NURS 1426 HESI PHARMACOLOGY STUDY GUIDE

A nurse is caring for a client with histoplasmosis who is receiving intravenous amphotericin B (Fungizone). What should the nurse do while the medication is being administered?

A   Monitor the client’s urine output Correct

B   Monitor the client for hypothermia

C   Check the client’s neurological status Incorrect

D   Check the client’s blood glucose level

Rationale: Amphotericin B can produce medication toxicity during administration and exhibit symptoms such as chills, fever, headache, vomiting, and impairment of renal function. The medication is also irritating to the IV site, commonly causing thrombophlebitis.

2.             A nurse is assessing a peripheral intravenous (IV) site and notes blanching, coolness, and edema at the insertion site. What should the nurse do first?

E    Remove the IV Correct

F    Apply a warm compress

G   Check for blood return

H   Measure the area of infiltration

Rationale: Blanching, coolness, and edema of the IV site are all signs of infiltration. Because infiltration may result in damage to the surrounding tissue, the nurse must first remove the IV cannula to prevent any further damage. The nurse should not depend solely on the blood return for assurance that the cannula is in the vein, because blood return may be present even if the cannula is only partially in the vein. Compresses may be used, but the compress (warm or cool) depends on the type of solution infusing and physician preference. The nurse should measure the area of infiltration after the IV has been removed so that further tissue damage is prevented.

3.             A nurse provides instructions to a client who will be taking furosemide (Lasix). Which of the following statements by the client indicates to the nurse that the client needs additional instruction?

I      “I need to sit or stand up slowly.”

J     “I should expect to have ringing in my ears.” Correct

K   “I need to maintain my fluid intake.” Incorrect

L    “This medication will make me urinate.”

Rationale: Furosemide is a loop diuretic. Adverse effects of furosemide therapy include orthostatic hypotension and ototoxicity. Therefore the client should change positions slowly to help prevent lightheadedness. The client must also contact the physician if signs of ototoxicity, such as hearing loss or ringing in the ears, occur. Fluid intake should be maintained to prevent dehydration.

4.             Fluoxetine hydrochloride (Prozac) is prescribed for a client, and the nurse provides instruction regarding the use of the medication. The nurse tells the client that it is best to take the medication:

M  At lunchtime

N   In the morning Correct

O   With the evening meal

P    Midafternoon, with an antacid

Rationale: Fluoxetine hydrochloride (Prozac) is a selective serotonin reuptake inhibitor that elicits an antidepressant response. It is best administered in the early morning, and there is no need to coordinate the dose with a meal. (If the medication causes lightheadedness or dizziness, the healthcare provider may advise the client to take it at bedtime.) The other options are incorrect.

5.             A nurse is changing the central line dressing of a client receiving parenteral nutrition (PN). The nurse notes moisture under the dressing covering the catheter insertion site. What does the nurse assess next?

Q   Temperature

R   Time of the last dressing change

S    Expiration date on the infusion bag

T    Tightness of the tubing connections Correct

Rationale: A loose tubing connection — the most obvious cause of the moisture that could be readily detected and fixed by the nurse — is the first thing the nurse should look for. The client’s temperature