HESI RN
RN HESI Pharmacology Exam Questions
Extract:
Question 1 of 5
A client with bulimia and depression who is taking phenelzine 90 mg daily is admitted to an acute care hospital for uncontrolled hypertension. Which dietary choices should the nurse instruct the client to avoid?
Correct Answer: C
Rationale: Phenelzine, an MAOI, interacts with tyramine-rich foods like pepperoni (aged meat) and cheese on pizza, risking hypertensive crisis. Beef, shrimp, and catfish are low in tyramine and safe.
Extract:
History and Physical
The client is a 42-year-old female who had a right above-the-knee amputation for osteomyelitis. The client has a drain in place and a surgical dressing that will need to be changed by the surgeon on post-op day 1.
Nurses' Notes
1400: Started continuous morphine in the left antecubital vein peripheral intravenous line. No redness, edema, or bleeding noted at the site. Vital signs: heart rate 77 bpm, blood pressure 118/74 mmHg, respiratory rate 16.
1800: Vital signs: heart rate 79 bpm, blood pressure 114/78 mmHg, respiratory rate 14.
1900: Responded to an alarm in the room. The client is not responsive. Her respiratory rate is 5 bpm. Her heart rate is 92 bpm. Her pupils are pinpoint.
Orders
• Admit to the surgical floor
• Clear liquid diet, advance as tolerated
• Continuous cardiorespiratory monitoring
• Morphine 1 mg/hr intravenously
• Alert surgeon to signs of bleeding or infection in the surgical site
• Docusate sodium 240 mg orally every am
• Naloxone 2 mg intravenously as needed for respiratory depression
• Ibuprofen 600 mg orally every 6 hours
Question 2 of 5
What should the nurse do immediately? Select all that apply.
Correct Answer: B,C,F
Rationale: Low responsiveness and respiratory rate suggest morphine overdose. Rescue breaths, naloxone (opioid antagonist), and rapid response address respiratory depression. ECG, oxygen, and compressions are secondary without specific indications.
Extract:
Question 3 of 5
A client with myasthenia gravis receives a new prescription for pyridostigmine. Which information should the nurse obtain prior to administering the medication?
Correct Answer: D
Rationale: Pyridostigmine, a cholinesterase inhibitor, is best taken on an empty stomach to enhance absorption. Recent oral intake informs timing. Sleep, urination, and weight loss are unrelated to administration.
Question 4 of 5
A client is receiving orlistat as part of a weight management program. Which ongoing assessment should be included in the plan of care to determine the effectiveness of the medication?
Correct Answer: B
Rationale: Orlistat blocks dietary fat absorption, aiding weight loss. Monitoring body mass index (BMI) assesses weight reduction and program success. Depression, calorie counts, and protein levels are unrelated to orlistat’s direct effects.
Extract:
History and Physical
The client is a 42-year-old female who had a right above-the-knee amputation for osteomyelitis. The client has a drain in place and a surgical dressing that will need to be changed by the surgeon on post-op day 1.
Nurses' Notes
1400: Started continuous morphine in the left antecubital vein peripheral intravenous line. No redness, edema, or bleeding noted at the site.
Vital signs: heart rate 77 bpm, blood pressure 118/74 mmHg, respiratory rate 16.
1800: Vital signs: heart rate 79 bpm, blood pressure 114/78, respiratory rate 14 bpm.
1900: Responded to an alarm in the room. The client is not responsive. Her respiratory rate is 5 bpm. Her heart rate is 92 bpm. Her pupils are pinpoint.
Orders
- Admit to the surgical floor
- Clear liquid diet, advance as tolerated
- Continuous cardiorespiratory monitoring
- Morphine 1 mg/hr intravenously
- Alert surgeon to signs of bleeding or infection in the surgical site
1500:
- Docusate sodium 240 mg orally every am
- Naloxone 2 mg intravenously as needed for respiratory depression
- Ibuprofen 600 mg orally every 6 hours
Question 5 of 5
For each statement, click to indicate whether the statements by the student nurse indicate understanding or no understanding of naloxone.
| Options | Understanding | No Understanding |
|---|---|---|
| "You can give naloxone intravenously, intramuscularly, or subcutaneously." | ||
| "Naloxone works best on pure agonist opioids." | ||
| "If the first dose does not work, you can give as many doses as needed to reverse respiratory depression." | ||
| "Naloxone will not affect the client's level of pain." | ||
| "When given IV, naloxone starts working immediately and can last several hours." |
Correct Answer:
Rationale: A: Naloxone can be given IV, IM, or SC (Understanding). B: It works best on pure agonists like morphine (Understanding). C: Repeated doses risk adverse effects like agitation (No Understanding). D: Naloxone reverses analgesia, increasing pain (No Understanding). E: IV naloxone acts quickly but lasts 30-90 minutes, not hours (No Understanding).