HESI LPN
Pharmacology HESI 2023
1. 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.
2. A client is prescribed methylprednisolone for an allergic reaction. The nurse should monitor for which potential side effect of this medication?
- A. Nausea and vomiting
- B. Weight gain
- C. Insomnia
- D. Increased appetite
Correct answer: B
Rationale: When a client is prescribed methylprednisolone, a corticosteroid, the nurse should monitor for weight gain as a potential side effect. Corticosteroids like methylprednisolone can cause weight gain and fluid retention due to their impact on metabolism and sodium retention. Nausea and vomiting are less common side effects of methylprednisolone. Insomnia and increased appetite are not typically associated with methylprednisolone use.
3. A client is prescribed clonidine 0.1 mg/24 hours via a transdermal patch. Which client outcome would indicate that the medication is effective?
- A. No complaints of recent episodes of angina
- B. Change in peripheral edema from +3 to +1
- C. No complaints of new onset of nausea or vomiting
- D. Blood pressure changes from 180/120 to 140/70 mm Hg
Correct answer: D
Rationale: Clonidine is an antihypertensive agent that works centrally to reduce blood pressure. A significant decrease in blood pressure, such as changing from 180/120 to 140/70 mm Hg, indicates that the medication is effectively managing hypertension. Monitoring blood pressure levels is crucial in assessing the response to clonidine therapy. Choices A, B, and C are incorrect as they do not directly relate to the therapeutic effect of clonidine in managing hypertension, which is the primary goal of the medication in this scenario.
4. A client with diabetes mellitus type 2 is prescribed liraglutide. The nurse should include which instruction in the client's teaching plan?
- A. Administer this medication once a week.
- B. Administer this medication once a month.
- C. Administer this medication twice a day.
- D. Administer this medication once a day.
Correct answer: D
Rationale: The correct answer is to administer liraglutide once a day. Liraglutide is typically prescribed to be taken once daily, as directed by the healthcare provider. This dosing schedule helps maintain consistent levels of the medication in the body to effectively manage blood sugar levels in clients with diabetes mellitus type 2. Option A, administering once a week, is incorrect as it would not provide consistent control of blood sugar levels. Option B, administering once a month, is also incorrect as it is not the recommended dosing frequency for liraglutide. Option C, administering twice a day, is inaccurate as liraglutide is not typically dosed in this manner. It is important for the nurse to emphasize the importance of adherence to the prescribed dosing regimen to achieve optimal therapeutic outcomes.
5. Which action should be taken to assess for analgesic tolerance in a client who is unable to communicate?
- A. Review the client's laboratory values for changes in peak and trough levels of the analgesic
- B. Prolong the interval between analgesic medication doses and monitor the client's vital signs
- C. Observe the client for the presence of pain behaviors before the next analgesic dose is due
- D. Ask family members to report behaviors suggesting that the client's pain has returned
Correct answer: C
Rationale: In clients who are unable to communicate, observing for pain behaviors is crucial in assessing analgesic tolerance. Changes in pain behaviors can indicate if the current analgesic regimen is effective or if tolerance has developed. Therefore, closely observing the client for pain behaviors before the next analgesic dose helps healthcare providers evaluate the client's response to pain management. Reviewing laboratory values may not directly reflect analgesic tolerance. Prolonging the interval between doses and monitoring vital signs may not provide direct information on analgesic tolerance. Relying solely on family members to report pain behaviors may not be as accurate or immediate as observing the client directly.
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