HESI LPN
Pharmacology HESI 2023
1. A 59-year-old client is prescribed furosemide 40 mg twice a day for the management of heart failure. The practical nurse should monitor the client for the development of which complication?
- A. Hypokalemia
- B. Hyperchloremia
- C. Hypercalcemia
- D. Hypophosphatemia
Correct answer: A
Rationale: Corrected Rationale: Furosemide is a loop diuretic that inhibits the reabsorption of sodium and chloride in the kidneys, leading to increased potassium excretion and potentially causing hypokalemia. Hypokalemia can lead to cardiac irregularities, making it crucial for the practical nurse to monitor the client for this electrolyte imbalance. Choice B, Hyperchloremia, is not typically associated with furosemide use. Choices C and D, Hypercalcemia and Hypophosphatemia, are not common complications of furosemide therapy.
2. A client with a productive cough and fever has been diagnosed with bacterial pneumonia and is being admitted to the unit from the emergency room. Which intervention should the practical nurse ensure has been done prior to the administration of antibiotics?
- A. Sputum specimen
- B. Set of vital signs
- C. Electrocardiogram
- D. Glucometer check
Correct answer: A
Rationale: Before initiating antibiotic therapy in a client with bacterial pneumonia, obtaining a sputum specimen for culture and sensitivity is essential. This helps identify the specific bacteria causing the infection and guides the selection of the most effective antibiotic treatment.
3. A client with asthma is prescribed montelukast. The nurse should instruct the client that this medication is used for which purpose?
- A. Immediate relief of acute asthma attacks
- B. Long-term control of asthma symptoms
- C. Treatment of exercise-induced bronchospasm
- D. Immediate relief of allergic rhinitis symptoms
Correct answer: B
Rationale: Montelukast is a leukotriene receptor antagonist used for the long-term control of asthma symptoms by reducing inflammation in the airways. It is not typically used for immediate relief during acute asthma attacks, where short-acting bronchodilators are more appropriate. Montelukast does not specifically target exercise-induced bronchospasm or allergic rhinitis symptoms. Therefore, the correct answer is B. Choice A is incorrect because montelukast is not for immediate relief of acute asthma attacks. Choice C is incorrect as montelukast is not primarily used to treat exercise-induced bronchospasm. Choice D is incorrect because montelukast is not indicated for immediate relief of allergic rhinitis symptoms.
4. A client with severe rheumatoid arthritis is prescribed methotrexate. The nurse should monitor the client for which potential adverse effect?
- A. Bone marrow suppression
- B. Increased risk of infection
- C. Liver toxicity
- D. Kidney stones
Correct answer: A
Rationale: The correct answer is A: Bone marrow suppression. Methotrexate, commonly used in rheumatoid arthritis, can lead to bone marrow suppression, reducing the production of blood cells and increasing the risk of infection. Monitoring for signs of anemia, leukopenia, and thrombocytopenia is crucial to detect bone marrow suppression early and prevent complications. Choices B, C, and D are incorrect because while methotrexate can increase the risk of infection, liver toxicity, and kidney issues, the primary concern and most significant adverse effect to monitor for is bone marrow suppression due to its impact on blood cell production.
5. A client with chronic kidney disease is prescribed ferric citrate. The nurse should monitor for which potential side effect?
- A. Constipation
- B. Diarrhea
- C. Nausea
- D. Hyperphosphatemia
Correct answer: A
Rationale: When a client with chronic kidney disease is prescribed ferric citrate, the nurse should monitor for constipation as a potential side effect. Ferric citrate can lead to constipation due to its effects on the gastrointestinal system, causing a decrease in bowel movements. It is essential for the nurse to assess and manage constipation promptly to prevent complications and ensure the client's comfort and well-being. Monitoring bowel movements, providing adequate hydration, and recommending dietary interventions can help alleviate constipation in clients taking ferric citrate. Diarrhea, nausea, and hyperphosphatemia are not typically associated with the use of ferric citrate in clients with chronic kidney disease.
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