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EVOLVE PHARMACOLOGY HESI PRACTICE
QUESTIONS WITH 100% ACCURATE ANSWERS
A client who has been taking phenazopyridine (Pyridium) for symptoms of urethritis and cystitis comes to the clinic because her urine is reddish-orange. Which question should the practical nurse ask to determine if the medication has been effective? A) How much water have you been drinking each day? B) Does the urine color stain your toilet bowl or undergarments? C) Have you had any relief from urinary pain, burning, or urgency? D) Did your urine appear cloudy or have a foul odor on voiding? - Accurate answers C) Have you had any relief from urinary pain, burning, or urgency? Feedback: Phenazopyridine, an over-the-counter urinary analgesic, acts on the mucosa of the urinary tract to relieve urinary pain, burning, itching, or urgency (C) associated with urethritis and cystitis. Although determining if the client is forcing fluids (A), experiencing staining from Pyridium's side effect (B), or having signs of a urinary infection (D) are worthwhile assessments, the therapeutic response of Pyridium is related to urinary discomforts only. A male client who has been receiving an antineoplastic drug has developed thrombocytopenia. What instructions should the practical nurse (PN) reinforce? A) Use suppository form of drugs. B) Avoid large public gatherings. C) Rise slowly when standing up. D) Shave with an electric razor. - Accurate answers D) Shave with an electric razor. Feedback: Thrombocytopenia is a common side effect of bone marrow depression caused by several antineoplastic agents. The client is experiencing a low platelet count and should use an electric razor (D) to reduce his risk of bleeding. (A, B, and C) are not indicated for a client who needs to implement thrombocytopenia precautions. The practical nurse (PN) is caring for a client who has been taking prednisone (Deltasone) daily for a year. Which adverse effect should the PN document in the client's record? A) Photosensitvity. B) Weight gain. C) Loss of hair. D) Pale skin color. - Accurate answers B) Weight gain. Feedback: Long term use of prednisone causes fluid retention and redistribution of fat deposition. Weight gain (B) and moon face reflect adverse effects of long-term prednisone use and should be documented. (A, C, and D) do not occur with treatment using prednisone. A female client with recurring headaches tells the practical nurse (PN) that she has been taking at least 4 grams of acetaminophen a day. Which laboratory studies should the PN review for this client? A) Creatinine clearance. B) Hepatic enzymes.
C) Coagulation values. D) Arterial blood gases. - Accurate answers B) Hepatic enzymes. Feedback: Liver toxicity can occur when doses of acetaminophen exceed 4 grams a day, resulting in an elevation in hepatic enzyme values (B). (A, C, and D) do not reveal findings related to acetaminophen toxicity. A client receives a prescription for an oral opioid analgesic for post-operative pain. Which adverse effect should the practical nurse (PN) monitor for with the client? A) Constipation. B) Photosensitivity. C) Decreased heart rate. D) Frequent urination. - Accurate answers A) Constipation. Feedback: Opioid analgesics slow peristalsis, which leads to constipation (A), a common side effect of opiates. (B, C, and D) are not associated with opioid analgesics. Which action should the practical nurse implement when administering a buccal medication? A) Encourage the client to swallow. B) Administer water with medication. C) Ensure the medication is positioned under the tongue. D) Place the medication between the upper molar teeth and cheek. - Accurate answers D) Place the medication between the upper molar teeth and cheek. Feedback: Buccal medications are placed between the upper molar teeth and the cheek (D) for absorption by the capillaries of the oral mucosa. The client should be cautioned against swallowing, not (A). Buccal medications are not administered with water (B). (C) describes sublingual administration. What assessment is most important for the practical nurse (PN) to obtain prior to initiating medication therapy with phenelzine (Nardil) for a client with depression? A) Activity level. B) Mood and affect. C) Understanding of diet modification. D) The client's support system. - Accurate answers C) Understanding of diet modification. Feedback: To prevent a potentially lethal hypertensive crisis, a tyramine-free diet should be maintained during antidepressant therapy with Nardil, a monoamine oxidase inhibitor (MAOI). It is most important to determine if the client understands diet modification (C) before Nardil is initiated to prevent consumption of foods that interact with Nardil. Although a client's activity level (A) and mood and affect (B) should be monitored during antidepressant therapy, it is most important that the client understand diet modifications. The client's support system (D) and network of family and friends is important, but the client should understand the responsibility of dietary compliance with the medication regimen. The practical nurse (PN) is unable to arouse a client who is receiving meperidine (Demerol) for postoperative pain. The client is stuporous, has constricted pupils, and a respiratory rate of 8 breaths/minute. Which PRN prescription should the PN give the client? A) Naloxone (Narcan). B) Promethazine (Phenergan). C) Metoclopramide (Reglan).
Hydrochlorothiazide (HydroDIURIL), a thiazide diuretic, reduces blood pressure by reducing blood volume and reducing arterial resistance. Adverse effects of thiazides include hypokalemia, fatigue (B), dehydration (E), hyperglycemia, and hyperuricemia. Although (A, C, D and F) may be associated with aging or other pathology, they are not side effects commonly associated with HydroDIURIL. A client who returns from surgery for bowel resection complains of severe pain around the incision. Which assessment is most important for the practical nurse (PN) to obtain prior to the administration of morphine sulfate? A) Rate of respirations. B) Core temperature. C) Appearance of the incision. D) Presence of bowel sounds. - Accurate answers A) Rate of respirations. Feedback: Opioids cause respiratory depression, so the respiratory rate (A) should be assessed prior to administration of morphine sulfate. (B, C, and D) do not address the concept of medication safety. A client is receiving the third course of 5-fluorouracil (5FU) therapy for a tumor of the liver. Which action should the practical nurse implement to reduce the client's risk for stomatitis? A) Use commercial oral products to reduce the risk of oral infections. B) Observe for black, tarry stools or bleeding ulcerations. C) Increase intake of foods containing fiber and citric acid. D) Examine mouth daily for bleeding, white spots, and ulcerations. - Accurate answers D) Examine mouth daily for bleeding, white spots, and ulcerations. Feedback: 5-fluorouracil (5FU) is an antimetabolite, antineoplastic agent that causes sloughing of the rapid proliferating epithelial cells of the oral mucosa causing ulceration, bleeding, and oral candidiasis (thrush). Daily examination of the oral mucosa (D) should be implemented to identify signs of stomatitis, such as white spots, ulcerations, and bleeding of the mouth, so early intervention can be implemented. Oral commercial products usually contain alcohol, which contributes to inflammation of the oral mucosa, and should be avoided (A). Although monitoring the stool for bleeding (B) should be implemented, stomatitis occurs in 75% of clients who receive 5FU. Foods high in fiber and citric acid should also be avoided (C) to reduce pain and trauma to the mouth. Which instruction should the practical nurse (PN) reinforce with a client who is taking disulfiram (Antabuse)? A) Cigarette smoking cessation program should be started. B) Avoid using any over-the-counter substances containing alcohol. C) This drug is similar to alcohol but without euphoric effects. D) Small amounts of mouthwash or cough medicine can be used. - Accurate answers B) Avoid using any over-the-counter substances containing alcohol. Feedback: The use of disulfiram (Antabuse) with over-the-counter (OTC) products that contain alcohol causes severe adverse reactions, such as severe nausea, vomiting, chest pain, hyperventilation, tachycardia, seizures, and cardiovascular collapse, and should be avoided (B). Although a smoking cessation program is always a good health recommendation (A), it is not a priority with Antabuse. (C) is inaccurate. Small amounts, as little as 7 ml, of mouthwash or cough syrup that contains alcohol can precipitate a disulfiram reaction and should not be used (D).
Which prescription should the practical nurse administer for a client who is experiencing an acute episode of bronchial asthma? A) Nedocromil (Tilade). B) Albuterol (Proventil). C) Zafirlukast (Accolate). D) Triamcinolone (Azmacort). - Accurate answers B) Albuterol (Proventil). Feedback: Albuterol (Proventil) (B), an adrenergic agonist, is the first line of treatment for acute episodes of bronchial asthma. (A, C, and D) are maintenance medications used in the prevention of asthmatic episodes and are routinely taken every day, not during an acute episode. The practical nurse (PN) should recommend that oral contraceptives be avoided in which group of women? A) Women who smoke. B) Multigravidous women. C) Monogamous women. D) Women with an intrauterine device. - Accurate answers A) Women who smoke. Feedback: Oral contraceptives pose an increased risk of thromboembolism for women who smoke (A), and this risk is not increased in (B, C, and D). A client with gastroesophageal reflux disease (GERD) is having symptoms of reflux despite taking omeprazole (Prilosec) 20 mg daily. What action should the practical nurse (PN) implement? A) Notify the healthcare provider about the symptoms. B) Obtain vital signs every 30 minutes until symptoms are alleviated. C) Instruct the client to stop taking the medication. D) Tell the client to take an antacid in addition to the omeprazole. - Accurate answers A) Notify the healthcare provider about the symptoms. Feedback: Omeprazole, a proton pump inhibitor, acts to reduce gastric acid secretion. If once daily dosing fails to control the client's symptoms, the healthcare provider should be notified (A) for dose adjustment. (B) will not help to reduce the client's symptoms. Unless the client shows symptoms of a hypersensitivity to the medication, the client should not stop the medication (C). (D) should not suggested without a prescription from the healthcare provider. The practical nurse (PN) administers isoproterenol (Isuprel) to a client with heart block. The PN should evaluate the client for which physiological response? A) Thirst and dry mucous membranes. B) Decrease in gastric motility. C) Increased heart rate. D) Bronchoconstriction. - Accurate answers C) Increased heart rate. Feedback: Isoproterenol (Isuprel) acts on beta 1 receptors in the heart, causing an increased cardiac reactivity in AV heart block and an increase in the client's heart rate (C). (A and B) are anticholinergic responses and are not typical with adrenergic agents, such as isoproterenol. By activating beta 2 receptors found in the smooth muscle of bronchioles, isoproterenol causes bronchodilation, not (D).
administering the injection of penicillin, the PN tells the client to stay for 30 minutes of observation. Which finding should the PN identify that is indicative of a reaction to the medication? A) Rash, itching, and hives. B) Fever and abdominal pain. C) Drop in temperature and blood pressure. D) A vasovagal response with bradycardia. - Accurate answers A) Rash, itching, and hives. Feedback: A client who is unsure about the response to a new antibiotic, especially penicillin, should be assessed for allergy to the drug after receiving a parenteral dose. The symptoms that indicate an allergic reaction include rash, itching, hives (A) and anaphylactic reactions causing laryngeal edema with difficulty breathing. (B, C, and D) are not typical of allergic responses to penicillin. A client receives a prescription for clotrimazole 1% (Gyne-Lotrimin) vaginal cream for Candidiasis. Which information should the practical nurse provide the client? A) Discontinue medication if menstruation begins. B) Instill cream using the intravaginal applicator each night for 7 days. C) Use daily douching as part of the treatment for vaginal yeast infections. D) Abstain from sexual intercourse until treatment is completed. - Accurate answers B) Instill cream using the intravaginal applicator each night for 7 days. Feedback: The intravaginal cream should be instilled each night for 7 days to complete the medication (B) even if symptoms are relieved. Medication should be continued until it is completed, even during menstruation (A). Douching (C) is contraindicated. Abstinence (D) is not required. A client receives a new prescription for beclomethasone (Beclovent Oral Inhaler). What information should the practical nurse (PN) reinforce with the client about the use of this medication? A) Use for rapid results in acute asthmatic attacks. B) Most effective in preventing upper respiratory infections. C) Daily use provides prophylaxis in asthma management. D) Inhale when exposed to allergens in the environment. - Accurate answers C) Daily use provides prophylaxis in asthma management. Feedback: Beclovent Oral Inhaler, an inhaled glucocorticoid, is used for prophylaxis in the management of chronic asthma (C) and should be administered on a fixed schedule, not (D). Inhaled beta 2 agonists, not a glucocorticoid, work rapidly in acute asthma attacks (A) precipitated by environmental allergen exposure (D). A client with tuberculosis (TB) asks the practical nurse (PN) the value of prescribed multidrug therapy. What explanation should the PN provide? A) Required to eradicate TB. B) Enhances the effect of each drug. C) Provides a faster effect than single drug therapy. D) Reduces development of TB resistant drugs. - Accurate answers D) Reduces development of TB resistant drugs. Feedback: The use of multiple medications reduces the possibility of the tubercle bacilli becoming drug resistant (D). (A, B, and C) are incorrect.
The healthcare provider prescribes an antibiotic for a male adolescent with an upper respiratory tract infection who asks the practical nurse (PN) how long the prescribed antibiotics should be taken. What information should the PN provide? A) Continue the medication until all of the prescription is taken. B) Use the medication for 24 hours after the cough subsides. C) Stop the medication when the temperature returns to normal. D) Take any remaining capsules if the infection occurs again. - Accurate answers A) Continue the medication until all of the prescription is taken. Feedback: Although the client may feel better after 24 hours of antibiotics, the prescription (A) should be taken until all of it is used. If the antibiotic is discontinued because symptoms have disappeared (B and C), pathogens have an opportunity to increase in virulence or become resistant to the drug. Antibiotics should not be saved (D) for other infections, but new symptoms should be evaluated by the healthcare provider. A male client tells the practical nurse (PN) that he takes acetylsalicylic acid (aspirin) 325 mg daily. Which finding should alert the PN that the client may be experiencing a side effect of salicylate therapy? A) Skin tears. B) Hypothermia. C) Hepatotoxicity. D) Gastrointestinal distress. - Accurate answers D) Gastrointestinal distress. Feedback: Salicylates, such as aspirin, commonly irritate the gastric mucosa, causing gastrointestinal distress (D). (A, B, and C) are inaccurate. The healthcare provider prescribes celecoxib (Celebrex), a nonsteroidal antiinflammatory drug (NSAID), for a client with osteoarthritis. Which finding in the client's history should the practical nurse (PN) report? A) Gout. B) Hypertension. C) Diabetes mellitus. D) Peptic-ulcer disease. - Accurate answers D) Peptic-ulcer disease. Feedback: Celecoxib (Celebrex), an NSAID, causes gastrointestinal irritation and bleeding. Peptic-ulcer disease is a contraindication to therapy with NSAIDs (D). (A, B, and C) are inaccurate. What laboratory results should the practical nurse monitor to evaluate the therapeutic effects of heparin? A) Platelet count. B) Hematocrit. C) Prothrombin time (PT). D) Activated partial thromboplastin time (APTT). - Accurate answers D) Activated partial thromboplastin time (APTT). Feedback: Ongoing APTT (D) values measure the prolongation times of thromboplastin in the clotting cascade, which is monitored during heparin therapy. (A, B, and C) do not indicate the therapeutic action of heparin.
D) Gastric bleeding. Feedback: CORRECT - Accurate answers D) Gastric bleeding. Feedback: Prednisone, a glucocorticoid, decreases the viscosity of gastric mucus, which normally protects the lining of the stomach from irritants, which increases the risk of gastric erosion by hydrochloric acid, resulting in gastric bleeding (D). Other adverse effects include sodium and fluid retention, hyperglycemia, and skin fragility, not (A, B, and C). A male client who is hypertensive is starting a new prescription for clonidine (Catapress) 0.4 mg PO daily. In reviewing common side effects, what information should the practical nurse (PN) provide the client? A) Report problems with sexual function. B) Monitor respirations on a daily basis. C) Increased libido may be experienced. D) Weight gain may indicate fluid retention. - Accurate answers A) Report problems with sexual function. Feedback: Sexual dysfunction (A), such as impotence and decreased libido, is a common complication of antihypertensive medications in male clients. Respiratory changes (B), increased libido (C), and increased weight (D) do not commonly occur with this antihypertensive. A client who is receiving an antibiotic suddenly develops hives. The practical nurse should report that the client is most likely experiencing which type of drug response? A) Adverse response. B) Hypersensitivity reaction. C) Idiosyncratic reaction. D) Multiple drug interaction. - Accurate answers B) Hypersensitivity reaction. Feedback: Hives, a symptom of a hypersensitivity reaction (B), involve an abnormal immune response and are not uncommon with the use of antibiotics. Although (A, C, and D) are unexpected pharmacologic reactions, hives represent a life-threatening allergic response and should be reported to ensure prompt intervention. The healthcare provider prescribes cycloplegic and mydriatic ophthalmic drops for a client who is having a cataract removal. What explanation about the drug actions should the practical nurse (PN) provide the client? A) Reduces intraocular pressure. B) Relieves eye pain. C) Treats conjunctivitis. D) Dilates the pupil. - Accurate answers D) Dilates the pupil. Feedback: Cycloplegic drugs cause ciliary paralysis, and mydriatics dilate the pupil (D), which facilitates access into the anterior chamber for removal of the lens in cataract surgery. (A, B, and C) are incorrect actions. The practical nurse (PN) is assessing a client who takes olanzapine (Zyprexa), an antipsychotic. Which side effect should the PN most likely note in this client? A) Insomnia and irritability. B) Hand tremors and tearing. C) Nausea and frontal headache.
D) Weight gain and constipation. - Accurate answers D) Weight gain and constipation. Feedback: Olanzapine (Zyprexa), an atypical antipsychotic, causes orthostatic hypotension, weight gain, and anticholinergic effects, such as constipation (D). Common anticholinergic side effects include dry mouth, blurred vision, nasal stuffiness, weight gain, difficulty urinating, decreased sweating, increased sensitivity to sunlight, and constipation (D). (A, B, and C) are not expected side effects of this medication. The practical nurse (PN) discusses antihypertensive drug therapy with several clients diagnosed with high blood pressure. To improve client understanding, the PN should emphasize that which medication preserves renal function in a client with diabetes? A) Verapamil (Calan). B) Captopril (Capoten). C) Clonidine (Catapres). D) Nifedipine (Procardia). - Accurate answers B) Captopril (Capoten). Feedback: Hypertension contributes to diabetic nephropathy, and angiotensin converting enzyme (ACE) inhibitors, such as captopril (B), slow progression of renal damage for clients with diabetes by reducing blood pressure, contributing to blood sugar control by increasing the body's sensitivity to insulin, and moving glucose from the bloodstream into cells. Verapamil (A), nifedipine (D), and clonidine (C) are used the treatment of hypertension, but do not provide the same effects on blood glucose as captopril does for clients with diabetes. A client with schizophrenia has been taking clozapine (Clozaril) for several months. The practical nurse (PN) monitors the client for extrapyramidal symptoms (EPS). Which reason supports the PN's assessment? A) Prolonged use of antidepressant medications reduce skeletal muscle tone. B) The excess amount of norepinephrine causes an increase in blood pressure. C) The increased availability of serotonin affects mood and behavior. D) Atypical antipsychotics can deplete the brain's supply of dopamine. - Accurate answers D) Atypical antipsychotics can deplete the brain's supply of dopamine. Feedback: The use of an atypical antipsychotic, such as clozapine, should include an assessment of musculoskeletal functioning for signs and symptoms of any EPS reaction that can occur from a lack of the brain neurotransmitter dopamine (D). (A, B, and C) do not explain the cause of EPS. A client who is transferred to the cardiac rehabilitation unit after a myocardial infarction is ready for discharge with a new prescription for metoprolol (Lopressor). The client asks, I don't have high blood pressure, so why did my healthcare provider give me this medicine? What information should the practical nurse (PN) provide? A) Anticoagulation is the most important action of metoprolol. B) Beta-blockers are routinely prescribed after heart damage. C) Heart failure is prevented as a complication while healing. D) A slower heart rate reduces the heart's oxygen demand. - Accurate answers D) A slower heart rate reduces the heart's oxygen demand. Feedback: Lopressor, a beta-blocker, slows the heart rate and is prescribed after a myocardial infarction to reduce the heart's work load and oxygen demand (D). (A, B, and D) are incorrect.
A) Provide continuous telemetry monitoring. B) Monitor for signs of respiratory arrest. C) Administer prescribed naloxone (Narcan). D) Keep a dose of diazepam at the bedside. - Accurate answers B) Monitor for signs of respiratory arrest. Feedback: An overdose of baclofen (Lioresal), a centrally acting muscle relaxant, can cause coma and respiratory depression that requires respiratory support. Monitoring for early signs of respiratory arrest (B) is most important so immediate respiratory resuscitation can be provided. Although telemetry (A) provides close cardiac monitoring, early recognition of respiratory arrest is indicated due to the actions of Lioresal. Narcan (C) is ineffective for baclofen overdose. (D) is not indicated. A 35-week gestation primigravida who takes lithium (Eskalith) tells the practical nurse (PN) that she would like to breastfeed her infant. What information should the PN provide to the client? A) The medication does not cross the placental barrier. B) Mood swings will occur if lithium is discontinued. C) Breast milk should be discarded after each oral dose of lithium. D) The drug is excreted in breast milk so use formula to feed the infant. - Accurate answers D) The drug is excreted in breast milk so use formula to feed the infant. Feedback: Lithium crosses the placental barrier and is excreted in the breast milk, so the client should formula feed her newborn. (A and C) are inaccurate information. Although (B) may occur, the option of the mother discontinuing the prescribed lithium should not be suggested. Dietary trays usually arrive on the hospital unit at 7:30 AM. When should the practical nurse (PN) plan to administer NPH insulin 40 units subcutaneously to a client with diabetes mellitus? A) 6:30 and 7:00 AM. B) 7:00 and 7:30 AM. C) 7:30 and 8:00 AM. D) 8:00 and 8:30 AM. - Accurate answers A) 6:30 and 7:00 AM. Feedback: NPH, an intermediate-acting insulin, should be given 30 to 60 minutes (A) before the arrival of breakfast trays at 7:30 AM. (B, C, and D) delay the action of NPH. The practical nurse (PN) is administering an enteric-coated form of erythromycin (EES) to a male client with an upper respiratory infection. The client tells the PN that the medication should be taken with his meals. What information should the PN offer the client? A) Taking EES with food anytime is recommended. B) EES should be taken on an empty stomach. C) ESS may be taken without regard to meals. D) The best time to take EES is once daily at night. - Accurate answers C) ESS may be taken without regard to meals. Feedback: The enteric-coated formulation of erythromycin may be taken without regard to meals (C). Because an enteric coating makes the drug less irritating to the gastrointestinal tract, this is likely to enhance compliance with drug therapy without regard to meals. (A, B, and D) are not indicated.
Which International Normalized Ratio (INR) value indicates that warfarin (Coumadin) therapy is at a therapeutic range? A) 1.0 to 2. B) 2.1 to 3. C) 3.1 to 4. D) 4.1 to 5.0 - Accurate answers B) 2.1 to 3. Feedback: Warfarin dosage for therapeutic anticoagulation is adjusted to target a client's INR range between 2 to 3 (B). (A, C, and D) are outside the narrow therapeutic range. A client with Parkinson's disease has been taking antiparkinsonian medications for three months. Which client finding should the practical nurse (PN) identify as a therapeutic response? A) Decreased appetite. B) Gradual development of cogwheel rigidity. C) Occurrence of confusion. D) Improved ability to perform activities. - Accurate answers D) Improved ability to perform activities. Feedback: Therapeutic responses to antiparkinsonian agents include an improved sense of well-being and improved ability to think clearly and perform activities (D). An increase in appetite, not (A), and less- intense parkinsonism manifestations are expected, not (B or C). A male client diagnosed with tuberculosis asks the practical nurse (PN) about his course of drug therapy. Which information should the PN provide? A) Drug therapy requires compliance for 6 to 12 months. B) Medication is stopped when clinical symptoms subside. C) To prevent reactivation, drug therapy is maintained for life. D) To prevent resistance and side effects, drugs are changed. - Accurate answers A) Drug therapy requires compliance for 6 to 12 months. Feedback: Antitubercular drug therapy is prescribed for 6 to 12 months, which requires continuous compliance to prevent resistance of the tubercle bacillus, to ensure encapsulation, and prevent reactivation. Drug therapy continues until sputum tests are negative for the tubercle bacillus, and the client is no longer infectious to others, not (B). (C) is inaccurate. Although antibiotics used in antitubercular drug protocols may be changed throughout the course of therapy (D), strict compliance for the duration of therapy is vital in preventing reinfection and spread to others. The practical nurse (PN) is reviewing the discharge plan for a client with mania who is receiving lithium carbonate (Eskalith). To achieve a stable serum level, which information should the PN reinforce with the client? A) How to inject this drug. B) When to increase the dosage. C) When to stop using this drug. D) How to recognize symptoms of toxicity. - Accurate answers D) How to recognize symptoms of toxicity. Feedback:
Adverse effects associated with aminoglycoside antibiotics, such as amikacin, are nephrotoxicity and ototoxicity, so the client should be monitored for hearing loss (C). (A, B, and D) are not associated with amikacin. Which client statement indicates to the practical nurse (PN) that a client understands discharge instructions about a new prescription for digoxin (Lanoxin)? A) I should double the dose if one is missed. B) I will take my pulse for one minute every day. C) I should take an antacid to minimize stomach upset. D) I will alternate my dose between morning and afternoon. - Accurate answers B) I will take my pulse for one minute every day. Feedback: The client is conveying understanding of the use of Lanoxin by the statement that daily pulse rates should be taken for a full one minute (B), which provides information about possible drug toxicity. (A, C, and D) are inaccurate. The practical nurse (PN) observes a thick white coating on the tongue of a client who takes fluphenazine (Prolixin). What instructions should the PN reinforce with the client about this medication? A) No treatment is needed as the coating should subside in a couple of weeks. B) Attempt to stop smoking if the white coating on your tongue persists. C) If you are taking any inhalants, wash the mouthpiece after each use. D) Brush your teeth and tongue, floss, gargle, and notify the healthcare provider. - Accurate answers D) Brush your teeth and tongue, floss, gargle, and notify the healthcare provider. Feedback: Fluphenazine (Prolixin), an antipsychotic with anticholinergic effects, causes dry mouth, which contributes to a thick white coating on the tongue that alters the normal flora in the mouth. Regular brushing of the tongue and teeth is a good preventive measure, and the healthcare provider should be notified (D) because treatment may be indicated if an oral infection develops. (A) is inaccurate. (B and C) do not convey the importance of calling the healthcare provider. An adult male arrives in the clinic requesting a prescription for sildenafil (Viagra). Which client history should the practical nurse (PN) report to the healthcare provider? A) Hypogonadism. B) Fluid retention. C) The use of nitrates. D) Benign prostatic hypertrophy. - Accurate answers C) The use of nitrates. Feedback: Sildenafil can lower blood pressure by causing vasodilation. A client who takes a nitrate (C), a vasodilator, for a pre-existing cardiovascular disease can experience significant hypotension if Viagra is taken concomittently with nitrates, such as nitroglycerin, which should be reported to the healthcare provider. (A, B, and D) are not contraindications for the use of Viagra. The practical nurse (PN) should reinforce what time frame with a client about self-administration of lispro insulin (Humalog)? A) Take after a meal is completed. B) Take once daily at the midday meal. C) Take within 15 minutes of beginning a meal.
D) Take only before bedtime with an evening snack. - Accurate answers C) Take within 15 minutes of beginning a meal. Feedback: Lispro, a very rapid acting insulin, has on onset of 5 to15 minutes after administration with a duration of 4 to 6 hours, so the client should self-administer this insulin within 15 minutes before a meal (C). (A, B, and D) are inaccurate.
