HESI LPN
Pharmacology HESI 2023
1. A 59-year-old client is prescribed furosemide 40 mg twice a day for the management of heart failure. The practical nurse should monitor the client for the development of which complication?
- A. Hypokalemia
- B. Hyperchloremia
- C. Hypercalcemia
- D. Hypophosphatemia
Correct answer: A
Rationale: Corrected Rationale: Furosemide is a loop diuretic that inhibits the reabsorption of sodium and chloride in the kidneys, leading to increased potassium excretion and potentially causing hypokalemia. Hypokalemia can lead to cardiac irregularities, making it crucial for the practical nurse to monitor the client for this electrolyte imbalance. Choice B, Hyperchloremia, is not typically associated with furosemide use. Choices C and D, Hypercalcemia and Hypophosphatemia, are not common complications of furosemide therapy.
2. A client diagnosed with seizures is prescribed phenytoin. Which medication instruction should the practical nurse (PN) reinforce to this client?
- A. Maintain consistent sodium intake.
- B. Use sunscreen when outdoors.
- C. Return for monthly urinalysis.
- D. Brush and floss teeth daily.
Correct answer: D
Rationale: The correct answer is to reinforce the instruction to brush and floss teeth daily. Phenytoin therapy can lead to gingival hyperplasia (gum disease), which can be prevented by maintaining good oral hygiene practices such as brushing and flossing daily. Choices A, B, and C are incorrect because they are not directly related to the side effects or management of phenytoin therapy. Maintaining consistent sodium intake is not a specific concern with phenytoin. Using sunscreen when outdoors is important to prevent sunburn but is not directly related to phenytoin therapy. Returning for monthly urinalysis may be necessary for other medications, but it is not specifically required for monitoring phenytoin therapy.
3. A client is taking levodopa-carbidopa for Parkinson's disease. The nurse should include which instruction when educating the client about this medication?
- A. Increase fluid intake to prevent dehydration.
- B. Take medication with food to improve absorption.
- C. Take medication at bedtime to avoid daytime drowsiness.
- D. It can cause nausea and dizziness.
Correct answer: A
Rationale: The correct instruction for a client taking levodopa-carbidopa for Parkinson's disease is to increase fluid intake to prevent dehydration. Levodopa-carbidopa should be taken with food to reduce gastrointestinal upset and improve absorption. Taking medication at bedtime is not necessary to avoid daytime drowsiness. It is crucial to prevent dehydration due to the medication's side effects. Choice B is incorrect because the medication should be taken with food, not at bedtime. Choice C is incorrect as taking the medication with food, rather than on an empty stomach, aids in absorption and reduces gastrointestinal side effects. Choice D is incorrect as it states the side effects of the medication rather than providing specific instructions on its administration.
4. A client with chronic obstructive pulmonary disease (COPD) is prescribed tiotropium. The nurse should instruct the client to report which potential side effect?
- A. Dry mouth
- B. Blurred vision
- C. Nausea
- D. Tachycardia
Correct answer: A
Rationale: The correct answer is A: Dry mouth. Tiotropium, a commonly prescribed medication for COPD, can cause dry mouth as a side effect. While it may not be severe, clients should report it if it becomes bothersome. Dry mouth is a common side effect of tiotropium due to its anticholinergic properties. Blurred vision, nausea, and tachycardia are not typically associated with tiotropium use in the context of COPD.
5. In the immediate postoperative period, a client is prescribed morphine via a patient-controlled analgesia (PCA) pump. Which finding should the PN consider the highest priority in this client?
- A. Monitoring the expiration date of the PCA morphine
- B. Assessing the rate and depth of the client's respirations
- C. Reviewing the type of anesthesia used during the surgery
- D. Observing the client's signs of disorientation
Correct answer: B
Rationale: The highest priority for the PN is to assess the rate and depth of the client's respirations when a client is receiving morphine via a PCA pump. Respiratory depression is a life-threatening side effect of intravenous morphine administration. If the client's respiratory rate falls below 10 breaths/min, the PCA pump should be stopped, and the healthcare provider must be notified immediately to prevent further complications. Monitoring the expiration date of the PCA morphine is important but not the highest priority compared to assessing respiratory status. Reviewing the type of anesthesia used during the surgery is not directly related to the immediate management of the client receiving morphine via PCA. Observing signs of disorientation is also important but not as critical as assessing respirations for potential respiratory depression.
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