HESI RN
HESI Bsn 225 RN Pharmacology Questions
Extract:
Question 1 of 5
A client with multiple sclerosis starts a new prescription, baclofen, to control muscle spasticity. Three days later, the client calls the clinic nurse and reports feeling fatigued and dizzy. Which instruction should the nurse provide?
Correct Answer: A
Rationale: Fatigue and dizziness are common baclofen side effects, so avoiding hazardous activities is appropriate. Stopping abruptly, increasing fluids/protein, or seeking emergency care are not warranted without further assessment.
Extract:
History and physical
The client is a 24-year-old female who was hit by a car while riding her bicycle. She was wearing a helmet, but her head struck the windshield of the vehicle at approximately 40 miles per hour (mph).
Nurses notes
1800
Client is intubated and on a ventilator. Breath sounds clear and equal. Pupils are 3 mm and sluggish. Responds to painful stimuli. Intracranial pressure 12 mm Hg. Pulses 2+ in all extremities. Capillary refill 2 seconds.
1900
Pupils are 3 mm and sluggish. Client is unresponsive to painful stimuli. Intracranial pressure 24 mm Hg. Healthcare provider (HCP) notified of status. Mannitol given as prescribed.
2000
Breath sounds clear and equal. Pupils are 4 mm and sluggish. Now responds to painful stimuli. Intracranial pressure 11 mm Hg. Has some dependent peripheral edema noted.
Flowsheet
Heart rate 79 beats/minute • Respiratory rate 18 breaths/minute
Blood pressure 111/79 mm Hg
Oxygen saturation 99% on ventilator
Orders
Admit to the surgical intensive care unit
Monitor intracranial pressure every hour
Lactated Ringer's 100 mL/hr IV infusion
Vital signs every hour
Neurological check every hour
Complete blood count, blood gas, and chemistry every 4 hours
Imaging
Head CT scan: cerebral edema
Question 2 of 5
Review H and P, nurse's notes, laboratory values, flow sheet, and prescriptions.Click to mark whether the assessment finding represents a therapeutic result of the mannitol administered, a non-therapeutic side effect, or an unrelated finding. Each row must have one option selected.
| Options | Therapeutic result | Non therapeutic side effect | Unrelated finding |
|---|---|---|---|
| Peripheral edema: Non-therapeutic side effect | |||
| Potassium 2.9: Non-therapeutic side effect | |||
| Urine output 280 ml: Therapeutic result | |||
| Heart rate 79: Unrelated finding | |||
| Intracranial pressure 11mmHg: Therapeutic result | |||
| Oxygen saturation: Unrelated finding |
Correct Answer:
Rationale: A: Edema is a mannitol side effect. B: Hypokalemia is a side effect. C: Increased urine output is therapeutic. D: Normal heart rate is unrelated. E: Reduced intracranial pressure is therapeutic. F: Normal oxygen saturation is unrelated.
Extract:
Question 3 of 5
Before administering the initial dose of sumatriptan succinate to a client with a migraine headache, it is most important to determine if the client's history includes which problem?
Correct Answer: A
Rationale: Sumatriptan causes vasoconstriction, which can exacerbate coronary artery disease, making this history critical to assess. IBS, rhinitis, and diabetes are not contraindications.
Question 4 of 5
The nurse is caring for a client with hypertension, gastroesophageal reflux, and osteoarthritis. While performing a bedside assessment, the nurse observes the client is alert and oriented, but is exhibiting signs of jaundice. The nurse should notify the healthcare provider about which scheduled medication?
Correct Answer: B
Rationale: Acetaminophen can cause liver toxicity, manifesting as jaundice, especially with high doses. Captopril, omeprazole, and prednisone are less commonly associated with jaundice.
Question 5 of 5
When preparing to apply a scheduled fentanyl transdermal patch, the nurse notes that the previously applied patch is intact on the client's upper back and the client denies pain. Which action should the nurse take?
Correct Answer: B
Rationale: Fentanyl transdermal patches should be applied to a different location after removing the original patch to ensure consistent pain management while preventing skin irritation or overdose. Administering an oral analgesic is unnecessary if the client has no pain, leaving both patches risks overdose, and consulting the provider is not immediate unless opioid need is reassessed.