HESI RN
Pharmacology HESI
1. The client has been taking omeprazole (Prilosec) for 4 weeks. The ambulatory care nurse evaluates that the client is receiving the optimal intended effect of the medication if the client reports the absence of which symptom?
- A. Diarrhea
- B. Heartburn
- C. Flatulence
- D. Constipation
Correct answer: B
Rationale: Omeprazole, a proton pump inhibitor, is used as an antiulcer agent to reduce gastric acid secretion. The optimal intended effect of omeprazole is the relief of pain and discomfort associated with gastric irritation, commonly referred to as heartburn. Therefore, the absence of heartburn indicates that the medication is working effectively in managing the client's gastric condition.
2. A client with acute glomerulonephritis (GN) is being evaluated by a nurse. Which manifestation should the nurse recognize as a positive response to the prescribed treatment?
- A. The client has lost 11 pounds in the past 10 days.
- B. The client’s urine specific gravity is 1.048.
- C. No blood is observed in the client’s urine.
- D. The client’s blood pressure is 152/88 mm Hg.
Correct answer: A
Rationale: A weight loss of 11 pounds in the past 10 days indicates fluid loss, a positive response to treatment for acute glomerulonephritis. It signifies that the glomeruli are functioning adequately to filter excess fluid. A urine specific gravity of 1.048 is high, indicating concentrated urine, which is not a positive response in this context. Blood in the urine is not a typical finding in glomerulonephritis, so its absence is expected and does not indicate a positive response to treatment. A blood pressure of 152/88 mm Hg is elevated and may suggest kidney damage or fluid overload, which are not positive responses to treatment.
3. The healthcare provider prescribes exenatide (Byetta) for a client with type 1 diabetes mellitus who takes insulin. What is the appropriate intervention for the nurse?
- A. Administer the medication within 60 minutes before the morning and evening meal.
- B. Withhold the medication and question the prescription with the healthcare provider.
- C. Monitor the client for gastrointestinal side effects after administration of the medication.
- D. Withdraw the insulin from the Penlet into an insulin syringe to prepare for administration.
Correct answer: B
Rationale: Exenatide (Byetta) is specifically indicated for the treatment of type 2 diabetes mellitus and is not recommended for clients with type 1 diabetes mellitus who are taking insulin. Choice A is incorrect because exenatide should not be administered to a client with type 1 diabetes mellitus who takes insulin. Choice C is not the most appropriate initial action when the prescription is not suitable for the client. Choice D is unrelated to the administration of exenatide. Therefore, the appropriate intervention for the nurse is to withhold the medication and question the prescription with the healthcare provider to ensure the safety and appropriateness of the treatment plan for the client.
4. The nurse notes that the only ECG for a 55-year-old male client scheduled for surgery in two hours is dated two years ago. The client reports that he has a history of 'heart trouble,' but has no problems at present. Hospital protocol requires that those over 50 years of age have a recent ECG prior to surgery. What nursing action is best for the nurse to implement?
- A. Ask the client to explain what he means by 'heart trouble.'
- B. Call for an ECG to be performed immediately.
- C. Notify surgery that the ECG is over two years old.
- D. Notify the client's surgeon immediately.
Correct answer: B
Rationale: In this scenario, the client is 55 years old with a history of 'heart trouble,' which necessitates a recent ECG before surgery as per hospital policy. The nurse should prioritize patient safety and adhere to the protocol by arranging for an ECG to be performed immediately. Option A is not the best initial action as the focus should be on obtaining the necessary test first. Option C is not the immediate action required, and option D is premature without obtaining the necessary ECG first.
5. What is included in the Quality of Care in reproductive health?
- A. Ensuring accessible services, privacy, confidentiality, and continuity of care.
- B. Providing reproductive health services only in urban areas.
- C. Ensuring that all women deliver in a hospital setting.
- D. Ensuring that reproductive health services are only provided by doctors.
Correct answer: A
Rationale: The correct answer is A. Quality of care in reproductive health encompasses ensuring accessible services, privacy, confidentiality, and continuity of care. These elements are crucial in providing comprehensive and effective reproductive health services. Choices B, C, and D are incorrect because they do not adequately address the holistic approach required for quality reproductive health care. Providing services only in urban areas limits accessibility, mandating hospital deliveries may not be suitable for all women, and restricting services to doctors only disregards the importance of a multi-disciplinary approach in reproductive health care.