HESI RN
Pharmacology HESI
1. The client with small cell lung cancer is being treated with etoposide (VePesid). The nurse assisting in caring for the client during its administration understands that which side effect is specifically associated with this medication?
- A. Alopecia
- B. Chest pain
- C. Pulmonary fibrosis
- D. Orthostatic hypotension
Correct answer: D
Rationale: The correct answer is 'D: Orthostatic hypotension.' Etoposide is associated with orthostatic hypotension, a sudden drop in blood pressure that can occur when transitioning from lying down to standing up. It is important for the nurse to monitor the client's blood pressure during the infusion to detect and manage this potential side effect.
2. A client has a prescription to take guaifenesin (Humibid) every 4 hours, as needed. The nurse determines that the client understands the most effective use of this medication if the client states that he or she will:
- A. Watch for irritability as a side effect.
- B. Take the tablet with a full glass of water.
- C. Take an extra dose if the cough is accompanied by fever.
- D. Crush the sustained-release tablet if immediate relief is needed.
Correct answer: B
Rationale: Guaifenesin is an expectorant used to help loosen mucus and make coughs more productive. Taking it with a full glass of water helps decrease the viscosity of secretions, making it easier to expel mucus from the respiratory tract. It is important not to crush sustained-release tablets, as this can alter the intended release of the medication and lead to potential adverse effects.
3. 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.
4. A client who is taking hydrochlorothiazide (HydroDIURIL, HCTZ) has been started on triamterene (Dyrenium) as well. The client asks the nurse why both medications are required. The nurse formulates a response, based on the understanding that:
- A. Both are weak potassium-losing diuretics.
- B. The combination of these medications prevents renal toxicity.
- C. Hydrochlorothiazide is less expensive, so using a combination of diuretics is cost-effective.
- D. Triamterene is a potassium-sparing diuretic, whereas hydrochlorothiazide is a potassium-losing diuretic.
Correct answer: D
Rationale: The combination of triamterene and hydrochlorothiazide is used because triamterene is a potassium-sparing diuretic, which helps retain potassium, while hydrochlorothiazide is a potassium-losing diuretic, which promotes potassium excretion. This combination helps balance potassium levels in the body, preventing imbalances that can occur when using potassium-losing diuretics alone.
5. Insulin glargine (Lantus) is prescribed for a client with diabetes mellitus. The nurse tells the client that it is best to take the insulin:
- A. 1 hour after each meal
- B. Once daily, at the same time each day
- C. 15 minutes before breakfast, lunch, and dinner
- D. Before each meal, based on the blood glucose level
Correct answer: B
Rationale: Insulin glargine (Lantus) is a long-acting insulin with a duration of action of approximately 24 hours, making it suitable for once-daily dosing at the same time each day. This regimen helps maintain consistent blood glucose levels and simplifies the client's treatment routine. Taking insulin glargine once daily provides basal insulin coverage throughout the day, reducing the risk of hypoglycemia compared to short-acting insulins that are taken before each meal.
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