HESI RN
Pharmacology HESI
1. A client has been started on long-term therapy with rifampin (Rifadin). A nurse teaches the client that the medication:
- A. Should always be taken with food or antacids
- B. Should be double-dosed if one dose is forgotten
- C. Causes orange discoloration of sweat, tears, urine, and feces
- D. May not be discontinued independently if symptoms are gone in 3 months
Correct answer: C
Rationale: Rifampin causes orange-red discoloration of body secretions, including sweat, tears, urine, and feces. It can also permanently stain soft contact lenses. It is essential to take rifampin exactly as directed and not discontinue it without consulting the healthcare provider.
2. Who is likely to have the most influence on these women's perceptions about their children's healthcare needs?
- A. husbands
- B. clinic healthcare provider
- C. older females
- D. tribal chief
Correct answer: C
Rationale: In many cultures, older women, such as grandmothers or aunts, hold significant influence over health-related decisions and practices within the family. They are often the ones consulted for advice on healthcare matters concerning children. Husbands (choice A) may have influence in other areas, but when it comes to healthcare decisions for children, older females are typically more influential. Clinic healthcare providers (choice B) may offer guidance, but the influence of older females within the community is usually stronger. Tribal chiefs (choice D) may hold authority but might not be as directly involved in individual healthcare decisions within families as older females.
3. A client with hyperthyroidism is admitted to the postoperative unit after subtotal thyroidectomy. Which of the client's serum laboratory values requires intervention by the nurse?
- A. Total calcium 5.0 mg/dL.
- B. Serum sodium 140 mEq/L.
- C. Serum potassium 4.0 mEq/L.
- D. Serum glucose 90 mg/dL.
Correct answer: A
Rationale: The correct answer is A. A calcium level of 5.0 mg/dL is critically low and could indicate hypoparathyroidism, a possible complication after thyroidectomy. Low calcium levels can lead to tetany, seizures, and cardiac dysrhythmias, requiring immediate intervention. Choices B, C, and D fall within the normal range and do not require immediate intervention in this scenario.
4. A female client with Cushing's syndrome is admitted to the medical-surgical unit. During the admission assessment, Nurse Tyzz notes that the client is agitated, irritable, has poor memory, reports loss of appetite, and appears disheveled. These findings are consistent with which problem?
- A. Depression
- B. Neuropathy
- C. Hypoglycemia
- D. Hyperthyroidism
Correct answer: A
Rationale: The correct answer is A: Depression. Depression is a common psychological manifestation in clients with Cushing's syndrome. In this scenario, the client's symptoms of agitation, irritability, poor memory, loss of appetite, and disheveled appearance are indicative of depressive symptoms rather than neuropathy, hypoglycemia, or hyperthyroidism. Neuropathy typically presents with sensory changes and motor deficits, which are not described in the scenario. Hypoglycemia would manifest with symptoms such as diaphoresis, tremors, and confusion, which are not mentioned. Hyperthyroidism symptoms include weight loss, heat intolerance, and palpitations, which are not consistent with the client's presentation.
5. A client is scheduled for a barium swallow (esophagography) in 2 days. The nurse, providing preprocedure instructions, should tell the client to:
- A. Eat a regular supper and breakfast
- B. Remove all metal and jewelry before the test
- C. Expect diarrhea for a few days after the procedure
- D. Take all oral medications as scheduled with milk on the day of the test
Correct answer: B
Rationale: The correct answer is B: 'Remove all metal and jewelry before the test.' Before a barium swallow procedure, the client should fast for 8 to 12 hours to ensure the stomach and intestines are empty for optimal visualization. Removing all metal and jewelry is essential to prevent any interference with x-ray imaging. Choice A is incorrect because the client should fast, not eat supper and breakfast, before the test. Choice C is incorrect as diarrhea is not an expected outcome of a barium swallow. Choice D is incorrect as the client should not take any oral medications with milk on the day of the test to ensure accurate test results.