HESI PHARMACOLOGY RN EXIT EXAM 2024
A 43-year-old female client is receiving thyroid replacement hormone
following a thyroidectomy. What adverse effects associated with thyroid
hormone toxicity should the nurse instruct the client to report promptly
to the healthcare provider?
A) Tinnitus and dizziness.
B) Tachycardia and chest pain.
C) Dry skin and intolerance to cold.
D) Weight gain and increased appetite. – ANSWER- B. Tachycardia and
chest pain.
Rationale: Thyroid replacement hormone increases the metabolic
rate of all tissues, so common signs and symptoms of toxicity include
tachycardia and chest pain (B). (A, C, and D) do not indicate a
thyroid hormone toxicity.
Following the administration of sublingual nitroglycerin to a client
experiencing an acute anginal attack, which assessment finding indicates
to the nurse that the desired effect has been achieved?
A. Client states chest pain is relieved
B. Client’s pulse decreases from 120 to 90
C. Client’s systolic blood pressure decreases from 180 to 90
D. Clients SaO2 level increases from 92% to 96% – ANSWER- A.
Client states chest pain is relieved
Rationale: nitroglycerin reduces mycocardial oxygen consumption
which decreases ischemia and reduces chest pain
An adult client is given a prescription for a scopolamine patch
(Transderm Scop) to prevent motion sickness while on a cruise. Which
information should the nurse provide to the client?
A) Apply the patch at least 4 hours prior to departure.
B) Change the patch every other day while on the cruise.
C) Place the patch on a hairless area at the base of the skull.
D) Drink no more than 2 alcoholic drinks during the cruise. – ANSWERA. Apply the patch at least 4 hours prior to departure.
Rationale: Scopolamine, an anticholinergic agent, is used to prevent
motion sickness and has a peak onset in 6 hours, so the client should
be instructed to apply the patch at least 4 hours before departure
(A) on the cruise ship. The duration of the transdermal patch is 72
hours, so (B) is not needed. Scolopamine blocks muscarinic
receptors in the inner ear and to the vomiting center, so the best
application site of the patch is behind the ear, not at the base of the
skull (C). Anticholinergic medications are CNS depressants, so the
client should be instructed to avoid alcohol (D) while using the
patch.
Which action is most important for the nurse to implement prior to the
administration of the antiarrhythmic drug adenosine (Adenocard)?
A) Assess pupillary response to light.
B) Instruct the client that facial flushing may occur.
C) Apply continuous cardiac monitoring.
D) Request that family members leave the room. – ANSWER- C. Apply
continuous cardiac monitoring.
Rationale: Adenosine (Adenocard) is an antiarrhythmic drug used
to restore a normal sinus rhythm in clients with rapid
supraventricular tachycardia. The client’s heart rate should be
monitored continuously (C) for the onset of additional arrhythmias
while receiving adenosine. (A and B) are valuable nursing
interventions, but are of less importance than monitoring for
potentially fatal arrhythmias. Family members may be asked to
leave the room because of the potential for an emergency situation
(D), however, this is also of less priority than (C).
A client is receiving clonidine (catapres) 0.1mg/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 – ANSWER- D.
Blood pressure has changed from 180/120 to 140/70
Rationale: Catapres acts as a centrally-acting analgesic and
antihypertensive agent. D. indicates a reduction in hypertention
A client’s dose of isosorbide dinitrate (Imdur) is increased from 40 mg to
60 mg PO daily. When the client reports the onset of a headache prior to
the next scheduled dose, which action should the nurse implement?
A) Hold the next scheduled dose of Imdur 60 mg and administer a PRN
dose of acetaminophen (Tylenol).
B) Administer the 40 mg of Imdur and then contact the healthcare
provider.
C) Administer the 60 mg dose of Imdur and a PRN dose of
acetaminophen (Tylenol).
D) Do not administer the next dose of Imdur or any acetaminophen until
notifying the healthcare provider. – ANSWER- C. Administer the 60 mg
dose of Imdur and a PRN dose of acetaminophen (Tylenol).
Rationale: Imdur is a nitrate which causes vasodilation. This
vasodilation can result in headaches, which can generally be
controlled with acetaminophen (C) until the client develops a
tolerance to this adverse effect. (A and B) may result in the onset of
angina if a therapeutic level of Imdur is not maintained. Lying down
(D) is less likely to reduce the headache than is a mild analgesic.
A category X drug is prescribed for a young adult female client. Which
instruction is most important for the nurse to teach this client?
A) Use a reliable form of birth control.
B) Avoid exposure to ultra violet light.
C) Refuse this medication if planning pregnancy.
D) Abstain from intercourse while on this drug. – ANSWER- A. Use a
reliable form of birth control
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