PHARM HESI REVIEW

A client has been taking escitalopram for treatment of a major depressive episode. On the fifth day of therapy the client refuses the medication, stating, "It doesn't help, so what's the use of taking it?" What is the best response by the nurse?

"It can take 1 to 4 weeks to see an improvement."

The nurse provides medication discharge instructions to a client who received a prescription for digoxin following the client's myocardial infarction. Which statement by the client leads the nurse to conclude that the teaching was effective?

"It will be important to check my radial pulse rate daily." Checking the radial pulse rate daily is necessary for monitoring cardiac function; digoxin slows and strengthens the heart rate. Digoxin should be withheld and the healthcare provider notified if the pulse rate falls below a predetermined rate (e.g., 60 beats per minute). Hypokalemia increases the potential for digoxin toxicity; potassium intake should be increased, not decreased. An increase in the intake of foods rich in vitamin K is unnecessary; vitamin K is not related to digoxin intake. Adjusting the dosage according to activities is not an appropriate decision for the client; the healthcare provider should make this decision.

A client on a psychiatric unit who has been hearing voices is receiving a neuroleptic medication for the first time. The client takes the cup of water and the pill and stares at them. What is the most therapeutic statement the nurse can make?

"This will help you not to hear the voices. It will only work if you take it."

A nurse is completing the discharge protocol for a 14-year-old adolescent with osteomyelitis. The nurse teaches the parents how and when to administer the intravenous antibiotic at home. The schedule for administration is four times a day. At what times should the parents administer the antibiotic?

6:00 AM, 12:00 PM, 6:00 PM, 12:00 AM

A client is admitted for treatment of obsessive-compulsive disorder that is interfering with activities of daily living. Which medication does the nurse anticipate the primary healthcare provider will prescribe?

Clomipramine potentiates the effects of serotonin (antiobsessional effect) and norepinephrine in the central nervous system; it diminishes obsessive-compulsive behaviors. Benztropine and amantadine are antiparkinsonian agents, not antianxiety agents. Diphenhydramine is an antihistamine, not an antianxiety agent.

A nurse is teaching a client about drug therapy for gonorrhea. Which fact about drug therapy should the nurse emphasize?

Cures the infection

A nurse determines that the teaching about the side effects of azithromycin has been understood when the adolescent client identifies which problem as the most common side effect of this medication?

Diarrhea

A client in a hospice home care program is experiencing severe pain. Morphine has been prescribed for pain management. Which information should the nurse plan to explain to the client in preparation for this pain management regimen?

Dosages of the drug will be given automatically at regular intervals around the clock. The drug will be given routinely to maintain a continuous therapeutic blood level to keep the terminally ill client comfortable. Addiction is not a major concern for the terminally ill client. The client should not have to request this medication; it should be given regularly. Morphine is not administered intermittently; usually, it is prescribed in liquid form and is taken orally when administered in the home.

The nurse is caring for a child with a very low platelet count related to chemotherapy. The nurse will monitor this child's urine for the presence what component?

Erythrocytes

Chelation therapy with calcium disodium edetate (EDTA) has effects besides the desired effect of removing lead from the blood. What side effect does the nurse anticipate?

Hypocalcemia

A nurse is caring for a client who reports urinary problems, and the healthcare provider prescribes a cholinergic medication. Which urinary problem will this medication correct?

Urinary retention due to bladder atony

The nurse is caring for a client with type 1 diabetes. For which signs or symptoms of insulin-induced hypoglycemia should the nurse particularly be observant?

• Headache • Diaphoresis

Which statements regarding the use of selegiline to treat depression are true?

• Oxcarbazepine significantly raises the level of selegiline. • The most common adverse reaction of selegiline is a localized rash. • Transdermal selegiline is the only transdermal treatment for major depression.