PRACTICE HESI ONE BSN 315 EXAM QUESTIONS AND
ANSWERS WITH COMPLETE SOLUTIONS VERIFIED
A client with pneumonia receives a prescription for tetracycline. Which
precaution should the nurse include in this client's teaching?
Avoid dairy product for 2 hours after taking the medication.
Rationale
Dairy products should not be ingested until at least 2 hours after taking tetracycline
because the calcium from the dairy binds with tetracycline and decreases the
medication's absorption.
A client is diagnosed with peptic ulcer disease and receives a prescription for
esomeprazole 20 mg capsule daily. When providing this client with discharge
teaching, the nurse should include which instruction?
Take the same time each day one hour before a meal. Rationale
Esomeprazole, a proton pump inhibitor (PPI), is a first-line agent for symptomatic GERD
that poorly responds to other acid-reducing drugs, such as H2 antagonists. Nexium is
most effective when taken 30 to 60 minutes before a meal.
A female client receives a prescription for cefadroxil for a urinary tract infection.
The client informs the nurse that she is currently taking oral contraceptives
(OCP). Which information is important for the nurse to share with the client?
Use an additional form of birth control until your menstral cycle. Rationale
Cephalosporins such as cefadroxil can potentially decrease the efficacy of oral
,contraceptives, so the client should be instructed to use an additional form of
contraception. Further study is needed to determine if a correlation exists.
While reviewing the client's electronic medical record (EMR), the nurse assesses
a client who is at risk for a possible interaction with an over-the-counter (OTC)
decongestant. Which client health history should the nurse report to the
healthcare provider concerning the OTC medication? (Select all that apply).
Closed angle glaucoma and chronic hypertension Rationale
OTC decongestants can increase intraocular pressure and should be avoided in clients
with closed-angle glaucoma. Decongestants can also increase the heart rate and
elevate blood pressure which can impact the client's management of chronic
hypertension.
A client who was recently diagnosed with myasthenia gravis receives a
prescription for pyridostigmine, a cholinergic agent. Which information should
the nurse instruct the client to implement when taking this medication?
Report muscle weakness and bradycardia. Rationale
The nurse should instruct the client to report muscle weakness or bradycardia which
can indicate a cholinergic crisis, or underdosing. The doses should also be spaced
evenly apart to optimize the effects of the medication.
A client who has Trichomonas vaginalis receives a prescription for
metronidazole. Which instruction should the nurse provide during client
education?
Avoid over the counter antitussives. Rationale
Metronidazole can produce a disulfiram-like reaction when combined with products
,containing alcohol, such as over-the-counter cough remedies, so the client should be
informed to avoid ingesting any alcohol product during the use of metronidazole.
Which side effects should the nurse monitor for a client who is receiving
dexamethasone following neurosurgery? (Select all that apply.)
Mood swings, increase weight gain, delayed incision wound healing, and hemoglobin
level of 9mg/dl. Rationale
Dexamethasone is a long-acting glucocorticoid prescribed for neurosurgical procedures
because it suppresses inflammation and has a low sodium-retaining ability, which is
important in averting cerebral edema. However, the medication does produce the
following side effects such as: mood swings, an increase in appetite, resulting in weight
gain, hyperglycemia (serum glucose level above 120 mg/dl) which is related to the
gluconeogenesis properties of corticosteroids, delayed in wound healing related to
immune suppression properties, and complete blood count resulting in a decreased in
WBC and hemoglobin (less than 12mg/dl). When a client is receiving dexamethasone,
they should be monitored for these side effects.
A client is taking cyclosporine for renal allograft rejection prevention. After 9
months of drug therapy, the nurse reviews laboratory data and notes that the
blood urea nitrogen level is 36 mg/dl. What additional finding should the nurse
identify?
Creatinine level of 2.8 mg/dl. Rationale
Acute organ rejection usually occurs in the first 3 months after transplantation or at any
time if an infection develops. Cyclosporine is a cytokine inhibitor used to prevent and
treat organ rejection, which is manifested by elevated blood urea nitrogen(normal
, ranges are 10 to 20 mg/dl or 3.6-7.1 mmol/L) and creatinine (normal ranges are 0.6 to
1.2 mg/dl or 53-106 μmol/L).
What pathophysiological action supports the expected outcome for a client with
chronic cancer pain who is treated with imipramine, a tricyclic antidepressant?
Decrease transmission of pain impulses by alternating serotonin and norepinephrine
activity at nerve synapses. Rationale
Tricyclic antidepressants reduce neuropathic pain due to cancer invasion by blocking
the reuptake of serotonin and norepinephrine in the CNS, thereby inhibiting pain
transmission in the spinal cord dorsal horn, which is part of the descending pain-
modulating system.
A client with depression receives a prescription for amitriptyline. Which
instruction should the nurse include in the client's teaching?
Avoid consumption of alcohol. Rationale
Tricyclic antidepressants (TCAs) such as amitriptyline can cause sedation and should
not be mixed with agents that depress the central nervous system, so the client should
be instructed to avoid alcohol. The consumption of alcohol and TCAs interaction could
worsen the client's depression, increase drunkenness, and potentially cause death.
A client is taking sulfisoxazole for a urinary tract infection (UTI) and complains of
nausea and gastric upset since starting the medication. Which additional adverse
reaction should the nurse instruct the client to report?
Rash.
Diarrhea.
ANSWERS WITH COMPLETE SOLUTIONS VERIFIED
A client with pneumonia receives a prescription for tetracycline. Which
precaution should the nurse include in this client's teaching?
Avoid dairy product for 2 hours after taking the medication.
Rationale
Dairy products should not be ingested until at least 2 hours after taking tetracycline
because the calcium from the dairy binds with tetracycline and decreases the
medication's absorption.
A client is diagnosed with peptic ulcer disease and receives a prescription for
esomeprazole 20 mg capsule daily. When providing this client with discharge
teaching, the nurse should include which instruction?
Take the same time each day one hour before a meal. Rationale
Esomeprazole, a proton pump inhibitor (PPI), is a first-line agent for symptomatic GERD
that poorly responds to other acid-reducing drugs, such as H2 antagonists. Nexium is
most effective when taken 30 to 60 minutes before a meal.
A female client receives a prescription for cefadroxil for a urinary tract infection.
The client informs the nurse that she is currently taking oral contraceptives
(OCP). Which information is important for the nurse to share with the client?
Use an additional form of birth control until your menstral cycle. Rationale
Cephalosporins such as cefadroxil can potentially decrease the efficacy of oral
,contraceptives, so the client should be instructed to use an additional form of
contraception. Further study is needed to determine if a correlation exists.
While reviewing the client's electronic medical record (EMR), the nurse assesses
a client who is at risk for a possible interaction with an over-the-counter (OTC)
decongestant. Which client health history should the nurse report to the
healthcare provider concerning the OTC medication? (Select all that apply).
Closed angle glaucoma and chronic hypertension Rationale
OTC decongestants can increase intraocular pressure and should be avoided in clients
with closed-angle glaucoma. Decongestants can also increase the heart rate and
elevate blood pressure which can impact the client's management of chronic
hypertension.
A client who was recently diagnosed with myasthenia gravis receives a
prescription for pyridostigmine, a cholinergic agent. Which information should
the nurse instruct the client to implement when taking this medication?
Report muscle weakness and bradycardia. Rationale
The nurse should instruct the client to report muscle weakness or bradycardia which
can indicate a cholinergic crisis, or underdosing. The doses should also be spaced
evenly apart to optimize the effects of the medication.
A client who has Trichomonas vaginalis receives a prescription for
metronidazole. Which instruction should the nurse provide during client
education?
Avoid over the counter antitussives. Rationale
Metronidazole can produce a disulfiram-like reaction when combined with products
,containing alcohol, such as over-the-counter cough remedies, so the client should be
informed to avoid ingesting any alcohol product during the use of metronidazole.
Which side effects should the nurse monitor for a client who is receiving
dexamethasone following neurosurgery? (Select all that apply.)
Mood swings, increase weight gain, delayed incision wound healing, and hemoglobin
level of 9mg/dl. Rationale
Dexamethasone is a long-acting glucocorticoid prescribed for neurosurgical procedures
because it suppresses inflammation and has a low sodium-retaining ability, which is
important in averting cerebral edema. However, the medication does produce the
following side effects such as: mood swings, an increase in appetite, resulting in weight
gain, hyperglycemia (serum glucose level above 120 mg/dl) which is related to the
gluconeogenesis properties of corticosteroids, delayed in wound healing related to
immune suppression properties, and complete blood count resulting in a decreased in
WBC and hemoglobin (less than 12mg/dl). When a client is receiving dexamethasone,
they should be monitored for these side effects.
A client is taking cyclosporine for renal allograft rejection prevention. After 9
months of drug therapy, the nurse reviews laboratory data and notes that the
blood urea nitrogen level is 36 mg/dl. What additional finding should the nurse
identify?
Creatinine level of 2.8 mg/dl. Rationale
Acute organ rejection usually occurs in the first 3 months after transplantation or at any
time if an infection develops. Cyclosporine is a cytokine inhibitor used to prevent and
treat organ rejection, which is manifested by elevated blood urea nitrogen(normal
, ranges are 10 to 20 mg/dl or 3.6-7.1 mmol/L) and creatinine (normal ranges are 0.6 to
1.2 mg/dl or 53-106 μmol/L).
What pathophysiological action supports the expected outcome for a client with
chronic cancer pain who is treated with imipramine, a tricyclic antidepressant?
Decrease transmission of pain impulses by alternating serotonin and norepinephrine
activity at nerve synapses. Rationale
Tricyclic antidepressants reduce neuropathic pain due to cancer invasion by blocking
the reuptake of serotonin and norepinephrine in the CNS, thereby inhibiting pain
transmission in the spinal cord dorsal horn, which is part of the descending pain-
modulating system.
A client with depression receives a prescription for amitriptyline. Which
instruction should the nurse include in the client's teaching?
Avoid consumption of alcohol. Rationale
Tricyclic antidepressants (TCAs) such as amitriptyline can cause sedation and should
not be mixed with agents that depress the central nervous system, so the client should
be instructed to avoid alcohol. The consumption of alcohol and TCAs interaction could
worsen the client's depression, increase drunkenness, and potentially cause death.
A client is taking sulfisoxazole for a urinary tract infection (UTI) and complains of
nausea and gastric upset since starting the medication. Which additional adverse
reaction should the nurse instruct the client to report?
Rash.
Diarrhea.
