HESI RN
HESI Pharmacology Exam 2 Questions
Extract:
Question 1 of 5
The nurse is administering sodium polystyrene sulfonate to a client in acute kidney injury (AKI). Which laboratory finding indicates that the medication has been effective? Glucose [Reference Range: 74 to 106 mg/dL (4.1 to 5.9 mmol/L)] Hemoglobin (Hgb) [Reference Range: 12-16 g/dL (120-160 g/L)] Potassium (K+) [Reference Range: 3.5 to 5.0 mEq/L (3.5 to 5.0 mmol/L)] Ammonia [Reference Range: Adult: 10 to 80 Mcg/dL (6 to 47 Mcmol/dL)]
Correct Answer: B
Rationale: Sodium polystyrene sulfonate treats hyperkalemia by binding potassium in the gut. A serum potassium level of 3.8 mEq/L (normal range) indicates effective reduction of potassium levels in AKI. Ammonia, glucose, and hemoglobin are not affected by this medication.
Question 2 of 5
An older adult with iron deficiency anemia is being discharged with a prescription for ferrous sulfate enteric-coated tablets. To promote best absorption of the medication, which information should the nurse include in the discharge instructions?
Correct Answer: C
Rationale: Ferrous sulfate is best absorbed on an empty stomach, waiting 2 hours after meals to avoid interference from food or minerals like calcium. Bedtime dosing risks GI upset, crushing enteric-coated tablets causes irritation, and multivitamins may contain interfering substances.
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:
Question 4 of 5
A client with heart failure (HF) develops hyperaldosteronism and spironolactone is prescribed. Which instruction should the nurse include in this client’s plan of care?
Correct Answer: D
Rationale: Spironolactone, a potassium-sparing diuretic, can cause hyperkalemia. Limiting high-potassium foods like bananas prevents dangerous potassium elevations, which can lead to arrhythmias. Salt substitutes often contain potassium, and bruising or photosensitivity are not primary concerns.
Question 5 of 5
A client who received a renal transplant three months ago is readmitted to the acute care unit with signs of graft rejection. While taking the client’s history, the nurse determines that the client has been self-administering St. John’s Wort, an herbal preparation, on the advice of a friend. Which information is most significant about this finding?
Correct Answer: D
Rationale: St. John’s Wort induces liver enzymes, reducing cyclosporine levels, an immunosuppressant critical for preventing transplant rejection. This interaction directly contributes to graft rejection, making it the most significant finding. Sodium intake, corticosteroid needs, or depression treatment are less relevant to the acute issue.