HESI RN
RN HESI Pharmacology Exam Questions
Extract:
History and Physical
The client is a 75-year-old female who was admitted to the preop area to prepare for pacemaker insertion. She states that she needs this procedure because her heart rate has been very low, she feels tired all the time, and she has fainted once due to low heart rate. She has a history of worsening symptomatic bradycardia and atrial fibrillation controlled by medication. She has been off anticoagulants for four days to prepare for the procedure.
Nurses' Notes
0700: Labs were drawn and completed during a preadmission visit. After changing clothes and settling into bed, she was placed on continuous monitoring. Admission process was completed.
0800: A PIV was started in her right antecubital with a 20-gauge intracath. IVF of NS was started at 50 mL/hr. The cardiac surgeon came to see the client and answer her questions about the procedure.
0830: The client reports no known allergies. Vancomycin 1 gram in 250 mL NS was started at 125 mL/hr as endocarditis prophylaxis.
0840: The client was awaiting transfer to OR. Vancomycin was infusing at 125 mL/hr.
0845: The client says, "I don't feel well." Assessment reveals dizziness, headache, burning sensation on extremities, and red color on face and extremities. Blood pressure is 108/46 mmHg. Vancomycin infusion was stopped. The surgeon was notified.
0850: The client has flushing and redness over her entire body with hives developing. She complains of feeling hot and nauseous. Cool cloths were applied to her face and extremities. She is restless in bed. IVF of NS is running.
Orders
1140
Diphenhydramine 25 mg IV now
Methylprednisolone 100 mg IV now
Question 1 of 5
The nurse is implementing the plan of care.For each body system, select to specify the potential nursing intervention that would be appropriate for the care of the client. Each body system may support more than one potential nursing intervention. Each category must have at least one response option selected.
Correct Answer:
Rationale: Respiratory: Assessing lung sounds monitors for complications like anaphylaxis. Cardiovascular: Continuous vital signs, warmth, and defibrillator address bradycardia and hypothermia risks. Immunological: Antihistamines and steroids treat potential vancomycin-related anaphylaxis. Other options are less relevant to immediate needs.
Extract:
Question 2 of 5
A client with multiple sclerosis starts a new prescription, baclofen, to control muscle spasticity. Three days later, the client calls the clinic nurse and reports feeling fatigued and dizzy. Which instruction should the nurse provide?
Correct Answer: D
Rationale: Baclofen’s common side effects include fatigue and dizziness, which may subside with time. Avoiding hazardous activities prevents injury. Fluids/protein, stopping abruptly, or ER visits are inappropriate without severe symptoms.
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 3 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 4 of 5
A client with bulimia and depression who is taking phenelzine 90 mg daily is admitted to an acute care hospital for uncontrolled hypertension. Which dietary choices should the nurse instruct the client to avoid?
Correct Answer: C
Rationale: Phenelzine, an MAOI, interacts with tyramine-rich foods like pepperoni (aged meat) and cheese on pizza, risking hypertensive crisis. Beef, shrimp, and catfish are low in tyramine and safe.
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
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 5 of 5
The charge nurse places a fall precautions sign on the client's door. What side effects of morphine could contribute to this client's fall risk? Select all that apply.
Correct Answer: B,C,D,E,F,G
Rationale: Nausea, orthostatic hypotension, sedation, euphoria, itching, and urinary retention can cause dizziness, weakness, or distraction, increasing fall risk. Seizures are rare with therapeutic morphine doses.