HESI RN
Pharmacology HESI
1. A client with hyperlipidemia is prescribed simvastatin (Zocor). Which instruction should the nurse include in the teaching plan?
- A. Take the medication in the evening.
- B. Report any muscle pain to your healthcare provider.
- C. Avoid increasing your intake of grapefruit juice.
- D. Do not take the medication with a high-fat meal.
Correct answer: B
Rationale: Muscle pain can be a sign of a serious side effect of simvastatin (Zocor) known as rhabdomyolysis and should be reported to the healthcare provider immediately. The medication is usually taken in the evening to coincide with the body's natural production of cholesterol. Grapefruit juice should be avoided as it can increase the risk of toxicity by affecting the metabolism of the medication. Additionally, taking simvastatin with a high-fat meal can reduce its effectiveness, so it should be taken without food or with a light meal.
2. A client who had a kidney transplant is receiving therapy with cyclosporine (Sandimmune). Which statement by the client indicates a need for further instruction?
- A. I need to obtain a yearly influenza vaccine.
- B. I need to have dental checkups every 3 months.
- C. I need to self-monitor my blood pressure at home.
- D. I need to call the health care provider (HCP) if my urine volume decreases or my urine becomes cloudy.
Correct answer: A
Rationale: The correct answer is A. Cyclosporine is an immunosuppressant that can reduce the effectiveness of vaccines. Clients should avoid vaccinations without consulting their health care provider to prevent potential complications or reduced efficacy of the vaccines.
3. Mycophenolate mofetil (CellCept) is prescribed for a client as prophylaxis for organ rejection following an allogeneic renal transplant. Which of the following instructions does the nurse reinforce regarding administration of this medication?
- A. Administer on an empty stomach.
- B. Take the medication with a calcium-type antacid.
- C. Open the capsule and mix with food for administration.
- D. Contact the health care provider (HCP) if a sore throat occurs.
Correct answer: D
Rationale: The correct instruction for administering mycophenolate mofetil (CellCept) is to contact the healthcare provider (HCP) if unusual bleeding or bruising, sore throat, or other adverse effects occur. It is essential not to open or crush the capsules to maintain the medication's efficacy.
4. Which statement by the client indicates a need for further teaching about the use of metoprolol (Lopressor)?
- A. I will not stop taking the medication abruptly.
- B. I will take my pulse before taking the medication.
- C. I will take the medication with food.
- D. I will take the medication at bedtime.
Correct answer: D
Rationale: The correct answer is D because taking metoprolol (Lopressor) at bedtime is not specifically recommended. Metoprolol should be taken with food to enhance absorption. It is crucial for the client not to stop taking the medication abruptly to prevent rebound hypertension or other adverse effects. Additionally, monitoring the pulse before taking metoprolol is important for assessing its effect on heart rate.
5. A client who has been newly diagnosed with diabetes mellitus has been stabilized with daily insulin injections. Which information should the nurse teach when carrying out plans for discharge?
- A. Keep insulin vials refrigerated at all times.
- B. Rotate the insulin injection sites systematically.
- C. Increase the amount of insulin before unusual exercise.
- D. Monitor the urine acetone level to determine the insulin dosage.
Correct answer: B
Rationale: When a client is stabilized with daily insulin injections, it is crucial to rotate the injection sites systematically. This practice helps prevent the development of lipodystrophy, which can affect insulin absorption and lead to inconsistent glucose control. Additionally, rotating sites minimizes discomfort and tissue damage, ensuring optimal insulin delivery and effectiveness.
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