HESI LPN
Pharmacology HESI 55 Questions 2023
1. A client who takes metformin for diabetes mellitus type 2 is nothing by mouth (NPO) for surgery. What pre-op prescription should the practical nurse (PN) anticipate for this client's glucose management?
- A. NPO except for metformin and regular snacks
- B. NPO except for oral antidiabetic agent
- C. Novolin-N insulin subcutaneously twice daily
- D. Regular insulin subcutaneously per sliding scale
Correct answer: D
Rationale: When a client taking metformin for diabetes mellitus type 2 is NPO for surgery, it is crucial to manage their glucose levels effectively. The best approach in this situation is to prescribe regular insulin subcutaneously according to a sliding scale based on the client's blood glucose levels. This method allows for precise adjustment of insulin doses to maintain blood glucose within the target range while the client is unable to take oral medications. Choices A and B are incorrect because metformin is typically held when a client is NPO, and oral antidiabetic agents may not provide sufficient glucose control. Choice C is incorrect as Novolin-N insulin given twice daily may not offer the flexibility needed for glucose management in a surgical setting where the client's intake is restricted.
2. A client is prescribed phenobarbital 100 mg daily for the treatment of seizures. Which statement made by the client indicates an accurate understanding of the medication phenobarbital?
- A. I will take my medicine at 10 PM before retiring to bed.
- B. The medication will turn the color of my urine to a pink color.
- C. I should not eat or drink anything for at least 2 hours before taking my medicine.
- D. In the event a seizure occurs in the middle of the day, I need to take an extra dose of my medicine.
Correct answer: A
Rationale: The correct answer is A. Phenobarbital should be taken at the same time every day to maintain blood levels and enhance compliance. Common side effects of phenobarbital include drowsiness, lethargy, dizziness, and nausea; therefore, it is best to take it before bedtime to minimize these effects and improve sleep quality. Choice B is incorrect because phenobarbital does not affect the color of urine. Choice C is incorrect because there is no need to fast before taking phenobarbital. Choice D is incorrect because taking extra doses without healthcare provider guidance can lead to overdose and adverse effects.
3. A client with a history of hypertension is prescribed hydrochlorothiazide. The practical nurse should monitor the client for which potential adverse effect?
- A. Hyperkalemia
- B. Hypokalemia
- C. Hypernatremia
- D. Hyponatremia
Correct answer: B
Rationale: Corrected Rationale: Hydrochlorothiazide is a diuretic that can lead to potassium loss, resulting in hypokalemia. Monitoring for hypokalemia is essential because it can cause various complications such as cardiac dysrhythmias. Therefore, the practical nurse should closely watch for signs and symptoms of low potassium levels in clients taking hydrochlorothiazide. Incorrect Rationale for Other Choices: A. Hyperkalemia is not typically associated with hydrochlorothiazide use; instead, it is more commonly linked to medications like ACE inhibitors or potassium-sparing diuretics. C. Hypernatremia is unlikely with hydrochlorothiazide use as it tends to cause sodium loss. D. Hyponatremia is more commonly associated with conditions where there is excessive water intake or syndrome of inappropriate antidiuretic hormone secretion (SIADH), rather than with hydrochlorothiazide use.
4. A client with a diagnosis of generalized anxiety disorder is prescribed paroxetine. The nurse should instruct the client that this medication may have which potential side effect?
- A. Drowsiness
- B. Dry mouth
- C. Nausea
- D. Headache
Correct answer: A
Rationale: The correct answer is A: Drowsiness. Paroxetine, used for generalized anxiety disorder, can cause drowsiness. Clients should be advised not to drive or operate heavy machinery until they know how the medication affects them. Dry mouth, nausea, and headache are potential side effects of other medications but are not commonly associated with paroxetine. Drowsiness is a common side effect for paroxetine and can impact a client's ability to perform tasks that require alertness.
5. A client with type 2 diabetes mellitus is prescribed dulaglutide. The nurse should monitor for which potential adverse effect?
- A. Nausea
- B. Hypoglycemia
- C. Hyperglycemia
- D. Pancreatitis
Correct answer: A
Rationale: The correct answer is 'Nausea.' Dulaglutide, a medication commonly used in the management of type 2 diabetes, can lead to gastrointestinal side effects such as nausea. While hypoglycemia and hyperglycemia are potential concerns in diabetes management, they are not typically associated with dulaglutide use. Pancreatitis is a serious adverse effect of some diabetes medications, but it is not a common side effect of dulaglutide.
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