HESI LPN
Pharmacology HESI 2023
1. A client with diabetes mellitus type 1 is prescribed insulin glargine. When should the nurse instruct the client to administer this medication?
- A. Before meals
- B. After meals
- C. At bedtime
- D. In the morning
Correct answer: C
Rationale: Corrected Rationale: Insulin glargine is a long-acting insulin that provides a consistent level of insulin over 24 hours. Administering it at bedtime helps mimic the body's natural insulin secretion pattern and provides optimal blood glucose control during the night and throughout the day. Choice A (Before meals) is incorrect because insulin glargine is not a rapid-acting insulin meant to cover meals. Choice B (After meals) is incorrect as the timing doesn't align with the insulin's mechanism. Choice D (In the morning) is incorrect as administering insulin glargine in the morning may not provide adequate coverage throughout the night and the following day.
2. A female client who started chemotherapy three days ago for cancer of the breast calls the clinic reporting that she is so upset she cannot sleep. The client has several PRN medications available. Which drug should the nurse instruct her to take?
- A. Ondansetron 8mgPO no
- B. Lorazepam 2mg PO bedtime
- C. Oxycodone, acetylsalicylic acid one tablet q4 hours PRN
- D. Acetaminophen, diphenhydramine 2 capsules bedtime
Correct answer: D
Rationale: Acetaminophen and diphenhydramine help with sleep without severe side effects.
3. A client with a history of deep vein thrombosis is prescribed apixaban. The nurse should monitor for which potential adverse effect?
- A. Increased risk of bleeding
- B. Decreased risk of bleeding
- C. Increased risk of infection
- D. Decreased risk of infection
Correct answer: A
Rationale: The correct answer is A: Increased risk of bleeding. Apixaban is an anticoagulant medication that works by preventing blood clots. While this is beneficial for individuals with a history of deep vein thrombosis, it also increases the risk of bleeding. Therefore, the nurse should monitor the client for signs of bleeding, such as easy bruising, prolonged bleeding from cuts, or blood in the urine or stool. Monitoring for bleeding is crucial to ensure the client's safety and to take appropriate actions if necessary. Choices B, C, and D are incorrect because apixaban does not decrease the risk of bleeding, increase the risk of infection, or decrease the risk of infection. The primary concern when administering apixaban is monitoring for potential bleeding complications.
4. A client with a diagnosis of bipolar disorder is prescribed lamotrigine. The nurse should monitor for which potential adverse effect?
- A. Rash
- B. Tremors
- C. Hair loss
- D. Weight gain
Correct answer: A
Rationale: The correct answer is A: Rash. Lamotrigine can cause a rash, which may indicate a serious adverse effect like Stevens-Johnson syndrome. Monitoring for a rash is crucial in clients taking lamotrigine to promptly address any potential severe reactions.
5. A client is prescribed cyclobenzaprine for muscle spasms. The nurse should instruct the client to avoid which substance while taking this medication?
- A. Alcohol
- B. Caffeine
- C. Nicotine
- D. Dairy products
Correct answer: A
Rationale: The correct answer is A: Alcohol. When taking cyclobenzaprine, it is important to avoid alcohol as it can potentiate the central nervous system depressant effects of the medication. This interaction can lead to increased drowsiness, dizziness, and impaired coordination. Therefore, it is essential for the client to refrain from alcohol consumption while on cyclobenzaprine to prevent these adverse effects and ensure their safety. Choices B, C, and D are incorrect because caffeine, nicotine, and dairy products do not have significant interactions with cyclobenzaprine. While caffeine and nicotine may have stimulant effects that could theoretically counteract some of the sedative effects of cyclobenzaprine, they are not contraindicated. Dairy products, on the other hand, do not interact with cyclobenzaprine and can be consumed safely.
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