HESI PRACTICE EXAM -PHARM BSN 315 Actual Questions and Answers with Rationale 100% Correct | New Update 2024 Which client should the nurse identify as being at highest risk for complications during the use of an opioid analgesic? - Answer A young adult with inflammatory bowel disease. Rationale: The principal indication for opioid use is acute pain, and a client with inflammatory bowel disease is at risk for toxic megacolon or paralytic ileus related to slowed peristalsis, a side effect of morphine. Adverse effects of morphine do not pose as great a risk for clients with diabetes or a fracture as for the client with bowel disease. The healthcare provider prescribes digitalis (Digoxin) for a client diagnosed with heart failure. Which intervention should the nurse implement prior to administering the digoxin? - Answer Assess the serum potassium level. Rationale: Hypokalemia (decreased serum potassium) will precipitate digitalis toxicity in persons receiving digoxin. The nurse should monitor the client's serum potassium levels. Blood pressure and respiratory rate will not inform the nurse about potential safety issues with digitalis. A client with hyperlipidemia receives a prescription for niacin (Niaspan). Which client teaching is most important for the nurse to provide? - Answer Expected duration of flushing. Rationale: Flushing of the face and neck, lasting up to an hour, is a frequent reason for discontinuing niacin. Inclusion of this effect in client teaching may promote compliance in taking the medication. While nutrition tips and managing pruritis are worthwhile instructions to help clients minimize or cope with normal side effects associated with niacin (Niaspan), flushing is intense and causes the most concern for the client. A client who was prescribed atorvastatin (Lipitor) one month ago calls the triage nurse at the clinic complaining of muscle pain and weakness in his legs. Which statement reflects the correct drug -specific teaching the nurse should provide to this client? - Answer Make an appointment to see the healthcare provider, because muscle pain may be an indication of a serious side effect . Rationale: Myopathy, suggested by the leg pain and weakness, is a serious, and potentially life-threatening, complication of Lipitor, and should be evaluated immediately by the healthcare provider. An antacid (Maalox) is prescribed for a client with peptic ulcer disease. The nurse knows that the purpose of this medication is to - Answer maintain a gastric pH of 3.5 or above. Rationale: The objective of antacids is to neutralize gastric acids and keep pH of 3.5 or above which is necessary for pepsinogen inactivity. Which dosing schedule should the nurse teach the client to observe for a controlled -release oxycodone prescription? - Answer Every 12 hours . Rationale: A controlled -release oxycodone provides long -acting analgesia to relieve moderate to severe pain, so a dosing schedule of every 12 hours provides the best around -the-clock pain management. Controlled -release oxycodone is not prescribed for breakthrough pain on a PRN or as needed schedule. Using a schedule of every 4 to 6 hours may jeopardize patient safety due to cumulative effects. A client with osteoarthritis receives a new prescription for celecoxib (Celebrex) orally for symptom management. The nurse notes the client is allergic to sulfa. Which action is most important for the nurse to implement prior to administering the first dose? - Answer Notify the healthcare provider. Rationale: Celebrex contains a sulfur molecule, which can lead to an allergic reaction in individuals who are sensitive to sulfonamides, so the healthcare provider should be notified of the client's allergies. The nurse is assessing a client who is experiencing anaphylaxis from an insect sting. Which prescription should the nurse prepare to administer this client? - Answer Epinephrine . Rationale: Epinephrine is an adrenergic agent that stimulates beta receptors to increase cardiac automaticity in cardiac arrest and relax bronchospasms in anaphylaxis. On the ither hand, dopamine is a vasopressor used to treat clients with shock. Ephedrine causes peripheral vasoconstriction and is used in the treatment of nasal congestion. Diphenhydramine is an antihistamine decongestant used in the
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