HESI-P HESI Pharmacology - Set 4 - Part 2

Correct Answer: Drink three thousand milliliters of fluid

Allopurinol clients are instructed to drink three thousand milliliters of fluid daily unless contraindicated to prevent uric acid kidney stones. Full therapeutic effect requires one week or longer, and the drug is taken with meals or milk. Option a is incorrect because allopurinol is taken with or immediately after meals or milk to reduce gastric irritation. The empty stomach directive does not apply to this antigout medication and contradicts the chapter's administration guidance for clients. Option b is incorrect because the full therapeutic effect requires one week or longer rather than an immediate response. Teaching the client to expect immediate effect creates unrealistic expectations and may prompt premature discontinuation or self-adjustment of dosing. Option c is incorrect because swelling of the lips or mouth represents a hypersensitivity reaction that requires prescriber notification and possible medication discontinuation. Calling this finding normal misrepresents the

Correct Answer: Chronic kidney disease stage three

Colchicine is used with caution in older clients, debilitated clients, and those with cardiac, renal, or gastrointestinal disease. If gastrointestinal symptoms occur, the nurse withholds the medication and notifies the prescriber promptly. Option a is incorrect because hypothyroidism is not on the chapter's caution list for colchicine therapy. The chapter focuses specifically on cardiac, renal, and gastrointestinal disease for colchicine cautions rather than thyroid disorders in any setting. Option b is incorrect because diabetes is not identified as a caution for colchicine in the chapter. The renal and gastrointestinal organ systems are the chapter's caution parameters because of metabolism and elimination concerns rather than glycemic concerns. Option d is incorrect because myxedema is a severe form of hypothyroidism but remains absent from the chapter's colchicine caution list. The chapter focuses on cardiac, renal, and gastrointestinal systems rather than thyroid pa

Correct Answer: Take with full water on rising

Alendronate is taken in the morning after rising with a full glass of water before eating or drinking anything else. The client remains sitting or standing for at least thirty minutes to prevent esophageal irritation. Option a is incorrect because taking the medication at bedtime is incorrect because the client cannot remain upright for thirty minutes while sleeping. The chapter requires upright positioning to prevent reflux and esophageal irritation after each dose. Option c is incorrect because taking with breakfast impairs absorption of the bisphosphonate and reduces therapeutic effect substantially. The chapter requires an empty stomach interval before food or drink so the medication can be absorbed properly in the gastrointestinal tract. Option d is incorrect because lying down after the dose allows reflux of the bisphosphonate against the esophageal mucosa and increases esophagitis risk. The chapter explicitly directs the client to remain sitting or standing after the dose.

Correct Answer: Avoid the use of alcohol

Baclofen is a skeletal muscle relaxant that potentiates central nervous system depression when combined with alcohol. The client should also be warned about constipation, urinary retention, and the importance of avoiding other depressants. Option b is incorrect because fluid restriction is not part of baclofen teaching, since constipation and urinary retention are the relevant gastrointestinal and urinary effects. The chapter directs warning about alcohol rather than fluid limitation for this medication. Option c is incorrect because constipation rather than diarrhea is associated with baclofen, so the premise is inaccurate. Discontinuing baclofen abruptly can cause life-threatening withdrawal effects, especially with intrathecal pump delivery in chronic users. Option d is incorrect because fatigue is a common early central nervous system effect of baclofen that typically diminishes over time. The chapter does not direct prescriber notification for routine fatigue, but does direct alco

Correct Answer: Liver function tests

Dose-related liver damage is the most serious adverse effect of dantrolene. Liver function tests are performed before initiation and throughout therapy, and the medication is given at the lowest effective dose for the shortest necessary duration. Option a is incorrect because platelet count does not detect dantrolene's primary adverse effect on the liver. Bone marrow suppression is not the chapter-described risk for this skeletal muscle relaxant, so platelet monitoring is not the targeted test. Option b is incorrect because serum creatinine evaluates renal function rather than dantrolene's primary hepatic toxicity risk. The chapter directs liver enzyme monitoring rather than kidney chemistry because the liver is the affected organ in dantrolene therapy. Option c is incorrect because blood urea nitrogen evaluates renal function and protein metabolism, not the hepatic injury risk of dantrolene. Selecting this test would miss the chapter-described dose-related hepatotoxicity tha

Correct Answer: Angle-closure glaucoma

Cyclobenzaprine has significant anticholinergic effects that increase intraocular pressure and worsen angle-closure glaucoma. The chapter also lists urinary retention as a caution and limits use to two to three weeks of short-term therapy. Option a is incorrect because type two diabetes is not a chapter-listed contraindication or caution for cyclobenzaprine therapy. The anticholinergic profile creates ocular and urinary concerns rather than glycemic risks in this skeletal muscle relaxant for adults. Option b is incorrect because hypothyroidism on levothyroxine is not flagged as a cyclobenzaprine contraindication in the chapter. The chapter focuses on glaucoma, urinary retention, and cardiac disease as the specific cautions for this medication in clinical practice. Option d is incorrect because mild emphysema without oxygen does not appear among the chapter's flagged conditions for this medication. Pulmonary disease is not the target of anticholinergic caution, whereas the elevated

Correct Answer: Avoid aspirin; use acetaminophen instead

Aspirin and other salicylates interfere with the uricosuric action of probenecid. The chapter directs clients on antigout medications to take acetaminophen rather than aspirin, since concurrent salicylate use elevates uric acid levels. Option b is incorrect because once-daily aspirin still interferes with the uricosuric action of probenecid regardless of frequency. The chapter directs complete avoidance of aspirin in favor of acetaminophen for clients receiving antigout medication for gout management. Option c is incorrect because taking aspirin with meals reduces gastric irritation but does not address the interference with probenecid uricosuric action. The chapter directs replacing aspirin with acetaminophen rather than adjusting timing of salicylate doses for antigout therapy. Option d is incorrect because doubling aspirin doses worsens the chapter-described interaction by increasing uric acid retention. The chapter directs replacement of aspirin with acetaminophen rather than dose

Correct Answer: Bradycardia and hypotension

Intravenous methocarbamol can cause hypotension, bradycardia, anaphylaxis, and seizures, especially when administered rapidly. The nurse also monitors the infusion site for extravasation because the medication can cause thrombophlebitis and tissue sloughing. Option a is incorrect because hypertension with bounding pulse is the opposite of the chapter-described hemodynamic effect of intravenous methocarbamol. The medication lowers rather than raises blood pressure during and after administration in the clinical setting. Option c is incorrect because tachycardia is not the chapter-described intravenous effect of methocarbamol on heart rate. The recognized cardiovascular adverse effect is bradycardia, contrasting with the sympathetic stimulation pattern suggested in this option. Option d is incorrect because rapid pulse and fever do not match the chapter-described intravenous methocarbamol effect. Febrile sympathetic activation suggests anaphylactoid reaction or infection rather than the

Correct Answer: Tardive dyskinesia of the face

Tardive dyskinesia presents as protrusion of the tongue, chewing motions, and involuntary movement of the body and extremities. It typically appears after prolonged antipsychotic therapy and may persist even after the medication is discontinued. Option a is incorrect because parkinsonism presents with tremor, mask-like facies, rigidity, shuffling gait, and drooling rather than tongue protrusion. The described movements are characteristic of late-onset dyskinetic syndrome rather than parkinsonism extrapyramidal symptoms in clinical practice. Option b is incorrect because hypertensive crisis is associated with monoamine oxidase inhibitor tyramine interaction, not antipsychotic movements. The described oral and facial signs are dyskinetic rather than autonomic, so they do not represent a hypertensive event. Option c is incorrect because neuroleptic malignant syndrome features hyperpyrexia, rigidity, autonomic instability, and altered consciousness rather than isolated facial movement. The

Correct Answer: White blood cell count for agranulocytosis

Clozapine carries a black-box risk of agranulocytosis, so the white blood cell count is monitored routinely. The client is instructed to report sore throat, fever, and malaise as early signs that warrant prescriber notification immediately. Option a is incorrect because blood glucose can rise with antipsychotic therapy but is not the chapter's signature clozapine monitoring focus. The agranulocytosis risk drives the specific white blood cell surveillance schedule for clozapine rather than glycemic concerns. Option b is incorrect because liver function and bilirubin studies belong to hepatic injury surveillance for medications like dantrolene or methotrexate. Clozapine carries a black-box warning specifically for life-threatening bone marrow toxicity, which a hepatic panel would entirely miss. Option d is incorrect because coagulation studies evaluate bleeding and clotting status for anticoagulants such as warfarin or heparin. They do not detect granulocyte depletion, which is the

Correct Answer: Plain crackers and a tossed salad

Plain crackers and tossed salad lack tyramine and are safe with monoamine oxidase inhibitor therapy. Tyramine-containing foods including aged cheese, sausage, yogurt, bananas, figs, soy sauce, and sauerkraut can trigger life-threatening hypertensive crisis. Option b is incorrect because aged cheese and pepperoni are high-tyramine foods that can cause hypertensive crisis with monoamine oxidase inhibitor therapy. The chapter lists both items among the foods to be avoided during treatment with this antidepressant class. Option c is incorrect because yogurt, bananas, and figs all appear on the chapter's tyramine-containing food list and should be avoided. Combining all three on monoamine oxidase inhibitor therapy creates substantial risk of a hypertensive crisis event. Option d is incorrect because soy sauce and sauerkraut are fermented foods rich in tyramine, exactly the category prohibited during therapy. Eating either item with this antidepressant can precipitate hypertensive crisi

Correct Answer: Take at the same time each evening

Sertraline is an antidepressant administered once every twenty-four hours. Evening administration is often preferred because drowsiness is a side effect, and it may be taken with or without food depending on gastrointestinal tolerance. Option a is incorrect because sertraline may be taken with food if gastrointestinal distress occurs, so empty stomach administration is not required. The chapter directs consistent timing rather than fasting as the key administration principle for this antidepressant. Option b is incorrect because sertraline is not prescribed as needed for symptom flare and must be taken consistently to maintain serum levels. As-needed dosing would prevent achieving the steady-state required for therapeutic antidepressant response over time. Option c is incorrect because spacing doses around the clock contradicts the once-daily dosing schedule for sertraline. The medication is taken once every twenty-four hours at the same time each day rather than divided across the day

Correct Answer: Increase fluids and dietary fiber

Tricyclic antidepressants cause anticholinergic effects including dry mouth, urinary retention, and decreased gastrointestinal motility with constipation. Increasing fluids and dietary bulk helps maintain bowel function and reduces the risk of fecal impaction during therapy. Option a is incorrect because a low-fiber diet would worsen the constipation caused by anticholinergic effects of the medication. The chapter directs increased fiber and fluids to counter the gastrointestinal slowing rather than further restricting bulk intake here. Option c is incorrect because walking would not relieve urinary retention caused by anticholinergic blockade and could be harmful if the bladder is distended. The chapter directs assessment for retention and prescriber notification rather than activity tolerance approaches. Option d is incorrect because rapid heartbeat from tricyclic-induced tachycardia or dysrhythmia warrants prescriber notification rather than rest. The chapter directs all clients to

Correct Answer: Get up slowly when changing positions

Risperidone causes orthostatic hypotension, so the client should rise slowly from sitting or lying positions to prevent dizziness and falls. Sunscreen, hats, and protective clothing should be worn because the medication causes photosensitivity. Option a is incorrect because avoiding potassium-rich foods is not a risperidone-specific teaching point in the chapter. The orthostatic hypotension risk drives the priority discharge teaching rather than dietary potassium restriction for this atypical antipsychotic medication. Option b is incorrect because the client should not continue driving until the response to the medication is known, since sedation and orthostatic effects impair alertness. The chapter directs avoidance of tasks requiring alertness until response is established firmly. Option d is incorrect because encouraging unprotected sun exposure contradicts the photosensitivity warning attached to risperidone. Sunscreen, hats, and protective clothing are required during therapy beca

Correct Answer: Two to three weeks of therapy

Antidepressant medications including imipramine may take several weeks to produce the desired effect, with client response not occurring until two to four weeks after the first dose. The chapter emphasizes this delayed onset during teaching. Option b is incorrect because the first week is too early for maximum desired antidepressant effect. The chapter states that response may not occur until two to four weeks after the first dose. Option c is incorrect because six weeks exceeds the typical chapter-described maximum effect window for tricyclic antidepressants. The expected interval is two to four weeks rather than six, although some response may continue to develop in longer chronic therapy intervals. Option d is incorrect because two months would leave the client waiting longer than the timeline the chapter ties to this tricyclic. Quoting that span risks discontinuation from perceived treatment failure before therapeutic levels and symptom relief actually take hold.

Correct Answer: Seizure activity occurring

Bupropion can lower the seizure threshold, and seizure activity is the adverse effect that suggests excessive dosage. The chapter lists seizures with bupropion among the side and adverse effects requiring immediate prescriber notification and dose review. Option a is incorrect because constipation is a common gastrointestinal effect of several antidepressants but does not specifically indicate excessive bupropion dosage. The chapter ties seizure activity to bupropion overdose rather than gastrointestinal slowing in this clinical scenario. Option b is incorrect because orthostatic dizziness on standing up reflects autonomic blood pressure shifts that occur even at therapeutic antidepressant doses. This common adverse response would not distinguish the dosing problem that the chapter ties to lowered seizure threshold. Option c is incorrect because weight gain is not the chapter-described bupropion adverse effect that signals excessive dosing. The seizure threshold reduction marks bupropi

Correct Answer: Avoid drinking alcohol on this medication

Phenobarbital is a barbiturate that combines with alcohol to cause severe central nervous system depression, drowsiness, slowed breathing, confusion, and coma. Alcohol avoidance is the highest-priority safety teaching for this medication during long-term therapy. Option a is incorrect because taking the medication with meals is a comfort measure but not the highest-priority safety teaching. The life-threatening alcohol interaction outweighs gastrointestinal tolerance considerations in priority ranking for this barbiturate medication during long-term therapy. Option b is incorrect because consistent dosing supports therapeutic levels but is a secondary teaching point compared with avoiding the life-threatening alcohol interaction. The chapter prioritizes alcohol avoidance over scheduling among the discharge instructions for this barbiturate. Option d is incorrect because pill organizers help with adherence but do not address the chapter-identified life-threatening interaction. The alcoh

Correct Answer: Gastrointestinal dysfunctions over weeks

Selective serotonin reuptake inhibitors such as fluoxetine commonly cause gastrointestinal dysfunctions including abdominal pain, diarrhea, and dry mouth. The nurse assesses these effects to determine tolerability and identify possible serotonin syndrome warning signs. Option a is incorrect because cardiovascular palpitations can occur but gastrointestinal effects are the more common adverse effect cluster requiring follow-up. The chapter directs gastrointestinal monitoring as the priority since these symptoms appear early and may affect adherence to therapy. Option c is incorrect because mouth dryness can occur but is less prominent with selective serotonin reuptake inhibitors than with tricyclic antidepressants. Anticholinergic complaints fit tricyclic teaching, while abdominal pain and altered bowel habits dominate this drug class follow-up. Option d is incorrect because excessive sweating problems may suggest serotonin syndrome but represent a rare urgent finding rather than a rout

Correct Answer: Atropine sulfate for cholinergic reversal

Atropine sulfate is the antidote for pilocarpine cholinergic toxicity and must be available during administration. Pilocarpine can cause bradycardia, hypotension, bronchospasm, increased salivation, and other muscarinic effects requiring rapid anticholinergic reversal in emergency situations. Option b is incorrect because naloxone reverses opioid toxicity rather than cholinergic excess from pilocarpine. The chapter pairs each toxicity with a specific antidote, and naloxone does not address the muscarinic effects of this miotic glaucoma medication appropriately. Option c is incorrect because flumazenil reverses benzodiazepine toxicity rather than cholinergic effects of pilocarpine. Stocking the wrong reversal agent leaves bradycardia, bronchospasm, and salivation untreated while precious minutes pass during a glaucoma medication adverse event. Option d is incorrect because phentolamine reverses hypertensive crisis from monoamine oxidase inhibitor and tyramine interaction. It is not the

Correct Answer: Sulfonamide drug allergy

Carbonic anhydrase inhibitors are contraindicated in clients with sulfonamide allergy because of cross-reactivity. The chapter also lists severe renal or liver disease as cautions and warns about hypokalemia, paresthesias, and renal calculi during therapy. Option a is incorrect because latex allergy is not the chapter-identified contraindication for carbonic anhydrase inhibitors. The sulfonamide cross-reactivity drives the specific allergy screening for this drug class rather than environmental rubber allergens in standard glaucoma practice. Option b is incorrect because iodine and shellfish allergy is associated with contrast media reactions rather than carbonic anhydrase inhibitor cross-reactivity. The chapter identifies sulfonamide allergy as the specific contraindication for this antiglaucoma drug class in clinical practice. Option c is incorrect because pollen and seasonal allergies are not associated with carbonic anhydrase inhibitor cross-reactivity. Environmental rhinitis trigg