Pharmacology HESI

HESI RN

1. 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.

2. 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.

3. 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.

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 who is receiving digoxin (Lanoxin) daily has a serum potassium level of 3.0 mEq/L and is complaining of anorexia. A healthcare provider prescribes a digoxin level to rule out digoxin toxicity. A nurse checks the results, knowing that which of the following is the therapeutic serum level (range) for digoxin?

A. 3 to 5 ng/mL
B. 0.5 to 2 ng/mL
C. 1.2 to 2.8 ng/mL
D. 3.5 to 5.5 ng/mL

Correct answer: B

Rationale: The therapeutic serum level for digoxin ranges from 0.5 to 2 ng/mL. This range is considered optimal for therapeutic effects while minimizing the risk of toxicity. Levels above 2 ng/mL may lead to digoxin toxicity, which can manifest as anorexia among other symptoms. Therefore, the nurse should be vigilant in monitoring the digoxin levels to ensure the client's safety and therapeutic effectiveness of the medication.