HESI RN
HESI Pharmacology Exam 2 Questions
Extract:
Question 1 of 5
The nurse is caring for a client who has been taking ibuprofen. Which finding is most important for the nurse to report to the healthcare provider?
Correct Answer: A
Rationale: Hematemesis (vomiting blood) indicates potential gastrointestinal bleeding, a serious NSAID complication. Immediate reporting to the provider ensures evaluation and management. Nausea, insomnia, and dizziness are less urgent side effects of ibuprofen.
Question 2 of 5
Prior to administering oral doses of calcitriol and calcium carbonate to a client with hypoparathyroidism, the nurse notes that the client’s total calcium level is 14 mg/dL (3.5 mmol/L). Which action should the nurse implement? Reference Range: Total Calcium [Reference Range: Adult 9 to 10.5 mg/dL or 2.25 to 2.62 mmol/L]
Correct Answer: B
Rationale: A calcium level of 14 mg/dL indicates hypercalcemia, risking complications like arrhythmias. Holding both calcitriol and calcium carbonate and contacting the provider prevents further calcium elevation. Administering either medication could worsen hypercalcemia, making holding both the safest action.
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? Reference Range: Hemoglobin (Hgb) [Reference Range: Male: 14 to 18 g/dL (8.7 to 11.2 mmol/L)]
Correct Answer: A
Rationale: Epoetin alfa stimulates red blood cell production, increasing hemoglobin. A hemoglobin level of 12 g/dL indicates effective treatment of anemia, though still below the male reference range. Subjective energy improvements, iron intake, or therapy tolerance are less direct indicators of epoetin’s efficacy.
Question 4 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.
Question 5 of 5
While assessing a client who takes acetaminophen for chronic pain, the nurse observes that the client’s skin looks yellow in color. Which action should the nurse take in response to this finding?
Correct Answer: C
Rationale: Yellow skin suggests jaundice, indicating potential liver damage from acetaminophen, which is hepatotoxic in high doses. Reporting to the provider ensures evaluation and possible dose adjustment. Glucose, oxygen saturation, or self-reducing the dose are inappropriate without further assessment.