HESI LPN
Pharmacology HESI 2023
1. A client with epilepsy is prescribed lamotrigine. The nurse should monitor for which potential side effect?
- A. Drowsiness
- B. Nausea and vomiting
- C. Skin rash
- D. Dizziness
Correct answer: C
Rationale: When a client is prescribed lamotrigine, the nurse should closely monitor for the potential side effect of skin rash. Lamotrigine is known to cause skin rashes, which can be mild or severe, indicating a serious adverse reaction like Stevens-Johnson syndrome. Monitoring for skin rash is crucial to detect any signs of severe allergic reactions early and prevent further complications. Choices A, B, and D are incorrect as drowsiness, nausea and vomiting, and dizziness are not typically associated with lamotrigine use. While dizziness can be a side effect of some antiepileptic medications, it is not a common side effect of lamotrigine.
2. What information should the practical nurse provide to a female client who started taking an oral sulfonamide for a urinary tract infection the previous day and reports slight anorexia, while also experiencing urinary frequency?
- A. Take the medication with an antacid instead of cranberry juice to reduce the anorexia.
- B. Continue to take the medication with a sip of cranberry juice, restricting fluids until the frequency is controlled.
- C. Continue to drink cranberry juice, but take the medicine on an empty stomach with a full glass of water.
- D. Take the medication with a spoonful of ice cream or applesauce and avoid drinking cranberry juice.
Correct answer: C
Rationale: The practical nurse should advise the client to take sulfonamides with a full glass of water to help prevent crystalluria. It is essential to take the medication on an empty stomach, ideally 1 hour before eating or 2 hours after eating to maximize its absorption and effectiveness. Continuing to drink cranberry juice is beneficial, but it is important to take the medicine separately to enhance its therapeutic action.
3. A client with chronic kidney disease is prescribed sucroferric oxyhydroxide. What potential side effect should the nurse monitor for?
- A. Diarrhea
- B. Constipation
- C. Nausea
- D. Hyperphosphatemia
Correct answer: A
Rationale: Sucroferric oxyhydroxide is known to cause diarrhea as a side effect. Therefore, the nurse should closely monitor the client for any signs of diarrhea while on this medication to ensure timely intervention and management.
4. A client vomits 30 minutes after receiving a dose of hydromorphone on the first postoperative day. What initial intervention is best for the practical nurse (PN) to implement?
- A. Obtain a prescription for nasogastric intubation.
- B. Administer a prn dose of ondansetron.
- C. Reduce the next scheduled dose of hydromorphone.
- D. Assess the client's abdomen and bowel sounds.
Correct answer: B
Rationale: In this scenario, the client's vomiting is likely due to the hydromorphone administration, indicating a need for an antiemetic such as ondansetron to address the nausea. Nasogastric intubation (Choice A) is not necessary at this point as the client is vomiting, not experiencing an obstruction. While reducing the dose of hydromorphone (Choice C) may be considered later, the immediate focus should be managing the client's symptoms. Assessing the client's abdomen and bowel sounds (Choice D) can be important but is not the initial priority when addressing the vomiting post hydromorphone administration.
5. A client with a diagnosis of bipolar disorder is prescribed carbamazepine. The nurse should monitor for which potential adverse effect?
- A. Agranulocytosis
- B. Hair loss
- C. Liver toxicity
- D. Weight gain
Correct answer: A
Rationale: Carbamazepine is associated with the potential adverse effect of agranulocytosis, a serious condition characterized by a low white blood cell count. Monitoring white blood cell counts regularly is crucial to detect this adverse effect early and prevent complications.
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