PHARMACOLOGY HESI COMPREHENSIVE REVIEW FOR THE NCLEX-PN EXAM EXAM GUARANTEED PASS GUIDE

PHARMACOLOGY HESI COMPREHENSIV E REVIEW FOR THE NCLEX -PN EXAM 2023 -2024 EXAM GUARANTEED PASS GUIDE A client who received a prescription for cyclosporine ophthalmic emulsion for dry eyes asks the practical nurse (PN) if it is safe to continue using artificial tears. What information should the PN provide? a. Avoid t he use of artificial tears because they decrease the efficacy of cyclosporine. b. Discontinue the use of both products if transient blurring occurs after administration. c. Allow a 15 -minute interval between the administration of cyclosporine and artificia l tears. d. Discontinue the use of cyclosporine and artificial tears when tear production reaches a normal level. c. Allow a 15 -minute interval between the administration of cyclosporine and artificial tears. Rationale: Cyclosporine, an ophthalmic emulsion which increases tear production, may be used in conjunction with artificial tears as long as the products are administered 15 minutes apart. Transient blurring after administration is a side effect of cyclosporine and does not necessitate discontinuation of the medication. After tear production is increased, artificial tears may be stopped, but discontinuing cyclosporine will result in a decrease in tear production. A first -day postoperative client vomits 30 minutes after receiving a dose of hydromorphone. What initial intervention is best for the practical nurse (PN) to implement? a. Obtain a prescription for nasogastric intubation. b. Administer a prn dose of ondansetron. c. Reduce the next scheduled dose of hydromorphone. d. Assess the client's abdomen a nd bowel sounds. b. Administer a prn dose of ondansetron. Rationale: Because the emesis appears to be directly related to the administration of the opiate analgesic, the first action should be to reduce the client's nausea with the administration of the on dansetron, which is an antiemetic. A client has been prescribed losartan. Which change in data indicates to the practical nurse (PN) that the desired effect of this medication has been achieved? a. Dependent edema reduced from +3 to +1. b. Serum HDL increa sed from 35 to 55 mg/dL. c. Pulse rate reduced from 150 to 90 beats/min. d. Blood pressure reduced from 160/90 to 130/80 mm Hg. d. Blood pressure reduced from 160/90 to 130/80 mm Hg. Rationale: Losartan is prescribed for the treatment of hypertension. The desired effect is a decrease in blood pressure. A child is admitted to the emergency department for accidental ingestion of a poison. The practical nurse (PN) should know that inducing vomiting is recommended for which child? a. An 8 month old who ate four to six ibuprofen tablets b. A 3 year old who drank an unknown amount of charcoal lighter fluid c. A 16 month old who drank 2 ounces of acetaminophen elixir d. A 2 year old who ate a handful of automatic dishwasher detergent c. A 16 month old who drank 2 ounces of acetaminophen elixir Rationale: Emesis should be induced for the child who drank the large dose of acetaminophen elixir because this medication is hepatotoxic. Vomiting is contraindicat ed for children younger than 1 year of age. Inducing vomiting of corrosives such as dishwasher detergents and lighter fluid is contraindicated. A practical nurse (PN) is reviewing teaching with the client and/or significant others about the concurrent use of benztropine and olanzapine to manage psychotic behavior. What information should the PN reinforce? a. Benztropine will reduce the olanzapine' s side effect of urinary retention. b. Benztropine potentiates the effect of olanzapine. c. The benztropine is used to control the side effects of olanzapine. d. The combined effect of these drugs will modify psychotic behavior. c. The benztropine is used to control the side effects of olanzapine. Rationale: Benztropine, an anticholinergic drug, is used to control extrapyramidal symptoms associated with olanzapine use. Caution is required in the dosage of benztropine used in conjunction with olanzapine. A client diagnosed with a herniated disc is prescribed hydrocodone/acetaminophen 10 mg/300 mg prn every 4 to 6 hours. As the practical nurse (PN) enters the client's room to administer their requested medication, the client is seen talking and laughing with h is visiting family. Which action should the PN implement? a. Hold the pain medication until after the visitors leave. b. Notify the health care provider of the client's drug -seeking behavior. c. Administer analgesia as requested by the client. d. Inform th e client based on their display behavior, the medication is not needed. c. Administer analgesia as requested by the client. Rationale: The medication should be administered as per client's request. The client's self -report of pain is the single most reliab le indication of the existence, character, and intensity of pain. Analgesics should be administered as soon as pain occurs and before it increases in intensity. The PN should consult with the charge nurse after administering the medication about the situat ion. The nurse is assisting with evaluating the effectiveness of the drug amiodarone. Which client statement best indicates the drug has been effective? a. "I have not had as many spells of angina." b. "I have not had as much swelling in my ankles lately." c. "My doctor told me my cholesterol levels were getting better every visit." d. "I do not notice as many irregular heartbeats as before I started taking this medication." d. "I do not notice as many irregular heartbeats as before I started taking this me dication." Rationale: Amiodarone is the first choice drugs to treat ventricular dysrhythmias. It will not reduce angina spells, reduce ankle swelling, or improve cholesterol levels. A client who is prescribed sildenafil for pulmonary hypertension calls the clinic for advice. Which condition should the practical nurse notify the health care provider immediately and instruct the client to stop taking the medication? a. The client is experiencing vision and hearing loss. b. The client has an erection lasting l onger than 2 hours. c. The client is complaining about nasal congestion. d. The client is complaining about feeling flushed. a. The client is experiencing vision and hearing loss. Rationale: The client should be instructed to discontinue the use of the med ication and notify the health care provider immediately if the client is experiencing vision and/or hearing loss or an erection lasting more than 4 hours. A client is receiving heparin to treat a deep vein thrombosis. The nurse should monitor which laboratory result to assist in evaluating the efficacy of the drug? a. Platelet count b. Prothrombin time c. Partial thromboplastin time d. Serum levels of protam ine sulfate c. Partial thromboplastin time Rationale: The nurse should monitor the partial thromboplastin time to evaluate the efficacy of heparin. The platelet count does not monitor heparin efficacy. A client who is taking warfarin should have the prothr ombin time monitored. Protamine sulfate levels do not monitor efficacy of heparin. A client who is being discharged to home asks the practical nurse (PN) for a dose of hydrocodone before leaving the hospital. How should the PN respond to this client's requ est? a. Determine if a take -home prescription for hydrocodone was provided and, if so, tell him to take one of them.