HESI Pharmacology Exam Practice 149.) A client taking fexofenadine (Allegra) is scheduled for allergy skin testing and tells the nurse in the health care provider's office that a dose was taken this
morning. The nurse determines that:
- The client should reschedule the appointment.
- A lower dose of allergen will need to be injected.
- A higher dose of allergen will need to be injected.
- The client should have the skin test read a day later than usual. - ANSWER
- The client should reschedule the appointment.
Rationale:
Fexofenadine is an antihistamine, which provides relief of symptoms caused by allergy. Antihistamines should be discontinued for at least 3 days (72 hours) before allergy skin testing to avoid false-negative readings. This client should have the appointment rescheduled for 3 days after discontinuing the medication.
150.) A client complaining of not feeling well is seen in a clinic. The client is taking several medications for the control of heart disease and hypertension. These medications include a β-blocker, digoxin (Lanoxin), and a diuretic. A tentative diagnosis of digoxin toxicity is made. Which of the following assessment data would support this diagnosis?
- Dyspnea, edema, and palpitations
- Chest pain, hypotension, and paresthesia
- Double vision, loss of appetite, and nausea
- Constipation, dry mouth, and sleep disorder - ANSWER 3.
Double vision, loss of appetite, and nausea 1 / 4
Rationale:
Double vision, loss of appetite, and nausea are signs of digoxin toxicity. Additional signs of digoxin toxicity include bradycardia, difficulty reading, visual alterations such as green and yellow vision or seeing spots or halos, confusion, vomiting, diarrhea, decreased libido, and impotence.**gastrointestinal (GI) and visual disturbances occur with digoxin toxicity** 151.) A client is being treated for acute congestive heart failure with intravenously
administered bumetanide. The vital signs are as follows: blood pressure, 100/60
mm Hg; pulse, 96 beats/min; and respirations, 24 breaths/min. After the initial dose, which of the following is the priority assessment?
- Monitoring weight loss
- Monitoring temperature
- Monitoring blood pressure
- Monitoring potassium level - ANSWER 3. Monitoring blood
pressure
Rationale:
Bumetanide is a loop diuretic. Hypotension is a common side effect associated with the use of this medication. The other options also require assessment but are not the priority.**priority ABCs—airway, breathing, and circulation** 152.) Intravenous heparin therapy is prescribed for a client. While implementing this prescription, a nurse ensures that which of the following medications is available on the nursing unit?
- Protamine sulfate
- Potassium chloride
- Phytonadione (vitamin K )
- Aminocaproic acid (Amicar) - ANSWER 1. Protamine sulfate 2 / 4
Rationale:
The antidote to heparin is protamine sulfate; it should be readily available for use if excessive bleeding or hemorrhage occurs. Potassium chloride is administered for a potassium deficit. Vitamin K is an antidote for warfarin sodium.Aminocaproic acid is the antidote for thrombolytic therapy.
153.) A client is diagnosed with pulmonary embolism and is to be treated with streptokinase (Streptase). A nurse would report which priority data collection finding to the registered nurse before initiating this therapy?
- Adventitious breath sounds
- Temperature of 99.4° F orally
- Blood pressure of 198/110 mm Hg
- Respiratory rate of 28 breaths/min - ANSWER 3. Blood
pressure of 198/110 mm Hg
Rationale:
Thrombolytic therapy is contraindicated in a number of preexisting conditions in which there is a risk of uncontrolled bleeding, similar to the case in anticoagulant therapy. Thrombolytic therapy also is contraindicated in severe uncontrolled hypertension because of the risk of cerebral hemorrhage. Therefore the nurse would report the results of the blood pressure to the registered nurse before initiating therapy. The findings in options 1, 2, and 4 may be present in the client with pulmonary embolism.
154.) A nurse is reinforcing dietary instructions to a client who has been prescribed cyclosporine (Sandimmune). Which food item would the nurse instruct the client to avoid?
- Red meats
- Orange juice
- Grapefruit juice 3 / 4
- Green, leafy vegetables - ANSWER 3. Grapefruit juice
Rationale:
A compound present in grapefruit juice inhibits metabolism of cyclosporine. As a result, the consumption of grapefruit juice can raise cyclosporine levels by 50% to 100%, thereby greatly increasing the risk of toxicity. Grapefruit juice needs to be avoided. Red meats, orange juice, and green leafy vegetables are acceptable to consume.
155.) Mycophenolate mofetil (CellCept) is prescribed for a client as prophylaxis for organ rejection following an allogeneic renal transplant. Which of the following instructions does the nurse reinforce regarding administration of this medication?
- Administer following meals.
- Take the medication with a magnesium-type antacid.
- Open the capsule and mix with food for administration.
- Contact the health care provider (HCP) if a sore throat occurs. - ANSWER
- Contact the health care provider (HCP) if a sore throat occurs.
Rationale:
Mycophenolate mofetil should be administered on an empty stomach. The capsules should not be opened or crushed. The client should contact the HCP if unusual bleeding or bruising, sore throat, mouth sores, abdominal pain, or fever occurs because these are adverse effects of the medication. Antacids containing magnesium and aluminum may decrease the absorption of the medication and therefore should not be taken with the medication. The medication may be given in combination with corticosteroids and cyclosporine.**neutropenia can occur with this medication** 156.) A nurse is reviewing the laboratory results for a client receiving tacrolimus (Prograf). Which laboratory result would indicate to the nurse that the client is experiencing an adverse effect of the medication?
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