HESI LPN
HESI Pharmacology Exam Test Bank
1. The practical nurse administered 15 units of NPH insulin subcutaneously to a client before they consumed their breakfast at 7:30 AM. At what time is the client at an increased risk for a hypoglycemic reaction?
- A. 8:30 to 11:30 AM
- B. 3:30 to 7:30 PM
- C. 9:30 PM to midnight
- D. 1:00 to 5:00 AM
Correct answer: B
Rationale: NPH insulin, an intermediate-acting type, peaks approximately 8 to 12 hours after subcutaneous administration. Considering this, the client is most likely to experience a hypoglycemic reaction between 3:30 and 7:30 PM, making option B the correct answer. Choices A, C, and D are incorrect because they fall outside the peak time for a hypoglycemic reaction after administering NPH insulin.
2. A client with chronic heart failure is prescribed furosemide. The nurse should monitor the client for which potential adverse effect?
- A. Increased blood glucose levels
- B. Electrolyte imbalance
- C. Dehydration
- D. Weight gain
Correct answer: C
Rationale: When a client with chronic heart failure is prescribed furosemide, a diuretic, the nurse should be vigilant for potential adverse effects. Furosemide can lead to excessive fluid loss, resulting in dehydration. Dehydration is a significant concern as it can exacerbate heart failure symptoms. Additionally, furosemide can cause electrolyte imbalances, particularly affecting potassium and sodium levels. Monitoring for signs of dehydration and electrolyte disturbances is crucial to prevent complications and ensure the client's safety and well-being. Increased blood glucose levels and weight gain are not commonly associated with furosemide use in heart failure patients, making choices A and D incorrect.
3. What is the primary nursing intervention that the practical nurse should perform before administering ampicillin to a client diagnosed with a urinary tract infection?
- A. Obtain a clean-catch urine specimen.
- B. Assess the urine pH for acidity.
- C. Insert an indwelling catheter.
- D. Assess for complaints of dysuria.
Correct answer: A
Rationale: The correct answer is to obtain a clean-catch urine specimen. Before administering ampicillin to a client with a urinary tract infection, it is crucial to collect a urine specimen to determine the causative organism and evaluate the effectiveness of pharmacological therapy. Assessing the urine pH for acidity (choice B) is not the primary intervention needed before administering ampicillin. Inserting an indwelling catheter (choice C) is invasive and not necessary unless indicated for specific reasons. Assessing for complaints of dysuria (choice D) is important but does not take precedence over obtaining a urine specimen for proper diagnosis and treatment.
4. A client with pulmonary tuberculosis has been taking rifampin for 3 weeks. The client reports orange urine. What should be the nurse's next action?
- A. Notify the client's health care provider.
- B. Inform the client that this is not harmful.
- C. Assess the client for other signs of nephrotoxicity.
- D. Monitor the client's most recent creatinine level.
Correct answer: B
Rationale: The correct action for the nurse to take when a client reports orange urine after taking rifampin is to inform the client that this change is not harmful. Rifampin is known to cause orange discoloration of urine, which is a harmless side effect. There is no need to notify the health care provider as this is an expected outcome. Monitoring creatinine levels or assessing for nephrotoxicity is unnecessary in this situation, as rifampin does not typically cause kidney damage.
5. A client with hypertension is prescribed atenolol. The nurse should monitor the client for which potential side effect?
- A. Bradycardia
- B. Tachycardia
- C. Hypotension
- D. Hyperglycemia
Correct answer: A
Rationale: When a client is prescribed atenolol, a beta-blocker medication used to treat hypertension, the nurse should monitor for bradycardia as a potential side effect. Atenolol works by slowing the heart rate, and one common adverse effect is bradycardia, which is a slower than normal heart rate. Monitoring the client's heart rate is essential to detect and manage this potential side effect promptly. Choices B, C, and D are incorrect because atenolol typically does not cause tachycardia, hypotension, or hyperglycemia as primary side effects. Instead, bradycardia is a common concern due to the drug's mechanism of action in reducing heart rate.
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