HESI LPN
Pharmacology HESI Practice
1. A client with a diagnosis of schizophrenia is prescribed clozapine. The nurse should monitor the client for which potential side effect?
- A. Agranulocytosis
- B. Dry mouth
- C. Weight gain
- D. Hypersalivation
Correct answer: A
Rationale: The correct answer is Agranulocytosis. Clozapine is known to potentially cause agranulocytosis, a serious condition characterized by a dangerously low white blood cell count. Monitoring white blood cell counts is crucial to detect this side effect early and prevent complications. Choices B, C, and D are incorrect because dry mouth, weight gain, and hypersalivation are not typically associated with clozapine use. While dry mouth can be a common side effect of some antipsychotic medications, it is not specifically linked to clozapine. Weight gain can occur with certain antipsychotics, but clozapine is more commonly associated with metabolic side effects. Hypersalivation is not a common side effect of clozapine.
2. A client with a history of myocardial infarction is prescribed atorvastatin. The nurse should monitor the client for which potential adverse effect?
- A. Liver damage
- B. Kidney damage
- C. Muscle pain
- D. Increased appetite
Correct answer: C
Rationale: The correct answer is C: Muscle pain. Atorvastatin can cause muscle pain, which may indicate rhabdomyolysis, a serious adverse effect. Rhabdomyolysis is a condition where muscle breakdown releases a protein (myoglobin) into the bloodstream, potentially leading to kidney damage. Liver damage (choice A) is a less common side effect of atorvastatin compared to muscle pain. Kidney damage (choice B) is not a direct adverse effect of atorvastatin but can occur indirectly if rhabdomyolysis is severe. Increased appetite (choice D) is not a known adverse effect of atorvastatin.
3. A client who is in the rehabilitation facility with newly diagnosed Parkinson's disease (PD) has levodopa-carbidopa prescribed. During the care planning session for this client, the nurse discusses which aspects with the other members of the health care team? (Select all that apply.)
- A. Ask the dietician to avoid increasing the amounts of foods high in Vitamin B6.
- B. Lessening of tremors
- C. Remind others on the team that this medication will not relieve all symptoms of PD.
- D. Ask the evening shift nurses to give the last dose earlier in the day if the client has insomnia.
Correct answer: D
Rationale: Levodopa-carbidopa is a medication commonly used in the treatment of Parkinson's disease (PD). It can cause side effects such as hypotension with sudden position changes. To assist the client in managing this side effect, the physical therapy assistant can help avoid sudden position changes. Additionally, if insomnia occurs, adjusting the timing of the last dose earlier in the day can be beneficial. It is important to note that drowsiness can also be a side effect of the medication and should be reported to the nurse. Foods high in Vitamin B6 can interfere with the absorption of levodopa-carbidopa; hence, it is advisable to avoid increasing the consumption of such foods. Lastly, it is crucial to remind the team that while this medication helps alleviate symptoms like tremors, it may not relieve all symptoms of PD comprehensively.
4. A client with chronic kidney disease is prescribed ferric citrate. The nurse should monitor for which potential side effect?
- A. Constipation
- B. Diarrhea
- C. Nausea
- D. Hyperphosphatemia
Correct answer: A
Rationale: When a client with chronic kidney disease is prescribed ferric citrate, the nurse should monitor for constipation as a potential side effect. Ferric citrate can lead to constipation due to its effects on the gastrointestinal system, causing a decrease in bowel movements. It is essential for the nurse to assess and manage constipation promptly to prevent complications and ensure the client's comfort and well-being. Monitoring bowel movements, providing adequate hydration, and recommending dietary interventions can help alleviate constipation in clients taking ferric citrate. Diarrhea, nausea, and hyperphosphatemia are not typically associated with the use of ferric citrate in clients with chronic kidney disease.
5. Which action should be taken to assess for analgesic tolerance in a client who is unable to communicate?
- A. Review the client's laboratory values for changes in peak and trough levels of the analgesic
- B. Prolong the interval between analgesic medication doses and monitor the client's vital signs
- C. Observe the client for the presence of pain behaviors before the next analgesic dose is due
- D. Ask family members to report behaviors suggesting that the client's pain has returned
Correct answer: C
Rationale: In clients who are unable to communicate, observing for pain behaviors is crucial in assessing analgesic tolerance. Changes in pain behaviors can indicate if the current analgesic regimen is effective or if tolerance has developed. Therefore, closely observing the client for pain behaviors before the next analgesic dose helps healthcare providers evaluate the client's response to pain management. Reviewing laboratory values may not directly reflect analgesic tolerance. Prolonging the interval between doses and monitoring vital signs may not provide direct information on analgesic tolerance. Relying solely on family members to report pain behaviors may not be as accurate or immediate as observing the client directly.
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