HESI Pharmacology V1 Questions with Complete Solutions, A+

Heparin sodium is prescribed for the client. The nurse expects that the healthcare provider will prescribe which of the following to monitor for a therapeutic effect of the medication? 1. Hematocrit level 2. Hemoglobin level 3. Prothrombin time (PT) 4. Activated partial thromboplastin time (aPTT) 4. Activated partial thromboplastin time (aPTT) Rationale: The therapeutic effect of heparin sodium is assessed using the activated partial thromboplastin time (aPTT). This test helps in determining the appropriate dosing of heparin sodium. In contrast, Prothrombin time (PT) is used to monitor the therapeutic effect of warfarin sodium (Coumadin). Hematocrit and hemoglobin levels are indicators of red blood cell concentration and are not used to monitor heparin sodium. ________________________________________ A nurse is monitoring a client who is taking propranolol (Inderal LA). Which data collection finding would indicate a potential serious complication associated with propranolol? 1. The development of complaints of insomnia 2. The development of audible expiratory wheezes 3. A baseline blood pressure of 150/80 mm Hg followed by a blood pressure of 138/72 mm Hg after two doses of the medication 4. A baseline resting heart rate of 88 beats/min followed by a resting heart rate of 72 beats/min after two doses of the medication 2. The development of audible expiratory wheezes Rationale: The presence of audible expiratory wheezes may suggest a serious adverse reaction like bronchospasm, which can be induced by β-blockers, especially in clients with chronic obstructive pulmonary disease or asthma. Expected normal decreases in blood pressure and heart rate are not indicative of serious complications, and insomnia is a common mild side effect of propranolol. ________________________________________ Isosorbide mononitrate (Imdur) is prescribed for a client with angina pectoris. The client tells the nurse that the medication is causing a chronic headache. The nurse appropriately suggests that the client: 1. Cut the dose in half. 2. Discontinue the medication. 3. Take the medication with food. 4. Contact the healthcare provider (HCP). 3. Take the medication with food. Rationale: Headaches are a frequent side effect of isosorbide mononitrate and often subside with continued therapy. Taking the medication with food can help alleviate headaches. It is not recommended for the client to alter the dose or discontinue the medication without consulting the healthcare provider, nor is it necessary to contact the provider unless the headaches persist. ________________________________________ A client is diagnosed with an acute myocardial infarction and is receiving tissue plasminogen activator, alteplase (Activase, tPA). Which action is a priority nursing intervention? 1. Monitor for renal failure. 2. Monitor psychosocial status. 3. Monitor for signs of bleeding. 4. Have heparin sodium available. 3. Monitor for signs of bleeding. Rationale: As a thrombolytic, tissue plasminogen activator (tPA) can lead to hemorrhage, making it crucial to monitor for signs of bleeding. Monitoring for renal failure and psychosocial status, though important, are not as critical. Heparin sodium is used after thrombolytic therapy but does not pertain directly to the priority intervention required. ________________________________________ A nurse is planning to administer hydrochlorothiazide (HydroDIURIL) to a client. The nurse understands that which of the following are concerns related to the administration of this medication? 1. Hypouricemia, hyperkalemia 2. Increased risk of osteoporosis 3. Hypokalemia, hyperglycemia, sulfa allergy 4. Hyperkalemia, hypoglycemia, penicillin allergy 3. Hypokalemia, hyperglycemia, sulfa allergy Rationale: Hydrochlorothiazide, a thiazide diuretic, poses risks of hypokalemia, hyperglycemia, and sulfa allergies due to its sulfa-based composition. There is no association with hyperkalemia, osteoporosis, or penicillin allergy. ________________________________________ A home healthcare nurse is visiting a client with elevated triglyceride levels and a serum cholesterol level of 398 mg/dL. The client is taking cholestyramine (Questran). Which of the following statements, if made by the client, indicates the need for further education? 1. "Constipation and bloating might be a problem." 2. "I'll continue to watch my diet and reduce my fats." 3. "Walking a mile each day will help the whole process." 4. "I'll continue my nicotinic acid from the health food store." 4. "I'll continue my nicotinic acid from the health food store." Rationale: Nicotinic acid, including over-the-counter forms, can lead to liver abnormalities. Since cholestyramine and other lipid-lowering medications also carry the risk of liver abnormalities, combining them is inadvisable. Constipation, bloating, diet modification, and physical activity are appropriate measures. ________________________________________ A client is on nicotinic acid (niacin) for hyperlipidemia, and the nurse provides instructions to the client about the medication. Which statement by the client would indicate an understanding of the instructions? 1. "It is not necessary to avoid the use of alcohol." 2. "The medication should be taken with meals to decrease flushing." 3. "Clay-colored stools are a common side effect and should not be of concern." 4. "Ibuprofen (Motrin) taken 30 minutes before the nicotinic acid should decrease the flushing." 4. "Ibuprofen (Motrin) taken 30 minutes before the nicotinic acid should decrease the flushing." Rationale: To mitigate the flushing effect of nicotinic acid, the client can take ibuprofen or aspirin 30 minutes before the medication. Alcohol should be avoided as it can exacerbate flushing. Taking the medication with meals reduces gastrointestinal upset but does not impact flushing. Clay-colored stools indicate possible liver issues and require immediate healthcare provider notification.