HESI RN
HESI Pharmacology Exam 2 Questions
Extract:
Question 1 of 5
A client is receiving intravenous (IV) vancomycin and the nurse plans to draw blood for a peak and trough to determine the serum level of the drug. Which collection times provide the best determination of these levels?
Correct Answer: B
Rationale: Peak vancomycin levels, reflecting maximum concentration, are best measured one hour after IV dose completion. Trough levels, indicating minimum concentration, are drawn one hour before the next dose. This timing ensures accurate monitoring of therapeutic levels and prevents toxicity.
Question 2 of 5
A client with heart failure (HF) develops hyperaldosteronism and spironolactone is prescribed. Which instruction should the nurse include in this client’s plan of care?
Correct Answer: D
Rationale: Spironolactone, a potassium-sparing diuretic, can cause hyperkalemia. Limiting high-potassium foods like bananas prevents dangerous potassium elevations, which can lead to arrhythmias. Salt substitutes often contain potassium, and bruising or photosensitivity are not primary concerns.
Question 3 of 5
An older adult with iron deficiency anemia is being discharged with a prescription for ferrous sulfate enteric-coated tablets. To promote best absorption of the medication, which information should the nurse include in the discharge instructions?
Correct Answer: C
Rationale: Ferrous sulfate is best absorbed on an empty stomach, waiting 2 hours after meals to avoid interference from food or minerals like calcium. Bedtime dosing risks GI upset, crushing enteric-coated tablets causes irritation, and multivitamins may contain interfering substances.
Question 4 of 5
A nurse is caring for a client who has Parkinson’s disease and is prescribed an anticholinergic. Which of the following therapeutic outcomes should the nurse expect to see?
Correct Answer: B
Rationale: Anticholinergics reduce tremors in Parkinson’s by balancing acetylcholine and dopamine. They do not relieve depression, delay disease progression, or improve bladder function (they may worsen it due to urinary retention).
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 5 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.