HESI Pharmacology Exam V2| 2023 / 2024 Update | Questions and Verified Answers eith Rationales (55 Q & A)

HESI Pharmacology Exam V2| 2023 / 2024 Update | Questions and Verified Answers (55 Q & A) QUESTION A client receiving albuterol (Proventil) tablets complains of nausea every evening with her 9 p.m. dose. What action should the LPN/LVN take to alleviate this side effect? A) Change the time of the dose. B) Hold the 9 p.m. dose. C) Administer the dose with a snack. D) Administer an antiemetic with the dose. Answer: C. Administer the dose with a snack. Administering oral doses with food (C) helps minimize GI discomfort. (A) would be appropriate only if changing the time of the dose corresponds to meal times while at the same time maintaining an appropriate time interval between doses. (B) would disrupt the dosing schedule, and could result in a nontherapeutic serum level of the medication. (D) should not be attempted before other interventions, such as (C), have been proven ineffective in relieving the nausea. QUESTION A client is receiving digoxin for the onset of supraventricular tachycardia (SVT). Which laboratory findings should the LPN/LVN identify that places this client at risk? A) Hypokalemia. B) Hyponatremia. C) Hypercalcemia. D) Low uric acid levels. Answer: A. Hypokalemia. Hypokalemia affects myocardial contractility, so (A) places this client at greatest risk for dysrhythmias that may be unresponsive to drug therapy. Although an imbalance of serum electrolytes, (B and C), can effect cardiac rhythm, the greatest risk for the client receiving digoxin is (A). (D) does not cause any interactions related to digoxin therapy for supraventricular tachycardia (SVT). QUESTION Following heparin treatment for a PE, a client is being discharged with a prescription for warfarin. In conducting discharge teaching, the nurse advises the client to have which diagnostic test monitored regularly? A. Perfusion scan B. Prothrombin time (PT/INR) C. Activated Partial thromboplastin (APTT) D. Serum Coumadin Level (SCL) Answer: B. Prothrombin time (PT/INR) When used for a client with PE, the therapeutic goal for wafarin therapy is a PT 1/5 to 2/5 times greater than the control or an INR of 2-3. A perfusion might be preformed to monitor lung function but not monthly. APTT is monitored for Heparin. QUESTION A 43-year-old female client is receiving thyroid replacement hormone following a thyroidectomy. What adverse effects associated with thyroid hormone toxicity should the nurse instruct the client to report promptly to the healthcare provider? A) Tinnitus and dizziness. B) Tachycardia and chest pain. C) Dry skin and intolerance to cold. D) Weight gain and increased appetite. Answer: B. Tachycardia and chest pain. Thyroid replacement hormone increases the metabolic rate of all tissues, so common signs and symptoms of toxicity include tachycardia and chest pain (B). (A, C, and D) do not indicate a thyroid hormone toxicity. QUESTION Following the administration of sublingual nitroglycerin to a client experiencing an acute anginal attack, which assessment finding indicates to the LPN/LVN that the desired effect has been achieved? A. Client states chest pain is relieved B. Client's pulse decreases from 120 to 90 C. Client's systolic blood pressure decreases from 180 to 90 D. Clients SaO2 level increases from 92% to 96% Answer: A. Client states chest pain is relieved. Nitroglycerin reduces mycocardial oxygen consumption which decreases ischemia and reduces chest pain QUESTION An adult client is given a prescription for a scopolamine patch (Transderm Scop) to prevent motion sickness while on a cruise. Which information should the nurse provide to the client? A) Apply the patch at least 4 hours prior to departure. B) Change the patch every other day while on the cruise. C) Place the patch on a hairless area at the base of the skull. D) Drink no more than 2 alcoholic drinks during the cruise. Answer: A. Apply the patch at least 4 hours prior to departure. Scopolamine, an anticholinergic agent, is used to prevent motion sickness and has a peak onset in 6 hours, so the client should be instructed to apply the patch at least 4 hours before departure (A) on the cruise ship. The duration of the transdermal patch is 72 hours, so (B) is not needed. Scolopamine blocks muscarinic receptors in the inner ear and to the vomiting center, so the best application site of the patch is behind the ear, not at the base of the skull (C). Anticholinergic medications are CNS depressants, so the client should be instructed to avoid alcohol (D) while using the patch. QUESTION Which action is most important for the nurse to implement prior to the administration of the antiarrhythmic drug adenosine (Adenocard)? A) Assess pupillary response to light. B) Instruct the client that facial flushing may occur. C) Apply continuous cardiac monitoring. D) Request that family members leave the room. Answer: C. Apply continuous cardiac monitoring. Adenosine (Adenocard) is an antiarrhythmic drug used to restore a normal sinus rhythm in clients with rapid supraventricular tachycardia. The client's heart rate should be monitored continuously (C) for the onset of additional arrhythmias while receiving adenosine. (A and B) are valuable nursing interventions, but are of less importance than monitoring for potentially fatal arrhythmias. Family members may be asked to leave the room because of the potential for an emergency situation (D), however, this is also of less priority than (C).