse should contact the pharmacy to obtain the correct heparin formulation as the prescription calls for heparin 1,000 units IV STAT. Low molecular weight heparin is not the same as unfractionated heparin, and therefore, the nurse should not administer the available low molecular weight heparin without first obtaining the correct medication. Diluting the available heparin, calculating an equivalent dose, or changing the route of administration would not address the discrepancy between the prescribed heparin and the available low molecular weight heparin.
5. A client with chronic kidney disease is prescribed sucroferric oxyhydroxide. What potential side effect should the nurse monitor for?
- A. Diarrhea
- B. Constipation
- C. Nausea
- D. Hyperphosphatemia
Correct answer: A
Rationale: Sucroferric oxyhydroxide is known to cause diarrhea as a side effect. Therefore, the nurse should closely monitor the client for any signs of diarrhea while on this medication to ensure timely intervention and management.
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