Question

A client reports confusion and blurred vision after receiving a dose of glipizide. Which action should the nurse implement?

Answer 1

Correct Answers:

Obtain a fingerstick blood glucose.

Rationale :

🩸 Glipizide, a sulfonylurea, stimulates pancreatic beta cells to release insulin, which can lead to hypoglycemia as a common adverse effect.

🩸 The symptoms of confusion and blurred vision suggest low serum glucose levels that need immediate verification.

🩸 A fingerstick blood glucose test is the fastest and most appropriate diagnostic tool to determine if hypoglycemia is present.

🩸 Timely identification of low glucose allows for rapid intervention, such as oral glucose administration or glucagon if needed.

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Answer 2

Correct Answers:

Platelet count of 100,000/mm³ (100 x 10⁹/L).

Rationale :

✍️ Enoxaparin is an anticoagulant that can cause heparin-induced thrombocytopenia (HIT), a serious immune-mediated drop in platelet count.

✍️ A platelet count of 100,000/mm³ is significantly below the normal range (150,000–400,000/mm³), increasing the client’s risk for spontaneous bleeding.

✍️ Because enoxaparin inhibits clotting, its use in a patient with low platelets can exacerbate bleeding complications such as internal hemorrhage.

✍️ The nurse must immediately notify the provider, withhold the medication, and anticipate further orders such as HIT testing or a change in therapy.

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Answer 3

Correct Answers:

Decreased appetite.
Intolerance to cold.
Constipation

Rationale :

❄️ Decreased appetite

🔹Clients with hypothyroidism often experience a reduced appetite due to a lower metabolic rate and slowed gastrointestinal function.

🔹 Despite reduced food intake, these clients may gain weight, since energy expenditure is significantly impaired.

🔹 This change in appetite is a typical, though often overlooked, sign of thyroid hormone deficiency.

❄️ Intolerance to cold

🔹 One of the hallmark symptoms of hypothyroidism is cold intolerance, caused by a decrease in cellular metabolism and thermogenesis.

🔹Clients may report feeling cold even in warm environments due to reduced heat production in peripheral tissues.

🔹This occurs because thyroid hormones play a key role in regulating basal metabolic rate and body temperature.

❄️Constipation

🔹The slowing of gastrointestinal motility is a direct effect of thyroid hormone deficiency, contributing to chronic constipation.

🔹Clients often report infrequent and difficult bowel movements, which are resistant to dietary changes alone.

🔹 This symptom often improves with thyroid hormone replacement, highlighting the hormone's role in smooth muscle tone.

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Answer 4

Correct Answers:

Take the medication early in the day.

Rationale :

☀️ Levothyroxine is a synthetic form of thyroid hormone that can lead to insomnia if taken later in the day, due to its stimulatory effect on metabolism.

☀️ Administering it early in the morning on an empty stomach ensures maximum absorption and mimics the body's natural circadian rhythm of hormone release.

☀️ Clients reporting difficulty sleeping may be inadvertently taking the dose too late in the day, which elevates resting energy levels into the night.

☀️ Teaching proper timing of levothyroxine is essential to prevent adverse effects and ensure treatment adherence.

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Answer 5

Correct Answers:

Hypertension.

Rationale :

💢 Methylphenidate is a central nervous system stimulant that can cause sympathetic nervous system activation, resulting in increased heart rate and blood pressure.

💢 In clients with pre-existing hypertension, this effect may worsen their condition and increase the risk of stroke, cardiac arrhythmia, or hypertensive crisis.

💢 Prior to administration, the nurse should always review the client’s vital signs and history, especially for cardiovascular disorders, to determine if it's safe to proceed.

💢 Monitoring blood pressure trends is crucial, especially when initiating or adjusting stimulant medication.

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Answer 6

Correct Answers:

Another form of contraception is not needed.

Rationale :

✍️ St. John's Wort is known to induce cytochrome P450 enzymes, which leads to increased metabolism of many medications, including oral contraceptives.

✍️ This interaction reduces the efficacy of hormonal birth control, increasing the risk for unintended pregnancy.

✍️ Clients must be advised to use a barrier method or backup contraception while taking this herbal supplement, even if taken sporadically.

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Answer 7

Correct Answers:

"Smoking is hazardous to your health, and since you just had surgery, it would be best for you to avoid smoking."

Rationale :

🔷 After surgery, smoking can impair wound healing, reduce oxygenation, and increase the risk of postoperative pulmonary complications, such as atelectasis or pneumonia.

🔷 The nurse should use this opportunity to provide therapeutic health education, focusing on the long-term and immediate risks of tobacco use after surgery.

🔷 This statement demonstrates client-centered care by addressing a teachable moment and encouraging smoking cessation in the recovery phase.

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Answer 8

Correct Answers:

The drops increase the fluid in the eyes and cloud the visual field.

Rationale :

🔸Pilocarpine can cause miosis, increased aqueous humor outflow, and blurred vision.

🔸Clients may complain of clouding, decreased night vision, and difficulty focusing.

🔸This adverse effect should be monitored and reported, especially if it worsens.

🔸Slowed pupil accommodation may occur, but visual field clouding is more immediate.

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Answer 9

Correct Answers:

Notify the healthcare provider of the finding.

Rationale :

🔷 A serum total calcium level of 5.5 mg/dL is critically low and indicates severe hypocalcemia, which can cause muscle cramps, tetany, seizures, or cardiac arrhythmias.

🔷 Methylprednisolone, a corticosteroid, can further decrease calcium levels by reducing intestinal calcium absorption and increasing renal excretion.

🔷 Before administering this medication, the nurse must notify the provider immediately, as administration without correction could exacerbate the electrolyte imbalance.

🔷 The provider may order calcium supplementation, delay the steroid dose, or require more extensive monitoring depending on the client's condition.

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Answer 10

Correct Answers:

Takes metformin hydrochloride for type 2 diabetes mellitus.

Rationale :

🌟 Metformin combined with iodinated contrast can increase the risk of lactic acidosis, a potentially life-threatening condition.

🌟 This occurs due to possible renal impairment following contrast exposure, which can impair metformin excretion.

🌟 It is standard protocol to withhold metformin before and after the contrast-enhanced scan, depending on kidney function.

🌟 The nurse must notify the healthcare provider and possibly delay the scan or adjust the medication accordingly.

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HESI-RN Pharmacology~106A

No.

1 :
A client reports confusion and blurred vision after receiving a dose of glipizide. Which action should the nurse implement?

3 :
What are the signs and symptoms of hypothyroidism?

4 :
Levothyroxine sodium is prescribed for a client with hypothyroidism. The nurse should instruct the client to report which symptom because it indicates that the client is taking too much levothyroxine sodium?

5 :
A client with narcolepsy receives a new prescription for methylphenidate. Prior to administration of the medication, the nurse should review the medical record for which condition?

6 :
A female client with mild depression reports to the nurse recently starting St. John's wort. Which information provided by the client requires further instruction?

7 :
When the nurse discontinues a 24-hour postoperative client's patient-controlled analgesia (PC)

8 :
A client is receiving pilocarpine hydrochloride ophthalmic drops for glaucoma. The client calls the clinic nurse and reports difficulty seeing at night. Which explanation should the nurse provide?

9 :
Prior to administering an oral dose of methylprednisolone, the nurse determines the client's serum total calcium level is 5.5 mg/dL (1.4 mmol/L). Which action is most important for the nurse to take? Reference Range: Total Calcium (9 to 10.4 mg/dL (2.3 to 2.6 mmol/L)

10 :
A client is scheduled for a spiral computed tomography (CT) scan with contrast to evaluate for pulmonary embolism. Which information in the client's history requires follow-up by the nurse?

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HESI-RN Pharmacology~106A

No.

1 : A client reports confusion and blurred vision after receiving a dose of glipizide. Which action should the nurse implement?

3 : What are the signs and symptoms of hypothyroidism?

4 : Levothyroxine sodium is prescribed for a client with hypothyroidism. The nurse should instruct the client to report which symptom because it indicates that the client is taking too much levothyroxine sodium?

5 : A client with narcolepsy receives a new prescription for methylphenidate. Prior to administration of the medication, the nurse should review the medical record for which condition?

6 : A female client with mild depression reports to the nurse recently starting St. John's wort. Which information provided by the client requires further instruction?

7 : When the nurse discontinues a 24-hour postoperative client's patient-controlled analgesia (PC)

8 : A client is receiving pilocarpine hydrochloride ophthalmic drops for glaucoma. The client calls the clinic nurse and reports difficulty seeing at night. Which explanation should the nurse provide?

9 : Prior to administering an oral dose of methylprednisolone, the nurse determines the client's serum total calcium level is 5.5 mg/dL (1.4 mmol/L). Which action is most important for the nurse to take? Reference Range: Total Calcium (9 to 10.4 mg/dL (2.3 to 2.6 mmol/L)

10 : A client is scheduled for a spiral computed tomography (CT) scan with contrast to evaluate for pulmonary embolism. Which information in the client's history requires follow-up by the nurse?

1 :
A client reports confusion and blurred vision after receiving a dose of glipizide. Which action should the nurse implement?

3 :
What are the signs and symptoms of hypothyroidism?

4 :
Levothyroxine sodium is prescribed for a client with hypothyroidism. The nurse should instruct the client to report which symptom because it indicates that the client is taking too much levothyroxine sodium?

5 :
A client with narcolepsy receives a new prescription for methylphenidate. Prior to administration of the medication, the nurse should review the medical record for which condition?

6 :
A female client with mild depression reports to the nurse recently starting St. John's wort. Which information provided by the client requires further instruction?

7 :
When the nurse discontinues a 24-hour postoperative client's patient-controlled analgesia (PC)

8 :
A client is receiving pilocarpine hydrochloride ophthalmic drops for glaucoma. The client calls the clinic nurse and reports difficulty seeing at night. Which explanation should the nurse provide?

9 :
Prior to administering an oral dose of methylprednisolone, the nurse determines the client's serum total calcium level is 5.5 mg/dL (1.4 mmol/L). Which action is most important for the nurse to take? Reference Range: Total Calcium (9 to 10.4 mg/dL (2.3 to 2.6 mmol/L)

10 :
A client is scheduled for a spiral computed tomography (CT) scan with contrast to evaluate for pulmonary embolism. Which information in the client's history requires follow-up by the nurse?