HESI RN
RN HESI Pharmacology Exam Questions
Extract:
History and Physical
• - Admit to the surgical floor
• - Clear liquid diet, advance as tolerated
• - Continuous cardiorespiratory monitoring
• - Morphine 1 mg/hr intravenously
• - Alert surgeon to signs of bleeding or infection in the surgical site
•
Orders
- Admit to the surgical floor
- Clear liquid diet, advance as tolerated
- Continuous cardiorespiratory monitoring
- Morphine 1 mg/hr intravenously
- Alert surgeon to signs of bleeding or infection in the surgical site
Question 1 of 5
The nurse is discussing the client's pain management with a student nurse. Morphine is a(n) ----------------------- and it activates----------------receptors and is used to relieve -------------- .
Correct Answer: A,B,E
Rationale: Morphine is a pure opioid agonist (not antagonist, correcting the provided answer), activating mu receptors for analgesia, primarily for severe pain (e.g., post-surgical). Agonist-antagonists, local anesthetics, kappa, NMDA, or other pain types are incorrect.
Extract:
History and Physical
The client is a 42-year-old female who had a right above-the-knee amputation for osteomyelitis. The client has a drain in place and a surgical dressing that will need to be changed by the surgeon on post-op day 1.
Nurses' Notes
1400: Started continuous morphine in the left antecubital vein peripheral intravenous line. No redness, edema, or bleeding noted at the site. Vital signs are heart rate 77 bpm, blood pressure 118/74 mmHg, respiratory rate 16 breaths/min.
Orders
• Admit to the surgical floor
• Clear liquid diet, advance as tolerated
• Continuous cardiorespiratory monitoring
• Morphine 1 mg/hr intravenously
• Alert surgeon to signs of bleeding or infection in the surgical site
Question 2 of 5
What other medications would the nurse expect the surgeon to prescribe along with morphine? Select all that apply.
Correct Answer: A,D,E
Rationale: Ibuprofen enhances pain relief and reduces inflammation, while senna and docusate sodium prevent opioid-induced constipation. Propofol (anesthetic), methadone (chronic pain), and naloxone (emergency reversal) are inappropriate for routine post-op care.
Extract:
Question 3 of 5
The healthcare provider prescribes enoxaparin sodium 80 mg subcutaneously twice daily. The nurse is preparing a preloaded 1 mL syringe labeled, 'enoxaparin sodium injection, USP 60 mg/0.6 mL'. How many mL should the nurse administer? (Enter numeric value only. If rounding is required, round to the nearest tenth.)
Correct Answer: 0.8
Rationale: Calculate: (80 mg ÷ 60 mg) × 0.6 mL = 0.8 mL. The nurse should administer 0.8 mL to deliver 80 mg of enoxaparin.
Extract:
History and Physical
The client is a 42-year-old female who had a right above-the-knee amputation for osteomyelitis. The client has a drain in place and a surgical dressing that will need to be changed by the surgeon on post-op day 1.
Nurses' Notes
1400: Started continuous morphine in the left antecubital vein peripheral intravenous line. No redness, edema, or bleeding noted at the site.
Vital signs: heart rate 77 bpm, blood pressure 118/74 mmHg, respiratory rate 16.
1800: Vital signs: heart rate 79 bpm, blood pressure 114/78, respiratory rate 14 bpm.
1900: Responded to an alarm in the room. The client is not responsive. Her respiratory rate is 5 bpm. Her heart rate is 92 bpm. Her pupils are pinpoint.
Orders
- Admit to the surgical floor
- Clear liquid diet, advance as tolerated
- Continuous cardiorespiratory monitoring
- Morphine 1 mg/hr intravenously
- Alert surgeon to signs of bleeding or infection in the surgical site
1500:
- Docusate sodium 240 mg orally every am
- Naloxone 2 mg intravenously as needed for respiratory depression
- Ibuprofen 600 mg orally every 6 hours
Question 4 of 5
For each statement, click to indicate whether the statements by the student nurse indicate understanding or no understanding of naloxone.
| Options | Understanding | No Understanding |
|---|---|---|
| "You can give naloxone intravenously, intramuscularly, or subcutaneously." | ||
| "Naloxone works best on pure agonist opioids." | ||
| "If the first dose does not work, you can give as many doses as needed to reverse respiratory depression." | ||
| "Naloxone will not affect the client's level of pain." | ||
| "When given IV, naloxone starts working immediately and can last several hours." |
Correct Answer:
Rationale: A: Naloxone can be given IV, IM, or SC (Understanding). B: It works best on pure agonists like morphine (Understanding). C: Repeated doses risk adverse effects like agitation (No Understanding). D: Naloxone reverses analgesia, increasing pain (No Understanding). E: IV naloxone acts quickly but lasts 30-90 minutes, not hours (No Understanding).
Extract:
Question 5 of 5
A client with bipolar disorder admitted with severe depression and suicidal ideation receives a prescription for lithium carbonate. Which instruction should the nurse provide to the client?
Correct Answer: A
Rationale: NSAIDs increase lithium levels, risking toxicity (e.g., tremors, confusion). Eliminating NSAIDs is critical. Glucose, dental notifications, and iodine foods are unrelated to lithium safety.