HESI LPN
Pharmacology HESI 2023
1. When a client with hepatic encephalopathy is receiving lactulose, which parameter is essential to monitor for a response to the drug?
- A. Serum hepatic enzymes
- B. Fingerstick glucose
- C. Stool color and character
- D. Serum electrolytes and ammonia
Correct answer: D
Rationale: In hepatic encephalopathy, the goal of lactulose therapy is to reduce blood ammonia levels by promoting its excretion in the stool. Therefore, monitoring serum electrolytes and ammonia levels is crucial to assess the effectiveness of lactulose in lowering ammonia levels and improving the client's condition. Options A, B, and C are incorrect because serum hepatic enzymes, fingerstick glucose, and stool color/character are not directly related to monitoring the response to lactulose therapy in hepatic encephalopathy.
2. A client with a diagnosis of schizophrenia is prescribed ziprasidone. The nurse should monitor the client for which potential side effect?
- A. QT prolongation
- B. Weight gain
- C. Dry mouth
- D. Increased appetite
Correct answer: A
Rationale: The correct answer is A: QT prolongation. Ziprasidone is known to cause QT prolongation, which can potentially lead to serious cardiac issues. Monitoring the client's ECG is crucial to detect any changes and prevent adverse effects related to QT interval prolongation. Choices B, C, and D are incorrect because weight gain, dry mouth, and increased appetite are not commonly associated with ziprasidone. While weight gain can be a side effect of some antipsychotic medications, it is not a prominent side effect of ziprasidone. Dry mouth and increased appetite are also not typically linked to ziprasidone use.
3. A client with a history of stroke is prescribed clopidogrel. The nurse should monitor the client for which potential side effect?
- A. Bleeding
- B. Bruising
- C. Nausea
- D. Headache
Correct answer: A
Rationale: Clopidogrel is an antiplatelet medication that works to prevent blood clots, but it can also increase the risk of bleeding. Therefore, the nurse should monitor the client for signs of bleeding, such as easy bruising, prolonged bleeding from cuts, blood in urine or stool, or unusual bleeding from the gums. Prompt identification and management of bleeding are crucial to prevent complications. Choices B, C, and D are incorrect because while bruising and other symptoms can occur as a result of bleeding, they are not the primary side effect to monitor for with clopidogrel. Nausea and headache are less commonly associated with clopidogrel use compared to bleeding.
4. A client with schizophrenia is prescribed risperidone. Which statement by the client indicates the need for further teaching?
- A. I can stop taking this medication once I feel better.
- B. This medication may cause drowsiness.
- C. This medication might make me feel drowsy.
- D. I should avoid alcohol while taking this medication.
Correct answer: A
Rationale: Clients should not stop taking risperidone abruptly once they feel better without consulting their healthcare provider.
5. A client with diabetes mellitus type 2 is prescribed sitagliptin. The nurse should include which instruction in the client's teaching plan?
- A. Take this medication with meals.
- B. Avoid alcohol while taking this medication.
- C. Take this medication on an empty stomach.
- D. Report any signs of pancreatitis to the healthcare provider.
Correct answer: D
Rationale: The correct instruction to include in the teaching plan for a client prescribed sitagliptin is to report any signs of pancreatitis to the healthcare provider. Sitagliptin is generally taken with meals to reduce gastrointestinal side effects. Therefore, choice A, 'Take this medication with meals,' is incorrect. Sitagliptin does not have specific interactions with alcohol, so there is no need to advise the client to avoid alcohol, making choice B incorrect. Taking sitagliptin on an empty stomach is not recommended, so choice C is also incorrect. Pancreatitis is a rare but serious side effect of sitagliptin, so it is crucial for the client to report any signs or symptoms to their healthcare provider promptly.
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