HESI RN
HESI Pharmacology Exam 2 Questions
Extract:
Question 1 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.
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)]
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.
Orders
2/18/2021
Prescription for captopril 25mg by mouth twice a day.
4/10/2021
Discontinue spironolactone. Start hydrochlorothiazide 25mg daily.
Question 3 of 5
The nurse notifies the provider that the client is having trouble remembering to take his second dose of captopril. Which ACE inhibitors can be given only once per day? Select all that apply.
Correct Answer: B,C,D
Rationale: Lisinopril, ramipril, and trandolapril have long durations, allowing once-daily dosing, improving adherence for the client. Quinapril and captopril require twice-daily dosing due to shorter half-lives.
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 for captopril 25mg by mouth twice a day
Laboratory Test
Hemoglobin A1C
• Result- 6.8%
• Reference Range- 4 to 5.9%
Question 4 of 5
The provider would like the client to continue with the captopril dose and restart the spironolactone. The provider wants the client to return to the clinic in 6 weeks with lab work done. What 2 labs would be most appropriate for this client to complete on their return visit?
Correct Answer: D,E,
Rationale: Captopril and spironolactone can cause renal impairment and hyperkalemia. Kidney function tests (e.g.creatinine) and electrolyte panels (e.g. potassium) monitor these risks. Coagulation cardiac enzymes osmolality and blood counts are less relevant."
Extract:
Question 5 of 5
Prior to administering oral doses of calcitriol and calcium carbonate to a client with hypoparathyroidism, the nurse notes that the client’s total calcium level is 14 mg/dL (3.5 mmol/L). Which action should the nurse implement? Reference Range: Total Calcium [Reference Range: Adult 9 to 10.5 mg/dL or 2.25 to 2.62 mmol/L]
Correct Answer: B
Rationale: A calcium level of 14 mg/dL indicates hypercalcemia, risking complications like arrhythmias. Holding both calcitriol and calcium carbonate and contacting the provider prevents further calcium elevation. Administering either medication could worsen hypercalcemia, making holding both the safest action.