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. A client with severe rheumatoid arthritis is prescribed infliximab. The nurse should monitor for which potential adverse effect?
- A. Increased risk of infection
- B. Bone marrow suppression
- C. Hair loss
- D. Pancreatitis
Correct answer: A
Rationale: The correct answer is A: Increased risk of infection. Infliximab is known to increase the risk of infection due to its immunosuppressive effects. It is crucial for the nurse to monitor for signs of infection in the client receiving infliximab to promptly address any potential complications and ensure the client's safety and well-being. Choices B, C, and D are incorrect because bone marrow suppression, hair loss, and pancreatitis are not typically associated with infliximab therapy. While these adverse effects can occur with other medications, the primary concern with infliximab is the increased risk of infection.
3. A client with a diagnosis of bipolar disorder is prescribed oxcarbazepine. The nurse should monitor for which potential adverse effect?
- A. Hyponatremia
- B. Agranulocytosis
- C. Liver toxicity
- D. Weight gain
Correct answer: A
Rationale: The correct answer is A, Hyponatremia. Oxcarbazepine, an anticonvulsant used in bipolar disorder, can lead to hyponatremia. This is because it can cause the body to retain water, leading to a dilution of sodium levels in the blood. Monitoring sodium levels is crucial to prevent complications such as confusion, seizures, and even coma. Choices B, C, and D are incorrect. Agranulocytosis is not typically associated with oxcarbazepine use. Liver toxicity is a potential adverse effect of some medications but not commonly seen with oxcarbazepine. While weight gain can be a side effect of certain medications used in bipolar disorder treatment, it is not a common adverse effect of oxcarbazepine.
4. What instructions should the PN reinforce with the client regarding the newly prescribed medications isosorbide dinitrate and hydrochlorothiazide?
- A. Instruct the client to use a soft bristle toothbrush.
- B. Instruct the client to slowly rise from a sitting or lying down position.
- C. Instruct the client to elevate their legs above the level of their heart.
- D. Instruct the client to limit the amount of fiber in their diet.
Correct answer: B
Rationale: The correct instruction for the client is to slowly rise from a sitting or lying down position. Isosorbide dinitrate, a nitrate, and hydrochlorothiazide, a diuretic, can both cause hypotension. When used together, their additive effects can further lower blood pressure, leading to orthostatic hypotension. Instructing the client to change positions slowly helps prevent a sudden drop in blood pressure, reducing the risk of dizziness or falls. Choices A, C, and D are incorrect because they do not directly address the potential side effect of hypotension associated with the prescribed medications. Using a soft bristle toothbrush, elevating legs above the heart level, or limiting fiber intake are not specific instructions to mitigate the risk of orthostatic hypotension.
5. A client with a history of atrial fibrillation is prescribed digoxin. The nurse should monitor for which potential side effect?
- A. Bradycardia
- B. Tachycardia
- C. Headache
- D. Hyperglycemia
Correct answer: A
Rationale: The correct answer is A: Bradycardia. Digoxin can lead to bradycardia due to its effect on slowing down the heart rate, which can be dangerous in a client with atrial fibrillation. Monitoring the client's heart rate is essential to detect and manage this potential side effect. Choices B, C, and D are incorrect because digoxin is not known to cause tachycardia, headache, or hyperglycemia as common side effects.
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