HESI RN
HESI Pharmacology Practice Exam
1. When reviewing laboratory results for a client receiving tacrolimus (Prograf), which laboratory result would indicate to the nurse that the client is experiencing an adverse effect of the medication?
- A. Blood glucose of 200 mg/dL
- B. Potassium level of 3.8 mEq/L
- C. Platelet count of 300,000 cells/mm³
- D. White blood cell count of 6000 cells/mm³
Correct answer: A
Rationale: An elevated blood glucose level of 200 mg/dL indicates an adverse effect of tacrolimus. This finding suggests hyperglycemia, which is a known adverse effect of the medication. Other potential adverse effects of tacrolimus include neurotoxicity and hypertension. Monitoring blood glucose levels is crucial to detect and manage this adverse effect promptly. Choices B, C, and D are not directly associated with adverse effects of tacrolimus. Potassium, platelet count, and white blood cell count are important parameters to monitor for other reasons but not specifically for detecting adverse effects of tacrolimus.
2. When assessing the effectiveness of leflunomide (Arava) in a client with rheumatoid arthritis, which question should the nurse ask during data collection?
- A. Do you have any joint pain?
- B. Are you having any diarrhea?
- C. Do you have frequent headaches?
- D. Are you experiencing heartburn?
Correct answer: A
Rationale: To assess the effectiveness of leflunomide (Arava), a medication used to treat rheumatoid arthritis, the nurse should inquire about joint pain. Joint pain is a common symptom of rheumatoid arthritis, and improvement in joint pain indicates the medication's effectiveness in managing the condition.
3. The client with metastatic breast cancer is receiving tamoxifen. The nurse specifically monitors which laboratory value while the client is taking this medication?
- A. Glucose level
- B. Calcium level
- C. Potassium level
- D. Prothrombin time
Correct answer: B
Rationale: The correct answer is B: Calcium level. Tamoxifen may increase calcium levels, leading to hypercalcemia. Symptoms of hypercalcemia include increased urine volume, excessive thirst, nausea, vomiting, constipation, muscle weakness, and bone pain. Monitoring serum calcium levels is essential to detect and manage this potential side effect. Choices A, C, and D are incorrect because tamoxifen does not directly affect glucose, potassium, or prothrombin time levels significantly.
4. A healthcare provider has written a prescription for ranitidine (Zantac), once daily. When should the nurse schedule the medication?
- A. At bedtime
- B. After lunch
- C. With supper
- D. Before breakfast
Correct answer: A
Rationale: The correct answer is A: At bedtime. Ranitidine should be scheduled at bedtime because it provides a prolonged effect and offers the greatest protection of the gastric mucosa. Administering it at this time helps in managing nocturnal acid breakthrough and providing relief during the night.
5. A client has a prescription to take guaifenesin (Humibid) every 4 hours, as needed. The nurse determines that the client understands the most effective use of this medication if the client states that he or she will:
- A. Watch for irritability as a side effect.
- B. Take the tablet with a full glass of water.
- C. Take an extra dose if the cough is accompanied by fever.
- D. Crush the sustained-release tablet if immediate relief is needed.
Correct answer: B
Rationale: Guaifenesin is an expectorant used to help loosen mucus and make coughs more productive. Taking it with a full glass of water helps decrease the viscosity of secretions, making it easier to expel mucus from the respiratory tract. It is important not to crush sustained-release tablets, as this can alter the intended release of the medication and lead to potential adverse effects.
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