HESI RN
Pharmacology HESI
1. A client is receiving morphine sulfate subcutaneously for pain. Because morphine sulfate has been prescribed for this client, which nursing action would be included in the plan of care?
- A. Encourage fluid intake.
- B. Monitor the client's temperature.
- C. Maintain the client in a supine position.
- D. Encourage the client to cough and deep breathe.
Correct answer: D
Rationale: Morphine sulfate suppresses the cough reflex, which can lead to the retention of secretions in the lungs. Encouraging the client to cough and deep breathe helps prevent pneumonia by clearing the airways of any accumulated secretions. This intervention is crucial in clients receiving morphine sulfate to maintain optimal respiratory function.
2. A client is taking levothyroxine (Synthroid). The nurse instructs the client to notify the health care provider (HCP) if which of the following occurs?
- A. Fatigue
- B. Tremors
- C. Cold intolerance
- D. Excessively dry skin
Correct answer: B
Rationale: Tremors are a sign of excessive doses of levothyroxine, indicating hyperthyroidism. It is important for the client to report tremors to the healthcare provider to prevent complications associated with overdosing on levothyroxine.
3. A client with hyperlipidemia is prescribed atorvastatin (Lipitor). Which instruction should the nurse include in the teaching plan?
- A. Take the medication in the morning.
- B. Avoid consuming grapefruit juice.
- C. Increase your intake of dairy products.
- D. Take the medication with food.
Correct answer: B
Rationale: The correct instruction for the nurse to include in the teaching plan is to advise the client to avoid consuming grapefruit juice. Grapefruit juice can increase the risk of atorvastatin (Lipitor) toxicity by inhibiting its metabolism. Atorvastatin is typically taken in the evening as cholesterol synthesis occurs at night. Increasing dairy intake is not specifically recommended for atorvastatin therapy, and the medication can be taken with or without food.
4. A client has a prescription for albuterol (Proventil HFA) (two puffs) and beclomethasone dipropionate (Qvar) (nasal inhalation, two puffs) by metered-dose inhaler. The medications are to be administered by the nurse by giving the:
- A. Albuterol first and then the beclomethasone dipropionate
- B. Beclomethasone dipropionate first and then the albuterol
- C. Alternating a single puff of each, beginning with the albuterol
- D. Alternating a single puff of each, beginning with the beclomethasone dipropionate
Correct answer: A
Rationale: Albuterol, as a bronchodilator, should be administered first to help open up the airways, followed by beclomethasone dipropionate to reduce inflammation in the airways. This sequence ensures optimal therapeutic effects of the medications.
5. A client with a history of chronic heart failure is prescribed spironolactone (Aldactone). Which of the following statements indicates that the client understands the medication teaching?
- A. I will avoid potassium-rich foods.
- B. I will not use a salt substitute.
- C. I will monitor my weight daily.
- D. I will increase my fluid intake as prescribed.
Correct answer: A
Rationale: The correct statement is 'I will avoid potassium-rich foods.' Spironolactone (Aldactone) is a potassium-sparing diuretic, which can lead to hyperkalemia if potassium intake is not regulated. Therefore, avoiding potassium-rich foods is crucial to prevent this complication. Using a salt substitute can also increase potassium levels. Monitoring weight daily is essential in heart failure management, but it is not specific to spironolactone. Increasing fluid intake as prescribed is generally recommended for heart failure management but is not directly related to spironolactone use.
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