HESI LPN
HESI Pharmacology Exam Test Bank
1. A client with type 2 diabetes is prescribed metformin. What instruction should the practical nurse (PN) include in the client's teaching plan?
- A. Take the medication with meals to decrease gastrointestinal upset.
- B. Take the medication with a full glass of water.
- C. Avoid alcohol while taking the medication.
- D. Take the medication with meals to increase absorption.
Correct answer: B
Rationale: The correct instruction for a client prescribed metformin is to take the medication with a full glass of water. This helps ensure proper ingestion and absorption of the medication. While taking metformin with meals can help reduce gastrointestinal side effects, the primary focus should be on adequate hydration and absorption by taking it with water. Avoiding alcohol while taking metformin is also important as alcohol can increase the risk of lactic acidosis when combined with metformin. Taking the medication with meals to increase absorption is incorrect as metformin should be taken with food to reduce gastrointestinal upset, not to increase absorption.
2. A client with type 2 diabetes mellitus is admitted for frequent hyperglycemic episodes and a glycosylated hemoglobin (HbA1c) of 10%. Insulin glargine 10 units subcutaneously once a day at bedtime and a sliding scale with insulin aspart q6h are prescribed. What action should the nurse include in this client’s plan of care?
- A. Perform fingerstick glucose assessment q6h with meals
- B. Mix bedtime dose of insulin glargine with insulin aspart sliding scale dose
- C. Review proper foot care and prevention of injury with the client
- D. Avoid contaminating the insulin aspart for IV use
Correct answer: A
Rationale: Performing fingerstick glucose assessments q6h with meals is essential in monitoring the client's blood glucose levels closely, especially when managing hyperglycemic episodes and adjusting insulin doses with a sliding scale. This action helps in determining the effectiveness of the prescribed insulin regimen. Reviewing proper foot care and preventing injury is important for long-term diabetic management but not the immediate priority in this scenario. Mixing insulin glargine with insulin aspart is not recommended, as they are different types of insulin with distinct mechanisms of action. Ensuring the availability of insulin aspart for IV use is not relevant to the client's current care plan.
3. The nurse is assessing a client who has been diagnosed with chronic obstructive pulmonary disease (COPD). Which clinical finding is characteristic of this condition?
- A. Pursed-lip breathing
- B. Hyperresonance on percussion
- C. Bradycardia
- D. High-pitched inspiratory crackles
Correct answer: A
Rationale: Pursed-lip breathing is a characteristic finding in clients with COPD. It helps keep the airways open during exhalation, acting as a compensatory mechanism to prevent airway collapse, which is common in COPD. Hyperresonance on percussion is typically found in conditions like emphysema, which is a component of COPD but not characteristic of the overall disease. Bradycardia is not typical in COPD; instead, clients often exhibit tachycardia due to chronic hypoxemia. High-pitched inspiratory crackles are more commonly associated with conditions like pneumonia, not COPD.
4. What should be assessed in a child with suspected appendicitis?
- A. Level of consciousness
- B. Bowel sounds and pain location
- C. Skin color and temperature
- D. Heart rate and blood pressure
Correct answer: B
Rationale: The correct answer is to assess bowel sounds and pain location. In a child with suspected appendicitis, focusing on bowel sounds and pain location, particularly in the lower right quadrant, is crucial. This assessment helps to identify symptoms commonly associated with appendicitis. Assessing the level of consciousness (Choice A) is important in other conditions such as head injuries or neurological issues. Skin color and temperature (Choice C) are more indicative of circulatory or skin-related problems. Heart rate and blood pressure (Choice D) are vital signs that are essential to assess in various conditions but are not specific to suspected appendicitis.
5. What is a procedure for using ultrasonic sound waves to create a picture of an embryo or fetus?
- A. Phenotype
- B. Sonogram
- C. Genotype
- D. Alpha-fetoprotein (AFP) assay
Correct answer: B
Rationale: A sonogram, also known as an ultrasound, is a procedure that utilizes sound waves to generate images of a developing embryo or fetus. This imaging technique is commonly used in prenatal care to monitor fetal development and identify any potential abnormalities. Choices A, C, and D are incorrect because a phenotype refers to an individual's observable traits resulting from genetic and environmental influences, a genotype is an individual's genetic makeup, and an alpha-fetoprotein (AFP) assay is a blood test used to screen for certain birth defects.