HESI RN
RN HESI Pharmacology Questions
Extract:
History and physical
The client is a 36-year-old female with moderate persistent asthma. She takes fluticasone/salmeterol 250 mcg/50 mcg, 1 inhalation twice daily, and albuterol 90 mcg/inhalation, 2 inhalations every 4 to 6 hours PRN.
Nurses notes
The client reports that she has had more severe asthma symptoms than usual in the past week. Her forced expiratory volume has been 60 to 65% even with multiple doses of albuterol for several days in a row. She came to the hospital feeling dizzy, lightheaded, and reporting “heart palpitations.” Upon assessment, no wheezes were found. Her oxygen saturation is 99% on room air.
Question 1 of 5
Review H and P, and nurse’s note. Complete the diagram by dragging from the choices area to specify which condition the client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client’s progress.
Correct Answer:
Rationale: Tachydysrhythmia from albuterol overuse requires monitoring (
A) and cautious albuterol use (
C). Breath sounds (
A) and airway edema (H) assess respiratory status.
Extract:
Question 2 of 5
A client who is taking furosemide reports experiencing leg cramps, a cough, feeling tired, and palpitations. Which action should the nurse take first? Which action should the nurse take first?
Correct Answer: D
Rationale: Furosemide can cause electrolyte imbalances leading to arrhythmias. Palpitations and tiredness suggest cardiac issues, making cardiac monitoring the priority.
Question 3 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? Which client finding best indicates that the medication is effective?
Correct Answer: C
Rationale: Epoetin alfa stimulates red blood cell production. An increase in hemoglobin to 12 g/dL objectively indicates effective treatment of anemia.
Question 4 of 5
The nurse is reviewing the client’s laboratory values. Which serum laboratory value indicates to the nurse that a prescription for atorvastatin is having the desired effect for a client at risk for coronary artery disease? Which serum laboratory value indicates to the nurse that a prescription for atorvastatin is having the desired effect?
Correct Answer: A
Rationale: Atorvastatin reduces LDL cholesterol, a key risk factor for coronary artery disease. Lower LDL levels indicate the medication’s effectiveness.
Extract:
History and Physical
The client is a 75-year-old female admitted to the preoperative area to prepare for pacemaker insertion. The client reports she is having this done because her heart rate has been staying very low, she is always tired, and she has passed out once from a low heart rate. The client has a history of worsening symptomatic bradycardia and a history of atrial fibrillation controlled by medication. She has been off anticoagulants for 4 days to prepare for the procedure.
Nurses’ Notes
0700:
Laboratory specimens have been drawn and completed during a preadmission visit. After changing clothes and settling into bed, the client was placed on continuous monitoring. Admission process completed.
0800:
Peripheral IV (PIV) started in the right antecubital with a 20-gauge catheter. IV fluids of 0.9% sodium chloride started at 50 mL/hr. Cardiac surgeon in to see the client and answer questions about the procedure.
0830:
Client reports no known allergies. Vancomycin 1 gram in 250 mL 0.9% sodium chloride started at 125 mL/hr as endocarditis prophylaxis.
Laboratory Results
Laboratory Test Result Reference Range
White blood cells (WBC) 6,500/mm³ (6.5 x 10⁹/L) 5,000 to 10,000/mm³
Red blood cells (RBC) 3.78 x 10¹²/L 4.2 to 5.4 x 10¹²/L
Hemoglobin (Hgb) 11.2 g/dL (6.95 mmol/L) 12 to 16 g/dL (7.4 to 9.9 mmol/L)
Flow Sheet
0700
Vital Signs
• Temperature: 97.6°F (36.4°C) orally
• Heart rate: 44 beats/minute
• Respiratory rate: 18 breaths/minute
• Blood pressure: 136/80 mm Hg
Question 5 of 5
The nurse is preparing the client’s plan of care. Select 4 findings that would indicate to the nurse that the administration of the vancomycin antibiotic would be safe to administer.
Correct Answer: A,B,D,E
Rationale: No allergies, safe dosage, large vein IV, and prophylactic use ensure safe vancomycin administration.