HESI RN
RN HESI Pharmacology Questions
Extract:
Question 1 of 5
A client receives a prescription for penicillin 1.2 million units IM. The available vial is labeled, “600,000 units/mL.” How many mL should the nurse administer? (Enter numeric value only.) How many mL should the nurse administer?
Correct Answer: 2
Rationale: Volume = 1,200,000 units ÷ 600,000 units/mL = 2 mL.
Question 2 of 5
The nurse is providing discharge instructions to a client who has been prescribed gabapentin 300 mg by mouth (PO) three times a day for postherpetic neuralgia. Which symptom should the nurse tell the client to report to the healthcare provider? Which symptom should the nurse tell the client to report to the healthcare provider?
Correct Answer: B
Rationale: Gabapentin can cause fluid retention, leading to rapid weight gain, which may signal serious issues like heart or kidney problems. This symptom requires prompt reporting to the healthcare provider for further evaluation.
Extract:
History and physical
The client is a 36-year-old female with moderate persistent asthma. She takes fluticasone/salmeterol 250 mcg/50 mcg, 1 inhalation twice daily, and albuterol 90 mcg/inhalation, 2 inhalations every 4 to 6 hours PRN.
Nurses notes
The client reports that she has had more severe asthma symptoms than usual in the past week. Her forced expiratory volume has been 60 to 65% even with multiple doses of albuterol for several days in a row. She came to the hospital feeling dizzy, lightheaded, and reporting “heart palpitations.” Upon assessment, no wheezes were found. Her oxygen saturation is 99% on room air.
Question 3 of 5
Review H and P, and nurse’s note. Complete the diagram by dragging from the choices area to specify which condition the client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client’s progress.
Correct Answer:
Rationale: Tachydysrhythmia from albuterol overuse requires monitoring (
A) and cautious albuterol use (
C). Breath sounds (
A) and airway edema (H) assess respiratory status.
Extract:
History and Physical
Client is a 24-year-old male with a 2-day history of severe vomiting and diarrhea. The client believes he has a case of food poisoning after attending a party. Other individuals at the party were having similar symptoms.
Nurses’ Notes
1100:
• Admitted to the medical unit. He is pale with a capillary refill of 5 seconds. Is sleepy but responds to commands. An 18-gauge peripheral IV line started in the right hand, flushes easily with no redness or edema. Bolus of IV fluids given.
1115:
• Healthcare provider notified of arterial blood gas values. Sodium bicarbonate given as prescribed.
1200:
• Capillary refill 2 seconds
Laboratory Results
Laboratory Test 1115 1200 Reference Range
Blood Gas
pH 7.22 7.35 7.35 to 7.45
Bicarbonate (HCO3) 15 mEq/L (15 mmol/L) 22 mEq/L (22 mmol/L) 21 to 28 mEq/L (21 to 28 mmol/L)
Partial pressure of carbon dioxide (PaCO2) 39 mm Hg 34 mm Hg 35 to 45 mm Hg
Partial pressure of oxygen (PaO2) 88 mm Hg 92 mm Hg 80 to 100 mm Hg
Lactate 2 mEq/L (0.2 mmol/L) 1.7 mEq/L (0.17 mmol/L) 3 to 7 mg/dL (0.3 to 0.8 mmol/L)
Flow Sheet
1100:
• Vital signs:
o Heart rate: 102 beats/minute
o Respiratory rate: 19 breaths/minute
o Blood pressure: 100/77 mm Hg
o Oxygen saturation: 95% on room air
1200:
• Vital signs:
o Heart rate: 77 beats/minute
o Respiratory rate: 17 breaths/minute
o Blood pressure: 113/72 mm Hg
o Oxygen saturation: 100% on room air
Intake and Output:
1100:
• Intake: 400 mL
1200:
• Intake: 400 mL
Orders
1100:
• Admit to the medical unit
• Regular diet as tolerated
• Give 1 liter 0.9% sodium chloride IV bolus now, then start Lactated Ringer’s Infusion at 100 mL/hr
• Draw serum arterial blood gas, venous lactate, sodium, and potassium
• Vital signs every hour
• Strict intake and output
1115:
• Give sodium bicarbonate 50 mEq IV push now
• Repeat arterial blood gas after administration
Patient Data.
Question 4 of 5
Review H and P, nurses notes, laboratory results, flow sheet, and orders. Click to mark whether the assessment finding represents a therapeutic result of the sodium bicarbonate administered, a non-therapeutic side-effect, or an unrelated finding.
| Options | therapeutic result | non-therapeutic side-effect | unrelated finding |
|---|---|---|---|
| Capillary refill 2 seconds | |||
| Blood pressure 113/72 mm Hg | |||
| Bicarbonate 22 mEq/L (22 mmol/L) | |||
| Sodium 152 mEq/L (152 mmol/L) | |||
| 400 mL urine output | |||
| Heart rate 77 beats/minute |
Correct Answer:
Rationale: A: therapeutic result B: therapeutic result C: therapeutic result D: non-therapeutic side-effect E: unrelated finding F: therapeutic result Sodium bicarbonate corrects metabolic acidosis (
C) and improves perfusion (A, B, F). Hypernatremia (
D) is a side effect, and urine output (E) is unrelated to bicarbonate.
Extract:
Question 5 of 5
The nurse is caring for an adult client who is taking digoxin. Which laboratory value should be reported to the healthcare provider immediately? Which laboratory value should be reported to the healthcare provider immediately?
Correct Answer: B
Rationale: A potassium level of 3.2 mEq/L indicates hypokalemia, which increases the risk of digoxin toxicity by enhancing digoxin’s effects on the heart, potentially causing arrhythmias. This value requires immediate reporting.