HESI RN
Pharmacology HESI
1. A client is prescribed amlodipine (Norvasc) for hypertension. Which side effect should the nurse instruct the client to report to the healthcare provider?
- A. Dizziness
- B. Constipation
- C. Peripheral edema
- D. Dry cough
Correct answer: C
Rationale: The correct answer is C, 'Peripheral edema.' Amlodipine (Norvasc) can cause peripheral edema, which is an accumulation of fluid in the extremities and should be reported to the healthcare provider. Dizziness and constipation are possible side effects of amlodipine but are generally less concerning. Dry cough is more commonly associated with ACE inhibitors, not calcium channel blockers like amlodipine.
2. A 14-year-old adolescent with a history of substance abuse is brought to the emergency department by the parents, who suspect that the adolescent has relapsed. What is the nurse’s priority action?
- A. Obtain a urine sample for toxicology screening
- B. Discuss treatment options with the parents
- C. Establish a therapeutic relationship with the adolescent
- D. Administer a medication to reverse the effects of the substance
Correct answer: A
Rationale: In this scenario, the nurse's priority action should be to obtain a urine sample for toxicology screening. This step is crucial in identifying the substances involved in the relapse, which will guide appropriate treatment strategies. By knowing the specific substances, healthcare providers can tailor treatment plans effectively. Establishing a therapeutic relationship and discussing treatment options come after obtaining necessary diagnostic information to ensure a comprehensive care plan. Administering a medication to reverse substance effects is not the initial priority; identification of the substances through toxicology screening should precede any treatment intervention.
3. The caregiver is caring for a 2-month-old infant with a diagnosis of bronchiolitis. Which assessment finding would be most concerning to the caregiver?
- A. Nasal flaring and grunting
- B. Coughing and wheezing
- C. Poor feeding and irritability
- D. Increased respiratory rate
Correct answer: A
Rationale: Nasal flaring and grunting are indicative of respiratory distress, suggesting the infant is having difficulty breathing. This finding requires immediate attention as it signifies a more severe respiratory compromise compared to the other symptoms listed.
4. A client with diabetes mellitus is admitted with an infected foot ulcer. What intervention is most important for the nurse to implement?
- A. Obtain a wound culture for testing.
- B. Administer prescribed IV antibiotics.
- C. Elevate the affected foot to reduce swelling.
- D. Consult the wound care nurse for assessment.
Correct answer: B
Rationale: Administering prescribed IV antibiotics is the most crucial intervention in managing an infected foot ulcer in a client with diabetes mellitus. Antibiotics help combat the infection and prevent its spread systemically, which is vital in diabetic clients to prevent serious complications like sepsis. While obtaining a wound culture (Choice A) may provide valuable information for targeted antibiotic therapy, administering antibiotics promptly takes precedence to prevent the infection from worsening. Elevating the affected foot (Choice C) can help reduce swelling but is not as urgent as administering antibiotics. Consulting the wound care nurse (Choice D) may be beneficial for long-term wound management but does not address the immediate need to control the infection.
5. What action should be taken by the healthcare provider for a child who has ingested a corrosive product?
- A. Induce vomiting using Ipecac to remove the corrosive agent.
- B. Administer vinegar or lemon juice to neutralize the caustic agent.
- C. Give activated charcoal to decontaminate the stomach.
- D. Telephone the poison control center and follow their advice.
Correct answer: D
Rationale: In cases of corrosive product ingestion, it is crucial to contact the poison control center for guidance. Inducing vomiting or attempting to neutralize the agent can lead to further harm. The poison control center professionals are trained to provide specific instructions tailored to the situation, ensuring the best possible outcome for the child. Therefore, the correct action is to call the poison control center for appropriate advice. Inducing vomiting can cause additional damage by re-exposing the esophagus and mouth to the corrosive substance. Administering vinegar or lemon juice is not recommended as it may worsen the situation by causing a chemical reaction. While activated charcoal can be useful in some cases of poisoning, it is not recommended for corrosive substances as it is ineffective in binding to them.