Question

The nurse is administering the muscle relaxant baclofen by mouth (PO) to a client diagnosed with multiple sclerosis. Which intervention should the nurse implement?

Answer 1

Correct Answers:

Advise the client to move slowly and cautiously when rising and walking.

Rationale :

🧍‍♀️Baclofen is a centrally acting muscle relaxant that can cause drowsiness, dizziness, and orthostatic hypotension, especially when therapy begins.

⚖️Clients are at risk for falls and injuries if they stand or walk quickly without caution.

🧪Monitoring intake/output or muscle strength is not a primary safety concern unless complications arise.

🚫It is not necessary to stop baclofen before other antispasmodics without provider guidance.

📌Core Message

Baclofen can cause dizziness and drowsiness, so instruct clients to rise slowly to prevent falls.

Answer 2

Correct Answers:

Advise the client that the healthcare provider needs to be made aware of her current diet.

Rationale :

🥗Leafy green vegetables contain vitamin K, which affects warfarin's anticoagulant action.

📈Sudden changes in vitamin K intake can lead to fluctuating INR levels, increasing the risk for bleeding or clotting.

📋The provider must be informed so they can adjust the warfarin dose accordingly.

🧘Maintaining a consistent diet is key—not eliminating healthy vegetables entirely.

📌Core Message

Vitamin K intake affects warfarin, so the provider must be aware of the client’s consistent diet.

Answer 3

Correct Answers:

Wort can decrease plasma concentrations of cyclosporine.

Rationale :

🌿St. John's Wort induces hepatic enzymes, which decrease cyclosporine levels, putting the client at risk of graft rejection.

💊Cyclosporine is a critical immunosuppressant, and reduced blood levels can result in immune attack on the transplanted organ.

🧪This interaction is more clinically significant than its use for depression or any nutritional effects.

📋Clients should be advised to avoid herbal supplements unless cleared by their provider.

📌Core Message

St. John's Wort reduces cyclosporine levels, increasing the risk of organ rejection after transplant.

Answer 4

Correct Answers:

Ask the client to rate the current level of pain using a pain scale.

Rationale :

📏Assessing pain with a validated pain scale helps the nurse determine the appropriate medication dose and timing.

🗣️It validates the client’s concern and provides a baseline for evaluating relief.

📋Reviewing drug history and last dose are important but come after assessing the current pain intensity.

💡Diversional strategies may help but are not substitutes for pain evaluation and treatment.

📌Core Message

Use a pain scale first to assess pain intensity before administering or adjusting pain medication.

Answer 5

Correct Answers:

Recent use of other antidepressants.

Rationale :

💣Combining duloxetine with other antidepressants can cause serotonin syndrome, a life-threatening complication.

🌡️Symptoms include hyperreflexia, agitation, tremor, and hyperthermia.

🧪Obtaining information about previous medications helps the nurse identify risk for dangerous drug interactions.

📋Family history, weight, and liver labs are relevant but not as urgent as drug interaction risks.

📌Core Message

Recent antidepressant use must be assessed before starting duloxetine to prevent serotonin syndrome.

Answer 6

Correct Answers:

Hold both medications until contacting the healthcare provider.

Rationale :

⚠️A calcium level of 14 mg/dL is indicative of severe hypercalcemia, which is a potential medical emergency.

🧪Both calcitriol and calcium carbonate can increase calcium levels and should be withheld to avoid complications.

📞The healthcare provider must be informed immediately before continuing treatment.

🧍Continuing either medication could exacerbate hypercalcemia and lead to cardiac arrhythmias or kidney stones.

📌Core Message

With hypercalcemia, hold both calcium supplements and vitamin D until the provider is consulted.

Answer 7

Correct Answers:

Involuntary movements.

Rationale :

💃Metoclopramide can cause extrapyramidal symptoms (EPS), such as tardive dyskinesia or dystonia, especially in long-term use.

🧠These include repetitive, involuntary facial or limb movements and require immediate discontinuation.

📋Diarrhea, nausea, or irritability are common side effects, but EPS is potentially irreversible and must be prioritized.

🧾Prompt reporting ensures early intervention to prevent permanent motor disturbances.

📌Core Message

Involuntary movements from metoclopramide suggest extrapyramidal effects and must be reported.

Answer 8

Correct Answers:

Protect the skin from sunlight while taking the drug.

Rationale :

🌞Tetracyclines cause photosensitivity, leading to severe sunburn even with brief sun exposure.

🧴Clients should use sunblock and protective clothing while taking this drug.

🍊Orange juice and dairy products reduce absorption due to calcium binding, and weekly drug levels are not needed.

📋GI irritation can be managed by taking with water—not with milk or antacids.

📌Core Message

Tetracyclines increase sun sensitivity, so clients must protect skin from sunlight during use.

Answer 9

Correct Answers:

Immediately after completion of the IV dose and 30 minutes before the next administration of the medication.

Rationale :

🩸The peak level of IV vancomycin is measured immediately after infusion ends, and the trough level is measured 30 minutes before the next dose.

🕐This helps determine therapeutic levels and toxicity risk.

🧪Monitoring ensures effectiveness while avoiding nephrotoxicity or ototoxicity.

📋Improper timing may lead to inaccurate results and unsafe dosing.

📌Core Message

Vancomycin peak and trough should be drawn immediately post-infusion and 30 minutes pre-dose for accuracy.

Answer 10

Correct Answers:

Low sodium antacid.

Rationale :

🔥Antacids can relieve reflux and heartburn, and low sodium formulations are preferred for clients with heart failure to prevent fluid retention.

💊Other choices like diphenhydramine, aspirin, or acetaminophen are not effective or may worsen symptoms or heart failure.

🧂Sodium-containing products can exacerbate fluid overload in heart failure clients.

📋This recommendation balances symptom relief and cardiac safety.

📌Core Message

Use a low sodium antacid to treat heartburn safely in clients with heart failure.

HESI RN Pharmacology2025 exam 2

No.

1 :
The nurse is administering the muscle relaxant baclofen by mouth (PO) to a client diagnosed with multiple sclerosis. Which intervention should the nurse implement?

2 :
A female client who is a vegetarian has a new prescription for warfarin. The client states she eats leafy green vegetables every day. How should the nurse respond?

4 :
A client in the surgical recovery area asks the nurse to bring the largest possible dose of pain medication available. Which action should the nurse implement first?

5 :
The nurse is planning care for a client with major depression who is receiving a new prescription for duloxetine. Which information is most important for the nurse to obtain?

7 :
A client with chemotherapy induced nausea receives a prescription for metoclopramide. Which adverse effect is most important for the nurse to report?

8 :
The healthcare provider prescribes the antibiotic tetracycline HCI for an adult client that arrived at an outpatient clinic. Which instruction should the nurse include in the teaching plan for this client?

9 :
A client is receiving intravenous (IV) vancomycin and the nurse plans to draw blood for a peak and trough to determine the serum level of the drug. Which collection times provide the best determination of these levels?

10 :
A male client with a history of heart failure (HF) complains of heartburn when he lies down after dinner. The home health nurse should encourage the client to talk to the healthcare provider about using which over-the-counter medication to relieve this problem?

HESI RN Pharmacology2025 exam 2

No.

1 : The nurse is administering the muscle relaxant baclofen by mouth (PO) to a client diagnosed with multiple sclerosis. Which intervention should the nurse implement?

2 : A female client who is a vegetarian has a new prescription for warfarin. The client states she eats leafy green vegetables every day. How should the nurse respond?

4 : A client in the surgical recovery area asks the nurse to bring the largest possible dose of pain medication available. Which action should the nurse implement first?

5 : The nurse is planning care for a client with major depression who is receiving a new prescription for duloxetine. Which information is most important for the nurse to obtain?

7 : A client with chemotherapy induced nausea receives a prescription for metoclopramide. Which adverse effect is most important for the nurse to report?

8 : The healthcare provider prescribes the antibiotic tetracycline HCI for an adult client that arrived at an outpatient clinic. Which instruction should the nurse include in the teaching plan for this client?

9 : A client is receiving intravenous (IV) vancomycin and the nurse plans to draw blood for a peak and trough to determine the serum level of the drug. Which collection times provide the best determination of these levels?

10 : A male client with a history of heart failure (HF) complains of heartburn when he lies down after dinner. The home health nurse should encourage the client to talk to the healthcare provider about using which over-the-counter medication to relieve this problem?

1 :
The nurse is administering the muscle relaxant baclofen by mouth (PO) to a client diagnosed with multiple sclerosis. Which intervention should the nurse implement?

2 :
A female client who is a vegetarian has a new prescription for warfarin. The client states she eats leafy green vegetables every day. How should the nurse respond?

4 :
A client in the surgical recovery area asks the nurse to bring the largest possible dose of pain medication available. Which action should the nurse implement first?

5 :
The nurse is planning care for a client with major depression who is receiving a new prescription for duloxetine. Which information is most important for the nurse to obtain?

7 :
A client with chemotherapy induced nausea receives a prescription for metoclopramide. Which adverse effect is most important for the nurse to report?

8 :
The healthcare provider prescribes the antibiotic tetracycline HCI for an adult client that arrived at an outpatient clinic. Which instruction should the nurse include in the teaching plan for this client?

9 :
A client is receiving intravenous (IV) vancomycin and the nurse plans to draw blood for a peak and trough to determine the serum level of the drug. Which collection times provide the best determination of these levels?

10 :
A male client with a history of heart failure (HF) complains of heartburn when he lies down after dinner. The home health nurse should encourage the client to talk to the healthcare provider about using which over-the-counter medication to relieve this problem?