HESI RN
RN HESI Pharmacology Questions
Extract:
Question 1 of 5
The nurse is teaching a client how to use an inhaler device. Which client statement indicates to the nurse that the client understands the instructions? Which client statement indicates to the nurse that the client understands the instructions?
Correct Answer: A
Rationale: Rinsing the mouth after inhaler use, especially with corticosteroids, prevents oral thrush and irritation, indicating proper understanding.
Extract:
History and physical
A 23-year-old female presents to the emergency department with altered mental status. She is accompanied by her roommate. The roommate says that symptoms started around 0900 today and have progressively worsened. She says the client first appeared euphoric but would switch to being irritable. The client also reported diarrhea and nausea. The client is combative. The client has a history of major depressive disorder and is being treated with paroxetine 50 mg PO once daily.
Nurses notes
1830
The nurse notes significant diaphoresis. The client appears confused and disoriented to person, place, and time. Lung sounds are clear. No arrhythmia is noted. Palpated pulses are strong and bounding. Capillary refill is
Flowsheet
Day 1, 1830
Vital Signs
• Temperature 102°F (38.8°C)
• Heart rate 118 beats/minute
• Respirations 16 breaths/minute
• Blood pressure 168/94 mm Hg
• Oxygen saturation 97% on room air
• Height 5 feet, 4 inches (64 cm)
• Weight 136 pounds (61.6 kg)
Question 2 of 5
Which assessment findings require follow-up by the nurse? Select all that apply.
Correct Answer: A,B,C,D,E
Rationale: Myoclonus, fever, hypertension, altered mental status, tachycardia, and diaphoresis suggest serotonin syndrome, requiring immediate follow-up.
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 3 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:
History and Physical
Client is a 24-year-old male with a 2-day history of severe vomiting and diarrhea. The client believes he has a case of food poisoning after attending a party. Other individuals at the party were having similar symptoms.
Nurses’ Notes
1100:
• Admitted to the medical unit. He is pale with a capillary refill of 5 seconds. Is sleepy but responds to commands. An 18-gauge peripheral IV line started in the right hand, flushes easily with no redness or edema. Bolus of IV fluids given.
1115:
• Healthcare provider notified of arterial blood gas values. Sodium bicarbonate given as prescribed.
1200:
• Capillary refill 2 seconds
Laboratory Results
Laboratory Test 1115 1200 Reference Range
Blood Gas
pH 7.22 7.35 7.35 to 7.45
Bicarbonate (HCO3) 15 mEq/L (15 mmol/L) 22 mEq/L (22 mmol/L) 21 to 28 mEq/L (21 to 28 mmol/L)
Partial pressure of carbon dioxide (PaCO2) 39 mm Hg 34 mm Hg 35 to 45 mm Hg
Partial pressure of oxygen (PaO2) 88 mm Hg 92 mm Hg 80 to 100 mm Hg
Lactate 2 mEq/L (0.2 mmol/L) 1.7 mEq/L (0.17 mmol/L) 3 to 7 mg/dL (0.3 to 0.8 mmol/L)
Flow Sheet
1100:
• Vital signs:
o Heart rate: 102 beats/minute
o Respiratory rate: 19 breaths/minute
o Blood pressure: 100/77 mm Hg
o Oxygen saturation: 95% on room air
1200:
• Vital signs:
o Heart rate: 77 beats/minute
o Respiratory rate: 17 breaths/minute
o Blood pressure: 113/72 mm Hg
o Oxygen saturation: 100% on room air
Intake and Output:
1100:
• Intake: 400 mL
1200:
• Intake: 400 mL
Orders
1100:
• Admit to the medical unit
• Regular diet as tolerated
• Give 1 liter 0.9% sodium chloride IV bolus now, then start Lactated Ringer’s Infusion at 100 mL/hr
• Draw serum arterial blood gas, venous lactate, sodium, and potassium
• Vital signs every hour
• Strict intake and output
1115:
• Give sodium bicarbonate 50 mEq IV push now
• Repeat arterial blood gas after administration
Patient Data.
Question 4 of 5
Review H and P, nurses notes, laboratory results, flow sheet, and orders. Click to mark whether the assessment finding represents a therapeutic result of the sodium bicarbonate administered, a non-therapeutic side-effect, or an unrelated finding.
| Options | therapeutic result | non-therapeutic side-effect | unrelated finding |
|---|---|---|---|
| Capillary refill 2 seconds | |||
| Blood pressure 113/72 mm Hg | |||
| Bicarbonate 22 mEq/L (22 mmol/L) | |||
| Sodium 152 mEq/L (152 mmol/L) | |||
| 400 mL urine output | |||
| Heart rate 77 beats/minute |
Correct Answer:
Rationale: A: therapeutic result B: therapeutic result C: therapeutic result D: non-therapeutic side-effect E: unrelated finding F: therapeutic result Sodium bicarbonate corrects metabolic acidosis (
C) and improves perfusion (A, B, F). Hypernatremia (
D) is a side effect, and urine output (E) is unrelated to bicarbonate.
Extract:
Question 5 of 5
A client receives a prescription for ciprofloxacin 400 mg intravenously (IV) every 12 hours to be infused over an hour. The IV bag contains ciprofloxacin 400 mg in dextrose 5% in water (D5W) 200 mL. The nurse should program the infusion pump to deliver how many mL/hr? (Enter numerical value only.) The nurse should program the infusion pump to deliver how many mL/hr?
Correct Answer: 200
Rationale: The IV bag contains 200 mL to be infused over 1 hour. Infusion rate = 200 mL ÷ 1 hour = 200 mL/hr.