HESI RN
HESI Pharmacology Exam 2 Questions
Extract:
Question 1 of 5
A client in the surgical recovery area asks the nurse to bring the largest possible dose of pain medication available. Which action should the nurse implement first?
Correct Answer: A
Rationale: Assessing the client’s pain level using a pain scale provides objective data to determine the appropriate dose and urgency of pain management, guiding safe administration. Diversional strategies, drug history, or prior dose timing are secondary to understanding current pain intensity.
Question 2 of 5
The nurse is caring for a client who has been taking ibuprofen. Which finding is most important for the nurse to report to the healthcare provider?
Correct Answer: A
Rationale: Hematemesis (vomiting blood) indicates potential gastrointestinal bleeding, a serious NSAID complication. Immediate reporting to the provider ensures evaluation and management. Nausea, insomnia, and dizziness are less urgent side effects of ibuprofen.
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 3 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 of captopril 25mg by mouth twice a day
Laboratory Test
Hemoglobin A1C:
• Result- 6.8%
• Reference Range- 4 to 5.9%
Question 4 of 5
For each instruction, click to indicate whether the instructions given by the nurse are indicated or contraindicated to prepare for the client’s first dose of captopril.
| Options | Indicated | Contraindicated |
|---|---|---|
| Increase the lantus dose by 3 units the morning of the first dose. | ||
| Limit fluids for several days before the first dose. | ||
| Hold spironolactone for 3 days. | ||
| Lay down if the blood pressure drops quickly after the first dose. | ||
| Monitor blood pressure for several hours after the first dose. |
Correct Answer:
Rationale: Holding spironolactone reduces hyperkalemia risk with captopril, lying down manages hypotension, and monitoring blood pressure ensures safety. Increasing insulin or limiting fluids lacks rationale and risks hypoglycemia or dehydration.
Extract:
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, reducing cyclosporine levels, an immunosuppressant critical for preventing transplant rejection. This interaction directly contributes to graft rejection, making it the most significant finding. Sodium intake, corticosteroid needs, or depression treatment are less relevant to the acute issue.