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Wgu HESI RN Pharmacology 1
Wgu HESI RN Pharmacology 1
Total Questions : 44
Showing 10 questions Sign up for moreA female client starts a new prescription, oxybutynin, for symptoms of an overactive bladder. The client tells the nurse that she is training to run in a half-marathon. Which instruction should the nurse emphasize?
Explanation
A. Wear padding to protect from bruising if a fall occurs:
While safety precautions are important for any physical activity, the specific concern with oxybutynin is not related to a higher risk of falls or bruising. The primary issue is managing side effects that might affect hydration and body temperature.
B. Take measures to avoid dehydration and over-heating:
Oxybutynin can cause dry mouth and decreased sweating, which can increase the risk of dehydration and overheating, especially during intense physical activities like running. Emphasizing hydration and measures to avoid overheating is crucial to prevent complications.
C. Avoid crowds to help prevent acquiring infections:
Oxybutynin does not typically affect the immune system or increase the risk of infections. The client’s concern should focus on managing side effects related to exercise and hydration, rather than avoiding crowds.
D. Keep skin and eyes covered to protect from sun injury:
Oxybutynin does not have a direct effect on sun sensitivity or increase the risk of sunburn. While sun protection is generally important for outdoor activities, it is not a specific concern related to the use of oxybutynin.
The nurse is administering sodium polystyrene sulfonate to a client in acute kidney injury (AKI). Which laboratory finding indicates that the medication has been effective?
Reference Range:
Glucose [74 to 106 mg/dL (4.1 to 5.9 mmol/L)]
Hemoglobin [14 to 18 g/dL (140 to 180 g/L)]
Potassium [3.5 to 5 mEq/L (3.5 to 5 mmol/L)]
Ammonia [10 to 80 μg/dL (6 to 47 μmol/dL)]
Explanation
A. Hemoglobin level of 13.5 g/dL (135 g/L):
Sodium polystyrene sulfonate is used to manage hyperkalemia, not to affect hemoglobin levels. While a hemoglobin level of 13.5 g/dL is within the normal range, it does not indicate the effectiveness of sodium polystyrene sulfonate.
B. Serum ammonia level of 30 μg/dL (17.62 μmol/dL):
Sodium polystyrene sulfonate is not used to manage ammonia levels; it is used to lower elevated potassium levels. Thus, a serum ammonia level of 30 μg/dL does not reflect the effectiveness of the medication.
C. Serum potassium level of 3.8 mEq/L (3.8 mmol/L):
Sodium polystyrene sulfonate is specifically used to treat hyperkalemia (high potassium levels). A serum potassium level of 3.8 mEq/L is within the normal range, indicating that the medication has effectively reduced elevated potassium levels.
D. Serum glucose level of 120 mg/dL (6.7 mmol/L):
Sodium polystyrene sulfonate does not affect glucose levels. A glucose level of 120 mg/dL is slightly elevated but unrelated to the effectiveness of the potassium-lowering medication.
A client who is newly diagnosed with diabetes insipidus (DI) is receiving a synthetic vasopressin intravenously. Which side effect of vasopressin reported by the client should the nurse report to the healthcare provider?
Explanation
A. Worsening headache:
Vasopressin is used to manage diabetes insipidus by reducing excessive urine output and increasing water reabsorption. A worsening headache could indicate an adverse reaction or side effect such as water intoxication or an increase in intracranial pressure, which requires immediate attention from the healthcare provider.
B. Low urine specific gravity:
Vasopressin should increase urine specific gravity by concentrating the urine. A low urine specific gravity would indicate that the medication is not effectively concentrating the urine, but it is not an immediate or severe side effect needing urgent reporting.
C. Polyuria:
Polyuria (excessive urine output) is a characteristic of diabetes insipidus, and vasopressin is intended to reduce this symptom. If polyuria persists despite treatment, it suggests that the medication is not working as intended but does not indicate a severe side effect.
D. Polydipsia:
Polydipsia (excessive thirst) can occur in diabetes insipidus and may continue despite treatment with vasopressin. While it indicates ongoing symptoms, it is not a severe side effect of the medication that would require urgent reporting to the healthcare provider.
Which action should the nurse implement to assess the effectiveness of amlodipine?
Explanation
A. Monitor the client's serum electrolytes:
Amlodipine, a calcium channel blocker, primarily affects blood pressure and not directly electrolyte levels. Monitoring electrolytes is more relevant for medications that affect electrolyte balance, such as diuretics or certain antihypertensives.
B. Measure the client's blood pressure:
Amlodipine is used to treat hypertension and angina by relaxing blood vessels. The primary measure of its effectiveness is the reduction in blood pressure. Therefore, measuring the client’s blood pressure is crucial to assess whether the medication is effectively managing hypertension.
C. Review the client's intake and output:
While monitoring intake and output is important for assessing fluid balance and kidney function, it is not the primary method for evaluating the effectiveness of amlodipine in controlling blood pressure.
D. Note the client's serum calcium levels:
Amlodipine affects calcium channels but does not directly influence serum calcium levels significantly. Serum calcium levels are not used to assess the effectiveness of amlodipine in treating hypertension or angina.
To control asthma, a client in a residential treatment facility uses a fluticasone propionate and salmeterol discus inhalation system, which provides an inhaled powdered form of these combined medications. Which instruction should the nurse provide to this client's caregivers?
Explanation
A. Clients using the discus may experience decreased blood pressure:
Fluticasone propionate and salmeterol are a combination of a corticosteroid and a long-acting beta-agonist. While they help control asthma, they are not typically associated with decreased blood pressure. Instead, potential side effects might include increased heart rate or hypertension.
B. Explain that the client should not use the discus more than twice daily:
Fluticasone propionate and salmeterol combination inhalers are usually prescribed for twice-daily use to maintain control of asthma symptoms. Using the inhaler more frequently than prescribed could lead to increased side effects or diminished effectiveness.
C. When using the discus, have the client breathe out rapidly into the mouthpiece:
The correct technique for using a dry powder inhaler involves inhaling deeply and forcefully to ensure the medication reaches the lungs. Breathing out rapidly into the mouthpiece is incorrect and will not deliver the medication effectively.
D. Offer the discus to the client for use during an acute asthma attack:
The discus is used for long-term control and prevention of asthma symptoms, not for immediate relief during an acute asthma attack. A rescue inhaler, typically containing a short-acting beta-agonist like albuterol, is used for acute symptoms.
A client with allergic rhinitis is taking the over-the-counter antihistamine diphenhydramine HCL. Which instruction is most important for the nurse to provide this client?
Explanation
A. Do not take the medication more than once every 8 hours:
Diphenhydramine is typically dosed every 4 to 6 hours, not just once every 8 hours. However, this instruction is less critical compared to addressing the safety concerns related to drowsiness.
B. Take the medication with food to prevent gastric upset:
Diphenhydramine is generally not known to cause significant gastric upset, so this instruction is less critical. The primary concern with diphenhydramine is its sedative effects rather than gastrointestinal issues.
C. Avoid driving, since this medication causes drowsiness:
Diphenhydramine is known to cause significant drowsiness and sedation. Advising the client to avoid driving is crucial to prevent accidents and ensure their safety, making this the most important instruction.
D. Use sugarless candy or gum to help prevent a dry mouth:
While diphenhydramine can cause dry mouth, using sugarless candy or gum is a helpful but secondary instruction. The primary concern with diphenhydramine is its sedative effect, which affects the client's ability to drive safely.
The nurse is teaching a client who has been diagnosed with human immunodeficiency virus (HIV) about the antiretroviral medication regimen. Which statement provided by the client requires additional instruction by the nurse?
Explanation
A. The viral load can be decreased to an undetectable level:
This statement is accurate. Antiretroviral medications can reduce the viral load in the blood to undetectable levels, which helps in managing HIV effectively.
B. Antiretroviral medication prevents the transmission of the virus:
This statement is misleading. While antiretroviral medications are effective in managing HIV and can reduce the viral load to undetectable levels, they do not entirely prevent the transmission of the virus. Safe practices, including the use of condoms and pre-exposure prophylaxis (PrEP), are also necessary to reduce transmission risk.
C. The medications can decrease acquired immunodeficiency syndrome (AIDS) related complications:
This is correct. Antiretroviral therapy helps manage HIV, preventing the progression to AIDS and reducing the likelihood of complications associated with AIDS.
D. HIV infection is not cured by the antiretroviral regimen:
This is true. Current antiretroviral therapies effectively control HIV and prevent progression to AIDS, but they do not cure the infection. Ongoing treatment is necessary to maintain viral suppression and overall health.
The nurse is providing discharge instructions to a client who has been prescribed gabapentin 300 mg by mouth (PO) three times a day for postherpetic neuralgia. Which symptom should the nurse tell the client to report to the healthcare provider?
Explanation
A. Gastric irritation:
Gastric irritation is not a common side effect of gabapentin. While gastrointestinal symptoms can occur, they are not typically severe or indicative of a serious issue. Thus, this symptom is less critical to report immediately.
B. Rapid weight gain:
Rapid weight gain can be a significant side effect of gabapentin, potentially indicating fluid retention or other systemic issues. It is important to report this symptom, as it may require further evaluation and adjustment of the medication.
C. Sexual dysfunction:
Sexual dysfunction is not commonly reported with gabapentin. While it may affect some individuals, it is not typically a primary concern for discontinuing or altering treatment. Therefore, it is less urgent compared to other side effects.
D. Photosensitivity:
Photosensitivity is not a recognized side effect of gabapentin. The medication does not generally cause sensitivity to light, so this symptom is unlikely to be related to gabapentin use and is less critical to report immediately.
A client with anemia secondary to chronic kidney disease (CKD) started a prescription for epoetin alfa two months ago. Which client finding best indicates that the medication is effective?
Reference Range:
Hemoglobin (Hgb) [14 to 18 g/dl. (8.7 to 11.2 mmol/L)]
Explanation
A. Food diary shows increased consumption of iron-rich foods:
While iron-rich foods are important for managing anemia, this finding does not directly indicate the effectiveness of epoetin alfa. The primary measure of epoetin alfa's effectiveness is an improvement in hemoglobin levels, not dietary changes.
B. Reports of increased energy levels and decreased fatigue:
Increased energy and decreased fatigue are positive effects and may suggest that the medication is helping. However, these symptoms are subjective and not as definitive as a measurable increase in hemoglobin levels.
C. Takes concurrent iron therapy without adverse effects:
Iron therapy is often used alongside epoetin alfa to enhance its effectiveness, but the absence of adverse effects from iron therapy does not alone confirm the effectiveness of epoetin alfa. The key indicator is the improvement in hemoglobin levels.
D. Hemoglobin level increased to 12 g/dL (7.45 mmol/L):
An increase in hemoglobin level to 12 g/dL is a direct measure of the effectiveness of epoetin alfa. This increase demonstrates that the medication is successfully stimulating red blood cell production, which is the intended therapeutic effect.
The client is a 75-year-old female admitted to the preoperative area to prepare for pacemaker insertion. Client reports she is having this done because her heart rate has been staying very low, she is always tired, and she has passed out once from low heart rate. Client has history of worsening symptomatic bradycardia. History of atrial fibrillation controlled. The nurse is preparing the client's plan of care. Select 4 findings that would indicate to the nurse that the administration of the vancomycin antibiotic would be safe to administer.
Explanation
A. No known allergies:
Having no known allergies is a significant factor in determining the safety of administering vancomycin, as it reduces the risk of an allergic reaction. Vancomycin can cause allergic reactions or hypersensitivity, so it’s important to ensure the client is not allergic to this medication.
B. Peripheral IV in large vein:
Vancomycin should be administered through a large vein because it can be irritating to smaller veins and potentially cause thrombophlebitis or vein damage. Using a large vein helps to minimize these risks and ensure safe administration.
C. Potassium 4.4 mEq/L (4.4 mmol/L):
While potassium levels are important to monitor, they are not directly related to the safety of administering vancomycin. Vancomycin does not have a direct impact on potassium levels, so this finding does not specifically indicate the safety of vancomycin administration.
D. Used for prophylaxis:
Vancomycin is often used as prophylaxis in certain surgical procedures to prevent infection, especially in cases where there is a high risk of methicillin-resistant Staphylococcus aureus (MRSA) infection. The use of vancomycin for prophylaxis is a common practice and indicates it is being administered for an appropriate reason.
E. Blood urea nitrogen 17 mg/dL (6.07 mmol/L):
A blood urea nitrogen (BUN) level of 17 mg/dL is slightly elevated but not necessarily a contraindication for vancomycin administration. However, vancomycin can impact kidney function, so it is important to monitor renal function but not the sole factor in determining safety.
F. Dosage in safe range:
Ensuring the dosage of vancomycin is within the safe range is crucial for preventing toxicity and achieving therapeutic efficacy. This is an essential consideration when administering the medication to avoid adverse effects and ensure effective treatment.
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