HESI RN
Pharmacology HESI
1. A client is taking levothyroxine (Synthroid) for hypothyroidism. Which symptom would indicate to the nurse that the client is taking too much medication?
- A. Bradycardia
- B. Lethargy
- C. Tremors
- D. Constipation
Correct answer: C
Rationale: When a client is taking an excessive dose of levothyroxine (Synthroid), it can lead to symptoms of hyperthyroidism. Tremors are a common sign of excessive medication, along with tachycardia and insomnia. Bradycardia, lethargy, and constipation are typical symptoms of hypothyroidism, indicating that the client may require a higher dose of levothyroxine rather than too much.
2. A client who has begun taking fosinopril (Monopril) is very distressed, telling the nurse that he cannot taste food normally since beginning the medication 2 weeks ago. The nurse provides the best support to the client by:
- A. Telling the client not to take the medication with food
- B. Suggesting that the client taper the dose until taste returns to normal
- C. Informing the client that impaired taste is expected and generally disappears in 2 to 3 months
- D. Requesting that the health care provider (HCP) change the prescription to another brand of angiotensin-converting enzyme (ACE) inhibitor
Correct answer: C
Rationale: The correct answer is to inform the client that impaired taste is an expected side effect of ACE inhibitors like fosinopril, such as Monopril, and typically resolves within 2 to 3 months. It is essential for the nurse to offer reassurance and education to the client about this common side effect to alleviate distress and encourage compliance with the medication regimen.
3. A nurse is monitoring a client receiving lithium carbonate for bipolar disorder. Which finding should the nurse report immediately to the healthcare provider?
- A. Increased thirst
- B. Fine hand tremors
- C. Frequent urination
- D. Persistent vomiting
Correct answer: D
Rationale: Persistent vomiting can be a sign of lithium toxicity, which requires immediate medical attention. Increased thirst, fine hand tremors, and frequent urination are common side effects of lithium.
4. A client with a history of chronic heart failure is prescribed spironolactone (Aldactone). Which of the following statements indicates that the client understands the medication teaching?
- A. I will avoid potassium-rich foods.
- B. I will not use a salt substitute.
- C. I will monitor my weight daily.
- D. I will increase my fluid intake as prescribed.
Correct answer: A
Rationale: The correct statement is 'I will avoid potassium-rich foods.' Spironolactone (Aldactone) is a potassium-sparing diuretic, which can lead to hyperkalemia if potassium intake is not regulated. Therefore, avoiding potassium-rich foods is crucial to prevent this complication. Using a salt substitute can also increase potassium levels. Monitoring weight daily is essential in heart failure management, but it is not specific to spironolactone. Increasing fluid intake as prescribed is generally recommended for heart failure management but is not directly related to spironolactone use.
5. The burn client is receiving treatments of topical mafenide acetate (Sulfamylon) to the site of injury. The nurse monitors the client, knowing that which of the following indicates that a systemic effect has occurred?
- A. Hyperventilation
- B. Elevated blood pressure
- C. Local pain at the burn site
- D. Local rash at the burn site
Correct answer: A
Rationale: Hyperventilation is an indication of a systemic effect of mafenide acetate (Sulfamylon) due to its potential to cause acidosis by suppressing renal excretion of acid. If hyperventilation occurs, the medication should be discontinued to prevent further complications.
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