HESI RN
Pharmacology HESI Quizlet
1. A client with diabetes mellitus is prescribed prednisone for an acute exacerbation of asthma. Which of the following should the nurse include in the client's teaching plan?
- A. Increase the dose of insulin while taking prednisone.
- B. Take the prednisone with food.
- C. Monitor blood glucose levels closely.
- D. Do not discontinue prednisone abruptly.
Correct answer: C
Rationale: The correct answer is to monitor blood glucose levels closely. Prednisone can elevate blood glucose levels, necessitating close monitoring. Adjusting the insulin dose may be necessary, but this should be managed by a healthcare provider. Prednisone should be taken with food to reduce gastrointestinal discomfort and should not be stopped suddenly to prevent adverse effects.
2. When monitoring tissue perfusion following an above the knee amputation (AKA), which action should the nurse include in the plan of care?
- A. Evaluate the closest proximal pulse.
- B. Observe the color and amount of wound drainage.
- C. Observe for swelling around the stump.
- D. Assess the skin elasticity of the stump.
Correct answer: A
Rationale: Evaluating the closest proximal pulse is essential when monitoring tissue perfusion post-amputation. This pulse provides crucial information about the circulation and perfusion to the limb. Observing the color and amount of wound drainage (Choice B) is more related to wound healing assessment rather than tissue perfusion. Observing for swelling around the stump (Choice C) may indicate inflammation or infection but is not the most direct assessment of tissue perfusion. Assessing skin elasticity of the stump (Choice D) is important for skin integrity but does not directly reflect tissue perfusion.
3. The healthcare provider is preparing to administer a scheduled dose of digoxin to a 4-year-old child with heart failure. The healthcare provider notes that the child’s heart rate is 70 beats per minute. What should the healthcare provider do next?
- A. Administer the medication as prescribed
- B. Hold the medication and notify the healthcare provider
- C. Recheck the heart rate in 30 minutes
- D. Administer half of the prescribed dose
Correct answer: B
Rationale: In pediatric patients, digoxin administration is guided by the heart rate. If the child's heart rate is below the established threshold, which is typically 90-100 beats per minute in a 4-year-old, the medication should be withheld, and the healthcare provider should be notified for further evaluation and instructions. Choice A is incorrect because administering the medication when the heart rate is low can lead to adverse effects. Rechecking the heart rate in 30 minutes (Choice C) may delay necessary intervention if the heart rate remains low. Administering half of the prescribed dose (Choice D) is not recommended without healthcare provider guidance.
4. A client with hyperlipidemia is prescribed atorvastatin (Lipitor). Which instruction should the nurse include in the teaching plan?
- A. Take the medication in the morning.
- B. Avoid consuming grapefruit juice.
- C. Increase your intake of dairy products.
- D. Take the medication with food.
Correct answer: B
Rationale: The correct instruction for the nurse to include in the teaching plan is to advise the client to avoid consuming grapefruit juice. Grapefruit juice can increase the risk of atorvastatin (Lipitor) toxicity by inhibiting its metabolism. Atorvastatin is typically taken in the evening as cholesterol synthesis occurs at night. Increasing dairy intake is not specifically recommended for atorvastatin therapy, and the medication can be taken with or without food.
5. A client presents to the clinic with concerns about her left breast. Which assessment finding is most important for the nurse to report?
- A. Multiple firm, round, freely movable masses.
- B. A slight asymmetry of the breasts.
- C. A fixed nodular mass with dimpling of the skin.
- D. Bloody discharge from the nipple.
Correct answer: C
Rationale: The correct answer is C. A fixed nodular mass with dimpling of the skin is concerning for malignancy, such as breast cancer, and should be reported immediately for further evaluation. This finding is more suspicious compared to multiple firm, round, freely movable masses (choice A), which could be benign breast lumps. A slight asymmetry of the breasts (choice B) is a common finding and not as alarming as a fixed nodular mass with dimpling of the skin. Bloody discharge from the nipple (choice D) can be suggestive of other conditions like intraductal papilloma but is not as urgent as the finding described in choice C.