HESI Pharmacology

A client with hypertension is prescribed an angiotensin II receptor blocker (ARB). Which instruction will the nurse provide about this medication? Select all that apply. One, some, or all responses may be correct. "Monitor the blood pressure often." "Discontinue treatment if a cough develops." "Stop the medication if swelling of the mouth, lips, or face develops." "Have blood drawn for potassium levels 2 weeks after starting the medication." "Do not take nonsteroidal anti-inflammatory drugs (NSAIDs) concurrently with this medication." "Notify other prescribers of new ARB prescription." "Report lightheadedness or dizziness upon standing to the provider." "Serum levels will be drawn at least once a month to ensure therapeutic levels."

"Monitor the blood pressure often." "Stop the medication if swelling of the mouth, lips, or face develops." "Have blood drawn for potassium levels 2 weeks after starting the medication." "Notify other prescribers of new ARB prescription." "Report lightheadedness or dizziness upon standing to the provider."

Digoxin is prescribed for a client with heart failure. The nurse will assess for which clinical manifestation that indicates digoxin toxicity? Select all that apply. One, some, or all responses may be correct. Confusion Headache Nausea Yellow vision Dizziness Irregular pulse Increased urine output Decreased respiratory rate

Confusion Headache Nausea Yellow vision Dizziness Irregular pulse

Several hours after administering insulin to a pediatric client, the nurse assesses the response to the insulin. Which client response is indicative of a hypoglycemic reaction? Select all that apply. One, some, or all responses may be correct. Confusion Tremors Anorexia Anxiety Hunger Glycosuria Diaphoresis Paresthesias

Confusion Tremors Anxiety Hunger Diaphoresis (excessive sweating) Paresthesias (numbness and tingling)

A child with nephrotic syndrome has been receiving prednisone for 1 week. Which information in the child's record indicates to the nurse that the medication has been effective? Select all that apply. One, some, or all responses may be correct. Increased urine output Weight loss Lower blood pH Reduction of lethargy Decreased blood pressure Elevated activity level Normalized lipids Enhanced appetite

Increased urine output Weight loss Reduction of lethargy Elevated activity level Normalized lipids Enhanced appetite

The nurse is caring for an 8-year-old child with acute poststreptococcal glomerulonephritis (APSGN). Which medication would the nurse anticipate incorporating into the plan of care? Select all that apply. One, some, or all responses may be correct. Penicillin Morphine Incorrect answercancelIbuprofen Docusate Correct answercheck_circleLabetalol Correct answercheck_circleFurosemide Loperamide Midodrine

Labetalol (antihypertensive) Furosemide (diuretic) The child with APSGN is hypertensive; antihypertensives, such as labetalol, are used to reduce the blood pressure. The child is oliguric; diuretics, such as furosemide, are used to increase urine output. APSGN is a post-infection complication, the causative infection has already been treated, likely with penicillin, and no further antibiotic therapy is warranted. Pain is not an expected clinical manifestation of APSGN in children; therefore, morphine or ibuprofen would not be needed. Gastrointestinal manifestations are not noted to be associated with APSGN, therefore the client would not need to be treated with docusate for constipation or loperamide for diarrhea. Midodrine is used to treat hypotension and its related symptoms, it would not be used in a hypertensive client.

A client receiving chemotherapy develops bone marrow suppression. The nurse will monitor for which thrombocytopenic effect? Select all that apply. One, some, or all responses may be correct. Fatigue Pale skin Deep vein thrombosis Dizziness Melena Purpura Emboli Hematuria

Melena Purpura Hematuria Bone marrow suppression causes: anemia, hypoxemia, fatigue Leukopenia, decreased immune system thrombocytopenia bleeding risk

A child undergoing prolonged steroid therapy takes on a cushingoid appearance. The nurse would expect to find which manifestation during further assessment? Select all that apply. One, some, or all responses may be correct. Obesity Truncal obesity Thin extremities Increased linear growth Loss of hair on the body Decreased blood pressure Reduced serum sodium levels Bruising

Obesity Truncal obesity Thin extremities Bruising

A health care provider prescribes aspirin therapy for a client with arthritis. The nurse will advise the client to report which adverse effect immediately? Select all that apply. One, some, or all responses may be correct. Ongoing nausea Correct answercheck_circleDiarrhea Correct answercheck_circleEasy bruising Decreased pulse Sour stomach Correct answercheck_circleRinging in the ears Trouble sleeping Dry mouth

Ongoing nausea Diarrhea Easy bruising Ringing in the ears salicylism: nausea, vomiting, ringing ears GI bleeding18 reye's syndrome (not for children less than 18)

Which newborn characteristic associated with renal excretion will the nurse consider to ensure safe medication administration? Select all that apply. One, some, or all responses may be correct. Reduced bladder capacity Renal blood flow Nephron location Immature metabolizing Glomerular filtration rate Incomplete tubular development Decreased plasma proteins Increased total body water

Renal blood flow Glomerular filtration rate Incomplete tubular development In a newborn, medications are excreted more slowly due to the kidneys having a higher resistance to blood flow. The glomerular filtration rate is reduced, partially because of incomplete glomerular and tubular development of the kidneys, which also reduces the newborn's ability to excrete medications. Bladder capacity is not associated with the reduction of renal excretion in newborns. The nephron is a structural and functional unit of the kidneys. Immature metabolizing enzymes in the liver, not the kidneys, can delay medication excretion. Regarding distribution of medications in the newborn, decreased plasma proteins available to bind with the drug contribute to the medication staying in the body longer. The total body water content of a newborn compared to an adult, 80% and 50% respectively, attribute to increased distribution of water-soluble medications.