HESI RN
Pharmacology HESI
1. A client with coronary artery disease complains of substernal chest pain. After checking the client's heart rate and blood pressure, a nurse administers nitroglycerin, 0.4 mg, sublingually. After 5 minutes, the client states, 'My chest still hurts.' Select the appropriate actions that the nurse should take.
- A. Call a code blue.
- B. Contact the registered nurse.
- C. Contact the client's family.
- D. Assess the client's pain level.
Correct answer: B
Rationale: The correct action for the nurse to take in this situation is to contact the registered nurse. When a client with coronary artery disease experiences chest pain and does not achieve relief after the initial administration of nitroglycerin, it is crucial to inform the registered nurse promptly. Following the usual guideline for nitroglycerin administration, the nurse may administer a second tablet after assessing the client's pain level. The nurse should continue to assess the client's pain and monitor vital signs before each dose administration. Calling a code blue is not warranted at this point, as the client's condition does not indicate an immediate life-threatening emergency. Contacting the client's family is not necessary unless requested by the client.
2. A client receiving nitrofurantoin (Macrodantin) calls the health care provider's office complaining of side effects related to the medication. Which side effect indicates the need to stop treatment with this medication?
- A. Nausea
- B. Diarrhea
- C. Anorexia
- D. Cough and chest pain
Correct answer: D
Rationale: Pulmonary reactions such as cough and chest pain are serious side effects associated with nitrofurantoin that require immediate discontinuation of the medication to prevent potential severe respiratory complications.
3. A healthcare professional is preparing to administer an intramuscular dose of penicillin to a client with a history of anaphylactic reactions to penicillin. Which action should the healthcare professional take first?
- A. Check the medication order for accuracy.
- B. Have an epinephrine injection available.
- C. Administer a test dose to check for a reaction.
- D. Ask the client about any allergies.
Correct answer: B
Rationale: When dealing with a client who has a history of anaphylactic reactions to penicillin, the priority action for the healthcare professional is to have an epinephrine injection readily available in case of a severe allergic reaction. In such cases, the immediate focus is on being prepared to manage a potentially life-threatening situation. While checking the medication order for accuracy, administering a test dose, and asking the client about allergies are essential steps in medication administration, the first priority is ensuring the availability of epinephrine to address a severe allergic reaction promptly.
4. Glimepiride (Amaryl) is prescribed for a client with diabetes mellitus. A healthcare provider reinforces instructions for the client and advises them to avoid which of the following while taking this medication?
- A. Alcohol
- B. Organ meats
- C. Whole-grain cereals
- D. Carbonated beverages
Correct answer: A
Rationale: Alcohol should be avoided when taking glimepiride (Amaryl) because it can cause a disulfiram-like reaction and enhance the hypoglycemic effects of the medication. Consuming alcohol with glimepiride can lead to symptoms such as flushing, palpitations, nausea, and vomiting. Therefore, it is crucial for individuals on glimepiride therapy to steer clear of alcohol to prevent adverse reactions and maintain optimal medication efficacy.
5. A client is receiving intravenous gentamicin (Garamycin). Which of the following findings should prompt the nurse to notify the healthcare provider immediately?
- A. Nausea
- B. Hearing loss
- C. Headache
- D. Diarrhea
Correct answer: B
Rationale: Gentamicin (Garamycin) is an aminoglycoside antibiotic known to cause ototoxicity, which can manifest as hearing loss. Hearing loss is a serious adverse effect that should be reported promptly to the healthcare provider to prevent further complications or adjust the treatment regimen. Nausea, headache, and diarrhea are common side effects of gentamicin but are not as severe or urgent as hearing loss in this context.
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