HESI RN
RN HESI Pharmacology Exam Questions
Extract:
Question 1 of 5
To prevent deep vein thromboses following knee replacement surgery, an adult male client is receiving daily subcutaneous enoxaparin. Which laboratory result requires immediate action by the nurse? Reference Range: Hematocrit [42% to 52% (0.42 to 0.52 volume fraction)] Platelets [150,000 to 400,000/mm² (150 to 400 × 10^9/L)] Creatinine [0.5 to 1.1 mg/dL (44 to 97 μmol/L)] Blood Urea Nitrogen (BUN) [10 to 20 mg/dL (3.6 to 7.1 mmol/L)]
Correct Answer: A
Rationale: A platelet count of 100,000/mm³ indicates thrombocytopenia, a potential enoxaparin side effect, increasing bleeding risk. Immediate action (notifying provider, monitoring for bleeding) is needed. Hematocrit, BUN, and creatinine are within normal ranges and do not require urgent intervention.
Extract:
History and Physical
The client is a 42-year-old female who had a right above-the-knee amputation for osteomyelitis. The client has a drain in place and a surgical dressing that will need to be changed by the surgeon on post-op day 1.
Nurses' Notes
1400: Started continuous morphine in the left antecubital vein peripheral intravenous line. No redness, edema, or bleeding noted at the site. Vital signs are heart rate 77 bpm, blood pressure 118/74 mmHg, respiratory rate 16 breaths/min.
Orders
• Admit to the surgical floor
• Clear liquid diet, advance as tolerated
• Continuous cardiorespiratory monitoring
• Morphine 1 mg/hr intravenously
• Alert surgeon to signs of bleeding or infection in the surgical site
1500:
• Docusate sodium 240 mg orally every am
• Naloxone 2 mg intravenously as needed for respiratory depression
• Ibuprofen 600 mg orally every 6 hours
Question 2 of 5
The charge nurse places a fall precautions sign on the client's door. What side effects of morphine could contribute to this client's fall risk? Select all that apply.
Correct Answer: B,C,D,E,F,G
Rationale: Nausea, orthostatic hypotension, sedation, euphoria, itching, and urinary retention can cause dizziness, weakness, or distraction, increasing fall risk. Seizures are rare with therapeutic morphine doses.
Extract:
Question 3 of 5
Azithromycin is prescribed for a client with Chlamydia trachomatis. In providing client teaching about the medication, the nurse should emphasize the importance of reporting the onset of which symptom to the health care provider?
Correct Answer: C
Rationale: Yellow sclera indicates potential hepatotoxicity, a rare but serious azithromycin side effect requiring immediate reporting. Flatulence, nausea, and headache are common and mild; urinary frequency is unrelated.
Extract:
History and Physical
The client is a 42-year-old female who had a right above-the-knee amputation for osteomyelitis. The client has a drain in place and a surgical dressing that will need to be changed by the surgeon on post-op day 1.
Nurses' Notes
1400: Started continuous morphine in the left antecubital vein peripheral intravenous line. No redness, edema, or bleeding noted at the site.
Vital signs: heart rate 77 bpm, blood pressure 118/74 mmHg, respiratory rate 16.
1800: Vital signs: heart rate 79 bpm, blood pressure 114/78, respiratory rate 14 bpm.
1900: Responded to an alarm in the room. The client is not responsive. Her respiratory rate is 5 bpm. Her heart rate is 92 bpm. Her pupils are pinpoint.
Orders
- Admit to the surgical floor
- Clear liquid diet, advance as tolerated
- Continuous cardiorespiratory monitoring
- Morphine 1 mg/hr intravenously
- Alert surgeon to signs of bleeding or infection in the surgical site
1500:
- Docusate sodium 240 mg orally every am
- Naloxone 2 mg intravenously as needed for respiratory depression
- Ibuprofen 600 mg orally every 6 hours
Question 4 of 5
For each statement, click to indicate whether the statements by the student nurse indicate understanding or no understanding of naloxone.
| Options | Understanding | No Understanding |
|---|---|---|
| "You can give naloxone intravenously, intramuscularly, or subcutaneously." | ||
| "Naloxone works best on pure agonist opioids." | ||
| "If the first dose does not work, you can give as many doses as needed to reverse respiratory depression." | ||
| "Naloxone will not affect the client's level of pain." | ||
| "When given IV, naloxone starts working immediately and can last several hours." |
Correct Answer:
Rationale: A: Naloxone can be given IV, IM, or SC (Understanding). B: It works best on pure agonists like morphine (Understanding). C: Repeated doses risk adverse effects like agitation (No Understanding). D: Naloxone reverses analgesia, increasing pain (No Understanding). E: IV naloxone acts quickly but lasts 30-90 minutes, not hours (No Understanding).
Extract:
Question 5 of 5
A client with myasthenia gravis receives a new prescription for pyridostigmine. Which information should the nurse obtain prior to administering the medication?
Correct Answer: D
Rationale: Pyridostigmine, a cholinesterase inhibitor, is best taken on an empty stomach to enhance absorption. Recent oral intake informs timing. Sleep, urination, and weight loss are unrelated to administration.