HESI LPN
Pharmacology HESI Practice
1. A client is prescribed an antacid for the treatment of peptic ulcer disease. What is the action of this medication that is effective in treating the client's ulcer?
- A. Decrease in the production of gastric secretions
- B. Production of an adherent barrier over the ulcer
- C. Maintenance of a gastric pH of 3.5 or above
- D. Decrease in the gastric motor activity
Correct answer: C
Rationale: The correct answer is C. Antacids work by neutralizing gastric acids and maintaining a gastric pH of 3.5 or above. This pH level is crucial to prevent the activation of pepsinogen, a precursor to pepsin, which can further damage the ulcer. Choice A is incorrect because antacids do not directly decrease the production of gastric secretions; they neutralize existing acid. Choice B is incorrect as antacids do not form a physical barrier over the ulcer but rather neutralize the acid around it. Choice D is also incorrect as antacids do not affect gastric motor activity but focus on reducing acidity in the stomach.
2. The practical nurse is assigned a client on digoxin therapy. Which finding is likely to predispose this client to developing digoxin toxicity?
- A. Hyponatremia
- B. Hypernatremia
- C. Hyperkalemia
- D. Hypokalemia
Correct answer: D
Rationale: Hypokalemia predisposes a client on digoxin to digoxin toxicity. Symptoms of digoxin toxicity include abdominal pain, anorexia, nausea, vomiting, visual disturbances, bradycardia, and atrioventricular (AV) dissociation. Therefore, assessment of serum potassium levels and prompt correction of hypokalemia are crucial interventions for clients taking digoxin.
3. A client vomits 30 minutes after receiving a dose of hydromorphone on the first postoperative day. What initial intervention is best for the practical nurse (PN) to implement?
- A. Obtain a prescription for nasogastric intubation.
- B. Administer a prn dose of ondansetron.
- C. Reduce the next scheduled dose of hydromorphone.
- D. Assess the client's abdomen and bowel sounds.
Correct answer: B
Rationale: In this scenario, the client's vomiting is likely due to the hydromorphone administration, indicating a need for an antiemetic such as ondansetron to address the nausea. Nasogastric intubation (Choice A) is not necessary at this point as the client is vomiting, not experiencing an obstruction. While reducing the dose of hydromorphone (Choice C) may be considered later, the immediate focus should be managing the client's symptoms. Assessing the client's abdomen and bowel sounds (Choice D) can be important but is not the initial priority when addressing the vomiting post hydromorphone administration.
4. A client is prescribed methylprednisolone for an allergic reaction. The nurse should monitor for which potential side effect of this medication?
- A. Nausea and vomiting
- B. Weight gain
- C. Insomnia
- D. Increased appetite
Correct answer: B
Rationale: When a client is prescribed methylprednisolone, a corticosteroid, the nurse should monitor for weight gain as a potential side effect. Corticosteroids like methylprednisolone can cause weight gain and fluid retention due to their impact on metabolism and sodium retention. Nausea and vomiting are less common side effects of methylprednisolone. Insomnia and increased appetite are not typically associated with methylprednisolone use.
5. An adolescent client with a seizure disorder is prescribed the anticonvulsant medication carbamazepine. The nurse should notify the healthcare provider if the client develops which condition?
- A. Experiences dry mouth.
- B. Experiences dizziness.
- C. Develops a sore throat.
- D. Develops gingival hyperplasia.
Correct answer: C
Rationale: The correct answer is C: 'Develops a sore throat.' When a client on carbamazepine develops flu-like symptoms such as pallor, fatigue, sore throat, and fever, it could indicate blood dyscrasias (aplastic anemia, leukopenia, anemia, thrombocytopenia), which are potential adverse effects of the medication. These symptoms warrant immediate notification of the healthcare provider for further evaluation and management to prevent complications. Choices A, B, and D are incorrect because dry mouth, dizziness, and gingival hyperplasia are not commonly associated with carbamazepine use and do not indicate serious adverse effects that require immediate healthcare provider notification.
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