HESI LPN
Pharmacology HESI Practice
1. Twenty-four hours after starting to take oral penicillin for strep throat, a client calls the nurse to report the onset of a rash on the chest. What action should the nurse implement?
- A. Instruct the client to discontinue the penicillin immediately
- B. Instruct the client regarding the use of topical analgesic cream PRN
- C. Question the client about any other related symptoms
- D. Reinforce the need to take all doses of the penicillin
Correct answer: A
Rationale: In this scenario, the client has developed a rash after starting oral penicillin, which can indicate an allergic reaction. It is crucial for the nurse to instruct the client to discontinue the penicillin immediately. Continuing the medication can potentially lead to severe allergic reactions. Instructing about topical analgesic cream or questioning about other related symptoms may delay appropriate action in case of a severe allergic reaction. Reinforcing the need to complete all doses is not appropriate when an allergic reaction is suspected, as safety takes precedence over completing the antibiotic course.
2. The healthcare professional is caring for a patient with a new order for an oral laxative. Which is a contraindication in administering an oral laxative?
- A. Cardiac problems
- B. Abdominal pain of unknown origin
- C. Several hemorrhoids
- D. Chronic constipation
Correct answer: B
Rationale: Administering an oral laxative to a patient with abdominal pain of unknown origin is contraindicated because it could be a sign of a more serious underlying condition that needs immediate medical evaluation. Giving a laxative in such a situation without proper diagnosis could potentially worsen the patient's condition or delay appropriate treatment. Choice A (Cardiac problems) is not a contraindication for an oral laxative unless the patient has a specific cardiac condition that interacts with the laxative. Choice C (Several hemorrhoids) and Choice D (Chronic constipation) are not contraindications for administering an oral laxative.
3. A client who is being discharged to home asks the practical nurse (PN) for a dose of hydrocodone before leaving the hospital. How should the PN respond to this client's request?
- A. Determine if a take-home prescription for hydrocodone was provided and, if so, tell him to take one of them.
- B. Encourage him to wait until he is at home to take a medication that might impair reasoning.
- C. Give him a tablet from the hospital stock and tell him to wait until he is almost home to take it.
- D. Ask him to describe the location and severity of the pain and to rate it on a scale from 1 to 10.
Correct answer: D
Rationale: Hydrocodone is a narcotic analgesic, and the practical nurse should gather more data from the client about the pain he is experiencing before giving the medication. The client's need for pain medication should be addressed, and pain medication should not be withheld because he is going home.
4. 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.
5. Which assessment finding requires nursing intervention prior to the administration of medication?
- A. Apical pulse heard best at the pulmonic site
- B. Irregular apical pulse rhythm
- C. Presence of a systolic heart murmur
- D. Apical pulse rate of 50 beats/minute
Correct answer: D
Rationale: An apical pulse rate of 50 beats/minute indicates bradycardia, a heart rate below the normal range, which requires immediate nursing intervention before administering medication to address the potential impact of the bradycardia on the patient's overall condition.
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