HESI RN
HESI RN Patho Pharmacology Questions
Extract:
Question 1 of 5
Two days after admission for an exacerbation of chronic obstructive pulmonary disease (COPD), an older client’s arterial blood gas (ABG) indicate an acid base imbalance. The client’s laboratory results reveal a low hemoglobin level, an elevated creatinine clearance, and decreased urine specific gravity. Which is the most likely cause for the acid base imbalance?
Correct Answer: C
Rationale: Chronic renal insufficiency (
C) causes metabolic acidosis due to impaired acid excretion and bicarbonate regulation, consistent with low hemoglobin (anemia), elevated creatinine clearance (renal dysfunction), and low urine specific gravity (poor concentration). Prior MI (
A) is unrelated. Antacids (
B) don’t cause acidosis. Exertional dyspnea (
D) may cause respiratory acidosis, not metabolic.
Question 2 of 5
Three days after a cholecystectomy for cholelithiasis, a client reports persistent upper abdominal pain that radiates to the back. The client has vomited three times in the last 12 hours and has a temperature of 101.8° F (38.7° C). Serum amylase and lipase are twice the normal value. Based on these findings, the nurse should observe the client for which pathophysiological condition?
Correct Answer: A
Rationale: Elevated amylase/lipase, pain radiating to the back, vomiting, and fever suggest acute pancreatitis (
A), possibly triggered by gallstones. Surgical site infection (
B) lacks pancreatic markers. Hepatorenal failure (
C) involves kidney/liver dysfunction. Biliary obstruction (
D) may elevate bilirubin, not amylase.
Question 3 of 5
A client received midazolam 2 mg and morphine sulfate 4 mg for a liver biopsy. After the procedure, the nurse positions the client on the right side and monitors the vital signs. Which is the physiological reason for the nurse’s intervention?
Correct Answer: A
Rationale: Positioning on the right side (
A) applies pressure to the liver biopsy site, promoting hemostasis and reducing bleeding risk, as the liver is on the right. Aspiration prevention (
B) is relevant during anesthesia recovery, not post-biopsy. Pain management (
C) involves analgesics, not positioning. Pulmonary expansion (
D) is achieved via breathing exercises, not side-lying.
Question 4 of 5
The nurse is explaining the underlying cause of bruising with a client who is recently diagnosed with acute leukemia. Which pathophysiology is a result of the myeloblastic dysfunction of leukemia?
Correct Answer: B
Rationale: This question is identical to Question 36. Leukemia-induced thrombocytopenia (
B) causes bruising by delaying clotting. Oxyhemoglobin (
A) is unrelated. Phagocytic deficiency (
C) affects infections. Iron deficiency (
D) causes anemia. Note: Duplicate question; consider removing.
Question 5 of 5
What is the inherent rate of the AV (atrioventricular) node area?
Correct Answer: A
Rationale: The AV node’s inherent pacemaker rate is 40-60 bpm (
A), slower than the SA node (60-100 bpm). 20-40 (
B) is too slow. 60-80 (
C) and 80-100 (
D) overlap with SA node rates.