HESI RN
HESI Pharmacology Practice Exam
1. Nalidixic acid (NegGram) is prescribed for a client with a urinary tract infection. On review of the client's record, the nurse notes that the client is taking warfarin sodium (Coumadin) daily. Which prescription should the nurse anticipate for this client?
- A. Discontinuation of warfarin sodium (Coumadin)
- B. A decrease in the warfarin sodium (Coumadin) dosage
- C. An increase in the warfarin sodium (Coumadin) dosage
- D. A decrease in the usual dose of nalidixic acid (NegGram)
Correct answer: B
Rationale: Nalidixic acid can intensify the effects of oral anticoagulants by displacing these agents from binding sites on plasma proteins. When an oral anticoagulant, like warfarin sodium (Coumadin), is combined with nalidixic acid, a decrease in the anticoagulant dosage may be necessary to avoid excessive anticoagulation and potential bleeding risks. Therefore, the correct action for the nurse to anticipate in this situation is a decrease in the warfarin sodium (Coumadin) dosage. Choice A is incorrect because discontinuing warfarin sodium abruptly can lead to thrombosis or embolism. Choice C is incorrect as increasing the warfarin sodium dosage can potentiate the anticoagulant effect, leading to bleeding complications. Choice D is incorrect as reducing the dose of nalidixic acid would not directly address the interaction with warfarin sodium.
2. A healthcare professional is monitoring a client who is receiving intravenous amphotericin B. Which of the following should prompt the healthcare professional to notify the healthcare provider immediately?
- A. Fever
- B. Headache
- C. Nausea
- D. Oliguria
Correct answer: D
Rationale: Amphotericin B is known to cause nephrotoxicity, which can lead to kidney damage. Oliguria, which is decreased urine output, is a concerning sign of kidney dysfunction and should be reported promptly to the healthcare provider to prevent further complications. Fever, headache, and nausea are common side effects of amphotericin B but are not as critical as oliguria in indicating potential kidney damage.
3. During an admission assessment, a client informs the nurse that they take propylthiouracil (PTU) daily. Based on this information, the nurse suspects that the client has a history of:
- A. Myxedema
- B. Graves' disease
- C. Addison's disease
- D. Cushing's syndrome
Correct answer: B
Rationale: Propylthiouracil (PTU) is a medication commonly used to treat hyperthyroidism, including Graves' disease, which is characterized by an overactive thyroid gland. The client mentioning the daily use of PTU indicates that they likely have a history of Graves' disease, as this medication helps manage the condition by reducing the production of thyroid hormones. Therefore, the correct answer is B: Graves' disease. Choice A, Myxedema, is incorrect as it refers to a condition of severe hypothyroidism, the opposite of hyperthyroidism. Choices C and D, Addison's disease and Cushing's syndrome, respectively, are unrelated to the use of PTU or hyperthyroidism, making them incorrect choices.
4. Bethanechol chloride (Urecholine) is prescribed for a client with urinary retention. Which disorder would be a contraindication to the administration of this medication?
- A. Gastric atony
- B. Urinary strictures
- C. Neurogenic atony
- D. Gastroesophageal reflux
Correct answer: B
Rationale: Bethanechol chloride (Urecholine) should not be administered to clients with urinary strictures as it can contract the bladder and increase pressure within the urinary tract. In individuals with urinary strictures, this elevated pressure may lead to bladder rupture. Therefore, caution is advised when considering the use of Bethanechol chloride in clients with urinary strictures to prevent potential complications. Gastric atony, neurogenic atony, and gastroesophageal reflux are not contraindications for the administration of Bethanechol chloride for urinary retention.
5. A client is taking cetirizine hydrochloride (Zyrtec). The nurse checks for which of the following side effects of this medication?
- A. Diarrhea
- B. Excitability
- C. Drowsiness
- D. Excess salivation
Correct answer: C
Rationale: Cetirizine hydrochloride (Zyrtec) is known to commonly cause drowsiness or sedation as a side effect. Therefore, the nurse should monitor the client for signs of drowsiness when administering this medication. Choice A, Diarrhea, is not a common side effect of cetirizine. Choice B, Excitability, is not a typical side effect of this antihistamine; instead, it tends to cause drowsiness. Choice D, Excess salivation, is not associated with cetirizine use.
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