Review Care Hope College RN HESI Pharmacology

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Care Hope College RN HESI Pharmacology

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Total Questions : 55

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Question 1:

The nurse administers risedronate to a client with osteoporosis at 0700. The client asks for a glass of milk to drink with the medication.
What action should the nurse take?

A. Instruct the client that it is necessary to take nothing but water with the medication. B. Withhold the medication until the client’s breakfast tray is available on the unit. C. Consult with a pharmacist about scheduling the dose one hour after the client eats. D. Assign an unlicensed assistive personnel (UAP) to bring the client a glass of low-fat milk.

Answer and Explanation

Choice A:

Risedronate is a type of medication known as a bisphosphonate, which is used to treat and prevent osteoporosis. It works by slowing bone loss to help maintain strong bones and reduce the risk of fractures. It’s important to take risedronate correctly to ensure it works effectively. One key instruction is that it should be taken with a full glass of plain water, at least 30 minutes before any food, beverage, or other medicines. This is because food and beverages can decrease the amount of risedronate absorbed by the body. Therefore, the nurse should instruct the client that it is necessary to take nothing but water with the medication.

Choice B:

Withholding the medication until the client’s breakfast tray is available on the unit would not be the best action. This is because risedronate needs to be taken as soon as you get out of bed in the morning and at least 30 minutes before any food, beverage, or other medicines. Waiting for the breakfast tray could delay the administration of the medication and potentially decrease its effectiveness.

Choice C:

Consulting with a pharmacist about scheduling the dose one hour after the client eats is not the best action. As mentioned earlier, risedronate should be taken at least 30 minutes before any food, beverage, or other medicines. Taking it after eating could decrease the amount of medication that is absorbed by the body, reducing its effectiveness.

Choice D:

Assigning an unlicensed assistive personnel (UAP) to bring the client a glass of low-fat milk is not the correct action. This is because risedronate should be taken with a full glass of plain water, not milk. In fact, taking risedronate with milk could decrease the amount of medication that is absorbed by the body.

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Question 2:

The nurse initiates an infusion of piperacillin-tazobactam for a client with a urinary tract infection. Five minutes into the infusion, the client reports not feeling well.
Which client manifestation should the nurse identify as a reason to stop the infusion?

A. Hypertension. B. Scratchy throat. C. Bradycardia. D. Pupillary constriction.

Answer and Explanation

Choice A:

Hypertension, or high blood pressure, is not typically a side effect of piperacillin-tazobactam. While it’s important to monitor a client’s blood pressure during any infusion, hypertension alone would not typically be a reason to stop the infusion of piperacillin-tazobactam.

Choice B:

A scratchy throat could be a sign of an allergic reaction to piperacillin-tazobactam. Allergic reactions to medications can range from mild to severe, and can include symptoms such as hives, difficulty breathing, and swelling in the face or throat. If a client reports a scratchy throat shortly after starting an infusion of piperacillin-tazobactam, it would be prudent for the nurse to stop the infusion and assess the client for other signs of an allergic reaction.

Choice C:

Bradycardia, or a slow heart rate, is not typically a side effect of piperacillin-tazobactam. While it’s important to monitor a client’s heart rate during any infusion, bradycardia alone would not typically be a reason to stop the infusion of piperacillin-tazobactam.

Choice D:

Pupillary constriction is not typically a side effect of piperacillin-tazobactam. While it’s important to monitor a client’s pupils during any infusion, pupillary constriction alone would not typically be a reason to stop the infusion of piperacillin-tazobactam.

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Question 3:

A client in the surgical recovery area asks the nurse to bring the largest possible dose of pain medication available. Which action should the nurse implement first?

A. Determine when the last dose was administered. B. Review the history for past use of recreational drugs. C. Ask the client to rate the current level of pain using a pain scale. D. Encourage the client to use diversional thoughts to manage pain.

Answer and Explanation

Choice A:

Determining when the last dose was administered is an important step in managing a client’s pain. However, it should not be the first action taken when a client requests the largest possible dose of pain medication. The nurse first needs to assess the client’s current level of pain to determine the appropriate intervention.

Choice B:

Reviewing the history for past use of recreational drugs is an important part of a comprehensive pain assessment. However, it should not be the first action taken when a client requests the largest possible dose of pain medication. The nurse first needs to assess the client’s current level of pain to determine the appropriate intervention.

Choice C:

Asking the client to rate the current level of pain using a pain scale should be the first action the nurse takes when a client requests the largest possible dose of pain medication. Pain is subjective and can only be accurately assessed by the person experiencing it. Using a pain scale helps the nurse quantify the client’s pain and guide appropriate interventions.

Choice D:

Encouraging the client to use diversional thoughts to manage pain can be a helpful non- pharmacological pain management strategy. However, it should not be the first action taken when a client requests the largest possible dose of pain medication. The nurse first needs to assess the client’s current level of pain to determine the appropriate intervention.

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Question 4:

A client has a new prescription for zolpidem, a hypnotic.
The client tells the home health nurse that he plans to take a dose of the medication during the day because he is exhausted and needs to take a short afternoon nap prior to an evening activity in his home.
Which action should the nurse take?

A. Explain that the client needs to allow for sleep time of at least two hours. B. Advise the client to take the medication with the noon meal. C. Encourage the client to wait until bedtime to take the medication. D. Remind the client to drink plenty of fluids when taking the medication.

Answer and Explanation

Choice A:

Explaining that the client needs to allow for sleep time of at least two hours after taking zolpidem is not the best action. While it’s true that zolpidem should be taken right before going to sleep, the client’s plan to take a short afternoon nap may not provide enough time for the effects of the medication to wear off, which could lead to drowsiness and potential safety issues.

Choice B:

Advising the client to take the medication with the noon meal is not the best action. Zolpidem should be taken on an empty stomach right before going to sleep. Taking it with food or right after a meal may decrease its effectiveness.

Choice C:

Encouraging the client to wait until bedtime to take the medication is the best action. Zolpidem is a sedative-hypnotic medication used to treat insomnia. It works quickly to put you to sleep and should be taken right before going to bed. Taking it during the day could lead to drowsiness and potential safety issues.

Choice D:

Reminding the client to drink plenty of fluids when taking the medication is not the best action. While staying hydrated is generally good advice, it’s not specifically related to the use of zolpidem. The key instruction for zolpidem is to take it right before going to bed.

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Question 5:

A client with chemotherapy-induced nausea receives a prescription for metoclopramide. Which adverse effect is most important for the nurse to report?

A. Diarrhea. B. Unusual irritability. C. Nausea. D. Involuntary movements.

Answer and Explanation

Choice A:

Diarrhea is a common side effect of many medications, including metoclopramide. However, it is not considered a serious adverse effect that would require immediate medical attention.

Choice B:

Unusual irritability can be a side effect of metoclopramide, but it is not the most serious adverse effect of this medication. It is important to monitor for changes in mood or behavior, but these changes do not typically require immediate medical intervention.

Choice C:

Nausea is actually one of the conditions that metoclopramide is used to treat. If a patient experiences nausea while taking this medication, it may indicate that the medication is not effectively managing the patient’s symptoms, but it is not considered a serious adverse effect.

Choice D:

Involuntary movements, also known as tardive dyskinesia, are a serious potential side effect of metoclopramide. This condition is characterized by repetitive, involuntary movements, most often affecting the lower face. Tardive dyskinesia can be irreversible, even after discontinuation of the medication, and can be debilitating. Therefore, any signs of involuntary movements should be reported to a healthcare provider immediately.

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Question 6:

Which nursing action has the highest priority when administering a dose of codeine with acetaminophen to a client?

A. Instruct the client to request assistance when ambulating to the bathroom. B. Administer a stool softener/laxative at the same time as the analgesic. C. Tell the client to notify the nurse if the pain is not relieved. D. Advise the client that the medication should start to work in about 30 minutes.

Answer and Explanation

Choice A:

Codeine is an opioid medication that can cause drowsiness and dizziness. This can increase the risk of falls, particularly in older adults or those with balance or mobility issues. Therefore, it is important to instruct the client to request assistance when ambulating to prevent falls.

Choice B:

While constipation is a common side effect of opioid medications like codeine, and a stool softener or laxative may be helpful in managing this side effect, it is not the highest priority nursing action. The risk of falls due to drowsiness or dizziness is a more immediate safety concern.

Choice C:

While it is important for the client to notify the nurse if the pain is not relieved, this is not the highest priority nursing action. The safety of the client is the primary concern, and preventing falls by providing assistance with ambulation is a more immediate need.

Choice D:

Advising the client that the medication should start to work in about 30 minutes is an important part of patient education, but it is not the highest priority nursing action. The safety of the client is the primary concern, and preventing falls by providing assistance with ambulation is a more immediate need.

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Question 7:

A client with heart failure (HF) develops hyperaldosteronism and spironolactone is prescribed. Which instruction should the nurse include in this client’s plan of care?

A. Replace salt with a salt substitute. B. Cover your skin before going outside. C. Limit intake of high-potassium foods. D. Monitor skin for excessive bruising.

Answer and Explanation

Choice A:

While reducing salt intake is generally beneficial for clients with heart failure, replacing salt with a salt substitute is not recommended for clients taking spironolactone. Many salt substitutes contain potassium, and spironolactone can cause high potassium levels in the blood.

Choice B:

Covering the skin before going outside is a general recommendation for sun protection, but it is not specifically related to the use of spironolactone.

Choice C:

Spironolactone is a potassium-sparing diuretic, which means it can cause the body to retain potassium. Therefore, clients taking this medication should be advised to limit their intake of high-potassium foods to prevent hyperkalemia, a potentially serious condition characterized by high levels of potassium in the blood.

Choice D:

While it is always important to monitor for signs of bruising, this is not the most critical instruction for a client taking spironolactone. The risk of hyperkalemia is a more immediate concern.

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Question 8:

A patient is currently on an oral contraceptive and has been prescribed erythromycin. What advice should the nurse provide to the patient?

A. Utilize an additional form of contraception. B. Immediately discontinue the oral contraceptive. C. Ensure a 12-hour gap between taking the medications. D. Avoid prolonged exposure to direct sunlight.

Answer and Explanation

Choice A:

Erythromycin is an antibiotic that can potentially reduce the effectiveness of oral contraceptives. Therefore, patients who are taking both erythromycin and an oral contraceptive should be advised to use an additional form of contraception to prevent unintended pregnancy.

Choice B:

Immediately discontinuing the oral contraceptive is not necessary when taking erythromycin. Instead, the patient should be advised to use an additional form of contraception.

Choice C:

Ensuring a 12-hour gap between taking the medications is not a recommended strategy for managing the potential interaction between erythromycin and oral contraceptives. The patient should be advised to use an additional form of contraception.

Choice D:

Avoiding prolonged exposure to direct sunlight is a general recommendation for sun protection, but it is not specifically related to the use of erythromycin or oral contraceptives.

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Question 9:

An adult patient at an outpatient clinic has been prescribed the antibiotic tetracycline HCI. What should the nurse include in the patient’s teaching plan?

A. Consume with milk or antacids to prevent gastrointestinal irritation. B. Protect your skin from sunlight while on this medication. C. Enhance gastrointestinal absorption by taking with orange juice. D. Return to the clinic weekly for serum drug level checks.

Answer and Explanation

Choice A:

Tetracycline should not be consumed with milk or antacids. These substances contain calcium, which can bind to tetracycline in the stomach and reduce its absorption and effectiveness.

Choice B:

Tetracycline can make the skin more sensitive to sunlight, increasing the risk of sunburn. Patients should be advised to protect their skin from sunlight while taking this medication.

Choice C:

Taking tetracycline with orange juice is not recommended. Citrus fruits and juices contain calcium, which can bind to tetracycline in the stomach and reduce its absorption and effectiveness.

Choice D:

Returning to the clinic weekly for serum drug level checks is not typically necessary for patients taking tetracycline. While regular follow-up appointments may be needed to monitor the patient’s response to treatment, weekly serum drug level checks are not a standard part of tetracycline therapy.

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Question 10:

The nurse is preparing to administer the anti-ulcer gastrointestinal agent sucralfate to a patient with peptic ulcer disease.
What should be included in this patient’s care plan?

A. Administer sucralfate once daily, preferably at bedtime. B. Give sucralfate on an empty stomach. C. Monitor for a secondary Candida infection. D. Monitor for electrolyte imbalances.

Answer and Explanation

Choice A:

Sucralfate is not typically administered once daily, preferably at bedtime. It is usually given multiple times a day.

Choice B:

Sucralfate should be given on an empty stomach, at least one hour before meals and at bedtime. This is because the absorption of sucralfate can be affected by the presence of food in the stomach.

Choice C:

While it’s important to monitor for infections when administering any medication, there’s no specific association between sucralfate and secondary Candida infections.

Choice D:

Sucralfate does not typically cause electrolyte imbalances. Its main function is to form a protective barrier over the ulcer, preventing further damage from acid and pepsin.

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Total Questions : 55

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Care Hope College RN HESI Pharmacology

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