HESI RN
HESI Pharmacology Exam 2 Questions
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
2/18/2021
Prescription for captopril 25mg by mouth twice a day.
4/10/2021
Discontinue spironolactone. Start hydrochlorothiazide 25mg daily.
Question 1 of 5
The nurse notifies the provider that the client is having trouble remembering to take his second dose of captopril. Which ACE inhibitors can be given only once per day? Select all that apply.
Correct Answer: B,C,D
Rationale: Lisinopril, ramipril, and trandolapril have long durations, allowing once-daily dosing, improving adherence for the client. Quinapril and captopril require twice-daily dosing due to shorter half-lives.
Extract:
Question 2 of 5
The nurse is caring for a client who has been taking ibuprofen. Which finding is most important for the nurse to report to the healthcare provider?
Correct Answer: A
Rationale: Hematemesis (vomiting blood) indicates potential gastrointestinal bleeding, a serious NSAID complication. Immediate reporting to the provider ensures evaluation and management. Nausea, insomnia, and dizziness are less urgent side effects of ibuprofen.
Question 3 of 5
The nurse is administering the muscle relaxant baclofen by mouth (PO) to a client diagnosed with multiple sclerosis. Which intervention should the nurse implement?
Correct Answer: A
Rationale: Baclofen can cause dizziness or orthostatic hypotension, increasing fall risk in clients with multiple sclerosis, who may already have impaired coordination. Advising slow, cautious movement when rising and walking is the most critical intervention to prevent falls. Monitoring intake/output or muscle strength is not directly related to baclofen’s side effects, and abrupt discontinuation risks withdrawal.
Question 4 of 5
The nurse is providing instructions about a client’s new medications. How should the nurse explain the purpose of probenecid, a uricosuric drug?
Correct Answer: D
Rationale: Probenecid increases uric acid excretion in urine, reducing blood levels and preventing gout attacks. It does not affect kidney stone formation, urine stream strength, or urinary pain, making uric acid excretion the correct purpose.
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 5 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.