HESI PHARMACOLOGY
"Have you felt sad or depressed lately?"
Rationale: St. John's Wort is an herbal supplement that is often used for depression. The nurse
should further explore why the client felt the need for taking this over-the-counter (OTC) herb
and determine if the client is at risk for suicide (B). Gingko, not St. John's Wort, is often used to
improve memory (A). Although all OTC medications should be included in the client's
medication list, (C) is not indicated at this time. The vitamin niacin causes facial flushing (D).
A female client tells the practical nurse (PN) that she started taking an over-the-counter herbal
supplement, St. John's Wort (Hypericum perforatum), last week. Which question should the PN
ask the client?
Serum blood glucose.
Rationale: A side effect of large doses of steroids can cause in elevation in the serum glucose
levels, so the PN should monitor the client's serum glucose (A). (B, C, and D) are not affected
by the administration of corticosteroids.
A client is hospitalized with an asthma exacerbation and is being treated with
methylprednisolone (Solu-Medrol) 125 mg q6 hours. Which laboratory value should the practical
nurse (PN) to monitor?
A client who takes metformin (Glucophage) is scheduled for a test using iodine dye.
Rationale: Glucophage, which is used to treat type 2 diabetes, should be temporarily
discontinued before a client has a diagnostic test that requires the use of iodine-based dye,
which places the client at risk for renal complications (C). (A) is a harmless, common side effect
of Niacin. (B) is a common side effect of albuterol (Ventolin). Ampicillin can alter the normal
bowel flora and cause (D), a common side effect.
Which client situation requires a response from the practical nurse?
"I wonder if I will have to stop taking my diuretic for my kidney problem."
, An elderly female client who is starting a pain management program using opioid analgesia
receives a prescription for codeine 10 mg PO q4 hours PRN for pain, or codeine 15 mg PO q4
hours PRN for pain, or codeine 30 mg PO q4 hours PRN for pain. Which statement by the client
is most important to consider when deciding on the dose to administer at this time?
Clopidogrel (Plavix)
The practical nurse (PN) reinforces preoperative instructions to a client scheduled for abdominal
surgery. Which medication should the PN tell the client to stop taking 7 days prior to the
surgery?
Uses a salt substitute that has potassium
Rationale:
Avapro, angiotensin II receptor blocking (ARB) agent, causes vasodilation to reduce blood
pressure. Since ARBs can raise the concentration of potassium in the blood, the client should
be reinstructed to avoid the use of salt substitutes containing potassium (A). Avapro, an
antihypertensive, is also used to treat diabetic nephropathy, so having type 2 diabetes (B) is not
a contraindication for taking this drug. Dizziness (C) is a common side effect. The drug can be
taken with or without food (D).
A client with hypertension receives a prescription for irbesartan (Avapro). Which finding by the
practical nurse indicates that the client needs additional instruction regarding the medication?
History of dysrhythmias.
Rationale
Thyroid supplement can increase the heart rate and precipitate angina in a client who has a
history of cardiac disease and dysrhythmia (C). (A, B, and D) do not impact the client's use of
thyroid replacement therapy.
Which co-morbidity of a client who is starting thyroid replacement should the practical nurse
report to the healthcare provider?
Hold the administration of the drug dose and notify the charge nurse.
"Have you felt sad or depressed lately?"
Rationale: St. John's Wort is an herbal supplement that is often used for depression. The nurse
should further explore why the client felt the need for taking this over-the-counter (OTC) herb
and determine if the client is at risk for suicide (B). Gingko, not St. John's Wort, is often used to
improve memory (A). Although all OTC medications should be included in the client's
medication list, (C) is not indicated at this time. The vitamin niacin causes facial flushing (D).
A female client tells the practical nurse (PN) that she started taking an over-the-counter herbal
supplement, St. John's Wort (Hypericum perforatum), last week. Which question should the PN
ask the client?
Serum blood glucose.
Rationale: A side effect of large doses of steroids can cause in elevation in the serum glucose
levels, so the PN should monitor the client's serum glucose (A). (B, C, and D) are not affected
by the administration of corticosteroids.
A client is hospitalized with an asthma exacerbation and is being treated with
methylprednisolone (Solu-Medrol) 125 mg q6 hours. Which laboratory value should the practical
nurse (PN) to monitor?
A client who takes metformin (Glucophage) is scheduled for a test using iodine dye.
Rationale: Glucophage, which is used to treat type 2 diabetes, should be temporarily
discontinued before a client has a diagnostic test that requires the use of iodine-based dye,
which places the client at risk for renal complications (C). (A) is a harmless, common side effect
of Niacin. (B) is a common side effect of albuterol (Ventolin). Ampicillin can alter the normal
bowel flora and cause (D), a common side effect.
Which client situation requires a response from the practical nurse?
"I wonder if I will have to stop taking my diuretic for my kidney problem."
, An elderly female client who is starting a pain management program using opioid analgesia
receives a prescription for codeine 10 mg PO q4 hours PRN for pain, or codeine 15 mg PO q4
hours PRN for pain, or codeine 30 mg PO q4 hours PRN for pain. Which statement by the client
is most important to consider when deciding on the dose to administer at this time?
Clopidogrel (Plavix)
The practical nurse (PN) reinforces preoperative instructions to a client scheduled for abdominal
surgery. Which medication should the PN tell the client to stop taking 7 days prior to the
surgery?
Uses a salt substitute that has potassium
Rationale:
Avapro, angiotensin II receptor blocking (ARB) agent, causes vasodilation to reduce blood
pressure. Since ARBs can raise the concentration of potassium in the blood, the client should
be reinstructed to avoid the use of salt substitutes containing potassium (A). Avapro, an
antihypertensive, is also used to treat diabetic nephropathy, so having type 2 diabetes (B) is not
a contraindication for taking this drug. Dizziness (C) is a common side effect. The drug can be
taken with or without food (D).
A client with hypertension receives a prescription for irbesartan (Avapro). Which finding by the
practical nurse indicates that the client needs additional instruction regarding the medication?
History of dysrhythmias.
Rationale
Thyroid supplement can increase the heart rate and precipitate angina in a client who has a
history of cardiac disease and dysrhythmia (C). (A, B, and D) do not impact the client's use of
thyroid replacement therapy.
Which co-morbidity of a client who is starting thyroid replacement should the practical nurse
report to the healthcare provider?
Hold the administration of the drug dose and notify the charge nurse.
