HESI RN
HESI RN 301 Pharmacology Final Exam Questions
Extract:
Question 1 of 5
A client with a history of angina reports the onset of chest pain. The nurse determines that the heart rate is 104 beats/minute and the blood pressure is 138/86 mm Hg. A transdermal nitroglycerin patch was applied 30 minutes ago to the right upper chest. Which action should the nurse take?
Correct Answer: A
Rationale: Sublingual nitroglycerin provides rapid relief for acute angina, complementing the slower-acting transdermal patch. Reassuring about delayed patch effects, withholding doses, or adding another patch are inappropriate for acute pain.
Question 2 of 5
An older female client comes to the clinic for a regular check-up. The client tells the nurse that she has increased her daily doses of acetaminophen for the past month to control joint pain. Based on this patient's comment, which previous laboratory results should the nurse compare with today's laboratory report?
Correct Answer: D
Rationale: High acetaminophen doses risk hepatotoxicity, potentially elevating LDH, a marker of liver damage. Potassium, APTT, and hemoglobin/hematocrit are not primarily affected by acetaminophen overuse.
Question 3 of 5
A client is receiving IV vancomycin and the nurse plans to draw blood for a peak and trough to determine the serum level of the medication. Which collection times provide the best determination of these levels?
Correct Answer: A
Rationale: Vancomycin trough levels are measured 30 minutes before the next dose to assess the lowest concentration, ensuring therapeutic levels. Peak levels, though less commonly monitored, are taken immediately after infusion to capture the highest concentration. Other timings are less accurate for these purposes.
Question 4 of 5
A patient with heart failure (HF) develops hyperaldosteronism and spironolactone is prescribed. Which instruction should the nurse include in the patient's plan of care?
Correct Answer: A
Rationale: Spironolactone, a potassium-sparing diuretic, risks hyperkalemia. Limiting potassium-rich foods is essential. Photosensitivity, salt substitutes (often potassium-based), and bruising are less relevant.
Question 5 of 5
A client with hepatic encephalopathy is receiving lactulose. Which assessment provides the nurse with the best information to evaluate the client's therapeutic response to the medication?
Correct Answer: D
Rationale: Lactulose reduces ammonia in hepatic encephalopathy, so monitoring serum ammonia and electrolytes (due to laxative effects) best evaluates response. Glucose, stool, and hepatic enzymes are less direct indicators.