HESI RN
RN HESI Pharmacology Questions
Extract:
History and Physical
The client is a 75-year-old female admitted to the preoperative area to prepare for pacemaker insertion. 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 low heart rate. 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. 0840: Awaiting transport to the operating room.
Orders
0800:
• a. Start peripheral IV
• b. Vancomycin 1 gram in 250 mL 0.9% sodium chloride
0840:
• c. Stop vancomycin
Question 1 of 5
The nurse is assessing the client to update the plan of care. Choose the most likely options for the information missing from the statement by selecting from the lists of options provided. The nurse determines that the client is experiencing ___ and the blood pressure changes are the result of ___.
Correct Answer: A,E
Rationale: Syncope from bradycardia causes low blood flow, with vasodilation contributing to blood pressure changes.
Extract:
Question 2 of 5
Which intervention is most important for the nurse to implement for a client with type 2 diabetes mellitus (DM) who is receiving insulin lispro? Which intervention is most important for the nurse to implement?
Correct Answer: D
Rationale: Insulin lispro is rapid-acting, peaking quickly. Providing meals at the same time as administration prevents hypoglycemia by ensuring glucose availability.
Question 3 of 5
The nurse is providing discharge instructions to a client who has been prescribed gabapentin 300 mg by mouth (PO) three times a day for postherpetic neuralgia. Which symptom should the nurse tell the client to report to the healthcare provider? Which symptom should the nurse tell the client to report to the healthcare provider?
Correct Answer: B
Rationale: Gabapentin can cause fluid retention, leading to rapid weight gain, which may signal serious issues like heart or kidney problems. This symptom requires prompt reporting to the healthcare provider for further evaluation.
Question 4 of 5
The nurse is caring for an adult client who is taking digoxin. Which laboratory value should be reported to the healthcare provider immediately? Which laboratory value should be reported to the healthcare provider immediately?
Correct Answer: B
Rationale: A potassium level of 3.2 mEq/L indicates hypokalemia, which increases the risk of digoxin toxicity by enhancing digoxin’s effects on the heart, potentially causing arrhythmias. This value requires immediate reporting.
Question 5 of 5
A client with generalized anxiety disorder (GAD) receives a new prescription for lorazepam. Which statement provided by the client requires additional instruction by the nurse? Which statement provided by the client requires additional instruction by the nurse?
Correct Answer: D
Rationale: Stopping lorazepam abruptly if effects are not immediate can lead to withdrawal symptoms and rebound anxiety. The nurse should instruct the client to follow the prescribed regimen and consult the provider before discontinuing.