HESI RN
HESI Pharmacology Exam 2 Questions
Extract:
History and Physical
The client is a 54-year-old male with a history of hypertension and type 2 diabetes. He takes spironolactone
25 mg per day, metformin 500 mg twice a day, and 25 units of insulin glargine.
Orders
2/18/2021
Prescription for captopril 25mg by mouth twice a day.
4/10/2021
Discontinue spironolactone. Start hydrochlorothiazide 25mg daily.
Question 1 of 5
The nurse notifies the provider that the client is having trouble remembering to take his second dose of captopril. Which ACE inhibitors can be given only once per day? Select all that apply.
Correct Answer: B,C,D
Rationale: Lisinopril, ramipril, and trandolapril have long durations, allowing once-daily dosing, improving adherence for the client. Quinapril and captopril require twice-daily dosing due to shorter half-lives.
Extract:
History and Physical
The client is a 54-year-old male with a history of hypertension and type 2 diabetes. He takes spironolactone 25 mg per day, metformin 500 mg twice a day, and 25 units of insulin glargine
Orders
• prescription for captopril 25mg by mouth twice a day
Laboratory Test
Hemoglobin A1C
• Result- 6.8%
• Reference Range- 4 to 5.9%
Question 2 of 5
The provider would like the client to continue with the captopril dose and restart the spironolactone. The provider wants the client to return to the clinic in 6 weeks with lab work done. What 2 labs would be most appropriate for this client to complete on their return visit?
Correct Answer: D,E,
Rationale: Captopril and spironolactone can cause renal impairment and hyperkalemia. Kidney function tests (e.g.creatinine) and electrolyte panels (e.g. potassium) monitor these risks. Coagulation cardiac enzymes osmolality and blood counts are less relevant."
Extract:
Question 3 of 5
The nurse is preparing a discharge teaching plan for a client who is taking ciprofloxacin hydrochloride tablets, which were prescribed because of a suspected anthrax exposure. Which instruction(s) should be included in the teaching plan? (Select all that apply.)
Correct Answer: C,D
Rationale: Ciprofloxacin is linked to tendonitis and rupture, requiring immediate reporting of tendon pain/swelling. Increased fluid intake prevents crystalluria, a side effect. Crushing tablets may alter efficacy, and NSAIDs increase seizure risk with ciprofloxacin, making these incorrect.
Question 4 of 5
A client with anemia secondary to chronic kidney disease (CKD) started a prescription for epoetin alfa two months ago. Which client finding best indicates that the medication is effective? Reference Range: Hemoglobin (Hgb) [Reference Range: Male: 14 to 18 g/dL (8.7 to 11.2 mmol/L)]
Correct Answer: A
Rationale: Epoetin alfa stimulates red blood cell production, increasing hemoglobin. A hemoglobin level of 12 g/dL indicates effective treatment of anemia, though still below the male reference range. Subjective energy improvements, iron intake, or therapy tolerance are less direct indicators of epoetin’s efficacy.
Question 5 of 5
After taking orlistat for one week, a female client tells the home health nurse that she is experiencing increasingly frequent oily stools and flatus. Which action should the nurse take?
Correct Answer: B
Rationale: Oily stools and flatus are expected side effects of orlistat, which inhibits fat absorption. Asking about recent dietary intake assesses compliance with a low-fat diet, which can reduce these side effects. Increasing fats worsens symptoms, and stopping the drug or testing stool is unnecessary without severe symptoms.