HESI RN Pharmacology Exam
VERSION 13
1) A nurse is caring for a client who has sickle cell anemia and is taking hydroxyurea. Which of the following findings should the nurse report to the provider? (select all that apply)
-Hemoglobin 7.0 g/dL = CORRECT ANSWER A hemoglobin level of 7.0 g/dL indicates hydroxyurea toxicity, and the nurse should report it to the provider.
-Platelets 75,000/mm 3
= CORRECT ANSWER
A platelet level of 75,000/mm 3 indicates hydroxyurea toxicity, and the nurse should report it to the provider.
-Potassium 5.2 mEq/L = CORRECT ANSWER A potassium level of 5.2 mEq/L indicates tumor lysis syndrome, and the nurse should report it to the provider.
-Creatinine 1 mg/dL A creatinine level of 1 mg/dL is within the expected reference range.
RBC 4.7 million/mm 3
A RBC 4.7 million/mm 3 is within the expected reference range.
2) A nurse is assessing a client who has myasthenia graves and is taking Neostigmine. Which of the following findings should indicate to the nurse the client is experiencing an adverse effect?
-Tachycardia Neostigmine can cause bradycardia, rather than tachycardia, due to the excessive muscarinic stimulation.
-Oliguria Neostigmine can cause urinary urgency, rather than decreased urinary output, due to the excessive muscarinic stimulation.
-Xerostomia Neostigmine can cause increased salivation, rather than dry mouth, due to the excessive muscarinic stimulation.
-Miosis = CORRECT ASNWER Miosis, which is pupillary constriction, is a common adverse effect of neostigmine due to the excessive muscarinic stimulation that causes difficulty with visual accommodation.
3) A nurse is monitoring a client who is receiving Amphotericin B intermittent IV bolus for the treatment of histoplasmosis. Which of the following findings should the nurse identify as an adverse reaction to the medication?
-Tachycardia Bradycardia, not tachycardia, is an adverse effect of amphotericin B.
-Oliguria = CORRECT ANSWER Oliguria can indicate renal compromise in a client who is taking amphotericin B. The nurse should report this finding to the provider.
-Hyperkalemia Hypokalemia, not hyperkalemia, is an adverse effect of amphotericin B due to the medication causing damage to the kidneys.
-Weight gain Weight loss, not weight gain, is an adverse effect of amphotericin B. 1 / 2
4) A nurse is reviewing the medical record of a client who has schizophrenia and a prescription for Clozapine. Which of the following laboratory tests should the nurse review before administering the medication?
-Troponin The nurse should review the troponin level of a client who has chest pain and possible myocardial infarction.
-Total cholesterol = CORRECT ANSWER The nurse should review the client's total cholesterol before administering clozapine, because this medication can cause hyperlipidemia.
-Creatinine Clozapine is not metabolized by the kidneys. Therefore, the nurse does not need to review the creatinine level before administering the medication.
-Thyroid stimulating hormone The nurse should review the thyroid stimulating hormone level of a client who has hypothyroidism or hyperthyroidism.
5) A nurse is teaching about Zolpidem with a client who has insomnia. The nurse should identify that which of the following client statements indicates an understanding of the teaching?
-"I will need to get laboratory testing prior to a refill of this medication." Laboratory testing is not needed when taking this medication for sleep.
-"I will use this medication for a short period of time." = CORRECT ANSWER Zolpidem is used for short-term treatment of insomnia. Therefore, the provider should reassess the client before refilling the prescription.
-"I will need to take this medication for 1 week before results are seen." The client who takes zolpidem should have improved sleep within 2 days of starting this medication.
-"I will need to change the medications to prevent building up a tolerance." The client who takes zolpidem should not build up a tolerance with short-term use.
6) A nurse is providing teaching to a client who has a new prescription for Phenytoin. Which of the following statements by the client indicates an understanding of the teaching?
-"I should take my medication with antacids to minimize gastric upset." The client should not take phenytoin with antacids because they can decrease the effects of phenytoin. If needed, antacids should be taken 2 hr before or after the phenytoin.
-"This type of medication does not require blood monitoring." The client should receive instructions to have blood levels of phenytoin monitored to determine effective dosage. Subtherapeutic and toxic levels can result in poor outcomes.
-"I should let my dentist know I'm taking this medication" = CORRECT ANSWER Phenytoin commonly causes gingival hyperplasia. As a result, the client should notify his dentist.
-"I should expect to experience some unusual eye movement when taking this medication." The client should not expect to experience unusual eye movement when taking phenytoin. However, nystagmus is a serious adverse effect when taking phenytoin that the client should report to the provider.
7) A nurse is caring for a client who reports lethargy and myalgia after taking clozapine for 6 months. Which of the following actions should the nurse plan to take?
-Infuse 0.9% sodium chloride 1,000 mL IV fluid bolus.The client who is dehydrated may receive 0.9% sodium chloride IV bolus, but it is not used to treat the adverse effects of lethargy, myalgia, and weakness from taking clozapine.
-Schedule the client for an electroencephalogram.The client who develops seizures may have an electroencephalogram, but it is not used to treat or diagnose the client who has lethargy and myalgia.
-Obtain WBC with absolute neutrophil count = CORRECT ANSWER The client who takes clozapine can develop lethargy and myalgia caused by the adverse effect of agranulocytopenia. Therefore, monitoring the WBC with absolute neutrophil count weekly for the first 6 months of treatment is recommended. After 6 months, monitoring can be changed to occur every 2 weeks up to 1 year.
-Place the client on a tyramine-free diet.The client can take clozapine with or without food and does not need to follow a tyramine-free diet, The client will follow a tyramine-free diet if taking monoamine oxidase inhibitors.
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