Question

A client who is taking an oral contraceptive receives a new prescription for erythromycin. Which instruction should the nurse provide to the client?

Answer 1

Correct Answers:

Use an additional form of contraception.

Rationale :

🔴 Erythromycin can interfere with the metabolism of hormonal contraceptives, particularly estrogen, by inducing hepatic enzymes.

🔴 This results in reduced effectiveness of the oral contraceptive, increasing the risk of unintended pregnancy.

🔴 The nurse should instruct clients to use a backup method, such as condoms, while taking erythromycin.

🔴 This recommendation protects the client during the period when hormonal protection may be compromised.

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Answer 2

Correct Answers:

Explain that the client should not use the discus more than twice daily.

Rationale :

🟠 The fluticasone-salmeterol discus is a long-acting maintenance inhaler, not for rescue during acute asthma attacks.

🟠 It should be used only twice daily, roughly 12 hours apart, to maintain steady control of inflammation and bronchospasm.

🟠 Overuse can lead to systemic side effects like adrenal suppression, tachycardia, and tremors.

🟠 Proper frequency ensures optimal control of chronic asthma symptoms and patient safety.

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Answer 3

Correct Answers:

Antiretroviral medication prevents the transmission of the virus.

Rationale :

🟡 Antiretroviral therapy (ART) can significantly reduce the viral load to undetectable levels, but it does not guarantee complete prevention of HIV transmission.

🟡 The principle of “undetectable = untransmittable” (U=U) applies only to sexual transmission and with strict adherence to ART.

🟡 Even with undetectable viral loads, other transmission routes (e.g., needle sharing, childbirth) may still pose risks.

🟡 The nurse must clarify that ART is highly effective but not absolute in eliminating transmission risk.

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Answer 4

Correct Answers:

Rapid weight gain.

Rationale :

🟢 Gabapentin can lead to fluid retention and cause symptoms like edema and rapid weight gain, especially in older adults or those with comorbidities.

🟢 A sudden increase in weight may signal cardiac, renal, or hepatic complications and should be reported immediately.

🟢 This side effect can be early evidence of a serious adverse reaction requiring dosage adjustment or discontinuation.

🟢 The nurse should prioritize teaching the client to report rapid weight changes promptly.

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Answer 5

Correct Answers:

Double the dose if a dose is missed.

Rationale :

🔵 Clients should be instructed never to double a dose of allopurinol if a dose is missed, as this can increase the risk of toxicity and side effects.

🔵 Instead, if the next dose is near, the missed dose should be skipped, and the regular dosing schedule resumed.

🔵 Allopurinol requires consistent daily dosing to maintain uric acid control; erratic use undermines its effectiveness.

🔵 Proper education about missed dose management helps prevent serious errors and improves adherence.

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Answer 6

Correct Answers:

Chronic alcoholism.

Rationale :

🟣 Chronic alcohol use increases the risk of gastrointestinal bleeding and liver toxicity, both of which are potential complications of NSAID use, including diclofenac.

🟣 NSAIDs are metabolized by the liver and can also irritate the gastric mucosa, making this combination especially dangerous.

🟣 Alcohol and diclofenac together significantly raise the risk for gastric ulcers, GI hemorrhage, and hepatotoxicity.

🟣 The nurse must assess alcohol history carefully and consider alternative pain management strategies.

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Answer 7

Correct Answers:

Determine presence of abdominal pain.

Rationale :

🟤 Long-term NSAID use, such as ibuprofen, is strongly associated with gastric ulcers and GI bleeding, often presenting first as abdominal pain.

🟤 This is a priority assessment to detect complications early, even before melena or hematemesis appears.

🟤 Abdominal pain could signal erosion of the gastric mucosa, necessitating prompt discontinuation and gastroprotection.

🟤 The nurse’s role includes early detection and prevention of adverse effects through targeted assessments.

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Answer 8

Correct Answers:

Potassium level of 3.2 mEq/L (3.2 mmol/L).

Rationale :

⚫ A low potassium level (hypokalemia) increases the risk of digoxin toxicity due to competition for sodium-potassium ATPase receptors.

⚫ Symptoms of digoxin toxicity can include arrhythmias, vision changes, nausea, and lethargy.

⚫ Prompt reporting is essential because digoxin has a narrow therapeutic index, and electrolyte imbalances exacerbate its effects.

⚫ Correcting the potassium level helps prevent potentially life-threatening cardiac complications.

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Answer 9

Correct Answers:

Hypertension.

Rationale :

⚪ Phenylephrine is a vasoconstrictor that raises blood pressure by stimulating alpha-adrenergic receptors, which is contraindicated in hypertensive clients.

⚪ It can exacerbate preexisting hypertension, increasing the risk of stroke, heart attack, or hypertensive crisis.

⚪ The nurse must review comorbidities before administering decongestants to prevent serious cardiovascular effects.

⚪ Clients with hypertension should receive alternative therapies for nasal congestion.

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Answer 10

Correct Answers:

Body mass index (BMI).

Rationale :

🟥 Orlistat works by blocking the absorption of dietary fats in the intestine, leading to weight loss over time.

🟥 The best measure of long-term effectiveness is the Body Mass Index (BMI), which evaluates weight relative to height.

🟥 Monitoring BMI regularly allows providers to assess whether the client is meeting weight loss goals.

🟥 BMI reflects true therapeutic outcomes, not just dietary compliance or mood.

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RN-HESI Pharmacology Final Exam

No.

1 :
A client who is taking an oral contraceptive receives a new prescription for erythromycin. Which instruction should the nurse provide to the client?

2 :
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?

3 :
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?

4 :
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?

5 :
A client receives a prescription for allopurinol. Which information provided by the client requires additional instruction by the nurse?

6 :
A client has a new prescription for diclofenac, a nonsteroidal anti-inflammatory drug (NSAID). Which information in the client’s history is of greatest concern to the nurse in monitoring the client’s response to this medication?

7 :
A client with chronic lower back pain has been taking ibuprofen PO twice a day for several months. Which assessment is most important for the nurse to complete?

9 :
A client with nasal congestion receives a prescription for phenylephrine 10 mg PO every 4 hours. Which client condition should the nurse report to the healthcare provider before administering the medication?

10 :
A client is receiving orlistat as part of a weight management program. Which ongoing assessment should be included in the plan of care to determine the effectiveness of the medication?

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RN-HESI Pharmacology Final Exam

No.

1 : A client who is taking an oral contraceptive receives a new prescription for erythromycin. Which instruction should the nurse provide to the client?

2 : 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?

3 : 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?

4 : 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?

5 : A client receives a prescription for allopurinol. Which information provided by the client requires additional instruction by the nurse?

6 : A client has a new prescription for diclofenac, a nonsteroidal anti-inflammatory drug (NSAID). Which information in the client’s history is of greatest concern to the nurse in monitoring the client’s response to this medication?

7 : A client with chronic lower back pain has been taking ibuprofen PO twice a day for several months. Which assessment is most important for the nurse to complete?

9 : A client with nasal congestion receives a prescription for phenylephrine 10 mg PO every 4 hours. Which client condition should the nurse report to the healthcare provider before administering the medication?

10 : A client is receiving orlistat as part of a weight management program. Which ongoing assessment should be included in the plan of care to determine the effectiveness of the medication?

1 :
A client who is taking an oral contraceptive receives a new prescription for erythromycin. Which instruction should the nurse provide to the client?

2 :
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?

3 :
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?

4 :
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?

5 :
A client receives a prescription for allopurinol. Which information provided by the client requires additional instruction by the nurse?

6 :
A client has a new prescription for diclofenac, a nonsteroidal anti-inflammatory drug (NSAID). Which information in the client’s history is of greatest concern to the nurse in monitoring the client’s response to this medication?

7 :
A client with chronic lower back pain has been taking ibuprofen PO twice a day for several months. Which assessment is most important for the nurse to complete?

9 :
A client with nasal congestion receives a prescription for phenylephrine 10 mg PO every 4 hours. Which client condition should the nurse report to the healthcare provider before administering the medication?

10 :
A client is receiving orlistat as part of a weight management program. Which ongoing assessment should be included in the plan of care to determine the effectiveness of the medication?