HESI RN
HESI Pharmacology Practice Exam
1. The client with metastatic breast cancer is receiving tamoxifen. The nurse specifically monitors which laboratory value while the client is taking this medication?
- A. Glucose level
- B. Calcium level
- C. Potassium level
- D. Prothrombin time
Correct answer: B
Rationale: The correct answer is B: Calcium level. Tamoxifen may increase calcium levels, leading to hypercalcemia. Symptoms of hypercalcemia include increased urine volume, excessive thirst, nausea, vomiting, constipation, muscle weakness, and bone pain. Monitoring serum calcium levels is essential to detect and manage this potential side effect. Choices A, C, and D are incorrect because tamoxifen does not directly affect glucose, potassium, or prothrombin time levels significantly.
2. A client is receiving sulfisoxazole. Which of the following should be included in the list of instructions?
- A. Restrict fluid intake.
- B. Maintain a high fluid intake.
- C. If the urine turns dark brown, call the healthcare provider (HCP) immediately.
- D. Decrease the dosage when symptoms are improving to prevent an allergic response.
Correct answer: B
Rationale: When a client is taking sulfisoxazole, it is important to maintain a high fluid intake. Each dose of sulfisoxazole should be taken with a full glass of water, as the medication is more soluble in alkaline urine. Restricting fluid intake is not recommended as it can lead to inadequate hydration. Dark brown urine may be a side effect of some forms of sulfisoxazole but does not necessarily warrant immediate notification of the healthcare provider unless accompanied by other concerning symptoms. Decreasing the dosage when symptoms improve is not advised as it may lead to treatment failure or the development of resistance.
3. 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.
4. A client is being taught about the use of nitroglycerin (Nitrostat) for angina. Which statement by the client indicates a need for further teaching?
- A. I will sit or lie down when I take the medication.
- B. I can take up to three tablets, 5 minutes apart, if needed.
- C. I will call 911 if my chest pain is not relieved after taking three tablets.
- D. I will keep the medication in its original dark container.
Correct answer: B
Rationale: The correct administration of nitroglycerin for angina is to take up to three tablets, 5 minutes apart. If the chest pain persists after the third tablet, emergency medical services should be called. Taking more than three tablets or reducing the time interval between doses may lead to hypotension and indicates a need for further teaching.
5. 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.
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