HESI LPN
Pharmacology HESI Practice
1. A client who is being discharged to home asks the practical nurse (PN) for a dose of hydrocodone before leaving the hospital. How should the PN respond to this client's request?
- A. Determine if a take-home prescription for hydrocodone was provided and, if so, tell him to take one of them.
- B. Encourage him to wait until he is at home to take a medication that might impair reasoning.
- C. Give him a tablet from the hospital stock and tell him to wait until he is almost home to take it.
- D. Ask him to describe the location and severity of the pain and to rate it on a scale from 1 to 10.
Correct answer: D
Rationale: Hydrocodone is a narcotic analgesic, and the practical nurse should gather more data from the client about the pain he is experiencing before giving the medication. The client's need for pain medication should be addressed, and pain medication should not be withheld because he is going home.
2. Phenytoin is prescribed for a client who has a seizure disorder. Which statement by the client needs to be clarified by the healthcare provider?
- A. I should notify the healthcare provider if the color of my urine turns pink.
- B. I should never stop taking this medication abruptly.
- C. I should monitor my glucose levels closely since I am diabetic.
- D. I should take the medicine with antacids if gastric upset occurs.
Correct answer: D
Rationale: The correct answer is D because antacids should not be taken with phenytoin as they can decrease its effects. Taking antacids with phenytoin is not recommended. Choice A is correct; pink discoloration of urine can occur with phenytoin use. Choice B is also correct; abruptly stopping phenytoin can lead to seizures. Choice C is correct; monitoring glucose levels is important as phenytoin can increase glucose levels. Therefore, the statement about using antacids with phenytoin needs clarification.
3. A client with diabetes mellitus type 2 is prescribed metformin. What instruction should the nurse include in the client's teaching plan?
- A. Take this medication with meals.
- B. Avoid alcohol while taking this medication.
- C. Take this medication on an empty stomach.
- D. Report any signs of lactic acidosis to the healthcare provider.
Correct answer: A
Rationale: The correct instruction for a client prescribed metformin is to take the medication with meals. Taking metformin with meals helps to minimize gastrointestinal side effects, which are common with this medication. Choice B, avoiding alcohol, is a good practice due to the increased risk of lactic acidosis when alcohol is consumed with metformin; however, it is not the priority teaching point in this scenario. Taking metformin on an empty stomach (Choice C) is incorrect because it can increase the risk of gastrointestinal side effects. Reporting signs of lactic acidosis (Choice D) is important, but it is more related to monitoring for adverse effects rather than a primary teaching point for administration.
4. A healthy 68-year-old client asks the practical nurse (PN) whether they should take the pneumococcal vaccine. Which statement should the PN offer to the client that provides the most accurate information about this vaccine?
- A. The vaccine is given annually before the flu season to those older than 50 years.
- B. The immunization is recommended for children younger than 2 years old and all adults 65 years or older.
- C. The vaccine is for all ages and is given primarily to those traveling overseas to areas of infection.
- D. The vaccine will prevent the occurrence of pneumococcal pneumonia for up to 5 years.
Correct answer: B
Rationale: The correct answer is B because it is usually recommended that children younger than 2 years old and adults 65 years or older get vaccinated against pneumococcal disease. This is because these age groups are more susceptible to severe complications from the infection. While the vaccine may be recommended for certain individuals with specific medical conditions at any age, the primary target groups are as mentioned in option B. Option A is incorrect as the pneumococcal vaccine is not given annually like the flu vaccine. Option C is incorrect because the vaccine is not primarily for travelers but for certain age groups and individuals with medical conditions at risk. Option D is incorrect as the vaccine's duration of protection can vary, and it is not guaranteed to prevent pneumococcal pneumonia for up to 5 years.
5. A client has metoprolol prescribed. The nurse should reinforce instructions that this medication has which potential adverse effect?
- A. Anxiety
- B. Tachycardia
- C. Sexual dysfunction
- D. Acute renal failure
Correct answer: C
Rationale: The correct answer is C: Sexual dysfunction. Metoprolol, a beta-blocker, can cause sexual dysfunction as an adverse effect. It is important for the nurse to educate the client about this potential side effect. Choice A is incorrect because metoprolol can cause depression, not anxiety. Choice B is incorrect as tachycardia is not an adverse effect of metoprolol; instead, it can lead to bradycardia. Choice D is incorrect because acute renal failure is not typically associated with the use of beta-blockers.
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