HESI LPN
Pharmacology HESI 2023
1. The client is being instructed on the correct technique for using... what to provide the client?
- A. Angle the tip of the inhaler upwards while spraying
- B. Hold one nostril closed while spraying the other nostril
- C. Avoid shaking the inhaler immediately before using
- D. Use the inhaler when first awakening in the morning
Correct answer: B
Rationale: The correct technique for using an inhaler for allergic rhinitis involves holding one nostril closed while spraying the other nostril to ensure proper delivery of the medication. This technique helps direct the medication into the nasal passages for optimal effectiveness. Choice A is incorrect as it refers to an incorrect technique for inhaler use. Choice C is incorrect as shaking the inhaler is often necessary to ensure proper mixing of the medication. Choice D is incorrect as the timing of inhaler use is typically based on individual preferences or healthcare provider recommendations, not specifically tied to the morning.
2. A female client who started chemotherapy three days ago for cancer of the breast calls the clinic reporting that she is so upset she cannot sleep. The client has several PRN medications available. Which drug should the nurse instruct her to take?
- A. Ondansetron 8mgPO no
- B. Lorazepam 2mg PO bedtime
- C. Oxycodone, acetylsalicylic acid one tablet q4 hours PRN
- D. Acetaminophen, diphenhydramine 2 capsules bedtime
Correct answer: D
Rationale: Acetaminophen and diphenhydramine help with sleep without severe side effects.
3. A client with rheumatoid arthritis is prescribed tofacitinib. What should the nurse include in the client's teaching plan?
- A. Avoid live vaccines while taking this medication.
- B. Take this medication with food to decrease gastrointestinal upset.
- C. Report any signs of infection to the healthcare provider.
- D. Avoid sunlight while taking this medication.
Correct answer: A
Rationale: Tofacitinib is an immunosuppressive medication used in rheumatoid arthritis. Patients taking tofacitinib should avoid live vaccines because the medication can weaken the immune system, making live vaccines potentially harmful. It is essential to educate the client on this to prevent any complications related to live vaccines during their treatment.
4. A client with a history of atrial fibrillation is prescribed warfarin. The nurse should monitor for which sign of potential bleeding?
- A. Elevated blood pressure
- B. Bruising
- C. Shortness of breath
- D. Nausea and vomiting
Correct answer: B
Rationale: Warfarin is an anticoagulant that increases the risk of bleeding. Bruising is a common sign of potential bleeding in clients taking warfarin. Monitoring for bruising is essential as it can indicate a risk of bleeding that needs further assessment and management. Elevated blood pressure, shortness of breath, nausea, and vomiting are not direct signs of potential bleeding associated with warfarin therapy.
5. A client with a history of atrial fibrillation is prescribed apixaban. The nurse should monitor for which potential side effect?
- A. Bleeding
- B. Weight gain
- C. Headache
- D. Nausea
Correct answer: A
Rationale: The correct answer is A: Bleeding. Apixaban is an anticoagulant medication that works by decreasing the blood's ability to clot. One of the significant side effects of apixaban is an increased risk of bleeding. Therefore, the nurse should monitor the client for signs of bleeding, such as easy bruising, prolonged bleeding from cuts, blood in the urine or stool, or unusual bleeding or bruising. Monitoring for these signs is crucial to prevent or manage any potential complications associated with the medication. Choices B, C, and D are incorrect because weight gain, headache, and nausea are not typically associated with apixaban use. Therefore, the nurse should primarily focus on monitoring for signs of bleeding in a client prescribed apixaban.
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