HESI RN
HESI Pharmacology Practice Exam
1. Nalidixic acid (NegGram) is prescribed for a client with a urinary tract infection. On review of the client's record, the nurse notes that the client is taking warfarin sodium (Coumadin) daily. Which prescription should the nurse anticipate for this client?
- A. Discontinuation of warfarin sodium (Coumadin)
- B. A decrease in the warfarin sodium (Coumadin) dosage
- C. An increase in the warfarin sodium (Coumadin) dosage
- D. A decrease in the usual dose of nalidixic acid (NegGram)
Correct answer: B
Rationale: Nalidixic acid can intensify the effects of oral anticoagulants by displacing these agents from binding sites on plasma proteins. When an oral anticoagulant, like warfarin sodium (Coumadin), is combined with nalidixic acid, a decrease in the anticoagulant dosage may be necessary to avoid excessive anticoagulation and potential bleeding risks. Therefore, the correct action for the nurse to anticipate in this situation is a decrease in the warfarin sodium (Coumadin) dosage. Choice A is incorrect because discontinuing warfarin sodium abruptly can lead to thrombosis or embolism. Choice C is incorrect as increasing the warfarin sodium dosage can potentiate the anticoagulant effect, leading to bleeding complications. Choice D is incorrect as reducing the dose of nalidixic acid would not directly address the interaction with warfarin sodium.
2. A client is taking ticlopidine hydrochloride (Ticlid). The nurse tells the client to avoid which of the following while taking this medication?
- A. Vitamin C
- B. Vitamin D
- C. Acetaminophen (Tylenol)
- D. Acetylsalicylic acid (aspirin)
Correct answer: D
Rationale: Ticlopidine hydrochloride is a platelet aggregation inhibitor. Aspirin or any aspirin-containing product should be avoided as they can precipitate or aggravate bleeding by affecting platelet function and increasing the risk of bleeding complications.
3. A client is prescribed allopurinol (Zyloprim) for chronic gout. Which instruction should the nurse include in the teaching plan?
- A. Take the medication with a full glass of water.
- B. Increase your intake of purine-rich foods.
- C. Stop taking the medication if you experience a gout attack.
- D. Take the medication with or without food.
Correct answer: A
Rationale: The correct instruction for a client prescribed allopurinol (Zyloprim) for chronic gout is to take the medication with a full glass of water. This helps prevent kidney stones which can be a side effect of the medication. It is important for the client to avoid purine-rich foods to help manage gout symptoms. They should continue taking the medication even during a gout attack as prescribed by the healthcare provider. Allopurinol can be taken with or without food, so there is no need to take it on an empty stomach. Therefore, option A is the correct choice. Options B, C, and D are incorrect as increasing purine-rich foods is not recommended, stopping the medication during a gout attack is not advised, and allopurinol can be taken with or without food.
4. 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.
5. Atenolol hydrochloride (Tenormin) is prescribed for a hospitalized client. The nurse should perform which of the following as a priority action before administering the medication?
- A. Listen to the client's lung sounds.
- B. Check the client's blood pressure.
- C. Check the recent electrolyte levels.
- D. Assess the client for muscle weakness.
Correct answer: B
Rationale: Atenolol hydrochloride is a beta-blocker used to treat hypertension. Checking the client's blood pressure is crucial before administration.
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