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 is a sulfonylurea that stimulates insulin secretion, increasing the risk of hypoglycemia.

👁️Symptoms such as confusion and blurred vision are classic signs of low blood sugar and warrant immediate evaluation.

🧪A fingerstick blood glucose test is the quickest and most accurate way to confirm hypoglycemia at the bedside.

📋This diagnostic step guides further interventions, such as glucose administration, if levels are critically low.

📌Core Message

Always check blood glucose when symptoms suggest hypoglycemia, especially with sulfonylureas like glipizide.

Answer 2

Correct Answers:

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

Rationale :

🧬Enoxaparin is a low molecular weight heparin that can cause thrombocytopenia, increasing the risk of bleeding.

🩸A platelet count of 100,000 is significantly low and may indicate heparin-induced thrombocytopenia (HIT).

⚠️Immediate notification of the healthcare provider is essential to prevent serious hemorrhagic complications.

📊Other labs listed are within normal limits and do not pose urgent risks when using enoxaparin.

📌Core Message

A low platelet count is a serious risk when using enoxaparin, requiring immediate action.

Answer 3

Correct Answers:

Decreased appetite.
Intolerance to cold.
Constipation.

Rationale :

🥶Cold intolerance is due to the decreased metabolic rate in hypothyroidism, reducing internal heat production.

🍽️Clients may experience decreased appetite despite potential weight gain, a result of slower digestion and reduced caloric needs.

🚽Constipation results from a sluggish gastrointestinal tract, common in hypothyroid states.

😴Restlessness is not typical; fatigue and lethargy are more consistent symptoms due to reduced cellular activity.

📌Core Message

Hypothyroidism is marked by low metabolism, leading to cold intolerance, low appetite, and constipation.

Answer 4

Correct Answers:

Take the medication early in the day.

Rationale :

⏰Taking levothyroxine early prevents insomnia, a sign of potential overdosage or increased sensitivity.

😴If taken late, the medication may mimic hyperthyroid symptoms, including difficulty sleeping.

📚Clients must be educated on proper timing to avoid accidental overstimulation and monitor for signs of toxicity.

🧠Other listed instructions are unrelated to dosage effects or timing.

📌Core Message

Take levothyroxine early to avoid insomnia, which may indicate excess thyroid hormone levels.

Answer 5

Correct Answers:

Hypertension.

Rationale :

💉Methylphenidate is a central nervous system stimulant that can raise blood pressure and exacerbate hypertension.

📈Pre-existing hypertension must be evaluated to prevent cardiovascular complications.

🩺Monitoring is especially important in older adults or those with cardiovascular risk factors.

💊Conditions like diabetes or bronchitis are not direct contraindications for this stimulant.

📌Core Message

Methylphenidate may increase blood pressure, so assess for hypertension before use.

Answer 6

Correct Answers:

Hard candy can be used for a dry mouth.
Insomnia may occur while taking the medication.

Rationale :

👅Dry mouth is a common anticholinergic side effect of tamsulosin, and hard candy can stimulate saliva and relieve discomfort.

🌙Tamsulosin may interfere with sleep due to its central nervous system activity, potentially causing insomnia.

💊Clients should be informed about how to manage these effects for better adherence.

📖Education about these symptoms improves comfort and compliance with long-term treatment.

📌Core Message

Tamsulosin can cause dry mouth and insomnia, which should be managed with simple supportive measures.

Answer 7

Correct Answers:

Another form of contraception is not needed.

Rationale :

💊St. John's wort can induce liver enzymes, reducing the effectiveness of hormonal contraceptives.

⚠️Clients must be advised to use additional contraception to avoid unintended pregnancy.

🌿Although other side effects like dry mouth and sun sensitivity are important, this interaction is most critical.

📋Proper education ensures that herbal use doesn’t undermine medication efficacy.

📌Core Message

St. John’s wort may reduce birth control effectiveness, so backup contraception is essential.

Answer 8

Correct Answers:

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

Rationale :

🚬Post-surgical smoking increases risks for delayed healing, pneumonia, and cardiac complications.

📣Nurses must provide clear health education to discourage harmful behaviors during recovery.

🛌Allowing smoking in the room or in a wheelchair ignores the physiological risks and safety policies.

💬This answer promotes smoking cessation and protects postoperative recovery.

📌Core Message

Smoking post-surgery is harmful—patients must be educated and discouraged from continuing.

Answer 9

Correct Answers:

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

Rationale :

👁️Some eye drops increase aqueous humor or cause blurred vision by altering fluid dynamics.

🌫️Clients should be educated to expect temporary changes in vision, especially with glaucoma medications.

🧴This helps distinguish between expected effects and true complications.

🧠Other options may be less immediately relevant to client-reported symptoms.

📌Core Message

Certain eye drops may cause blurred vision due to increased ocular fluid or pressure.

Answer 10

Correct Answers:

The eye drops slow pupil response to accommodate for darkness.

Rationale :

🌙Pilocarpine causes miosis, reducing the pupil’s ability to dilate in dim light.

🔅Clients may report night vision difficulties due to impaired light adaptation.

💊This is a normal effect of the medication and should be explained clearly to reduce anxiety or misuse.

📖Understanding expected effects builds medication confidence and adherence.

📌Core Message

Pilocarpine reduces pupil dilation, causing night vision problems due to impaired dark adaptation.

HESI RN Pharmacology 2024 Exam 4

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 client is receiving tamsulosin for the management of urinary retention due to benign prostatic hyperplasia (BPH). Which instruction is most important for the nurse to provide?

7 :
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?

8 :
When the nurse discontinues a 24-hour postoperative client's patient-controlled analgesia (PC).

9 :
The nurse discontinues the client's patient-controlled analgesia (PC).

10 :
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?

HESI RN Pharmacology 2024 Exam 4

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 client is receiving tamsulosin for the management of urinary retention due to benign prostatic hyperplasia (BPH). Which instruction is most important for the nurse to provide?

7 : 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?

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

9 : The nurse discontinues the client's patient-controlled analgesia (PC).

10 : 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?

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 client is receiving tamsulosin for the management of urinary retention due to benign prostatic hyperplasia (BPH). Which instruction is most important for the nurse to provide?

7 :
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?

8 :
When the nurse discontinues a 24-hour postoperative client's patient-controlled analgesia (PC).

9 :
The nurse discontinues the client's patient-controlled analgesia (PC).

10 :
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?