HESI RN
HESI Pharmacology Practice Exam
1. Bethanechol chloride (Urecholine) is prescribed for a client with urinary retention. Which disorder would be a contraindication to the administration of this medication?
- A. Gastric atony
- B. Urinary strictures
- C. Neurogenic atony
- D. Gastroesophageal reflux
Correct answer: B
Rationale: Bethanechol chloride (Urecholine) should not be administered to clients with urinary strictures as it can contract the bladder and increase pressure within the urinary tract. In individuals with urinary strictures, this elevated pressure may lead to bladder rupture. Therefore, caution is advised when considering the use of Bethanechol chloride in clients with urinary strictures to prevent potential complications. Gastric atony, neurogenic atony, and gastroesophageal reflux are not contraindications for the administration of Bethanechol chloride for urinary retention.
2. While taking trimethoprim-sulfamethoxazole (TMP-SMZ), a client should be instructed to report which symptom if it develops during the course of this medication therapy?
- A. Nausea
- B. Diarrhea
- C. Headache
- D. Sore throat
Correct answer: D
Rationale: Clients prescribed trimethoprim-sulfamethoxazole (TMP-SMZ) should be educated about potential blood disorders associated with the medication. Early signs of these disorders include symptoms like sore throat, fever, and pallor. If the client experiences any of these symptoms, they should promptly notify their healthcare provider. Nausea, diarrhea, and headache are common side effects of TMP-SMZ that usually do not require immediate medical attention.
3. A client with hyperparathyroidism has a serum calcium level of 13 mg/dL. Which medication should be prepared to administer as prescribed to the client?
- A. Calcium chloride
- B. Calcium gluconate
- C. Calcitonin (Miacalcin)
- D. Large doses of vitamin D
Correct answer: C
Rationale: The normal serum calcium level ranges from 8.6 to 10.0 mg/dL. In hypercalcemia, as seen in this client, Calcitonin (Miacalcin) is used to decrease plasma calcium levels by inhibiting bone resorption. Calcium gluconate and calcium chloride are typically used for hypocalcemia, not hypercalcemia. Large doses of vitamin D should be avoided in hypercalcemia as they can exacerbate hypercalcemia by increasing calcium absorption from the intestines.
4. A client presenting with complaints of not feeling well is seen in a clinic. The client is taking several medications for the control of heart disease and hypertension, including a beta-blocker, digoxin (Lanoxin), and a diuretic. A tentative diagnosis of digoxin toxicity is made. Which of the following assessment data would support this diagnosis?
- A. Dyspnea, edema, and palpitations
- B. Chest pain, hypotension, and paresthesia
- C. Double vision, loss of appetite, and nausea
- D. Constipation, dry mouth, and sleep disorder
Correct answer: C
Rationale: The correct answer is C. Double vision, loss of appetite, and nausea are classic signs of digoxin toxicity. Other signs may include bradycardia, visual disturbances, and confusion. These symptoms are indicators that the client may be experiencing adverse effects due to elevated levels of digoxin in the system, requiring immediate medical attention to prevent serious complications.
5. When administering hydrochlorothiazide (HydroDIURIL) to a client, the nurse should be aware of which of the following concerns?
- A. Hypouricemia, hyperkalemia
- B. Increased risk of osteoporosis
- C. Hypokalemia, hyperglycemia, sulfa allergy
- D. Hyperkalemia, hypoglycemia, penicillin allergy
Correct answer: C
Rationale: The correct answer is C. Hydrochlorothiazide is a thiazide diuretic, which can lead to hypokalemia and hyperglycemia. It is also associated with hypercalcemia, hyperlipidemia, and hyperuricemia. Being a sulfa-based medication, individuals with a sulfa allergy are at risk for an allergic reaction when taking hydrochlorothiazide. Choice A is incorrect because hydrochlorothiazide can cause hyperkalemia rather than hypouricemia. Choice B is incorrect as there is no direct link between hydrochlorothiazide and an increased risk of osteoporosis. Choice D is incorrect because hypoglycemia and penicillin allergy are not typically associated with hydrochlorothiazide use.
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