HESI LPN
Pharmacology HESI 55 Questions 2023
1. The healthcare provider is assessing the effectiveness of the drug amiodarone. Which client statement best indicates that the drug has been effective?
- A. I have not had as many spells of angina.
- B. I have not had as much swelling in my ankles lately.
- C. My doctor told me my cholesterol levels were improving with each visit.
- D. I do not notice as many irregular heartbeats as before I started taking this medication.
Correct answer: D
Rationale: The correct answer is option D. The effectiveness of amiodarone is best assessed by a reduction in irregular heartbeats since it is primarily used to treat ventricular dysrhythmias. This drug's main purpose is to control irregular heart rhythms, so a decrease in irregular heartbeats indicates its effectiveness. Options A, B, and C are incorrect because amiodarone is not primarily used to address angina, ankle swelling, or cholesterol levels, so improvements in these areas do not directly reflect the drug's effectiveness.
2. In a capillary glucose measurement, a client is to receive 10 units of regular insulin and isophane insulin. How should the nurse prepare?
- A. Withdraw ten units of regular insulin from a vial
- B. Withhold the dose until regular insulin is available
- C. Obtain a new vial of regular insulin and withhold
- D. Pull up 30 units from a vial but only administer 10 units
Correct answer: B
Rationale: In insulin administration, regular insulin is typically administered before isophane insulin to manage blood glucose effectively. If regular insulin is not available, it is best to withhold the dose until it can be administered as prescribed. Choice A is incorrect as it suggests withdrawing from a specific vial without specifying regular insulin. Choice C is incorrect as obtaining a new vial of regular insulin may not be necessary if it becomes available shortly. Choice D is incorrect as administering 10 units from a mixture of regular and isophane insulin is not the correct approach.
3. A male client receives a scopolamine transdermal patch 2 hours before surgery. Four hours after surgery, the client tells the nurse that he is experiencing pain and asks why the patch is not working. Which action should the nurse take?
- A. Advise the client that the effects of the medication have worn off
- B. Explain that the medication is not given to relieve pain
- C. Check for the correct placement of the patch on the client
- D. Offer to apply a new transdermal patch to address the pain
Correct answer: B
Rationale: The correct answer is B. Scopolamine is not a pain medication; it is commonly used to prevent nausea and vomiting, particularly in surgical settings. It works on the central nervous system to help control these symptoms, not to relieve pain. Therefore, it is important for the nurse to explain to the client that the medication is not intended to relieve pain but rather to manage other specific symptoms. Checking the correct placement of the patch is also important to ensure proper administration, but addressing the misconception about the medication's purpose is the priority in this scenario. Offering to apply a new patch would not address the client's pain as scopolamine is not meant for pain relief. Advising the client that the effects have worn off is inaccurate because the medication is not used for pain management.
4. A client has been diagnosed with open-angle glaucoma. The healthcare provider prescribes pilocarpine 1% eye drops. The nurse explains that which action of this drug makes it a useful treatment for the client's condition?
- A. The ciliary muscle contracts, increasing the outflow of aqueous humor in the eye.
- B. Ciliary muscles are paralyzed to decrease accommodation.
- C. Bilateral mydriasis with cycloplegia is accomplished.
- D. The production of aqueous humor in the eyes is decreased.
Correct answer: A
Rationale: Pilocarpine, a cholinergic agent, stimulates the ciliary muscle to contract, which opens the trabecular meshwork and facilitates the outflow of aqueous humor, reducing intraocular pressure. This mechanism helps in managing open-angle glaucoma by improving drainage and lowering pressure within the eye. Choice A is correct because the contraction of the ciliary muscle increases the outflow of aqueous humor, aiding in the treatment of open-angle glaucoma. Choices B, C, and D are incorrect because they do not describe the mechanism of action of pilocarpine in treating glaucoma.
5. A client receiving enalapril reports a persistent dry cough. The nurse should explain that this side effect is related to which medication action?
- A. It reduces the production of angiotensin II.
- B. It increases the production of angiotensin II.
- C. It causes increased production of bradykinin.
- D. It increases the production of aldosterone.
Correct answer: C
Rationale: The correct answer is C. Enalapril, an ACE inhibitor, inhibits the conversion of angiotensin I to angiotensin II, leading to increased levels of bradykinin. The accumulation of bradykinin is responsible for the persistent dry cough associated with ACE inhibitors like enalapril. Choices A, B, and D are incorrect because enalapril does not directly affect the production of angiotensin II or aldosterone. Instead, it primarily impacts the renin-angiotensin-aldosterone system by inhibiting the conversion of angiotensin I to angiotensin II, leading to bradykinin accumulation.
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