HESI RN
RN HESI Pharmacology Exam 3 Questions
Question 1 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) [14 to 18 g/dL (8.7 to 11.2 mmol/L)]
Correct Answer: C
Rationale: Epoetin alfa stimulates red blood cell production, directly increasing hemoglobin levels. A rise to 12 g/dL, though below the male reference range, objectively indicates effectiveness in treating anemia. Iron therapy tolerance, subjective energy improvements, or dietary changes are less direct measures of epoetin’s impact.
Question 2 of 5
To control asthma, a client in a residential treatment facility uses a fluticasone propionate and salmeterol discus inhalation system, which provides an inhaled powdered form of these combined medications. Which instruction should the nurse provide to this client's caregivers?
Correct Answer: D
Rationale: Fluticasone/salmeterol is a maintenance therapy, not for acute asthma attacks, and should be used no more than twice daily to avoid side effects like oral thrush. Exhaling into the discus risks clumping the powder, and hypotension is not a common side effect.
Question 3 of 5
The nurse administers naloxone to a client with opioid-induced respiratory depression. One hour later, nursing assessment reveals that the client has a respiratory rate of 4 breaths/minute, oxygen saturation of 75%, and is unable to be aroused. Which action should the nurse implement?
Correct Answer: D
Rationale: Persistent respiratory depression (4 breaths/minute, 75% oxygen saturation) suggests ongoing opioid toxicity. A second dose of naloxone is needed to reverse opioid effects, as the initial dose may have worn off or been insufficient. CPR, chest tubes, or GCS assessment do not address the opioid-related cause.
Question 4 of 5
The nurse is caring for a client receiving a prescription for sucralfate to treat a peptic ulcer. Which instruction should the nurse provide during discharge education?
Correct Answer: C
Rationale: Sucralfate adheres to ulcer sites best on an empty stomach, taken 1 hour before meals, maximizing its protective effect. Missing a dose should not prompt doubling, and scheduling with meals or bedtime reduces efficacy due to food interference.
Question 5 of 5
A client who received a renal transplant three months ago is readmitted to the acute care unit with signs of graft rejection. While taking the client's history, the nurse determines that the client has been self-administering St. John's Wort, an herbal preparation, on the advice of a friend. Which information is most significant about this finding?
Correct Answer: D
Rationale: St. John's Wort induces liver enzymes (CYP3A4), reducing cyclosporine levels, an immunosuppressant critical for preventing transplant rejection. This interaction increases rejection risk, making it the most significant finding. Corticosteroid needs, depression, or sodium intake are less critical.