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 is prescribed atorvastatin. The practical nurse should monitor the client for which potential adverse effect?
- A. Muscle pain and weakness
- B. Headache
- C. Hepatotoxicity
- D. Gastrointestinal bleeding
Correct answer: A
Rationale: The correct answer is A: Muscle pain and weakness. Atorvastatin is known to potentially cause muscle pain and weakness, which could indicate muscle damage or rhabdomyolysis. This adverse effect should be closely monitored by the practical nurse to ensure early detection and appropriate management. Choices B, C, and D are incorrect because they are not typically associated with atorvastatin use. Headache is a less common side effect, hepatotoxicity is rare but serious, and gastrointestinal bleeding is not a common adverse effect of atorvastatin.
3. A client with diabetes mellitus type 2 is prescribed saxagliptin. The nurse should include which instruction in the client's teaching plan?
- A. Report any signs of pancreatitis to the healthcare provider.
- B. Take this medication with meals.
- C. Avoid alcohol while taking this medication.
- D. Report any signs of heart failure to the healthcare provider.
Correct answer: A
Rationale: Corrected Rationale: When a client with diabetes mellitus type 2 is prescribed saxagliptin, it is crucial to instruct them to report any signs of pancreatitis to the healthcare provider. Saxagliptin can lead to pancreatitis as a side effect, making it essential for clients to be vigilant about recognizing and reporting any related symptoms promptly for timely intervention and management. Choice B is incorrect because saxagliptin can be taken with or without meals. Choice C is not specifically associated with saxagliptin use. Choice D is incorrect as heart failure is not a common side effect of saxagliptin.
4. A client with rheumatoid arthritis is prescribed hydroxychloroquine. What instruction should the nurse include in the client's teaching plan?
- A. Avoid sunlight exposure while taking this medication.
- B. Take this medication with food to reduce gastrointestinal upset.
- C. Report any signs of infection to the healthcare provider.
- D. Report any signs of vision changes to the healthcare provider.
Correct answer: D
Rationale: Hydroxychloroquine is known to cause vision changes, including retinopathy. Therefore, it is crucial for clients to report any vision changes promptly to their healthcare provider to prevent any potential ocular complications. While sunlight exposure should be limited due to photosensitivity, the key concern with hydroxychloroquine is the risk of vision changes, not gastrointestinal upset or infections.
5. Prior to administration of the initial dose of the GI agent misoprostol, which information should the nurse obtain from the client?
- A. Taking an anti-emetic medication
- B. History of glaucoma
- C. Currently pregnant
- D. Allergy to aspirin
Correct answer: C
Rationale: The correct answer is C. It is crucial for the nurse to obtain information regarding the client's pregnancy status before administering misoprostol, as this medication is contraindicated in pregnancy due to its potential to cause uterine contractions. This can lead to serious complications such as miscarriage or premature birth. Therefore, assessing whether the client is currently pregnant is essential to ensure the safe administration of misoprostol. Choices A, B, and D are not directly related to the administration of misoprostol. While knowing if the client is taking an anti-emetic medication may be relevant to prevent drug interactions, a history of glaucoma and allergy to aspirin are not primary concerns before administering misoprostol.
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