HESI RN
HESI Pharmacology Exam 2 Questions
Extract:
Question 1 of 5
After receiving five doses of filgrastim, the nurse notes that the client’s white blood cell count has increased from 2,500/mm3 (2.5 x 10^9/L) to 5,000/mm3 (5 x 10^9/L). Which action should the nurse implement? White Blood Cell (WBC) [Reference Range: 5000 to 10,000/mm3 (5 to 10 x 10^9/L)]
Correct Answer: D
Rationale: Filgrastim stimulates white blood cell production. An increase from 2,500 to 5,000/mm3 indicates effectiveness, though still at the lower normal range. Informing the client reinforces adherence. Culture reports, vital signs, or neutropenic precautions are unnecessary without infection signs.
Question 2 of 5
A client with chemotherapy-induced nausea receives a prescription for metoclopramide. Which adverse effect is most important for the nurse to report?
Correct Answer: C
Rationale: Involuntary movements (extrapyramidal symptoms) are a serious, potentially irreversible side effect of metoclopramide due to dopamine receptor blockade. Reporting these promptly allows intervention, such as dose adjustment or anticholinergic use. Nausea, diarrhea, and irritability are less urgent side effects.
Question 3 of 5
After receiving five doses of filgrastim, the nurse notes that the client’s white blood cell count has increased from 2,500/mm3 (2.5 x 10^9/L) to 5,000/mm3 (5 x 10^9/L). Which action should the nurse implement? White Blood Cell (WBC) [Reference Range: 5000 to 10,000/mm3 (5 to 10 x 10^9/L)]
Correct Answer: D
Rationale: Filgrastim stimulates white blood cell production. An increase from 2,500 to 5,000/mm3 indicates effectiveness, though still at the lower normal range. Informing the client reinforces adherence. Culture reports, vital signs, or neutropenic precautions are unnecessary without infection signs.
Question 4 of 5
A nurse is caring for a client who has Parkinson’s disease and is prescribed an anticholinergic. Which of the following therapeutic outcomes should the nurse expect to see?
Correct Answer: B
Rationale: Anticholinergics reduce tremors in Parkinson’s by balancing acetylcholine and dopamine. They do not relieve depression, delay disease progression, or improve bladder function (they may worsen it due to urinary retention).
Question 5 of 5
The nurse is planning care for a client with major depression who is receiving a new prescription for duloxetine. Which information is most important for the nurse to obtain?
Correct Answer: C
Rationale: Duloxetine is metabolized by the liver, and hepatotoxicity is a rare but serious risk. Obtaining liver function test results ensures safe administration, as impaired liver function increases toxicity risk. Family history, weight changes, or other antidepressant use are relevant but secondary to liver function.