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. The client is receiving vancomycin, and the nurse plans to draw blood for a peak and trough to determine... the best timing for these levels?
- A. Midway through administration of the IV dose and 30 minutes before the next
- B. Two hours after completion of the IV dose and 30 minutes before the next
- C. Two hours after completion of the IV dose and one hour before the next
- D. Immediately after completion of the IV dose and 30 minutes before
Correct answer: B
Rationale: To accurately determine peak and trough levels of vancomycin, blood should be drawn two hours after the completion of the IV dose and 30 minutes before the next dose. This timing allows for appropriate assessment of the drug levels in the body, ensuring accurate monitoring of therapeutic and toxic concentrations. Choice A is incorrect as drawing blood midway through administration does not provide an accurate peak level. Choice C is incorrect as drawing blood one hour before the next dose does not represent the trough level. Choice D is incorrect because drawing blood immediately after completion of the IV dose does not allow enough time for the drug to reach peak levels.
3. A client with a history of heart failure is prescribed carvedilol. The nurse should monitor the client for which adverse effect?
- A. Dizziness upon standing
- B. Weight loss
- C. Bradycardia
- D. Hypotension
Correct answer: D
Rationale: The correct answer is D: Hypotension. Carvedilol, a beta-blocker, can lead to hypotension by blocking the effects of adrenaline, which can cause blood vessels to dilate and reduce blood pressure. While dizziness upon standing is a potential adverse effect of carvedilol, it is more specifically related to orthostatic hypotension, which is a form of hypotension that occurs when a person stands up from a sitting or lying position. Weight loss and bradycardia are not typically associated with carvedilol use. Therefore, the nurse should primarily monitor for hypotension in a client taking carvedilol.
4. A client with hypertension is prescribed amlodipine. The nurse should monitor for which potential adverse effect?
- A. Peripheral edema
- B. Bradycardia
- C. Hypertension
- D. Increased appetite
Correct answer: A
Rationale: Corrected Rationale: Amlodipine is known to cause peripheral edema as a potential adverse effect due to its vasodilatory properties. This can lead to fluid accumulation in the extremities. Monitoring for peripheral edema in patients taking amlodipine is crucial to identify and manage this side effect promptly. Choices B, C, and D are incorrect because amlodipine is not associated with causing bradycardia, hypertension (as the patient already has hypertension), or increased appetite as adverse effects.
5. When a client with hypertension is prescribed losartan, what potential side effect should the nurse monitor for?
- A. Hyperkalemia
- B. Dry cough
- C. Bradycardia
- D. Headache
Correct answer: B
Rationale: The correct answer is B: Dry cough. Losartan, an angiotensin II receptor blocker, can lead to a dry cough as a potential side effect. This occurs due to the drug's effect on the bradykinin pathway in the lungs. Monitoring for a dry cough is essential as it may indicate the need for further evaluation or medication adjustment to manage this adverse reaction.
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