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Exam (elaborations)

HESI PHARMACOLOGY PRACTICE QUESTIONS FOR FINAL

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HESI PHARMACOLOGY PRACTICE QUESTIONS FOR FINAL A client is receiving clonidine (Catapres) 0.1 mg/24hr via transdermal patch. Which assessment finding indicates that the desired effect of the medication has been achieved? A. Client denies recent episodes of angina. B. Change in peripheral edema from +3 to +1. C. Client denies recent nausea or vomiting. D. Blood pressure has changed from 180/120 to 140/70. Correct - ANSWER Catapres acts as a centrally-acting analgesic and antihypertensive agent. (D) indicates a reduction in hypertension. Catapres does not affect (A, B, or C), so these findings do not indicate desired outcomes of Catapres 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? A. This medication is a blood thinner given to prevent blood clot formation. Correct B. This medication enhances antibiotics to prevent infection. C. This medication dissolves any clots that develop in the legs. Incorrect D. This abdominal injection assists in the healing of the abdominal wound. - ANSWER 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 (A) or to treat pulmonary embolism or deep vein thrombosis following knee and abdominal surgeries. Heparin does not dissolve clots but prevents clot extension or further clot formation (C). The anticoagulant heparin does not prevent infection (B) or influence operative wound healing (D). A client with coronary artery disease who is taking digoxin (Lanoxin) receives a new prescription for atorvastatin (Lipitor). Two weeks after initiation of the Lipitor prescription, the nurse assesses the client. Which finding requires the most immediate intervention? A. Heartburn. B. Headache. C. Constipation. D. Vomiting. Correct - ANSWER Vomiting, anorexia and abdominal pain are early indications of digitalis toxicity. Since Lipitor increases the risk for digitalis toxicity, this finding requires the most immediate intervention by the nurse (D). (A, B and C) are expected side effects of Lipitor A client with heart failure is prescribed spironolactone (Aldactone). Which information is most important for the nurse to provide to the client about diet modifications? Do not add salt to foods during preparation. Refrain for eating foods high in potassium. Correct Restrict fluid intake to 1000 ml per day. Increase intake of milk and milk products. - ANSWER Spironolactone (Aldactone), an aldosterone antagonist, is a potassium-sparing diuretic, so a diet high in potassium should be avoided (B), including potassium salt substitutes, which can lead to hyperkalemia. Although (A) is a common diet modification in heart failure, the risk of hyperkalemia is more important with Aldactone. Restriction of fluids (C) or increasing milk and milk products (D) are not indicated with this prescription. A client with a dysrhythmia is to receive procainamide (Pronestyl) in 4 divided doses over the next 24 hours. What dosing schedule is best for the nurse to implement? q6h. Correct QID. AC and bedtime. PC and bedtime. - ANSWER Pronestyl is a class 1A antidysrhythmic. It should be taken around-the-clock (A) so that a stable blood level of the drug can be maintained, thereby decreasing the possibility of hypotension (an adverse effect) occurring because of too much of the drug circulating systemically at any particular time of day. (B, C, and D) do not provide an around-the-clock dosing schedule. Pronestyl may be given with food if GI distress is a problem, but an around-the-clock schedule should still be maintained.

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