HESI RN
RN HESI Pharmacology Questions
Extract:
History and Physical
The client is a 75-year-old female admitted to the preoperative area to prepare for pacemaker insertion. The client reports she is having this done because her heart rate has been staying very low, she is always tired, and she has passed out once from a low heart rate. The client has a history of worsening symptomatic bradycardia and a history of atrial fibrillation controlled by medication. She has been off anticoagulants for 4 days to prepare for the procedure.
Nurses’ Notes
0700:
Laboratory specimens have been drawn and completed during a preadmission visit. After changing clothes and settling into bed, the client was placed on continuous monitoring. Admission process completed.
0800:
Peripheral IV (PIV) started in the right antecubital with a 20-gauge catheter. IV fluids of 0.9% sodium chloride started at 50 mL/hr. Cardiac surgeon in to see the client and answer questions about the procedure.
0830:
Client reports no known allergies. Vancomycin 1 gram in 250 mL 0.9% sodium chloride started at 125 mL/hr as endocarditis prophylaxis.
Laboratory Results
Laboratory Test Result Reference Range
White blood cells (WBC) 6,500/mm³ (6.5 x 10⁹/L) 5,000 to 10,000/mm³
Red blood cells (RBC) 3.78 x 10¹²/L 4.2 to 5.4 x 10¹²/L
Hemoglobin (Hgb) 11.2 g/dL (6.95 mmol/L) 12 to 16 g/dL (7.4 to 9.9 mmol/L)
Flow Sheet
0700
Vital Signs
• Temperature: 97.6°F (36.4°C) orally
• Heart rate: 44 beats/minute
• Respiratory rate: 18 breaths/minute
• Blood pressure: 136/80 mm Hg
Question 1 of 5
The nurse is preparing the client’s plan of care. Select 4 findings that would indicate to the nurse that the administration of the vancomycin antibiotic would be safe to administer.
Correct Answer: A,B,D,E
Rationale: No allergies, safe dosage, large vein IV, and prophylactic use ensure safe vancomycin administration.
Extract:
Question 2 of 5
The healthcare provider prescribes magnesium sulfate 300 mg/hour IV. The IV bag contains magnesium sulfate 4 grams in dextrose 5% in water (D5W) 500 mL. How many mL/hour should the nurse set the infusion pump? (Enter numerical value only. If rounding is required, round to the nearest tenth.) How many mL/hour should the nurse set the infusion pump?
Correct Answer: 37.5
Rationale: 4 grams = 4000 mg; concentration = 4000 mg ÷ 500 mL = 8 mg/mL; infusion rate = 300 mg/hour ÷ 8 mg/mL = 37.5 mL/hour.
Question 3 of 5
The nurse observes that a client has become lethargic 30 minutes after receiving an opioid injection for pain. Which vital sign should the nurse obtain first? Which vital sign should the nurse obtain first?
Correct Answer: B
Rationale: Opioids can cause respiratory depression, a life-threatening side effect. Assessing respiratory rate first ensures the client’s airway and breathing are adequate.
Extract:
History and physical
The client is a 75-year-old female admitted to the preoperative area to prepare for pacemaker insertion. The client reports she is having this done because her heart rate has been staying very low. She is always tired, and she has passed out once from a low heart rate. The client has a history of worsening symptomatic bradycardia and a history of atrial fibrillation controlled by medication. She has been off anticoagulants for 4 days to prepare for the procedure.
Nurses notes
0700: Laboratory specimens have been drawn and completed during a preadmission visit. After changing clothes and settling into bed, the client was placed on continuous monitoring. Admission process completed.
0800: Peripheral IV (PIV) started in the right antecubital with a 20-gauge catheter. IV fluids of 0.9% sodium chloride started at 50 mL/hr. Cardiac surgeon in to see the client and answer questions about the procedure.
0830: Client reports no known allergies. Vancomycin 1 gram in 250 mL 0.9% sodium chloride started at 125 mL/hr as endocarditis prophylaxis.
0840: Awaiting transfer to the operating room (OR). Vancomycin infusing at 125 mL/hr.
Question 4 of 5
The nurse would determine what actions to implement in an emergent situation. Drag from Word Choices to complete the sentence. "The client is at immediate risk for developing: ---------------,---------------------and-----------------------
Correct Answer: C,E,F
Rationale: The client’s bradycardia and atrial fibrillation increase risks for cardiac arrest, arrhythmias, and anaphylaxis (from vancomycin), requiring emergency preparedness.
Extract:
Question 5 of 5
The nurse is caring for a client who takes methotrexate for rheumatoid arthritis and receives a prescription for adalimumab. Which instructions should the nurse provide the client? Which instructions should the nurse provide the client?
Correct Answer: A
Rationale: Methotrexate and adalimumab suppress the immune system, increasing infection risk. Avoiding crowds and sick individuals is critical to prevent infections.