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 has been taking isoniazid (INH) for 2 months. The client complains to a nurse about numbness, paresthesias, and tingling in the extremities. The nurse interprets that the client is experiencing:
- A. Hypercalcemia
- B. Peripheral neuritis
- C. Small blood vessel spasm
- D. Impaired peripheral circulation
Correct answer: B
Rationale: The client's symptoms of numbness, paresthesias, and tingling in the extremities indicate peripheral neuritis, a common side effect of isoniazid (INH). This condition can be managed by supplementing with pyridoxine (vitamin B6) to minimize the symptoms.
3. A client is receiving furosemide (Lasix) and is being discharged. What should the nurse include in the teaching plan?
- A. Consume potassium-rich foods.
- B. Take the medication in the morning.
- C. Change positions slowly to prevent dizziness.
- D. Maintain an adequate fluid intake.
Correct answer: C
Rationale: The correct answer is to instruct the client to change positions slowly to prevent dizziness. Furosemide (Lasix) is a diuretic that can lead to orthostatic hypotension, causing dizziness. Consuming potassium-rich foods is essential to prevent hypokalemia when taking furosemide. Taking the medication in the morning helps reduce the need for frequent urination at night. Encouraging the client to maintain an adequate fluid intake is crucial to prevent dehydration while on this medication.
4. The home health care nurse is visiting a client who was recently diagnosed with type 2 diabetes mellitus. The client is prescribed repaglinide (Prandin) and metformin (Glucophage) and asks the nurse to explain these medications. The nurse should reinforce which instructions to the client? Select one that doesn't apply.
- A. Diarrhea can occur secondary to the metformin.
- B. The repaglinide is not taken if a meal is skipped.
- C. The repaglinide is taken 30 minutes before eating.
- D. Nausea and vomiting
Correct answer: D
Rationale: Repaglinide is a rapid-acting oral hypoglycemic that should be taken before meals and withheld if the client does not eat. Hypoglycemia is a side effect of repaglinide, so carrying a simple sugar is essential. Metformin decreases hepatic glucose production and can cause diarrhea. Muscle pain may occur as an adverse effect and should be reported to the HCP.
5. A client is taking docusate sodium (Colace). The nurse monitors which of the following to determine whether the client is experiencing a therapeutic effect from this medication?
- A. Abdominal pain
- B. Reduction in steatorrhea
- C. Hematest-negative stools
- D. Regular bowel movements
Correct answer: D
Rationale: The therapeutic effect of docusate sodium (Colace) is to soften stools and promote regular bowel movements, making option D the correct choice. Monitoring for regular bowel movements would indicate that the medication is working as intended by relieving or preventing constipation. Options A, B, and C are not directly related to the therapeutic effect of docusate sodium. Abdominal pain (option A) is a symptom that might indicate a problem rather than a therapeutic effect. Reduction in steatorrhea (option B) and Hematest-negative stools (option C) are not specific outcomes associated with docusate sodium.
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