HESI LPN
Pharmacology HESI 2023
1. 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.
2. A client with a history of chronic obstructive pulmonary disease (COPD) is prescribed salmeterol. The nurse should monitor for which potential side effect?
- A. Dry mouth
- B. Tachycardia
- C. Insomnia
- D. Increased appetite
Correct answer: A
Rationale: The correct answer is dry mouth. Salmeterol, a long-acting beta agonist used in COPD, can lead to dry mouth as a common side effect. Nurses should monitor for this side effect and advise clients to report it if it becomes bothersome.
3. A client taking long-term steroids also has ranitidine prescribed. The nurse provides which explanation as to why these drugs are given together?
- A. Ranitidine reduces the risk of ulcers associated with steroids.
- B. Ranitidine decreases the risk of infection associated with steroids.
- C. Ranitidine decreases blood sugar elevations associated with steroids.
- D. Ranitidine reduces sodium retention associated with steroid usage.
Correct answer: A
Rationale: The correct answer is A. Ranitidine is prescribed with long-term steroids to reduce the risk of ulcers associated with steroid therapy. Although steroids can increase the risk of ulcers due to their effect on the gastrointestinal system, ranitidine works by reducing stomach acid production, thus helping to prevent ulcer formation. Choices B, C, and D are incorrect as ranitidine is not given to decrease the risk of infection, reduce blood sugar elevations, or reduce sodium retention associated with steroid usage.
4. A client diagnosed with angina has been prescribed nitrate isosorbide dinitrate. Which instruction should the practical nurse reinforce in this client's teaching?
- A. Discontinue the medication if dizziness occurs.
- B. Avoid getting up quickly. Always rise slowly.
- C. Take the medication with or without food.
- D. Increase your intake of potassium-rich foods.
Correct answer: B
Rationale: The correct instruction that the practical nurse should reinforce with a client prescribed nitrate isosorbide dinitrate is to avoid getting up quickly and to rise slowly. Nitrates can cause orthostatic hypotension, a sudden drop in blood pressure when changing positions. By rising slowly, the client can prevent the occurrence of orthostatic hypotension and its associated symptoms. Choices A, C, and D are incorrect because discontinuing the medication without consulting a healthcare provider can be dangerous, taking the medication with or without food does not impact its effectiveness, and increasing potassium intake is not directly related to the use of nitrate isosorbide dinitrate.
5. A client with a productive cough and fever has been diagnosed with bacterial pneumonia and is being admitted to the unit from the emergency room. Which intervention should the practical nurse ensure has been done prior to the administration of antibiotics?
- A. Sputum specimen
- B. Set of vital signs
- C. Electrocardiogram
- D. Glucometer check
Correct answer: A
Rationale: Before initiating antibiotic therapy in a client with bacterial pneumonia, obtaining a sputum specimen for culture and sensitivity is essential. This helps identify the specific bacteria causing the infection and guides the selection of the most effective antibiotic treatment.
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