a client undergoing hemodialysis for chronic kidney disease is taking the medication erythropoietin the nurse should reinforce instructions to explain
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Nursing Elites

HESI LPN

Pharmacology HESI 2023

1. A client undergoing hemodialysis for chronic kidney disease is taking the medication erythropoietin. The nurse should reinforce instructions to explain for which reason this medication is prescribed?

Correct answer: C

Rationale: Erythropoietin is prescribed to stimulate the production of red blood cells. Clients undergoing hemodialysis often develop anemia due to end-stage renal disease. Erythropoietin helps correct this anemia by stimulating red blood cell production. It is not used to prevent infections associated with dialysis, prevent deep vein thrombosis, or balance phosphorus levels in the body.

2. A client with chronic heart failure is prescribed spironolactone. The nurse should monitor for which potential side effect?

Correct answer: A

Rationale: The correct answer is A: Hyperkalemia. Spironolactone is a potassium-sparing diuretic that can lead to an excess of potassium in the body, resulting in hyperkalemia. This side effect is important to monitor in clients taking spironolactone, especially those with chronic heart failure, as hyperkalemia can lead to serious cardiac complications.

3. In a capillary glucose measurement, a client is to receive 10 units of regular insulin and isophane insulin. How should the nurse prepare?

Correct answer: B

Rationale: In insulin administration, regular insulin is typically administered before isophane insulin to manage blood glucose effectively. If regular insulin is not available, it is best to withhold the dose until it can be administered as prescribed. Choice A is incorrect as it suggests withdrawing from a specific vial without specifying regular insulin. Choice C is incorrect as obtaining a new vial of regular insulin may not be necessary if it becomes available shortly. Choice D is incorrect as administering 10 units from a mixture of regular and isophane insulin is not the correct approach.

4. A client with a history of stroke is prescribed dabigatran. The nurse should monitor for which potential side effect?

Correct answer: C

Rationale: The correct answer is C: Headache. Dabigatran, an anticoagulant, can cause headache as a potential side effect. Headache is important to monitor as it may indicate adverse effects or complications that need attention. Choices A, B, and D are incorrect because dry mouth, weight gain, and dizziness are not commonly associated with dabigatran use.

5. What instructions should the PN reinforce with the client regarding the newly prescribed medications isosorbide dinitrate and hydrochlorothiazide?

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.

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