HESI RN
HESI Bsn 225 RN Pharmacology Questions
Extract:
Question 1 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 2 of 5
A client is scheduled for a spiral computed tomography (CT) scan with contrast to evaluate for pulmonary embolism. Which information in the client's history requires follow-up by the nurse?
Correct Answer: B
Rationale: Metformin use requires follow-up due to the risk of lactic acidosis with contrast agents affecting renal function. Metal prostheses, sobriety, and prior CT scans are less relevant to contrast administration safety.
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 3 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 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.
Extract:
History and physical
Client is a 66-year-old male with a history of type 2 diabetes mellitus and hypertension. He takes a metoprolol, hydrochlorothiazide, and metformin. He went to his primary healthcare provider reporting that he had been having trouble controlling his blood pressure in the last few days. He has also had a severe headache. Client was a direct admit to the hospital from the primary healthcare provider's office.
Nurses notes
1000
Admitted the client to the medical floor. He informs that he already took his metoprolol,
hydrochlorothiazide, and metformin dose. He says his morning glucose was 111 mg/dL (6.16 mmol/L). Rates his pain as 6 on a 0 to 10 pain scale. Minoxidil and ibuprofen given as prescribed.
1200
Pain rated at 1 on a 0 to 10 pain scale.
Lab results
Blood glucose 218mg/dl
Flowsheet
1000
Vital signs
. Temperature 99° F (37.2° C) orally
. Heart rate 59 beats/minute in atrial fibrillation
• Respiratory rate 20 breaths/minute
. Blood pressure 203/166 mm Hg
Oxygen saturation 97% on room air
Orders
Admit to the medical floor
Heart healthy diet
Vital signs every 2 hours and as needed (PRN)
Give minoxidil 5 mg PO now
Give 400 mg ibuprofen PO PRN for pain
Check blood glucose before meals and at sleep (HS)
Question 5 of 5
Review H and P, nurse's notes, laboratory results, flow sheet, and prescriptions. Click to mark whether the assessment finding represents a therapeutic result of the minoxidil 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 |
|---|---|---|---|
| Dizziness while sitting up: Non-therapeutic side effect | |||
| Blood glucose 218mg/dl: Unrelated finding | |||
| Mouth dryness: Non-therapeutic side effect | |||
| Blood pressure 162/111mmHg: Therapeutic result | |||
| Heart rate 99: Non-therapeutic side effect | |||
| Pain of 1 out of 10: Unrelated finding | |||
| Urine output 600ml: Unrelated finding |
Correct Answer:
Rationale: A: Dizziness is a minoxidil side effect (hypotension). B: High glucose relates to diabetes. C: Dry mouth is a possible side effect. D: Lowered blood pressure is therapeutic. E: Tachycardia is a side effect. F: Pain reduction relates to ibuprofen. G: Urine output is unrelated.