HESI-P HESI Pharmacology - Set 5 - Part 2

Correct Answer: New infection from leukopenic effect

Frequent adverse effects of pentamidine include leukopenia, thrombocytopenia, and anemia. A new fever in a leukopenic client most likely signals another infection, so the client is monitored routinely for signs of infection during therapy. Option a is incorrect because low dose would be associated with treatment failure or rising organism burden rather than a discrete fever spike. The chapter ties new fever in this scenario to leukopenia-driven infection risk, not to insufficient dosing. Option b is incorrect because toxic effects of pentamidine appear as leukopenia, anemia, and thrombocytopenia rather than fever directly. The fever follows from these effects by allowing infection, so the immediate explanation is infection rather than direct medication toxicity. Option c is incorrect because inadequate thermoregulation is not the leading explanation in a client with known leukopenia and AIDS. The chapter assigns the fever to a new opportunistic infection arising from the leukopenic eff

Correct Answer: Ototoxicity, renal toxicity, dysrhythmias

Aminoglycosides inhibit bacterial growth and cause adverse effects including ototoxicity, renal toxicity, gastrointestinal irritation, palpitations or dysrhythmias, blood pressure changes, confusion, and hypersensitivity reactions. The client is taught to recognize hearing changes immediately. Option b is incorrect because tendon rupture is the fluoroquinolone concern and depression is also listed with that class. Aminoglycoside teaching is anchored on ear, kidney, and rhythm changes, so these effects would belong to a different antimicrobial class. Option c is incorrect because seizures and hepatotoxicity are not the chapter's named adverse effects for aminoglycosides. Seizures appear with sulfonamides and hepatotoxicity with other classes, so grouping them with aminoglycoside teaching would misroute surveillance. Option d is incorrect because Stevens-Johnson syndrome and bone marrow suppression belong with sulfonamides per the chapter. Aminoglycoside teaching highlights hearing

Correct Answer: Anaphylactic hypersensitivity reaction

Penicillins can cause gastrointestinal effects such as sore mouth and furry tongue, superinfections, and hypersensitivity reactions including anaphylaxis. The nurse takes a careful allergy history, has emergency equipment readily available, and stays with the client during administration. Option a is incorrect because furry tongue is a minor adverse effect listed by the chapter and is not the severe reaction. The priority concern during a first dose is hypersensitivity progressing to anaphylaxis, not tongue appearance during continued therapy. Option c is incorrect because sore mouth or oral thrush represents a chronic adverse effect or superinfection rather than the acute reaction the chapter highlights. The severe reaction requiring vigilance for penicillin is anaphylactic hypersensitivity that develops quickly during administration. Option d is incorrect because pseudomembranous colitis is more closely linked with cephalosporins, macrolides, lincosamides, and broad-spectrum antibiot

Correct Answer: Monitor liver function, avoid alcohol and sun

Ketoconazole is hepatotoxic, so liver function studies are monitored, and clients avoid alcohol to reduce hepatic stress. Sun exposure is avoided due to photosensitivity, the drug is taken with food, and antacids are withheld for two hours. Option b is incorrect because restricting fluids is not recommended and could be harmful in this client. Antacids interfere with absorption when given near the dose, so pairing fluid restriction with antacid use contradicts the chapter's safe administration guidance. Option c is incorrect because ketoconazole must be taken with food rather than on an empty stomach, and antacids are withheld for two hours after the dose. The pairing in this option directly contradicts the chapter's stated administration guidance. Option d is incorrect because free use of antacids interferes with ketoconazole absorption and undermines the antifungal effect. Spacing is required because alkaline pH blunts uptake, so unrestricted daily pairing would lower serum

Correct Answer: Nephrotoxicity, marrow suppression, GI effects

Sulfonamides cause nephrotoxicity, bone marrow suppression, and gastrointestinal effects, along with hepatotoxicity, dermatological reactions such as Stevens-Johnson syndrome, photosensitivity, and neurological symptoms including headache, dizziness, vertigo, ataxia, depression, and seizures. Option a is incorrect because ototoxicity and palpitations are aminoglycoside concerns rather than sulfonamide concerns. Naming them for sulfonamide therapy misroutes the focus and would miss the kidney, marrow, and gastrointestinal effects paired with this class. Option b is incorrect because increased white blood cell count is not a sulfonamide adverse effect; bone marrow suppression more typically lowers blood cell counts. Selecting an increase contradicts the chapter's description of marrow effects produced by this class. Option c is incorrect because tendon rupture is a fluoroquinolone concern, and depression is also listed with that class. Pairing these effects with sulfonamide surveill

Correct Answer: Serum amylase level elevated

Didanosine can cause pancreatitis, and a serum amylase level rising to one and a half to two times normal may signify pancreatitis in clients with AIDS. The drug may need to be discontinued, since pancreatitis is potentially fatal. Option a is incorrect because serum protein levels reflect nutritional and synthetic liver status rather than pancreatic injury from didanosine. The chapter pairs this drug with amylase elevation, so a protein change would not be the discontinuation trigger named. Option b is incorrect because glucose elevation belongs with several other HIV medications and is not the discontinuation trigger for didanosine. The chapter specifies amylase elevation as the lab marker that signals pancreatitis, prompting consideration of holding this drug. Option d is incorrect because creatinine elevation reflects renal injury and is the marker followed for foscarnet rather than didanosine. The didanosine discontinuation signal is amylase elevation linked to pancreatitis, not c

Correct Answer: New hearing loss in either ear

Amikacin is an aminoglycoside, and adverse effects include ototoxicity such as hearing problems, confusion, disorientation, gastrointestinal irritation, palpitations, blood pressure changes, nephrotoxicity, and hypersensitivity. The client is taught to report hearing loss to the provider immediately. Option a is incorrect because lethargy is not listed by the chapter as an immediate-report adverse effect of amikacin. The chapter directs the client toward urgent reporting of hearing loss, so brief fatigue would not trigger the same call. Option c is incorrect because brief nausea after a meal is gastrointestinal irritation that may need follow-up only if it persists or is accompanied by vomiting. The chapter does not list a single occurrence as an immediate-report event. Option d is incorrect because muscle aches are not listed as an amikacin adverse effect requiring immediate provider notification. The chapter highlights hearing loss as the urgent report trigger, so leg discomfort woul

Correct Answer: Serum creatinine level periodically

Foscarnet is toxic to the kidneys, and serum creatinine is monitored before therapy, two to three times per week during induction, and at least weekly during maintenance. Calcium, magnesium, phosphorus, and potassium are checked with same frequency. Option a is incorrect because serum albumin reflects nutritional and hepatic synthetic status rather than the renal toxicity tied to foscarnet. The chapter sets creatinine as the watch value because foscarnet specifically threatens kidney function during ongoing antiviral therapy. Option b is incorrect because lymphocyte count reflects general immune status and the impact of HIV disease rather than foscarnet toxicity. The chapter pairs this antiviral with creatinine monitoring, so lymphocyte trending would not capture the drug-specific concern raised. Option c is incorrect because CD4 T cell count trends HIV disease progression rather than antiviral medication toxicity. The chapter directs creatinine monitoring for foscarnet, so a CD4 count

Correct Answer: Client's gait when walking

Stavudine is an antiretroviral used to manage HIV when conventional therapy fails or cannot be tolerated. The drug can cause peripheral neuropathy, so the nurse monitors the client's gait closely and asks about paresthesia during therapy. Option a is incorrect because appetite tracking helps general assessment but does not capture the neurological effect of stavudine. The chapter points to gait and paresthesia for this drug, so meal intake would not be the chapter-specified parameter. Option c is incorrect because level of consciousness changes are unrelated to stavudine's peripheral neuropathy pattern. The drug affects peripheral nerves rather than cortical function, so the chapter directs the nurse to gait monitoring as the surveillance parameter. Option d is incorrect because stool output volumes do not reflect peripheral neuropathy in the limbs and would not capture stavudine's concern. The chapter targets gait and paresthesia, which monitor lower extremity neurologi

Correct Answer: Counsel about sperm banking or egg preservation

The chapter encourages pretreatment counseling and supports sperm banking or preservation of eggs for clients still of childbearing age. Antineoplastic medications carry teratogenic effects and may cause irreversible infertility, so the conversation precedes treatment whenever possible. Option a is incorrect because encouraging immediate conception ignores the teratogenic effects of antineoplastic medications and the need for contraception. The chapter directs reproductive planning toward preservation and counseling rather than active conception during treatment. Option b is incorrect because discontinuing chemotherapy is not a chapter-supported response to a desire for pregnancy and would jeopardize cancer outcomes. The chapter directs counseling toward gamete preservation and reliable contraception during therapy rather than stopping prescribed treatment. Option c is incorrect because reassurance about quick fertility return contradicts the chapter, which notes potential infertility

Correct Answer: Inspect mouth, rinse, soft brush, antifungal

The nurse inspects the oral mucosa frequently for erythema and ulcers, rinses the mouth after meals, and supports good oral hygiene with a soft toothbrush. Mouth rinses and antifungal agents are used as prescribed when sores develop. Option a is incorrect because full-strength alcohol mouthwash would worsen mucositis by drying and irritating compromised oral tissue. The chapter directs gentle rinsing and soft mechanical care, not exposures that would increase mucosal injury during chemotherapy. Option b is incorrect because stiff bristled brushes cause gum bleeding and mucosal trauma in clients with mucositis and thrombocytopenia. The chapter directs soft toothbrush use to reduce both bleeding risk and mucosal injury during active antineoplastic therapy. Option d is incorrect because avoiding all rinses ignores the chapter's directive to rinse the mouth after meals and to use prescribed therapeutic rinses for sores. Skipping rinses would allow debris and microbial overgrowth, wors

Correct Answer: Speeds bone marrow recovery after suppression

Colony-stimulating factors induce more rapid bone marrow recovery after suppression by chemotherapy. The granulocyte colony-stimulating factor pegfilgrastim restores neutrophils so the next planned cycle can begin on schedule, reducing the window of severe infection risk. Option b is incorrect because uric acid management after cell destruction is allopurinol's role, not pegfilgrastim's. The chapter pairs colony-stimulating factors with marrow recovery, so the drug class does not match a uric acid reduction explanation. Option c is incorrect because hemorrhagic cystitis from cyclophosphamide is prevented by hydration and mesna with ifosfamide, not by pegfilgrastim. The chapter assigns marrow recovery to colony-stimulating factors and bladder protection to other strategies entirely. Option d is incorrect because cardiac protection during anthracycline therapy is provided by dexrazoxane rather than pegfilgrastim. Pegfilgrastim restores neutrophil counts and has no cardiac role,

Correct Answer: Dyspnea, dysrhythmias, hypotension, weight gain

The nurse assesses for myocardial toxicity, dyspnea, dysrhythmias, hypotension, and weight gain when administering doxorubicin or idarubicin. Crackles, peripheral edema, and rising weight reflect heart failure requiring prompt reporting and potential dose modification or dexrazoxane. Option a is incorrect because constipation, paralytic ileus, and ptosis belong with vincristine and the vinca alkaloid class. The cardiac concern of doxorubicin and idarubicin shows dyspnea, dysrhythmias, hypotension, and weight gain rather than neurological findings. Option b is incorrect because tinnitus, dizziness, and hearing loss belong with cisplatin per the chapter's platinum compound profile. Anthracycline concerns center on heart failure findings rather than on auditory and vestibular changes that would prompt different evaluation. Option c is incorrect because hematuria with reddish urine occurs with cyclophosphamide and ifosfamide as hemorrhagic cystitis. The anthracycline concern is cardia

Correct Answer: Therapy is not curative but preserves health

Standard treatment uses three or four medications known as highly active antiretroviral therapy. The regimen is not curative but can delay or reverse loss of immune function, preserve health, and prolong life during ongoing care of the client. Option b is incorrect because single-drug therapy is not the chapter's standard for HIV management; three or four medications are used together. Telling the client one drug suffices would undermine the rationale for the combination regimen prescribed for ongoing therapy. Option c is incorrect because describing the combination as curative misrepresents the chapter, which states this therapy is not curative. The regimen is intended for disease control and immune function preservation rather than eradication of HIV. Option d is incorrect because highly active antiretroviral therapy is ongoing rather than short-term coverage. The chapter frames the regimen as long-term management to preserve health and prolong life, so describing it as temporar

Correct Answer: Severe acute hypersensitivity including anaphylaxis

Basiliximab is used to prevent rejection following kidney transplantation and can cause severe acute hypersensitivity reactions, including anaphylaxis. The nurse keeps emergency equipment ready, monitors vital signs, and prepares to stop the infusion per anaphylaxis protocol. Option a is incorrect because hyperglycemia is associated with tacrolimus and atazanavir per the chapter rather than basiliximab. The chapter pairs basiliximab with infusion-related hypersensitivity, so glucose elevation would not be the dominant concern during this antibody therapy. Option c is incorrect because Stevens-Johnson syndrome is associated with sulfonamides and nevirapine per the chapter. Basiliximab's signature concern is acute hypersensitivity progressing to anaphylaxis, so a dermatological reaction pattern would not be the primary infusion-time vigilance. Option d is incorrect because peripheral neuropathy is associated with stavudine, vincristine, and several other agents per the chapter. Basi

Correct Answer: Pregnant women and children under eight

Tetracyclines cause teeth staining and bone damage, so they are avoided in pregnancy and in children under eight years of age. The chapter also notes gastrointestinal upset, hepatotoxicity, superinfections, photosensitivity, and hypersensitivity reactions during therapy. Option a is incorrect because adolescents over twelve are past the chapter's age cutoff of eight years and may receive tetracyclines without the same dental and bone concerns. Choosing this older group would not match the stated age-related restriction. Option b is incorrect because prior penicillin allergy is not the tetracycline restriction described by the chapter. The chapter pairs penicillin allergy concerns with the penicillin class itself, so this restriction would not direct decisions about prescribing tetracyclines. Option d is incorrect because older adults with renal impairment require dose adjustments for many drugs, but the chapter's tetracycline-specific restriction is pregnancy and children und

Correct Answer: Use sun protection during outdoor activity

Fluoroquinolones can cause photosensitivity, so the client is taught to use sun protection during outdoor activity. Other adverse effects include headache, dizziness, insomnia, depression, gastrointestinal effects, bone marrow depression, fever, and rash to report. Option b is incorrect because stopping the medication on sunny days is not a chapter-supported response and would interrupt antibiotic therapy. The chapter directs sun protection rather than self-discontinuation, since dose interruptions can compromise infection control and bacterial clearance. Option c is incorrect because limiting fluid intake is not a fluoroquinolone teaching point and would not address photosensitivity. The chapter directs the nurse toward sun protection during outdoor activity rather than restricting hydration during sun exposure for this antibiotic. Option d is incorrect because complete avoidance of outdoor activity is unnecessary and unrealistic for most clients. Sunscreen with protective clothing al

Correct Answer: Spontaneous uncontrollable bleeding may occur

When the platelet count drops below twenty thousand, spontaneous and uncontrollable bleeding can occur. Below fifty thousand, minor trauma can cause prolonged bleeding. The nurse withholds the medication per policy, notifies the provider, and initiates precautions. Option a is incorrect because mild bruising risk understates the chapter's concern at a platelet count of seventeen thousand. The chapter describes spontaneous and uncontrollable bleeding below twenty thousand, so the risk far exceeds what mild bruising would describe. Option b is incorrect because routine bleeding precautions alone do not fully address the spontaneous bleeding risk below twenty thousand. The chapter directs the nurse to withhold the medication and notify the provider in addition to initiating bleeding precautions. Option c is incorrect because anaphylaxis is an allergic infusion reaction independent of platelet count. The chapter ties platelet thresholds to bleeding risk, so naming anaphylaxis would mi

Correct Answer: Hold dose, neutropenic precautions, notify provider

The nurse withholds the medication and initiates neutropenic precautions if the segmented neutrophil count drops below eighteen percent in conventional units, then notifies the provider. Monitoring includes fever, sore throat, unusual bleeding, and signs of infection. Option a is incorrect because continuing the dose despite neutropenia worsens marrow suppression and infection risk. The chapter directs the nurse to withhold the medication per policy when the threshold is crossed, not to defer action while infection risk escalates. Option b is incorrect because increasing the dose during neutropenia would deepen marrow suppression and harm the client. The chapter calls for holding the medication and protecting the client from infection rather than escalating exposure when counts have dropped. Option d is incorrect because aspirin is avoided during antineoplastic therapy because of bleeding risk and is not a routine fever response in this setting. The chapter directs neutropenic precauti

Correct Answer: Blood pressure rising above baseline

Hypertension can occur in clients taking cyclosporine. When the client also reports a headache, blood pressure is the vital sign to monitor most closely. Other adverse effects include infection, nephrotoxicity, and hirsutism during continued immunosuppressive therapy today. Option a is incorrect because tachycardia is not the chapter's named cyclosporine vital sign change. The chapter pairs this drug with hypertension and would direct the nurse to a blood pressure measurement rather than heart rate alone. Option c is incorrect because pulse oximetry trends oxygen saturation and would matter for a pulmonary problem rather than this drug's hypertension. A falling reading does not explain the new headache and would miss the elevation cyclosporine actually produces. Option d is incorrect because respiratory rate rising points toward a pulmonary or anxiety problem, not the cardiovascular effect linked to this drug. The headache report aligns with blood pressure elevation rather th