HESI RN
HESI Pharmacology Exam 2 Questions
Extract:
Nurses Notes
The client is a 26-year-old female with acute appendicitis. She has a 12-year history of type 1 diabetes and no other significant medical history. The appendectomy was completed without issue, and the client will be admitted to the surgical floor to recover.
Laboratory Results
0730
Admitted the client. She is awake and alert. She rates her pain 2/10. Her pulses are equal bilaterally. Heart rate is 76 beats per 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° C). She urinated 50 ml upon arrival in the unit and is stating she is very thirsty. The patient states her last insulin glargine dose was this morning before surgery.
Flow Sheet
0745
2 units insulin lispro given
1800
12 units insulin glargine given
The client ate 45 carbohydrates from her dinner tray. 3 units of insulin lispro given.
Orders
• Admit to the surgical floor
• Dextrose 5% and 0.9% sodium chloride to infuse at 125 mL/hr
• Advance diet as tolerated
• Insulin glargine 12 units subcutaneous every 12 hours
• Ceftriaxone 2 g IV every 24 hours for 3 days, first dose given in surgery
• Insulin lispro 1 unit subcutaneously per 15 carbohydrates
Question 1 of 5
The nurse is preparing the client for discharge and discussing home medications. What home medications may affect the amount of insulin needed by the client? Select all that apply.
Correct Answer: A,B,C,E
Rationale: St. John’s Wort may reduce insulin effectiveness, corticosteroids cause insulin resistance, fluconazole enhances hypoglycemia, and oral contraceptives increase glucose levels, all requiring insulin adjustments. Ibuprofen has minimal impact on glucose control.
Extract:
Question 2 of 5
A nurse is assessing a client’s ability to swallow. Which of the following, when selected by the nurse, indicates an understanding of the cranial nerve that tests the ability to swallow?
Correct Answer: C
Rationale: The glossopharyngeal nerve (IX) controls swallowing and the gag reflex. Selecting this nerve demonstrates understanding. The facial (VII) nerve manages facial expressions, trigeminal (V) handles chewing, and hypoglossal (XII) controls tongue movements.
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 and no other significant medical histor The appendectomy was completed without issue, and the client will be admitted to the surgical floor to recover.
Question 3 of 5
For each nursing action below, click to specify if the action is indicated, contraindicated, or non-essential.
| Options | Indicated | Contraindicated | Non-essential |
|---|---|---|---|
| Verify that the client can count carbohydrates. | |||
| Restart the IV fluids until the tray arrives. | |||
| Give insulin lispro 4 units. | |||
| Give insulin glargine 12 units. | |||
| Mix the insulin lispro and insulin glargine in one syringe. |
Correct Answer:
Rationale: Verifying carbohydrate counting ensures glycemic control, and administering prescribed insulin glargine maintains basal insulin levels. Restarting IV fluids is unnecessary without indication, insulin lispro requires an order, and mixing lispro with glargine alters pharmacokinetics.
Extract:
Question 4 of 5
After receiving five doses of filgrastim, the nurse notes that the client’s white blood cell count has increased from 2,500/mm3 (2.5 x 10^9/L) to 5,000/mm3 (5 x 10^9/L). Which action should the nurse implement? White Blood Cell (WBC) [Reference Range: 5000 to 10,000/mm3 (5 to 10 x 10^9/L)]
Correct Answer: D
Rationale: Filgrastim stimulates white blood cell production. An increase from 2,500 to 5,000/mm3 indicates effectiveness, though still at the lower normal range. Informing the client reinforces adherence. Culture reports, vital signs, or neutropenic precautions are unnecessary without infection signs.
Question 5 of 5
A client in the surgical recovery area asks the nurse to bring the largest possible dose of pain medication available. Which action should the nurse implement first?
Correct Answer: A
Rationale: Assessing the client’s pain level using a pain scale provides objective data to determine the appropriate dose and urgency of pain management, guiding safe administration. Diversional strategies, drug history, or prior dose timing are secondary to understanding current pain intensity.