HESI RN
HESI Pharmacology Practice Exam
1. The client with non-Hodgkin's lymphoma is receiving daunorubicin (DaunoXome). Which of the following would indicate to the nurse that the client is experiencing a toxic effect related to the medication?
- A. Fever
- B. Diarrhea
- C. Complaints of nausea and vomiting
- D. Crackles on auscultation of the lungs
Correct answer: D
Rationale: Crackles on auscultation of the lungs would indicate a toxic effect related to daunorubicin, known to cause cardiotoxicity. Cardiotoxicity can manifest as heart failure, abnormal ECG findings, or cardiomyopathy. It is crucial for the nurse to monitor for signs of cardiotoxicity to ensure timely intervention and prevent further complications. Fever, diarrhea, and complaints of nausea and vomiting are common side effects of daunorubicin but do not specifically indicate a toxic effect like cardiotoxicity.
2. A client receives a prescription for methocarbamol (Robaxin), and the nurse reinforces instructions to the client regarding the medication. Which client statement would indicate a need for further instructions?
- A. My urine may turn brown or green.
- B. This medication is prescribed to help relieve my muscle spasms.
- C. If my vision becomes blurred, I need to be concerned about it.
- D. I need to call my doctor if I experience nasal congestion from this medication.
Correct answer: C
Rationale: The correct answer is C because blurred vision is an adverse effect of methocarbamol (Robaxin) and should be reported to a healthcare provider. Choices A, B, and D are all correct statements. Option A informs the client about a possible discoloration of urine, which is a known side effect. Option B correctly explains the purpose of the medication. Option D correctly advises the client to contact their doctor if they experience nasal congestion, which could indicate an adverse reaction.
3. A client is prescribed atorvastatin (Lipitor) for hyperlipidemia. Which instruction should the nurse include in the teaching plan?
- A. Take the medication in the morning.
- B. Avoid consuming grapefruit juice.
- C. Increase intake of dairy products.
- D. Take the medication with food.
Correct answer: B
Rationale: The correct instruction for the nurse to include in the teaching plan is to advise the client to avoid consuming grapefruit juice. Grapefruit juice can increase the risk of atorvastatin (Lipitor) toxicity by inhibiting its metabolism. Atorvastatin is typically taken in the evening because cholesterol synthesis occurs at night. Increasing dairy intake is not specifically recommended for atorvastatin use, and the medication can be taken with or without food.
4. A client is taking lansoprazole (Prevacid) for the chronic management of Zollinger-Ellison syndrome. The nurse advises the client to take which of the following products if needed for a headache?
- A. Naproxen (Aleve)
- B. Ibuprofen (Advil)
- C. Acetaminophen (Tylenol)
- D. Acetylsalicylic acid (aspirin)
Correct answer: C
Rationale: Acetaminophen is the preferred choice for pain relief in individuals taking lansoprazole for Zollinger-Ellison syndrome due to its lower risk of stomach irritation compared to NSAIDs like ibuprofen and aspirin. Naproxen, ibuprofen, and aspirin are NSAIDs that can increase the risk of stomach irritation and bleeding, which is why they are not recommended for individuals with Zollinger-Ellison syndrome who are already on lansoprazole to reduce stomach acid production.
5. Meperidine hydrochloride (Demerol) is prescribed for a client with pain. Which of the following would the nurse monitor for as a side effect of this medication?
- A. Diarrhea
- B. Bradycardia
- C. Hypertension
- D. Urinary retention
Correct answer: D
Rationale: Meperidine hydrochloride (Demerol) is an opioid analgesic that can cause various side effects. Common side effects include respiratory depression, orthostatic hypotension, tachycardia, drowsiness, constipation, and urinary retention. Diarrhea is not a common side effect of Meperidine hydrochloride. Bradycardia and hypertension are not typically associated with this medication. Therefore, the nurse should monitor for urinary retention as a potential side effect of Meperidine hydrochloride.
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