HESI RN
HESI Pharmacology Exam 2 Questions
Extract:
Question 1 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.
Extract:
Nurses Notes
0730
Admitted the client. She is awake and alert. She rates her pain 2/10. Her pulses are equal bilaterally. Heart rate is 76 beats per minute, normal sinus rhythm. Her oxygen saturation is 100% on room air. She has a gauze dressing over her surgical site, which is clean and dry. Her temperature is 98.5° F (37° C).
She urinated 50 ml upon arrival in the unit and is stating she is very thirsty. The patient states her last insulin glargine dose was this morning before surgery.
Orders
• Admit to the surgical floor
• Dextrose 5% and 0.9% sodium chloride to infuse at 125 mL/hr
• Advance diet as tolerated
• Insulin glargine 12 units subcutaneously every 12 hours
• Ceftriaxone 2 g IV every 24 hours for 3 days, first dose given in surgery
• Insulin lispro 1 unit subcutaneously per 15 carbohydrates
Question 2 of 5
The nurse prepares to give 2 units of insulin lispro. What should the nurse double-check with a second nurse? Select all that apply.
Correct Answer: A,C,E,G
Rationale: Double-checking the vial’s color/clarity ensures insulin stability, the dose in the syringe prevents errors, the expiration date confirms potency, and the concentration (e.g., U-100) ensures accurate dosing. History, sliding scale, and injection site do not require dual verification.
Extract:
Question 3 of 5
The nurse is preparing a discharge teaching plan for a client who is taking ciprofloxacin hydrochloride tablets, which were prescribed because of a suspected anthrax exposure. Which instruction(s) should be included in the teaching plan? (Select all that apply.)
Correct Answer: C,D
Rationale: Ciprofloxacin is linked to tendonitis and rupture, requiring immediate reporting of tendon pain/swelling. Increased fluid intake prevents crystalluria, a side effect. Crushing tablets may alter efficacy, and NSAIDs increase seizure risk with ciprofloxacin, making these incorrect.
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.
Laboratory Test
Hemoglobin A1C
• Result: 6.8%
• Reference Range: 4-5.9%
Serum Creatinine
• Result: 1 mg/dL (88.4 μmol/L)
• Reference Range: 0.5-1.1 mg/dL (44-97 μmol/L)
BUN (Blood Urea Nitrogen)
• Result: 9 mg/dL (3.2 mmol/L)
• Reference Range: 10-20 mg/dL (3.6-7.1 mmol/L)
Sodium
• Result: 136 mEq/L (136 mmol/L)
• Reference Range: 136-145 mEq/L (136-145 mmol/L)
Potassium
• Result: 6.1 mEq/L (6.1 mmol/L)
• Reference Range: 3.5-5 mEq/L (3.5-5 mmol/L)
Blood Glucose
• Result: 109 mg/dL (6.1 mmol/L)
• Reference Range: 74-106 mg/dL (4.1-5.9 mmol/L)
Question 4 of 5
The nurse reviews the lab values."What questions can the nurse ask the client based on the lab results? Select all that apply.
Correct Answer: A,B,C,D,E
Rationale: Without specific lab values, general questions about urinary urgency (renal function), salt substitutes (potassium intake), itching/hives (allergic reactions), supplements (drug interactions), and dry skin (electrolyte imbalances) are relevant to monitor captopril/spironolactone effects.
Extract:
Question 5 of 5
The nurse is administering the muscle relaxant baclofen by mouth (PO) to a client diagnosed with multiple sclerosis. Which intervention should the nurse implement?
Correct Answer: A
Rationale: Baclofen can cause dizziness or orthostatic hypotension, increasing fall risk in clients with multiple sclerosis, who may already have impaired coordination. Advising slow, cautious movement when rising and walking is the most critical intervention to prevent falls. Monitoring intake/output or muscle strength is not directly related to baclofen’s side effects, and abrupt discontinuation risks withdrawal.