HESI RN
HESI Pharmacology Exam 2 Questions
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 1 of 5
For each nursing action below, click to specify if the action is indicated, contraindicated, or non-essential.
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.
Extract:
Question 2 of 5
Prior to administering the evening dose of carbamazepine, the nurse notes that the client’s morning carbamazepine level was 8.4 mcg/L (35.6 mcmol/L). Which action should the nurse take? Carbamazepine level [Reference Range: 4 to 12 mcg/mL or 16.9 to 50.8 mcmol/L]
Correct Answer: C
Rationale: A carbamazepine level of 8.4 mcg/L is within the therapeutic range (4-12 mcg/mL), indicating safe and effective dosing. Administering the dose as prescribed maintains seizure control. Assessing side effects or notifying the provider is unnecessary without symptoms, and withholding risks subtherapeutic levels.
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.
Orders
• prescription of captopril 25mg by mouth twice a day
Laboratory Test
Hemoglobin A1C:
• Result- 6.8%
• Reference Range- 4 to 5.9%
Question 3 of 5
For each instruction, click to indicate whether the instructions given by the nurse are indicated or contraindicated to prepare for the client’s first dose of captopril.
| Options | Indicated | Contraindicated |
|---|---|---|
| Increase the lantus dose by 3 units the morning of the first dose. | ||
| Limit fluids for several days before the first dose. | ||
| Hold spironolactone for 3 days. | ||
| Lay down if the blood pressure drops quickly after the first dose. | ||
| Monitor blood pressure for several hours after the first dose. |
Correct Answer:
Rationale: Holding spironolactone reduces hyperkalemia risk with captopril, lying down manages hypotension, and monitoring blood pressure ensures safety. Increasing insulin or limiting fluids lacks rationale and risks hypoglycemia or dehydration.
Extract:
Question 4 of 5
The nurse is caring for a client who has been taking ibuprofen. Which finding is most important for the nurse to report to the healthcare provider?
Correct Answer: A
Rationale: Hematemesis (vomiting blood) indicates potential gastrointestinal bleeding, a serious NSAID complication. Immediate reporting to the provider ensures evaluation and management. Nausea, insomnia, and dizziness are less urgent side effects of ibuprofen.
Question 5 of 5
A client on alcohol withdrawal protocol suddenly begins to have a seizure in his bed. After several minutes the seizure has not ended and the nurse suspects the client is suffering from status epilepticus. What is the priority action the nurse will take?
Correct Answer: A
Rationale: Status epilepticus requires immediate seizure cessation to prevent brain damage. IV lorazepam is the priority to stop the seizure. Lowering to the floor, waiting, or calling a code delays critical intervention.