Pharmacology HESI

HESI RN

1. When a client taking warfarin sodium (Coumadin) is prescribed ciprofloxacin (Cipro), the nurse should closely monitor the client for which potential effect of this drug interaction?

A. Increased risk of bleeding
B. Decreased warfarin effectiveness
C. Increased risk of thrombosis
D. Decreased ciprofloxacin effectiveness

Correct answer: A

Rationale: When ciprofloxacin (Cipro) is given with warfarin sodium (Coumadin), it can potentiate the effects of warfarin, leading to an increased risk of bleeding. Therefore, the nurse should closely monitor the client's INR levels and watch for signs of bleeding such as bruising, petechiae, or black tarry stools.

2. The healthcare provider has prescribed silver sulfadiazine (Silvadene) for the client with a partial-thickness burn, which has cultured positive for gram-negative bacteria. The nurse is reinforcing information to the client about the medication. Which statement made by the client indicates a lack of understanding about the treatment?

A. The medication is an antibacterial.
B. The medication will help heal the burn.
C. The medication will permanently stain my skin.
D. The medication should be applied directly to the wound.

Correct answer: C

Rationale: The correct answer is C. Silver sulfadiazine is an antibacterial used to treat burns, helping in the healing process. It does not permanently stain the skin. Therefore, the statement indicating a lack of understanding is that the medication will permanently stain the skin.

3. 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.

4. 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.

5. A client has a prescription to take guaifenesin (Humibid) every 4 hours, as needed. The nurse determines that the client understands the most effective use of this medication if the client states that he or she will:

A. Watch for irritability as a side effect.
B. Take the tablet with a full glass of water.
C. Take an extra dose if the cough is accompanied by fever.
D. Crush the sustained-release tablet if immediate relief is needed.

Correct answer: B

Rationale: Guaifenesin is an expectorant used to help loosen mucus and make coughs more productive. Taking it with a full glass of water helps decrease the viscosity of secretions, making it easier to expel mucus from the respiratory tract. It is important not to crush sustained-release tablets, as this can alter the intended release of the medication and lead to potential adverse effects.