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Pharmacology HESI 55 Questions 2023
1. A client with a history of deep vein thrombosis is prescribed apixaban. The nurse should monitor for which potential adverse effect?
- A. Increased risk of bleeding
- B. Decreased risk of bleeding
- C. Increased risk of infection
- D. Decreased risk of infection
Correct answer: A
Rationale: The correct answer is A: Increased risk of bleeding. Apixaban is an anticoagulant medication that works by preventing blood clots. While this is beneficial for individuals with a history of deep vein thrombosis, it also increases the risk of bleeding. Therefore, the nurse should monitor the client for signs of bleeding, such as easy bruising, prolonged bleeding from cuts, or blood in the urine or stool. Monitoring for bleeding is crucial to ensure the client's safety and to take appropriate actions if necessary. Choices B, C, and D are incorrect because apixaban does not decrease the risk of bleeding, increase the risk of infection, or decrease the risk of infection. The primary concern when administering apixaban is monitoring for potential bleeding complications.
2. A client is prescribed phenobarbital 100 mg daily for the treatment of seizures. Which statement made by the client indicates an accurate understanding of the medication phenobarbital?
- A. I will take my medicine at 10 PM before retiring to bed.
- B. The medication will turn the color of my urine to a pink color.
- C. I should not eat or drink anything for at least 2 hours before taking my medicine.
- D. In the event a seizure occurs in the middle of the day, I need to take an extra dose of my medicine.
Correct answer: A
Rationale: The correct answer is A. Phenobarbital should be taken at the same time every day to maintain blood levels and enhance compliance. Common side effects of phenobarbital include drowsiness, lethargy, dizziness, and nausea; therefore, it is best to take it before bedtime to minimize these effects and improve sleep quality. Choice B is incorrect because phenobarbital does not affect the color of urine. Choice C is incorrect because there is no need to fast before taking phenobarbital. Choice D is incorrect because taking extra doses without healthcare provider guidance can lead to overdose and adverse effects.
3. A client with hypertension is prescribed clonidine. The nurse should monitor the client for which potential side effect?
- A. Hypotension
- B. Tachycardia
- C. Dizziness
- D. Hyperglycemia
Correct answer: A
Rationale: The correct answer is A: Hypotension. Clonidine, a medication used to treat hypertension, can cause a lowering of blood pressure leading to hypotension as a potential side effect. Monitoring for hypotension is essential to prevent complications such as dizziness, fainting, or falls. Option B, Tachycardia, is incorrect as clonidine typically causes bradycardia or a decreased heart rate. Option C, Dizziness, can occur due to hypotension caused by clonidine. Option D, Hyperglycemia, is not a common side effect associated with clonidine use.
4. A client with asthma is receiving long-term glucocorticoid therapy. The nurse includes a risk for impaired skin integrity on the client's problem list. What is the rationale for including this problem?
- A. Abnormal fat deposits impair circulation
- B. Frequent diarrhea can lead to skin issues
- C. Thinned skin bruises easily
- D. Decreased serum glucose prolongs healing time
Correct answer: C
Rationale: The correct answer is C. Glucocorticoids can cause skin thinning, which increases the likelihood of bruising. Thinning of the skin due to glucocorticoid therapy makes it more fragile and prone to injury, such as bruising, even with minimal trauma. Choices A, B, and D are incorrect because abnormal fat deposits impairing circulation, frequent diarrhea causing skin issues, and decreased serum glucose prolonging healing time are not direct effects of glucocorticoid therapy on skin integrity.
5. A healthcare professional prepares to administer a scheduled dose of labetalol by mouth to a client with hypertension. The client's heart rate is 48 beats/min, respirations are 16 breaths/min, and blood pressure is 150/90 mmHg.
- A. Administer the dose and monitor the client's blood pressure regularly
- B. Apply a telemetry monitor before administering the dose
- C. Assess for orthostatic hypotension before administering the dose
- D. Withhold the scheduled dose and notify the healthcare provider
Correct answer: D
Rationale: The client's low heart rate of 48 beats/min indicates bradycardia, a potential side effect of labetalol. Administering the dose in this case could further lower the heart rate, potentially causing adverse effects. Therefore, it is crucial to withhold the scheduled dose and notify the healthcare provider for further assessment and guidance. Choice A is incorrect because administering the dose without addressing the bradycardia can exacerbate the condition. Choice B is not relevant in this situation as telemetry monitoring is not the priority. Choice C is also not the priority in this case, as the focus should be on the client's bradycardia and the potential adverse effects of administering labetalol.
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