HESI-P HESI Pharmacology - Set 2 - Part 3

Correct Answer: Tendon pain, especially Achilles

Fluoroquinolones increase the risk of tendonitis and tendon rupture, especially the Achilles tendon, in clients over sixty, those on corticosteroids, or post-transplant clients. The nurse teaches the client to report new tendon pain immediately for evaluation. Option a is incorrect because a new cough is not the specific risk the chapter ties to fluoroquinolones in this age group. The flagged adverse effect is tendon injury, and the chapter emphasizes reporting tendon pain not a respiratory symptom. Option b is incorrect because mild headache is a general complaint that does not capture the tendon-rupture risk associated with this drug class. The chapter directs the nurse's teaching toward tendon pain because that symptom marks the precursor to rupture. Option d is incorrect because brief episodes of dizziness are common with many medications and do not match the tendon-specific risk of fluoroquinolones. The chapter's warning concerns tendon pain in older or corticosteroid-tr

Correct Answer: Infuse slowly over sixty minutes

Intravenous ciprofloxacin is infused slowly over sixty minutes to minimize discomfort and vein irritation. The nurse uses an infusion pump and monitors the access site for signs of phlebitis or extravasation throughout the duration of the infusion. Option b is incorrect because pushing the dose over thirty seconds far exceeds the safe rate for intravenous ciprofloxacin and would cause significant vein irritation. The chapter specifies a sixty-minute infusion to spare the vein from this rapid concentrated exposure. Option c is incorrect because a five-minute infusion is much shorter than the chapter's recommended duration and increases the risk of vein irritation. Ciprofloxacin requires the slower sixty-minute approach to protect peripheral access and reduce client discomfort during administration. Option d is incorrect because a two-minute slow bolus is well below the chapter's infusion window for intravenous ciprofloxacin. The chapter directs a slow continuous infusion over

Correct Answer: Open-angle glaucoma diagnosis

Oxybutynin is contraindicated in open-angle glaucoma because anticholinergic activity blocks intraocular fluid flow, raising intraocular pressure and risking optic nerve damage. The nurse holds the dose and notifies the prescriber so a safer alternative can be ordered. Option a is incorrect because mild osteoarthritis of the knees does not interact with oxybutynin in a way that contraindicates the drug. The chapter ties the contraindication to the eye condition because of the drug's effect on intraocular fluid dynamics. Option b is incorrect because stable hypertension is not the contraindication the chapter cites for oxybutynin. Blood pressure may shift modestly with anticholinergic drugs, but the categorical contraindication that drives the nurse's hold is the glaucoma diagnosis specifically. Option c is incorrect because borderline cholesterol elevation has no bearing on oxybutynin safety. The chapter cites glaucoma as the contraindication because the anticholinergic effec

Correct Answer: Atropine sulfate as antidote

Atropine sulfate is the antidote for bethanechol overdose and reverses the cholinergic crisis presenting with excessive secretions, bradycardia, and hypotension. The chapter directs the nurse to keep atropine readily available whenever a cholinergic agent is administered to a client. Option a is incorrect because naloxone reverses opioid overdose, not cholinergic crisis from bethanechol. The pharmacology differs entirely, and naloxone would have no effect on the muscarinic receptors driving the salivation, sweating, and bradycardia the client is showing. Option c is incorrect because activated charcoal is used for some oral ingestions of toxic substances and does not reverse bethanechol's pharmacologic effect. The chapter directs the nurse to a true pharmacologic antidote not a decontamination agent for the gut. Option d is incorrect because aminocaproic acid reverses thrombolytic medications and has no role in cholinergic crisis. The chapter is explicit that atropine is the antid

Correct Answer: Empty stomach, away from meals

Bethanechol is administered on an empty stomach, one hour before or two hours after meals. The chapter directs this timing to maximize the drug's effect and minimize gastrointestinal disturbance, and the medication is never given intramuscularly or intravenously. Option a is incorrect because taking the drug with every meal would reduce absorption and is not the chapter's recommended administration approach. The empty-stomach timing is specific and improves the drug's bladder-stimulating effect for the client managing urinary retention. Option b is incorrect because bedtime-only dosing does not match the chapter's instruction and may not align with the prescribed daily frequency. The chapter specifies empty-stomach administration, with timing relative to meals not time of day. Option d is incorrect because mixing with milk is not how the chapter directs the dose to be taken and may interfere with absorption. The teaching focus is the empty-stomach window, not a vehi

Correct Answer: Grapefruit juice

Grapefruit juice is strictly contraindicated with cyclosporine because it raises drug levels and increases nephrotoxicity risk. The nurse teaches the client to avoid grapefruit juice entirely and to discuss all new foods or supplements before starting them at home. Option b is incorrect because apple juice does not produce the cytochrome interaction grapefruit juice does. The chapter is specific that grapefruit is the problem beverage, since it inhibits the enzyme responsible for cyclosporine metabolism and pushes levels toxic. Option c is incorrect because orange juice with calcium is not the chapter's flagged interaction with cyclosporine. While certain orange juice formulations affect other medications, the cyclosporine interaction the chapter names specifically is grapefruit juice. Option d is incorrect because whole milk with each dose is not the categorical contraindication the chapter cites for cyclosporine. The strict food teaching is about grapefruit juice because of its

Correct Answer: Every twelve hours consistently

Tacrolimus is dosed every twelve hours consistently to maintain stable blood levels. Missing doses or shifting timing creates fluctuations that can either undertreat the graft and risk rejection or push levels into the toxic range for the client. Option a is incorrect because once at bedtime does not provide the steady twelve-hour interval the chapter specifies for tacrolimus. A single daily dose would let drug levels fall sharply between administrations and would not protect the graft consistently. Option b is incorrect because three times daily with meals does not match the chapter's twelve-hour interval requirement. The dosing schedule for tacrolimus is independent of meals and is anchored to the twelve-hour clock not to mealtimes during the day. Option c is incorrect because as-needed dosing is incompatible with an immunosuppressant that must maintain steady levels to prevent rejection. The chapter explicitly directs a twelve-hour fixed schedule because intermittent dosing ris

Correct Answer: Decongestants, anticholinergics, antidepressants

Decongestants, anticholinergics, and antidepressants trigger or worsen urinary retention in clients with benign prostatic hyperplasia. The nurse teaches the client to read over-the-counter labels carefully and to consult the pharmacist before starting any new product. Option a is incorrect because stool softeners and mild laxatives do not provoke urinary retention in benign prostatic hyperplasia. The chapter targets sympathomimetic and anticholinergic effects on the bladder neck, which do not come from a laxative. Option b is incorrect because vitamin supplements at recommended doses do not have urinary retention effects in this population. The chapter's flagged classes act on receptors that regulate bladder outlet tone, which standard vitamins do not influence at typical intake. Option d is incorrect because topical hydrocortisone cream applied locally does not produce systemic anticholinergic or sympathomimetic effects on the bladder. The chapter directs the warning toward oral

Correct Answer: Thirty to thirty-three percent hematocrit

Epoetin alfa's therapeutic effect appears when the hematocrit reaches thirty to thirty-three percent. Normal hematocrit ranges remain higher, but this threshold marks the point where the drug has produced enough red cell production to improve the client's anemia clinically. Option a is incorrect because less than fifteen percent hematocrit is profoundly anemic and represents an emergency not a therapeutic effect. The chapter is specific that the effect threshold appears at a higher value indicating drug-stimulated red cell production. Option c is incorrect because forty-two to forty-seven percent hematocrit falls within or above the normal range and exceeds the threshold the chapter describes. The therapeutic marker is much lower than the upper end of normal values. Option d is incorrect because above fifty percent hematocrit is supranormal and may indicate that the drug is producing too much effect. The chapter sets the therapeutic-appearance threshold lower so the nurse rec

Correct Answer: Relaxes smooth muscle; orthostatic risk

Alpha-blockers relax prostatic smooth muscle to improve urinary outflow in benign prostatic hyperplasia and commonly cause orthostatic hypotension. The nurse teaches the client to rise slowly from sitting or lying positions to avoid dizziness and falls during early therapy. Option a is incorrect because alpha-blockers do not increase prostate size; they relax smooth muscle to improve flow. Increasing prostate size would worsen obstruction not relieve it, the opposite of the drug's therapeutic intent here. Option b is incorrect because tightening the urethra would worsen obstructive symptoms in benign prostatic hyperplasia and is not how alpha-blockers act. The chapter describes smooth muscle relaxation as the mechanism that improves the urinary stream for the client. Option c is incorrect because blocking androgens to shrink the gland describes the five-alpha reductase inhibitor mechanism, not the alpha-blocker. The chapter pairs alpha-blockers with smooth muscle relaxation and or