HESI RN
Pharmacology HESI
1. Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse monitors the client, knowing that which of the following would indicate the presence of systemic toxicity from this medication?
- A. Tinnitus
- B. Diarrhea
- C. Constipation
- D. Decreased respirations
Correct answer: A
Rationale: The correct answer is A: Tinnitus. Salicylic acid can lead to systemic toxicity, known as salicylism, which may manifest with symptoms like tinnitus, dizziness, hyperventilation, and mental disturbances. Tinnitus is a common early sign of salicylism and should be monitored closely by the nurse to prevent further complications.
2. A client with a prescription to take theophylline (Theo-24) daily has been given medication instructions by the nurse. The nurse determines that the client needs further information about the medication if the client states that he or she will:
- A. Drink at least 2 L of fluid per day.
- B. Take the daily dose at bedtime.
- C. Avoid changing brands of the medication without health care provider (HCP) approval.
- D. Avoid over-the-counter (OTC) cough and cold medications unless approved by the HCP.
Correct answer: B
Rationale: The correct answer is B. Taking theophylline at bedtime is inappropriate because it can cause insomnia. The medication should be taken early in the morning to avoid disrupting sleep patterns. It is important to follow the healthcare provider's instructions regarding the timing of the medication to achieve optimal therapeutic effects.
3. A client is being monitored while receiving bethanechol chloride (Urecholine) for urinary retention. Which of the following indicates a therapeutic effect of this medication?
- A. Increased heart rate
- B. Increased peristalsis
- C. Passage of flatus
- D. Urinary output of 50 mL per hour
Correct answer: D
Rationale: Bethanechol chloride (Urecholine) is administered to stimulate the bladder and treat urinary retention. The therapeutic effect is indicated by an increased urinary output, as it demonstrates the medication's ability to prompt the bladder to empty. Increased heart rate and passage of flatus are unrelated to the therapeutic effects of bethanechol. Although bethanechol can increase peristalsis, the primary therapeutic goal is to address urinary retention.
4. A client is diagnosed with an acute myocardial infarction and is receiving tissue plasminogen activator, alteplase (Activase, tPA). Which action is a priority nursing intervention?
- A. Monitor for renal failure.
- B. Monitor psychosocial status.
- C. Monitor for signs of bleeding.
- D. Have heparin sodium available.
Correct answer: C
Rationale: The priority nursing intervention for a client receiving tissue plasminogen activator (alteplase) for an acute myocardial infarction is to monitor for signs of bleeding. Alteplase is a thrombolytic medication that can lead to hemorrhage as a complication. Therefore, closely monitoring the client for any signs of bleeding is essential to promptly address and manage this potential adverse effect.
5. A client is taking phenytoin (Dilantin) for seizure control, and a sample for a serum drug level is drawn. Which of the following indicates a therapeutic serum drug range?
- A. 5 to 10 mcg/mL
- B. 10 to 20 mcg/mL
- C. 20 to 30 mcg/mL
- D. 30 to 40 mcg/mL
Correct answer: B
Rationale: The correct therapeutic serum drug level range for phenytoin (Dilantin) is 10 to 20 mcg/mL. This range is considered optimal for seizure control while minimizing the risk of toxicity. Monitoring drug levels helps ensure that the client is within the therapeutic range for effective treatment.
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