HESI RN
Pharmacology HESI
1. A client with hyperlipidemia is prescribed simvastatin (Zocor). Which instruction should the nurse include in the teaching plan?
- A. Take the medication in the evening.
- B. Report any muscle pain to your healthcare provider.
- C. Avoid increasing your intake of grapefruit juice.
- D. Do not take the medication with a high-fat meal.
Correct answer: B
Rationale: Muscle pain can be a sign of a serious side effect of simvastatin (Zocor) known as rhabdomyolysis and should be reported to the healthcare provider immediately. The medication is usually taken in the evening to coincide with the body's natural production of cholesterol. Grapefruit juice should be avoided as it can increase the risk of toxicity by affecting the metabolism of the medication. Additionally, taking simvastatin with a high-fat meal can reduce its effectiveness, so it should be taken without food or with a light meal.
2. The healthcare provider is reviewing the history and physical examination of a client who will be receiving asparaginase (Elspar), an antineoplastic agent. The healthcare provider consults with the registered nurse regarding the administration of the medication if which of the following is documented in the client's history?
- A. Pancreatitis
- B. Diabetes mellitus
- C. Myocardial infarction
- D. Chronic obstructive pulmonary disease
Correct answer: A
Rationale: Asparaginase is contraindicated in clients with a history of pancreatitis due to the risk of impairing pancreatic function and causing complications. Therefore, the healthcare provider should consult with the registered nurse to assess the client's history of pancreatitis before administering asparaginase.
3. A client is prescribed warfarin (Coumadin) for atrial fibrillation. Which statement by the client indicates a need for further teaching?
- A. I will avoid foods high in vitamin K.
- B. I will take the medication at the same time each day.
- C. I will use an electric razor to shave.
- D. I will take aspirin if I have a headache.
Correct answer: D
Rationale: Clients taking warfarin (Coumadin) should avoid aspirin unless prescribed by their healthcare provider, as it can increase the risk of bleeding. The other statements are correct and do not indicate a need for further teaching. Taking aspirin along with warfarin can potentiate the anticoagulant effects of warfarin, leading to an increased risk of bleeding complications.
4. When a client taking warfarin sodium (Coumadin) is prescribed ciprofloxacin (Cipro), the nurse should closely monitor the client for which potential effect of this drug interaction?
- A. Increased risk of bleeding
- B. Decreased warfarin effectiveness
- C. Increased risk of thrombosis
- D. Decreased ciprofloxacin effectiveness
Correct answer: A
Rationale: When ciprofloxacin (Cipro) is given with warfarin sodium (Coumadin), it can potentiate the effects of warfarin, leading to an increased risk of bleeding. Therefore, the nurse should closely monitor the client's INR levels and watch for signs of bleeding such as bruising, petechiae, or black tarry stools.
5. A client with chronic renal failure is receiving ferrous sulfate (Feosol). The nurse monitors the client for which common side effect associated with this medication?
- A. Diarrhea
- B. Weakness
- C. Headache
- D. Constipation
Correct answer: D
Rationale: Constipation is a common side effect of iron supplements such as ferrous sulfate. Iron can cause constipation by slowing down the movement of the digestive system and hardening the stool. Patients should be advised to increase their fluid intake, dietary fiber, and physical activity to help alleviate this side effect. Diarrhea (Choice A) is not a common side effect associated with ferrous sulfate. Weakness (Choice B) and headache (Choice C) are not typically linked to this medication.
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