HESI RN
Pharmacology HESI
1. A client who had a kidney transplant is receiving therapy with cyclosporine (Sandimmune). Which statement by the client indicates a need for further instruction?
- A. I need to obtain a yearly influenza vaccine.
- B. I need to have dental checkups every 3 months.
- C. I need to self-monitor my blood pressure at home.
- D. I need to call the health care provider (HCP) if my urine volume decreases or my urine becomes cloudy.
Correct answer: A
Rationale: The correct answer is A. Cyclosporine is an immunosuppressant that can reduce the effectiveness of vaccines. Clients should avoid vaccinations without consulting their health care provider to prevent potential complications or reduced efficacy of the vaccines.
2. A client with rheumatoid arthritis is prescribed methotrexate. Which instruction should the nurse include in the client's teaching plan?
- A. Avoid taking folic acid supplements.
- B. Report any signs of infection immediately.
- C. Take the medication with a full meal.
- D. Limit fluid intake while on this medication.
Correct answer: B
Rationale: The correct instruction for the nurse to include in the client's teaching plan when taking methotrexate is to report any signs of infection immediately. Methotrexate can suppress the immune system, making the client more susceptible to infections. It is important for the client to promptly report any signs of infection to receive timely medical intervention. Choice A is incorrect because folic acid supplements are often recommended to reduce side effects of methotrexate. Choice C is incorrect as methotrexate is usually taken on an empty stomach unless the client experiences gastrointestinal upset. Choice D is incorrect as there is no need to limit fluid intake while on methotrexate; in fact, maintaining adequate fluid intake is important to prevent complications such as kidney damage.
3. A nurse reinforces discharge instructions to a postoperative client who is taking warfarin sodium (Coumadin). Which statement, if made by the client, reflects the need for further teaching?
- A. I will take my pills every day at the same time.
- B. I will be certain to avoid alcohol consumption.
- C. I have already called my family to pick up a Medic-Alert bracelet.
- D. I will take Ecotrin (enteric-coated aspirin) for my headaches because it is coated.
Correct answer: D
Rationale: Ecotrin is an aspirin-containing product and should be avoided. Clients should avoid alcohol consumption, take prescribed medication at the same time each day, and use a Medic-Alert bracelet for emergency information.
4. Before administering Methylergonovine (Methergine) to a client with postpartum hemorrhage caused by uterine atony, the nurse checks which of the following as the important client parameter?
- A. Temperature
- B. Lochial flow
- C. Urine output
- D. Blood pressure
Correct answer: D
Rationale: Methylergonovine (Methergine) acts by stimulating uterine contractions and causing vasoconstriction. As vasoconstriction can potentially impact blood pressure, it is crucial to check the client's blood pressure before administering Methylergonovine to monitor for any hypertensive effects.
5. Colcrys (colchicine) is prescribed for a client with a diagnosis of gout. The nurse reviews the client's medical history in the health record, knowing that the medication would be contraindicated in which disorder?
- A. Myxedema
- B. Renal failure
- C. Hypothyroidism
- D. Diabetes mellitus
Correct answer: B
Rationale: Colchicine is contraindicated in clients with severe gastrointestinal, renal, hepatic, or cardiac disorders, or blood dyscrasias. Renal failure is a condition where the kidneys fail to function adequately, leading to the accumulation of toxins in the body. Since colchicine is contraindicated in clients with renal disorders, including renal failure, it could exacerbate the condition and worsen the client's health. Myxedema, hypothyroidism, and diabetes mellitus are not contraindications for colchicine use. While these conditions may require caution or monitoring when administering colchicine, they are not absolute contraindications like renal failure.
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