a client with a history of deep vein thrombosis is prescribed fondaparinux the nurse should monitor for which potential adverse effect
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Nursing Elites

HESI LPN

Pharmacology HESI 2023

1. When a client with a history of deep vein thrombosis is prescribed fondaparinux, the nurse should monitor for which potential adverse effect?

Correct answer: A

Rationale: Fondaparinux is an anticoagulant prescribed to prevent blood clots. Therefore, the nurse should monitor the client for an increased risk of bleeding, which is a potential adverse effect of this medication. Choices B, C, and D are incorrect because fondaparinux does not decrease the risk of bleeding, increase the risk of infection, or decrease the risk of infection. Monitoring for signs of bleeding, such as unexplained bruising, bleeding gums, or blood in the urine or stool, is crucial when a client is on fondaparinux.

2. A client with a history of myocardial infarction is prescribed atorvastatin. The nurse should monitor the client for which potential adverse effect?

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. 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.

4. A client who is newly diagnosed with erosive esophagitis secondary to GERD experiences symptoms after taking lansoprazole PO for one full week. Which actions should the nurse take?

Correct answer: C

Rationale: The correct action for the nurse to take in this situation is to advise the client that healing from erosive esophagitis typically takes several weeks. Providing this information helps manage the client's expectations and anxiety about treatment effectiveness. It is not necessary to confirm medication timing, assess bowel sounds, or measure the apical pulse at this point. Since symptoms persist after one week of lansoprazole, it may not be appropriate to immediately escalate to a higher dose without further assessment or guidance from the healthcare provider. Auscultating bowel sounds and assessing the apical pulse are not relevant to the client's symptoms related to erosive esophagitis and GERD.

5. When planning to administer the antiulcer GI agent sucralfate, what instruction should the nurse provide regarding administration?

Correct answer: D

Rationale: Sucralfate is most effective when taken on an empty stomach. This allows the medication to form a protective layer over the ulcer, promoting healing and symptom relief. Administering sucralfate with or after meals may reduce its efficacy as it may bind to food instead of coating the ulcer site.

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