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RN HESI Pharmacology

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Total Questions : 54

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Question 1:

A client who is taking an oral contraceptive receives a new prescription for erythromycin. Which instruction should the nurse provide to the client?

A. Take the medications at least 12 hours apart. B. Stop the oral contraceptive immediately. C. Use an additional form of contraception. D. Avoid prolonged exposure to direct sunlight.

Answer and Explanation

Choice A:

: Taking the medications at least 12 hours apart does not address the interaction between erythromycin and oral contraceptives. Erythromycin can reduce the effectiveness of oral contraceptives by increasing the metabolism of the hormones in the contraceptive, leading to a higher risk of unintended pregnancy. Therefore, simply spacing out the medications will not mitigate this risk.

Choice B:

: Stopping the oral contraceptive immediately is not advisable without consulting a healthcare provider. Abruptly discontinuing the contraceptive can lead to hormonal imbalances and unintended pregnancy. The primary concern with erythromycin is its potential to reduce the effectiveness of the contraceptive, not that it necessitates stopping the contraceptive altogether.

Choice C:

: Using an additional form of contraception is the most appropriate advice. Erythromycin can interfere with the effectiveness of oral contraceptives, so using a backup method, such as condoms, is recommended to prevent unintended pregnancy. This ensures that the client remains protected while taking both medications.

Choice D:

: Avoiding prolonged exposure to direct sunlight is not relevant to the interaction between erythromycin and oral contraceptives. While some medications can increase photosensitivity, this is not a primary concern with erythromycin in the context of contraceptive use.

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Question 2:

To control asthma, a client in a residential treatment facility uses a fluticasone propionate and salmeterol discus inhalation system, which provides an inhaled powdered form of these combined medications. Which instruction should the nurse provide to this client’s caregivers?

A. Explain that the client should not use the discus more than twice daily. B. Clients using the discus may experience decreased blood pressure. C. When using the discus, have the client breathe out rapidly into the mouthpiece. D. Offer the discus to the client for use during an acute asthma attack.

Answer and Explanation

Choice A:

: The fluticasone propionate and salmeterol discus inhalation system is designed to be used twice daily, approximately 12 hours apart. Using it more frequently can increase the risk of side effects without providing additional benefits. The medication is intended to provide long-term control of asthma symptoms, not immediate relief during an acute attack.

Choice B:

: There is no significant evidence to suggest that using the fluticasone propionate and salmeterol discus inhalation system causes decreased blood pressure. The primary side effects are related to the respiratory system, such as throat irritation, hoarseness, and oral thrush. Therefore, this instruction is not relevant to the proper use of the medication.

Choice C:

: When using the discus, the client should breathe out gently and away from the mouthpiece before inhaling the medication. Breathing out rapidly into the mouthpiece can cause the medication to be expelled from the device, reducing its effectiveness. Proper technique involves exhaling gently, then inhaling quickly and deeply through the mouthpiece.

Choice D:

: The fluticasone propionate and salmeterol discus inhalation system is not intended for use during an acute asthma attack. It is a maintenance medication designed to prevent asthma symptoms over time. For acute asthma attacks, a short-acting bronchodilator, such as albuterol, should be used. Using the discus during an acute attack will not provide the rapid relief needed.

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Question 3:

The nurse is teaching a client who has been diagnosed with human immunodeficiency virus (HIV) about the antiretroviral medication regimen. Which statement provided by the client requires additional instruction by the nurse?

A. The medications can decrease acquired immunodeficiency syndrome (AIDS) related complications. B. The viral load can be decreased to an undetectable level. C. HIV infection is not cured by the antiretroviral regimen. D. Antiretroviral medication prevents the transmission of the virus.

Answer and Explanation

Choice A:

: Antiretroviral medications are effective in decreasing AIDS-related complications. These medications work by reducing the viral load in the body, which helps to maintain the immune system and prevent the progression of HIV to AIDS. By keeping the viral load low, the risk of opportunistic infections and other complications associated with AIDS is significantly reduced.

Choice B:

: One of the primary goals of antiretroviral therapy (ART) is to decrease the viral load to an undetectable level. When the viral load is undetectable, it means that the amount of HIV in the blood is so low that it cannot be detected by standard laboratory tests. Achieving and maintaining an undetectable viral load is crucial for the health of the individual and helps to prevent the progression of the disease.

Choice C:

: It is important to understand that while antiretroviral therapy can control HIV infection and reduce the viral load to undetectable levels, it does not cure the infection. HIV remains in the body, and if the medication is stopped, the viral load will increase again. Continuous adherence to the medication regimen is necessary to keep the virus under control and maintain health.

Choice D:

: While antiretroviral therapy significantly reduces the risk of HIV transmission, it does not completely prevent it. The concept of “undetectable = untransmittable” (U=U) means that individuals with an undetectable viral load have effectively no risk of transmitting the virus through sex7. However, it is still important to use other preventive measures, such as condoms, to further reduce the risk of transmission.

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Question 4:

The nurse is providing discharge instructions to a client who has been prescribed gabapentin 300 mg by mouth (PO) three times a day for postherpetic neuralgia. Which symptom should the nurse tell the client to report to the healthcare provider?

A. Photosensitivity. B. Rapid weight gain. C. Gastric irritation. D. Sexual dysfunction.

Answer and Explanation

Choice A:

: Photosensitivity is not a common side effect of gabapentin. While some medications can cause increased sensitivity to sunlight, gabapentin is not typically associated with this issue. Therefore, it is not a primary concern that needs to be reported to the healthcare provider.

Choice B:

: Rapid weight gain is a significant side effect that should be reported to the healthcare provider. Gabapentin can cause fluid retention and swelling, which may lead to rapid weight gain. This can be a sign of more serious underlying issues, such as heart or kidney problems, and requires prompt medical attention.

Choice C:

: Gastric irritation, such as nausea or upset stomach, can occur with gabapentin use but is generally not severe. While it can be uncomfortable, it is usually manageable with supportive care and does not typically require immediate reporting to a healthcare provider unless it becomes severe or persistent.

Choice D:

: Sexual dysfunction is not commonly associated with gabapentin. While some medications can affect sexual function, gabapentin’s side effects are more commonly related to the nervous system, such as dizziness, drowsiness, and coordination issues. Therefore, this is not a primary concern that needs to be reported.

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Question 5:

A client receives a prescription for allopurinol. Which information provided by the client requires additional instruction by the nurse?

A. Avoid taking on an empty stomach. B. Consume 2 liters of water daily. C. Reduce caffeine and acidic intake. D. Double the dose if a dose is missed.

Answer and Explanation

Choice A:

: Avoiding taking allopurinol on an empty stomach is a common recommendation to prevent stomach upset. Taking the medication with food can help reduce gastrointestinal discomfort, making this advice appropriate and not requiring additional instruction.

Choice B:

: Consuming 2 liters of water daily is advised when taking allopurinol to help prevent kidney stones and ensure proper hydration. Adequate fluid intake helps to dilute the urine and reduce the risk of uric acid crystal formation, making this advice correct and not needing further instruction.

Choice C:

: Reducing caffeine and acidic intake can be beneficial for individuals taking allopurinol, as these substances can increase uric acid levels and potentially exacerbate gout symptoms. This advice is appropriate and does not require additional instruction.

Choice D:

: Doubling the dose if a dose is missed is incorrect and potentially dangerous. Allopurinol should be taken exactly as prescribed, and doubling up on doses can increase the risk of side effects and toxicity. If a dose is missed, the client should take it as soon as they remember, but if it is almost time for the next dose, they should skip the missed dose and continue with their regular schedule. This instruction requires correction by the nurse.

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Question 6:

A client has a new prescription for diclofenac, a nonsteroidal anti-inflammatory drug (NSAID). Which information in the client’s history is of greatest concern to the nurse in monitoring the client’s response to this medication?

A. Osteoarthritis. B. Migraine headaches. C. Chronic alcoholism. D. Type 2 diabetes mellitus.

Answer and Explanation

Choice A:

: Osteoarthritis is a common condition treated with NSAIDs like diclofenac. While it is important to monitor for potential side effects, osteoarthritis itself does not pose a significant concern in the context of diclofenac use. The medication is often prescribed to manage the pain and inflammation associated with osteoarthritis.

Choice B:

: Migraine headaches are also treated with NSAIDs, including diclofenac. While it is essential to monitor for side effects, migraines do not present a significant concern regarding the use of diclofenac. The medication can help alleviate the pain associated with migraines.

Choice C:

: Chronic alcoholism is of greatest concern when prescribing diclofenac. Alcohol can increase the risk of gastrointestinal bleeding and liver damage, both of which are potential side effects of NSAIDs. Combining alcohol with diclofenac can exacerbate these risks, making it crucial for the nurse to monitor the client closely and provide appropriate guidance.

Choice D:

: Type 2 diabetes mellitus requires careful management, but it is not the primary concern when prescribing diclofenac. While it is important to monitor for potential interactions and side effects, diabetes itself does not significantly increase the risks associated with diclofenac use compared to chronic alcoholism.

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Question 7:

A client with chronic lower back pain has been taking ibuprofen PO twice a day for several months. Which assessment is most important for the nurse to complete?

A. Determine presence of abdominal pain. B. Palpate volume of pedal pulses. C. Evaluate ongoing sleep patterns. D. Assess back pain using numeric scale.

Answer and Explanation

Choice A:

: Determining the presence of abdominal pain is crucial because long-term use of ibuprofen can lead to gastrointestinal issues, including ulcers and bleeding. Abdominal pain can be an early sign of these complications, and prompt identification is essential to prevent more severe outcomes. Monitoring for gastrointestinal symptoms is a key aspect of managing patients on chronic NSAID therapy.

Choice B:

: While palpating the volume of pedal pulses is important for assessing peripheral circulation, it is not directly related to the potential side effects of long-term ibuprofen use. This assessment is more relevant for conditions affecting blood flow, such as peripheral artery disease, rather than for monitoring ibuprofen-related complications.

Choice C:

: Evaluating ongoing sleep patterns can provide valuable information about the client’s overall well-being and pain management. However, it is not the most critical assessment in the context of long-term ibuprofen use. Sleep disturbances may be related to chronic pain but are not directly indicative of ibuprofen’s adverse effects.

Choice D:

: Assessing back pain using a numeric scale is essential for evaluating the effectiveness of pain management strategies. However, it does not address the potential adverse effects of long-term ibuprofen use. While pain assessment is important, monitoring for signs of gastrointestinal complications takes precedence in this scenario.

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Question 8:

The nurse is caring for an adult client who is taking digoxin. Which laboratory value should be reported to the healthcare provider immediately?
Reference Range:
• Sodium: 136 to 145 mEq/L (136 to 145 mmol/L)
• Digoxin level: 0.8 to 2.6 ng/mL (0.6 to 13 nmol/L)
• Potassium (K+): 3.5 to 5.0 mEq/L (3.5 to 5.0 mmol/L)
• Creatinine: 0.5 to 1.1 mg/dL (44 to 97 µmol/L)

A. Digoxin level of 1.1 ng/mL (1.4 nmol/L). B. Potassium level of 3.2 mEq/L (3.2 mmol/L). C. Creatinine level of 0.8 mg/dL (70.72 µmol/L). D. Sodium level of 135 mEq/L (135 mmol/L).

Answer and Explanation

Choice A:

: A digoxin level of 1.1 ng/mL is within the therapeutic range of 0.8 to 2.6 ng/mL. Therefore, this value does not require immediate reporting to the healthcare provider. Monitoring digoxin levels is important to avoid toxicity, but this specific level is considered safe.

Choice B:

: A potassium level of 3.2 mEq/L is below the normal range of 3.5 to 5.0 mEq/L. Hypokalemia (low potassium levels) can increase the risk of digoxin toxicity, as digoxin and potassium compete for the same binding sites on the Na+/K+ ATPase pump. Low potassium levels can enhance the effects of digoxin, leading to potentially dangerous cardiac arrhythmias. Therefore, this value should be reported immediately.

Choice C:

: A creatinine level of 0.8 mg/dL is within the normal range of 0.5 to 1.1 mg/dL. This value indicates normal kidney function, which is important for the excretion of digoxin. Therefore, this value does not require immediate reporting.

Choice D:

: A sodium level of 135 mEq/L is just below the normal range of 136 to 145 mEq/L. While slightly low, this value is not critically abnormal and does not pose an immediate threat. It should be monitored, but it does not require urgent reporting to the healthcare provider.

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Question 9:

A client with nasal congestion receives a prescription for phenylephrine 10 mg PO every 4 hours. Which client condition should the nurse report to the healthcare provider before administering the medication?

A. Bronchitis. B. Diarrhea. C. Hypertension. D. Edema.

Answer and Explanation

Choice A:

: Bronchitis is a condition that affects the respiratory system, and while it is important to monitor, it is not a primary concern when administering phenylephrine. Phenylephrine is a decongestant that works by narrowing the blood vessels in the nasal passages, which can help relieve congestion but does not directly impact bronchitis.

Choice B:

: Diarrhea is a gastrointestinal condition that, while uncomfortable, does not significantly interact with phenylephrine. It is important to manage and monitor, but it does not pose a direct risk when taking phenylephrine.

Choice C:

: Hypertension is a significant concern when administering phenylephrine. Phenylephrine can increase blood pressure by causing vasoconstriction. For clients with hypertension, this can exacerbate their condition and lead to serious cardiovascular complications. Therefore, it is crucial to report this condition to the healthcare provider before administering the medication.

Choice D:

: Edema, or swelling, can be a symptom of various underlying conditions, including heart failure or kidney issues. While it is important to monitor, it is not as directly impacted by phenylephrine as hypertension. However, any underlying condition causing edema should be considered when administering medications.

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Question 10:

A client is receiving orlistat as part of a weight management program. Which ongoing assessment should be included in the plan of care to determine the effectiveness of the medication?

A. Depression screening. B. Daily calorie count. C. Body mass index (BMI). D. Serum protein levels.

Answer and Explanation

Choice A:

: Depression screening is important for overall health and well-being, especially in weight management programs where mental health can significantly impact outcomes. However, it is not the primary measure for determining the effectiveness of orlistat. Orlistat works by inhibiting the absorption of fats from the diet, leading to weight loss. Therefore, while mental health monitoring is crucial, it does not directly measure the medication’s effectiveness.

Choice B:

: Daily calorie count is a useful tool in weight management programs to ensure that clients are adhering to a calorie-restricted diet. However, it is not a direct measure of the effectiveness of orlistat. While calorie counting can help manage weight, the primary goal of orlistat is to reduce fat absorption, which is better reflected in changes in body weight and BMI.

Choice C:

: Body mass index (BMI) is a key indicator of weight management and is directly related to the effectiveness of orlistat. BMI is calculated based on height and weight, providing a clear measure of changes in body weight over time. Monitoring BMI helps determine if the client is losing weight as expected, making it the most appropriate assessment for evaluating the effectiveness of orlistat.

Choice D:

: Serum protein levels are important for assessing nutritional status and overall health. However, they do not directly measure the effectiveness of orlistat in a weight management program. Orlistat’s primary function is to reduce fat absorption, and its effectiveness is better assessed through changes in body weight and BMI rather than serum protein levels.

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Total Questions : 54

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