Wgu HESI RN Pharmacology 1

Extract:

Question 1 of 5

After receiving the third dose of a new oral anticoagulant prescription, an older adult client develops bleeding and tender gums and has many new bruises. Which actions should the nurse implement? Select all that apply.

Correct Answer: B,C,D,E

Rationale: Bleeding and bruising suggest anticoagulant-related complications. Completing a variance report documents issues, reviewing coagulation labs guides management, reporting to the provider ensures intervention, and a soft toothbrush reduces gum trauma. NSAIDs increase bleeding risk and are contraindicated.

Question 2 of 5

The client is a 75-year-old female admitted to the preoperative area to prepare for pacemaker insertion. Client reports she is having this done because her heart rate has been staying very low, she is always tired, and she has passed out once from low heart rate. Client has history of worsening symptomatic bradycardia. History of atrial fibrillation controlled. The nurse is preparing the client's plan of care. Select 4 findings that would indicate to the nurse that the administration of the vancomycin antibiotic would be safe to administer.

A. No known allergies B. Peripheral IV in large vein C. Potassium 4.4 mEq/L (4.4 mmol/L) D. Used for prophylaxis E. Blood urea nitrogen 17 mg/dL (6.07 mmol/L) F. Dosage in safe range

Correct Answer: A,B,D,F

Rationale: No known allergies reduce allergic reaction risks. A large vein IV minimizes thrombophlebitis. Prophylactic use is appropriate for surgery. Safe dosage prevents toxicity. Potassium and BUN, while important, are less specific to vancomycin safety.

Question 3 of 5

Which nursing intervention has priority when initiating a continuous epidural infusion with an opioid analgesic?

A. Apply a pulse oximeter to the client per protocol. B. Insert an indwelling urinary catheter per protocol. C. Administer an antiemetic per PRN prescription. D. Administer a stool softener per PRN protocol.

Correct Answer: A

Rationale: Opioids in epidural infusions risk respiratory depression. Applying a pulse oximeter monitors oxygen saturation, enabling early detection of hypoxia, prioritizing safety. Catheters, antiemetics, or stool softeners address secondary concerns like urinary retention, nausea, or constipation.

Question 4 of 5

A male client receives a scopolamine transdermal patch 2 hours before surgery. Four hours after surgery, the client tells the nurse that he is experiencing pain and asks why the patch is not working. Which action should the nurse take?

A. Check for correct placement of the patch behind the client's ear. B. Explain that the medication is not given to prevent pain. C. Advise the client that the effects of the medication have worn off. D. Offer to apply a new transdermal patch to relieve the pain.

Correct Answer: B

Rationale: Scopolamine prevents postoperative nausea, not pain. Explaining its purpose clarifies the client’s misunderstanding. Placement checks, expired effects, or new patches do not address the pain, which requires separate analgesia.

Question 5 of 5

A client with benign prostatic hyperplasia receives a new prescription of tamsulosin. Which intervention should the nurse perform to monitor for an adverse reaction?

A. Perform a bladder scan. B. Obtain daily weights. C. Assess urine output. D. Monitor blood pressure.

Correct Answer: D

Rationale: Tamsulosin, an alpha-1 blocker, can cause orthostatic hypotension, risking dizziness or fainting. Monitoring blood pressure detects this adverse reaction. Bladder scans, weights, or urine output assess BPH symptoms, not tamsulosin’s side effects.