HESI Pharmacology Exam 2

Extract:

Question 1 of 5

A male client with a history of heart failure (HF) complains of heartburn when he lies down after dinner. The home health nurse should encourage the client to talk to the healthcare provider about using which over-the-counter medication to relieve this problem?

Correct Answer: A

Rationale: Heartburn suggests gastroesophageal reflux disease (GER
D), common in heart failure. Low sodium antacids neutralize stomach acid without exacerbating fluid retention, unlike high-sodium options. Diphenhydramine, aspirin, and acetaminophen do not relieve heartburn and are inappropriate for GERD.

Question 2 of 5

A client with anemia secondary to chronic kidney disease (CKD) started a prescription for epoetin alfa two months ago. Which client finding best indicates that the medication is effective? Reference Range: Hemoglobin (Hgb) [Reference Range: Male: 14 to 18 g/dL (8.7 to 11.2 mmol/L)]

A. Hemoglobin level increased to 12 g/dL (7.45 mmol/L). B. Reports of increased energy levels and decreased fatigue. C. Food diary shows increased consumption of iron-rich foods. D. Takes concurrent iron therapy without adverse effects.

Correct Answer: A

Rationale: Epoetin alfa stimulates red blood cell production, increasing hemoglobin. A hemoglobin level of 12 g/dL indicates effective treatment of anemia, though still below the male reference range. Subjective energy improvements, iron intake, or therapy tolerance are less direct indicators of epoetin’s efficacy.

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 3 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.

A. Have you experienced urgency to urinate? B. Do you use any salt substitutes? C. Have you experienced itching or hives? D. Are you taking any supplements? E. Have you noticed that your skin is dry?

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:

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 4 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.

A. The insulin vial for color and clarity. B. The history and physical with the diabetes diagnosis listed. C. The dose of insulin drawn up in the syringe. D. The sliding scale insulin lispro order. E. The expiration date on the insulin vial. F. The site for the insulin administration. G. The insulin concentration.

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:

History and Physical

The client is a 26-year-old female with acute appendicitis. She has a 12-year history of type 1 diabetes and no other significant medical histor The appendectomy was completed without issue, and the client will be admitted to the surgical floor to recover.

Question 5 of 5

For each nursing action below, click to specify if the action is indicated, contraindicated, or non-essential.

Options	Indicated	Contraindicated	Non-essential
Verify that the client can count carbohydrates.
Restart the IV fluids until the tray arrives.
Give insulin lispro 4 units.
Give insulin glargine 12 units.
Mix the insulin lispro and insulin glargine in one syringe.

Correct Answer:

Rationale: Verifying carbohydrate counting ensures glycemic control, and administering prescribed insulin glargine maintains basal insulin levels. Restarting IV fluids is unnecessary without indication, insulin lispro requires an order, and mixing lispro with glargine alters pharmacokinetics.

HESI Pharmacology Exam 2 | Nurselytic

Nurselytic

HESI RN

HESI RN