HESI RN
HESI Pharmacology Practice Exam
1. 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.
2. A client is receiving vancomycin (Vancocin). Which of the following is the most important action for the nurse to take?
- A. Monitor the client for signs of nephrotoxicity.
- B. Monitor the client for signs of ototoxicity.
- C. Ensure adequate hydration.
- D. Administer the medication with food.
Correct answer: A
Rationale: The most important action for the nurse to take when a client is receiving vancomycin is to monitor for signs of nephrotoxicity. Vancomycin can cause kidney damage, so monitoring kidney function and signs of nephrotoxicity are crucial to prevent harm. While monitoring for ototoxicity and ensuring adequate hydration are important nursing actions, they are not as critical as preventing nephrotoxicity when administering vancomycin.
3. A client with heart failure is prescribed furosemide (Lasix) and digoxin (Lanoxin). Which instruction should the nurse include in the client's teaching plan?
- A. Avoid foods high in potassium.
- B. Report a pulse rate less than 60 beats per minute.
- C. Take the medications in the morning.
- D. Weigh yourself daily.
Correct answer: B
Rationale: The correct answer is B. The nurse should instruct the client to report a pulse rate less than 60 beats per minute, as it could indicate digoxin toxicity. Consuming potassium-rich foods is encouraged due to the potential for furosemide (Lasix) to cause hypokalemia. The medications should be taken in the morning to prevent nocturia. Weighing oneself daily is important to monitor for fluid retention, a crucial aspect in managing heart failure. Therefore, choices A, C, and D are incorrect as they do not address the specific teaching point related to digoxin and its potential toxicity.
4. 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.
5. A client who received a kidney transplant is taking azathioprine (Imuran), and the nurse provides instructions about the medication. Which statement by the client indicates a need for further instructions?
- A. I need to watch for signs of infection.
- B. I need to discontinue the medication after 14 days of use.
- C. I can take the medication with meals to minimize nausea.
- D. I need to call the health care provider (HCP) if more than one dose is missed.
Correct answer: B
Rationale: Azathioprine is an immunosuppressant taken for life. Discontinuing the medication after 14 days is incorrect.
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