HESI LPN
Pharmacology HESI Practice
1. Which assessment finding indicates that the expected outcome of administering donepezil to a client with Alzheimer's disease has been accomplished?
- A. Increased muscle strength and tone
- B. Fewer episodes of urinary incontinence
- C. Decreased confusion and improved mood
- D. Reversal of the disease process as evidenced by increased functioning
Correct answer: C
Rationale: The correct answer is C. Donepezil is a medication used for individuals with Alzheimer's disease. Its mechanism of action involves increasing acetylcholine levels by inhibiting its breakdown, which benefits cognitive function. The expected outcome of administering donepezil is a decrease in confusion and an improvement in mood due to the medication's impact on neurotransmitters. Choices A, B, and D are incorrect because donepezil does not primarily target muscle strength, urinary incontinence, or disease reversal; instead, it aims to slow down the progression of cognitive decline in Alzheimer's disease.
2. A client is prescribed metoprolol. The nurse should monitor for which common side effect of this medication?
- A. Dizziness
- B. Fatigue
- C. Orthostatic hypotension
- D. Headache
Correct answer: A
Rationale: The correct answer is A: Dizziness. Metoprolol, a beta-blocker, can lead to dizziness as a common side effect due to its mechanism of action in reducing heart rate and blood pressure. This effect can cause a sensation of lightheadedness or unsteadiness, particularly when standing up quickly. While fatigue, orthostatic hypotension, and headache are potential side effects of metoprolol, dizziness is commonly observed and should be closely monitored by the nurse to ensure patient safety.
3. A client with diabetes mellitus type 2 is prescribed glipizide. What instruction should the nurse include in the client's teaching plan?
- A. Take this medication with meals.
- B. Avoid alcohol while taking this medication.
- C. Take this medication on an empty stomach.
- D. Report any signs of hypoglycemia to the healthcare provider.
Correct answer: A
Rationale: The correct instruction for a client prescribed glipizide, a sulfonylurea used to lower blood sugar levels, is to take the medication with meals. Taking it with meals helps to minimize the risk of hypoglycemia by ensuring a more balanced effect on blood glucose levels throughout the day. It is important for the client to follow this instruction to maintain stable blood sugar levels and reduce the likelihood of experiencing low blood sugar (hypoglycemia) episodes. Choice B is incorrect because there are no specific contraindications between glipizide and alcohol. Choice C is incorrect as glipizide should not be taken on an empty stomach. Choice D is incorrect as while it is important to report signs of hypoglycemia, the primary focus should be on preventing hypoglycemia by taking the medication with meals.
4. A client with a diagnosis of bipolar disorder is prescribed lithium. The nurse should monitor for which potential side effect?
- A. Dry mouth
- B. Hair loss
- C. Weight gain
- D. Tremors
Correct answer: D
Rationale: The correct answer is D: Tremors. When a client is prescribed lithium for bipolar disorder, one common side effect to monitor for is tremors. Tremors are a known adverse effect of lithium therapy and should be monitored closely by healthcare providers. Choice A, dry mouth, is not typically associated with lithium use. Hair loss, as in choice B, is not a common side effect of lithium. Weight gain, as mentioned in choice C, can occur with some medications used to treat bipolar disorder, but it is not a prominent side effect of lithium specifically.
5. What instructions should the PN reinforce with the client regarding the newly prescribed medications isosorbide dinitrate and hydrochlorothiazide?
- A. Instruct the client to use a soft bristle toothbrush.
- B. Instruct the client to slowly rise from a sitting or lying down position.
- C. Instruct the client to elevate their legs above the level of their heart.
- D. Instruct the client to limit the amount of fiber in their diet.
Correct answer: B
Rationale: The correct instruction for the client is to slowly rise from a sitting or lying down position. Isosorbide dinitrate, a nitrate, and hydrochlorothiazide, a diuretic, can both cause hypotension. When used together, their additive effects can further lower blood pressure, leading to orthostatic hypotension. Instructing the client to change positions slowly helps prevent a sudden drop in blood pressure, reducing the risk of dizziness or falls. Choices A, C, and D are incorrect because they do not directly address the potential side effect of hypotension associated with the prescribed medications. Using a soft bristle toothbrush, elevating legs above the heart level, or limiting fiber intake are not specific instructions to mitigate the risk of orthostatic hypotension.
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