HESI RN
HESI Pharmacology Exam 2 Questions
Extract:
Nurses Notes
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.
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 subcutaneously 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 prepares to give 2 units of insulin lispro. What should the nurse double-check with a second nurse? Select all that apply.
Correct Answer: A,C,E,G
Rationale: Double-checking the vial’s color/clarity ensures insulin stability, the dose in the syringe prevents errors, the expiration date confirms potency, and the concentration (e.g., U-100) ensures accurate dosing. History, sliding scale, and injection site do not require dual verification.
Extract:
Question 2 of 5
A male client with a history of heart failure (HF) complains of heartburn when he lies down after dinner. The home health nurse should encourage the client to talk to the healthcare provider about using which over-the-counter medication to relieve this problem?
Correct Answer: A
Rationale: Heartburn suggests gastroesophageal reflux disease (GER
D), common in heart failure. Low sodium antacids neutralize stomach acid without exacerbating fluid retention, unlike high-sodium options. Diphenhydramine, aspirin, and acetaminophen do not relieve heartburn and are inappropriate for GERD.
Question 3 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 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.
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 5 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.