HESI RN
HESI Pharmacology Exam 2 Questions
Extract:
Question 1 of 5
The nurse is planning care for a client with major depression who is receiving a new prescription for duloxetine. Which information is most important for the nurse to obtain?
Correct Answer: C
Rationale: Duloxetine is metabolized by the liver, and hepatotoxicity is a rare but serious risk. Obtaining liver function test results ensures safe administration, as impaired liver function increases toxicity risk. Family history, weight changes, or other antidepressant use are relevant but secondary to liver function.
Question 2 of 5
A client is receiving intravenous (IV) vancomycin and the nurse plans to draw blood for a peak and trough to determine the serum level of the drug. Which collection times provide the best determination of these levels?
Correct Answer: B
Rationale: Peak vancomycin levels, reflecting maximum concentration, are best measured one hour after IV dose completion. Trough levels, indicating minimum concentration, are drawn one hour before the next dose. This timing ensures accurate monitoring of therapeutic levels and prevents toxicity.
Extract:
History and Physical
The client is a 54-year-old male with a history of hypertension and type 2 diabetes. He takes spironolactone 25 mg per day, metformin 500 mg twice a day, and 25 units of insulin glargine.
Orders
• prescription of captopril 25mg by mouth twice a day
Laboratory Test
Hemoglobin A1C:
• Result- 6.8%
• Reference Range- 4 to 5.9%
Question 3 of 5
For each instruction, click to indicate whether the instructions given by the nurse are indicated or contraindicated to prepare for the client’s first dose of captopril.
| Options | Indicated | Contraindicated |
|---|---|---|
| Increase the lantus dose by 3 units the morning of the first dose. | ||
| Limit fluids for several days before the first dose. | ||
| Hold spironolactone for 3 days. | ||
| Lay down if the blood pressure drops quickly after the first dose. | ||
| Monitor blood pressure for several hours after the first dose. |
Correct Answer:
Rationale: Holding spironolactone reduces hyperkalemia risk with captopril, lying down manages hypotension, and monitoring blood pressure ensures safety. Increasing insulin or limiting fluids lacks rationale and risks hypoglycemia or dehydration.
Extract:
Question 4 of 5
The nurse is planning care for a client with major depression who is receiving a new prescription for duloxetine. Which information is most important for the nurse to obtain?
Correct Answer: C
Rationale: Duloxetine is metabolized by the liver, and hepatotoxicity is a rare but serious risk. Obtaining liver function test results ensures safe administration, as impaired liver function increases toxicity risk. Family history, weight changes, or other antidepressant use are relevant but secondary to liver function.
Question 5 of 5
A female client who is a vegetarian has a new prescription for warfarin. The client states she eats leafy green vegetables every day. How should the nurse respond?
Correct Answer: B
Rationale: Warfarin’s anticoagulant effect is reduced by vitamin K, abundant in leafy greens. Informing the healthcare provider about the client’s consistent intake allows for dose adjustments to maintain therapeutic anticoagulation. Replacing vegetables is unnecessary, commending the diet ignores the interaction, and leafy greens may reduce warfarin’s efficacy, not enhance it.