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HESI PRACTICE EXAM-PHARM 315 Questions and answers latest update 2024
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HESI PRACTICE EXAM-PHARM 315 Questions and answers latest update 2024
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HESI PRACTICE EXAM -PHARM 315 Which client should the nurse identify as being at highest risk for complications during the use of an opioid analgesic? - correct answer A young adult with inflammatory bowel disease. Rationale: The principal indication for opioid use is acute pain, and a client with inflammatory bowel disease is at risk for toxic megacolon or paralytic ileus related to slowed peristalsis, a side effect of morphine. Adverse effects of morphine do not pose as great a risk for clients with diabetes or a fracture as for the client with bowel disease. The healthcare provider prescribes digitalis (Digoxin) for a client diagnosed with heart failure. Which intervention should the nurse implement prior to administering the digoxin? - correct answer Assess the serum potassium level. Rationale: Hypokalemia (decreased serum potassium) will precipitate digitalis toxicity in persons receiving digoxin. The nurse should monitor the client's serum potassium levels. Blood pressure and respiratory rate will not inform the nurse about potential safety iss ues with digitalis. A client with hyperlipidemia receives a prescription for niacin (Niaspan). Which client teaching is most important for the nurse to provide? - correct answer Expected duration of flushing. Rationale: Flushing of the face and neck, lasting up to an hour, is a frequent reason for discontinuing niacin. Inclusion of this effect in client teaching may promote compliance in taking the medication. While nutrition tips and managing pruritis are worthwhile inst ructions to help clients minimize or cope with normal side effects associated with niacin (Niaspan), flushing is intense and causes the most concern for the client. A client who was prescribed atorvastatin (Lipitor) one month ago calls the triage nurse at the clinic complaining of muscle pain and weakness in his legs. Which statement reflects the correct drug -specific teaching the nurse should provide to this client? - correct answer Make an appointment to see the healthcare provider, because muscle pain may be an indication of a serious side effect. Rationale: Myopathy, suggested by the leg pain and weakness, is a serious, and potentially life -threatening, complication of Lipitor, and should be evaluated immediately by the healthcare provider. An antacid (Maalox) is prescribed for a client with peptic ulcer disease. The nurse knows that the purpose of this medication is to - correct answer maintain a gastric pH of 3.5 or above. Rationale: The objective of antacids is to neutralize gastric acids and keep pH of 3.5 or above which is necessary for pepsinogen inactivity. Which dosing schedule should the nurse teach the client to observe for a controlled -release oxycodone prescription? - correct answer Every 12 hours. Rationale: A controlled -release oxycodone provides long -acting analgesia to relieve moderate to severe pain, so a dosing schedule of every 12 hours provides the best around -the-clock pain management. Controlled -release oxycodone is not prescribed for breakthrough pai n on a PRN or as needed schedule. Using a schedule of every 4 to 6 hours may jeopardize patient safety due to cumulative effects. A client with osteoarthritis receives a new prescription for celecoxib (Celebrex) orally for symptom management. The nurse notes the client is allergic to sulfa. Which action is most important for the nurse to implement prior to administering the first dos e? - correct answer Notify the healthcare provider. Rationale: Celebrex contains a sulfur molecule, which can lead to an allergic reaction in individuals who are sensitive to sulfonamides, so the healthcare provider should be notified of the client's allergies. The nurse is assessing a client who is experiencing anaphylaxis from an insect sting. Which prescription should the nurse prepare to administer this client? - correct answer Epinephrine. Rationale: Epinephrine is an adrenergic agent that stimulates beta receptors to increase cardiac automaticity in cardiac arrest and relax bronchospasms in anaphylaxis. On the ither hand, dopamine is a vasopressor used to treat clients with shock. Ephedrine causes per ipheral vasoconstriction and is used in the treatment of nasal congestion. Diphenhydramine is an antihistamine decongestant used in the treatment of mild allergic reactions and motion sickness. Epinephrine is the medication of choice in treating anaphylaxi s. A client is being treated for osteoporosis with alendronate (Fosamax), and the nurse has completed discharge teaching regarding medication administration. Which morning schedule would indicate to the nurse that the client teaching has been effective? - correct answer Take medication, go for a 30 minute morning walk, then eat breakfast. Rationale: Alendronate (Fosamax) is best absorbed when taken thirty minutes before eating in the morning. The client should also be advised to remain in an upright position for at least thirty minutes after taking the medication to reduce the risk of esophageal reflu x and irritation. After abdominal surgery, a male client is prescribed low molecular weight heparin (LMWH). During administration of the medication, the client asks the nurse why he is receiving this medication. Which is the best response for the nurse to provide? - correct answer This medication is a blood thinner given to prevent blood clot formation. Rationale: Unfractionated heparin or low molecular weight heparin (LMWH) is an anticoagulant that inhibits thrombin -mediated conversion of fibrinogen to fibrin and is given prophylactically to prevent postoperative venous thrombosis in order to prevent pulmonary embo lism or deep vein thrombosis following knee and abdominal surgeries. Which symptoms are serious adverse effects of beta -adrenergic blockers such as propranolol (Inderal)? - correct answer Wheezing, hypotension, and AV block. Rationale: Wheezing, hypotension, and AV block represents the most serious adverse effects of beta -blocking agents. AV block is generally associated with bradycardia and results in potentially life -threatening decreases in cardiac output. Additionally, wheezing secon dary to bronchospasm and hypotension represent life -threatening respiratory and cardiac disorders.
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