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Pharmacology HESI 55 Questions 2023
1. A client with a history of heart failure is prescribed digoxin. The nurse should monitor for which potential side effect?
- A. Bradycardia
- B. Tachycardia
- C. Hypertension
- D. Hypotension
Correct answer: A
Rationale: Digoxin, a medication commonly prescribed for heart failure, can lead to bradycardia, characterized by a slow heart rate. Monitoring for bradycardia is crucial to detect and manage this potential side effect early on to prevent complications such as arrhythmias or decreased cardiac output. Tachycardia (choice B) is not typically associated with digoxin use. Hypertension (choice C) and hypotension (choice D) are also not common side effects of digoxin.
2. A client with a diagnosis of generalized anxiety disorder is prescribed citalopram. The nurse should instruct the client that this medication may have which potential side effect?
- A. Nausea
- B. Drowsiness
- C. Insomnia
- D. Headache
Correct answer: A
Rationale: The correct potential side effect of citalopram is nausea. Citalopram can cause gastrointestinal disturbances such as nausea, so clients should be advised to take the medication with food if nausea occurs to help minimize this side effect. While other side effects like drowsiness, insomnia, and headache may also occur with citalopram, nausea is a common side effect that clients should be informed about. Drowsiness and insomnia are more commonly associated with other medications used to treat anxiety or depression, such as benzodiazepines or certain antidepressants. Headache is a less common side effect of citalopram compared to nausea.
3. A client with chronic kidney disease is prescribed cinacalcet. The nurse should monitor for which potential side effect?
- A. Hypocalcemia
- B. Hypercalcemia
- C. Hyperkalemia
- D. Hyperphosphatemia
Correct answer: A
Rationale: Corrected Rationale: Cinacalcet is a medication that can lower calcium levels, leading to hypocalcemia. Monitoring for signs of low calcium levels such as muscle cramps, tingling sensations, and abnormal heart rhythms is crucial to prevent complications in clients with chronic kidney disease.\nIncorrect Choices Rationale: B) Hypercalcemia is the opposite effect of cinacalcet; C) Hyperkalemia and D) Hyperphosphatemia are not typically associated with cinacalcet use.
4. During a home visit, a client with a history of angina reports frequent headaches. The client recently started a new prescription for diltiazem, a calcium channel blocker. What action should the nurse take?
- A. Explain the importance of obtaining a blood sample promptly to test for medication toxicity
- B. Consult with the healthcare provider regarding the necessity of an opioid analgesic for pain relief
- C. Recommend the client to discontinue the medication until contacting the healthcare provider
- D. Instruct the client on the use of acetaminophen every 4-6 hours as needed for headaches
Correct answer: D
Rationale: The correct action for the nurse to take is to instruct the client to use acetaminophen for headaches. Acetaminophen is a suitable and safer option for managing headaches associated with calcium channel blockers like diltiazem. It is essential to avoid medications that can interact negatively with diltiazem, such as opioid analgesics. Discontinuing the medication abruptly without consulting the healthcare provider is not recommended. Monitoring for medication toxicity through blood samples is not typically indicated for managing headaches in this scenario.
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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