HESI Bsn 225 RN Pharmacology Related

During a home visit, the nurse assesses a client with Alzheimer's disease who recently started a new prescription for rivastigmine. The caregiver reports that the client seems to be thinking more clearly but is not sleeping well at night. Which action should the nurse take?

• A. Advise the caregiver that the purpose of the medication is to promote sleep, so a change in medication may be needed.
• B. Explain to the caregiver that insomnia is a common and temporary side effect when the medication is first started.
• C. Instruct the caregiver to withhold the medication until the dosage can be decreased to ensure the client's safety.
• D. Notify the healthcare provider that the dosage of the medication may need to be increased to manage the client's insomnia.

When preparing to apply a scheduled fentanyl transdermal patch, the nurse notes that the previously applied patch is intact on the client's upper back and the client denies pain. Which action should the nurse take?

• A. Administer an oral analgesic and evaluate its effectiveness before applying the new patch.
• B. Apply the new patch in a different location after removing the original patch.
• C. Place the patch on the client's shoulder and leave both patches in place for 12 hours.
• D. Remove the patch and consult with the healthcare provider about the client's pain resolution.

The nurse is caring for a client with hypertension, gastroesophageal reflux, and osteoarthritis. While performing a bedside assessment, the nurse observes the client is alert and oriented, but is exhibiting signs of jaundice. The nurse should notify the healthcare provider about which scheduled medication?

• A. Captopril.
• B. Acetaminophen.
• C. Omeprazole.
• D. Prednisone.

Levothyroxine sodium is prescribed for a client with hypothyroidism. The nurse should instruct the client to report which symptom because it indicates that the client is taking too much levothyroxine sodium?

• A. Constipation.
• B. Decreased appetite.
• C. Restlessness.
• D. Intolerance to cold.

History and physical
The client is a 26-year-old female with acute appendicitis. She has a 12 year history of type 1 diabetes mellitus and no other significant medical history. The appendectomy was completed without issue, and the client will be admitted to the surgical floor to recover.
Nurses notes
0730
Admitted the client. She is awake and alert. She rates her pain 2 on a 0 to 10 pain scale. Her pulses are equal bilaterally. Heart rate is 76 beats/minute, normal sinus rhythm. Her oxygen saturation is 100% on room air. She has a gauze dressing over her surgical site, which is clean and dry. Her temperature is 98.5° F (37.0° C) orally. She urinated 50 mL upon arrival in the unit and is reporting she
Lab results
Blood glucose 279mg/dl
Flowsheet
0745
2 units insulin lispro given.
1800
12 units insulin glargine given.
Orders
0730
• Admit to the surgical floor
• Dextrose 5% and 0.9% sodium chloride IV to infuse at 125 mL/hr
-Advance diet as tolerated
• Insulin glargine 12 units SUBQ every 24 hours
. Ceftriaxone 2 gram IV piggy back (IVPB) every 24 hours for 3 days, first dose given in surgery

Choose the most likely options for the information missing from the statement(s) by selecting from the lists of options provided. The nurse should expect for the insulin glargine to start working in ------------------ and to continue working for---------------------------.

• A. 2 hours
• B. 24 hours
• C. 6 hours
• D. 30 minutes
• E. 8 hours