HESI Bsn 225 RN Pharmacology

Extract:

Question 1 of 5

The nurse is caring for a client with atrial fibrillation who receives a prescription for warfarin. The international normalized ratio (INR) is 2.8. Which action should the nurse take?

Correct Answer: C

Rationale: An INR of 2.8 is within the therapeutic range for atrial fibrillation, but monitoring for bleeding is critical as a routine precaution. Repeating the sample, giving the dose, or notifying the provider are less immediate.

Extract:

History and physical
The client is a 26-year-old female with acute appendicitis. She has a 12 year history of type 1 diabetes mellitus and no other significant medical history. The appendectomy was completed without issue, and the client will be admitted to the surgical floor to recover.
Nurses notes
0730
Admitted the client. She is awake and alert. She rates her pain 2 on a 0 to 10 pain scale. Her pulses are equal bilaterally. Heart rate is 76 beats/minute, normal sinus rhythm. Her oxygen saturation is 100% on room air. She has a gauze dressing over her surgical site, which is clean and dry. Her temperature is 98.5° F (37.0° C) orally. She urinated 50 mL upon arrival in the unit and is reporting she
Lab results
Blood glucose 279mg/dl
Orders
Admit to the surgical floor
• Dextrose 5% and 0.9% sodium chloride IV to infuse at 125 mL/hr
Advance diet as tolerated
• Insulin glargine 12 units SUBQ every 24 hours
. Ceftriaxone 2 gram IV piggy back (IVPB) every
24 hours for 3 days, first dose given in surgery

Question 2 of 5

It is 1800, and the client has a scheduled dose of insulin glargine due. The client has a regular diet tray ordered with 60 carbohydrates. The tray has not yet arrived in the room. For each nursing action below, click to specify if the action is indicated, contraindicated or nonessential.Each row must have one option selected.

Options	Therapeutic result	Non therapeutic side effect	Unrelated finding
Give insulin lispro 4 units: Contraindicated
Verify that the client can count carbohydrates: Nonessential
Mix the insulin lispro and insulin glargine in one syringe: Contraindicated
Give insulin glargine 12 units: Indicated

Correct Answer:

Rationale: A: Lispro is contraindicated without meal intake to avoid hypoglycemia. B: Carb counting is nonessential for scheduled glargine. C: Mixing lispro and glargine is contraindicated. D: Glargine is indicated as scheduled.

Extract:

Question 3 of 5

During a home visit, the nurse assesses a client with Alzheimer's disease who recently started a new prescription for rivastigmine. The caregiver reports that the client seems to be thinking more clearly but is not sleeping well at night. Which action should the nurse take?

A. Advise the caregiver that the purpose of the medication is to promote sleep, so a change in medication may be needed. B. Explain to the caregiver that insomnia is a common and temporary side effect when the medication is first started. C. Instruct the caregiver to withhold the medication until the dosage can be decreased to ensure the client's safety. D. Notify the healthcare provider that the dosage of the medication may need to be increased to manage the client's insomnia.

Correct Answer: B

Rationale: Insomnia is a common, often temporary side effect of rivastigmine. Explaining this reassures the caregiver. Rivastigmine is for cognition, not sleep, and withholding or increasing the dose is inappropriate without provider guidance.

Extract:

History and physical
The client is a 26-year-old female with acute appendicitis. She has a 12 year history of type 1 diabetes mellitus and no other significant medical history. The appendectomy was completed without issue, and the client will be admitted to the surgical floor to recover.
Nurses notes
0730
Admitted the client. She is awake and alert. She rates her pain 2 on a 0 to 10 pain scale. Her pulses are equal bilaterally. Heart rate is 76 beats/minute, normal sinus rhythm. Her oxygen saturation is 100% on room air. She has a gauze dressing over her surgical site, which is clean and dry. Her temperature is 98.5° F (37.0° C) orally. She urinated 50 mL upon arrival in the unit and is reporting she
Lab results
Blood glucose 279mg/dl
Orders
Admit to the surgical floor
• Dextrose 5% and 0.9% sodium chloride IV to infuse at 125 mL/hr
Advance diet as tolerated
• Insulin glargine 12 units SUBQ every 24 hours
. Ceftriaxone 2 gram IV piggy back (IVPB) every
24 hours for 3 days, first dose given in surgery

Question 4 of 5

The nurse prepares to give 2 units of insulin lispro. Which should the nurse double check with a second nurse? Select all that apply.

A. The dose of insulin drawn up in the syringe B. The expiration date on the insulin vial C. The type of insulin to be administered D. The sliding scale insulin lispro prescription E. The insulin concentration F. The insulin vial for color and clarity G. The history and physical with the diabetes diagnosis listed

Correct Answer: A,B,C,D,E,F

Rationale: Dose, type, prescription, concentration, vial clarity, and expiration ensure safe insulin administration. B and G are standard nurse assessments, not requiring double-checking.

Extract:

Question 5 of 5

Which instruction should the nurse include when teaching a client about self-administration of a bulk-forming laxative?

A. Avoid the intake of dairy products while using the medication. B. Remain upright for thirty minutes following drug administration. C. Take the medication one hour after meals and other medications. D. Follow medication administration with an additional glass of water.

Correct Answer: D

Rationale: Bulk-forming laxatives require ample water to prevent choking and ensure efficacy. Dairy avoidance, staying upright, or specific post-meal timing are not necessary.

HESI Bsn 225 RN Pharmacology | Nurselytic

Nurselytic

HESI RN

HESI RN