HESI PN PHARMACOLOGY PROCTORED EXAM

HESI PN PHARMACOLOGY PROCTORED EXAM

VERSION 7

A nurse is caring for a client with many different medications who is newly prescribed acetazolamide.What medications can interact with acetazolamide? High-dose aspirin (metabolic acidosis)  Quinidine (can increase risk of toxic effects)

• Instruct client to notify provider of concurrent use and to watch for indications of toxicity,

such as decreased heart rate  Lithium (decrease blood levels)

• Teach clients to watch for increased indications of mania. Monitor lithium levels regularly

 Phenytoin (increase osteomalacia)

• Teach clients to watch for bone pain or weakness and report symptoms to provider

 Sodium bicarbonate (increases risk of kidney stones)

• Question clients about use of sodium bicarbonate and other OTC antacids

A nurse is preparing to administer ipratropium by metered dose inhaler. What adverse effects should the nurse instruct the client to monitor for? Local anticholinergic effects (dry mouth, hoarseness)

• Advise client to sip fluids and suck on sugar-free hard candies to control dry mouth

A client has a new prescription for salmeterol. The nurse is teaching the client about adverse effects of the medication. What instructions should the nurse include in thus education? Tachycardia, angina

• Advise client to observe for chest, jaw or arm pain/palpitations and to notify provider if

they occur

• Instruct to check pulse and to report an increase of greater than 20-30/bpm
• Advise to avoid caffeine
• Dosage might need to be reduced

 Tremors

• Usually resolve with continued medication use
• Dosage might need to be reduced

A nurse is caring for a client prescribed the inhaled glucocorticoid beclomethasone (QVAR) for the treatment of asthma. What is a potential adverse effect of this medication and what are two (2) teaching points to discuss to address these adverse effects? Difficulty speaking, hoarseness, candidiasis

• Advise client to rinse mouth or gargle with water after use
• Advise client to monitor for redness, sores, or white patches and to report to provider if

they occur. Treat candidiasis with nystatin oral suspension

A client has a new prescription for an albuterol inhaler and a beclomethasone inhaler. What instructions should the nurse include concerning use of these inhalers? Advise client to inhale the beta2-agonist (albuterol) BEFORE inhaling the glucocorticoid (beclomethasone). The beta2-agonist promotes bronchodilation and enhances absorption of the glucocorticoid

A nurse is administering gemfibrozil to a client with elevated cholesterol. Identify two (2) adverse effects related to this medication. GI distress  Gallstones

• Advise to observe for indications of gallbladder disease ( RUQ aches, pain, fat intolerance,

bloating)

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