HESI RN
RN HESI Pharmacology Questions
Extract:
History and Physical
Client is a 24-year-old male with a 2-day history of severe vomiting and diarrhea. The client believes he has a case of food poisoning after attending a party. Other individuals at the party were having similar symptoms.
Nurses’ Notes
1100:
• Admitted to the medical unit. He is pale with a capillary refill of 5 seconds. Is sleepy but responds to commands. An 18-gauge peripheral IV line started in the right hand, flushes easily with no redness or edema. Bolus of IV fluids given.
1115:
• Healthcare provider notified of arterial blood gas values. Sodium bicarbonate given as prescribed.
1200:
• Capillary refill 2 seconds
Laboratory Results
Laboratory Test 1115 1200 Reference Range
Blood Gas
pH 7.22 7.35 7.35 to 7.45
Bicarbonate (HCO3) 15 mEq/L (15 mmol/L) 22 mEq/L (22 mmol/L) 21 to 28 mEq/L (21 to 28 mmol/L)
Partial pressure of carbon dioxide (PaCO2) 39 mm Hg 34 mm Hg 35 to 45 mm Hg
Partial pressure of oxygen (PaO2) 88 mm Hg 92 mm Hg 80 to 100 mm Hg
Lactate 2 mEq/L (0.2 mmol/L) 1.7 mEq/L (0.17 mmol/L) 3 to 7 mg/dL (0.3 to 0.8 mmol/L)
Flow Sheet
1100:
• Vital signs:
o Heart rate: 102 beats/minute
o Respiratory rate: 19 breaths/minute
o Blood pressure: 100/77 mm Hg
o Oxygen saturation: 95% on room air
1200:
• Vital signs:
o Heart rate: 77 beats/minute
o Respiratory rate: 17 breaths/minute
o Blood pressure: 113/72 mm Hg
o Oxygen saturation: 100% on room air
Intake and Output:
1100:
• Intake: 400 mL
1200:
• Intake: 400 mL
Orders
1100:
• Admit to the medical unit
• Regular diet as tolerated
• Give 1 liter 0.9% sodium chloride IV bolus now, then start Lactated Ringer’s Infusion at 100 mL/hr
• Draw serum arterial blood gas, venous lactate, sodium, and potassium
• Vital signs every hour
• Strict intake and output
1115:
• Give sodium bicarbonate 50 mEq IV push now
• Repeat arterial blood gas after administration
Patient Data.
Question 1 of 5
Review H and P, nurses notes, laboratory results, flow sheet, and orders. Click to mark whether the assessment finding represents a therapeutic result of the sodium bicarbonate administered, a non-therapeutic side-effect, or an unrelated finding.
| Options | therapeutic result | non-therapeutic side-effect | unrelated finding |
|---|---|---|---|
| Capillary refill 2 seconds | |||
| Blood pressure 113/72 mm Hg | |||
| Bicarbonate 22 mEq/L (22 mmol/L) | |||
| Sodium 152 mEq/L (152 mmol/L) | |||
| 400 mL urine output | |||
| Heart rate 77 beats/minute |
Correct Answer:
Rationale: A: therapeutic result B: therapeutic result C: therapeutic result D: non-therapeutic side-effect E: unrelated finding F: therapeutic result Sodium bicarbonate corrects metabolic acidosis (
C) and improves perfusion (A, B, F). Hypernatremia (
D) is a side effect, and urine output (E) is unrelated to bicarbonate.
Extract:
Question 2 of 5
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Question 3 of 5
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Question 5 of 5
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