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.
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
A client with benign prostatic hyperplasia receives a new prescription of tamsulosin. Which intervention should the nurse perform to monitor for an adverse reaction? Which intervention should the nurse perform to monitor for an adverse reaction?
Correct Answer: B
Rationale: Tamsulosin can cause orthostatic hypotension. Monitoring blood pressure detects this adverse reaction, ensuring client safety.
Question 3 of 5
The nurse administers risedronate to a client with osteoporosis at 0700. The client asks for a glass of milk to drink with the medication. Which action should the nurse take? Which action should the nurse take?
Correct Answer: D
Rationale: Risedronate must be taken with water on an empty stomach to ensure absorption and prevent esophageal irritation. Milk interferes with absorption.
Question 4 of 5
A client with nasal congestion receives a prescription for phenylephrine 10 mg PO every 4 hours. Which client condition should the nurse report to the healthcare provider before administering the medication? Which client condition should the nurse report to the healthcare provider before administering the medication?
Correct Answer: C
Rationale: Phenylephrine causes vasoconstriction, which can elevate blood pressure. In clients with hypertension, this can worsen the condition and lead to cardiovascular complications, necessitating reporting to the healthcare provider.
Question 5 of 5
Which action should the nurse implement to assess the effectiveness of amlodipine? Which action should the nurse implement?
Correct Answer: A
Rationale: Amlodipine, a calcium channel blocker, lowers blood pressure by relaxing blood vessels. Measuring blood pressure directly assesses its effectiveness.