HESI RN
RN HESI Pharmacology Exam Questions
Extract:
History and Physical
• 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
Nurses' Notes
1400: Started continuous morphine in the left antecubital vein peripheral intravenous line. No redness, edema, or bleeding noted at the site.
• 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
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
Question 1 of 5
What actions should the nurse take to ensure safety during morphine administration? Select all that apply.
Correct Answer: A,D,E
Rationale: Morphine risks respiratory depression; checking respiratory rate, having a resuscitation bag, and reviewing medications for interactions ensure safety. ECG, suctioning, and restraints are unnecessary without specific indications.
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
Question 2 of 5
What other medications would the nurse expect the surgeon to prescribe along with morphine? Select all that apply.
Correct Answer: A,D,E
Rationale: Ibuprofen enhances pain relief and reduces inflammation, while senna and docusate sodium prevent opioid-induced constipation. Propofol (anesthetic), methadone (chronic pain), and naloxone (emergency reversal) are inappropriate for routine post-op care.
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 3 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:
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 mmHg, respiratory rate 14.
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
• 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
What should the nurse do immediately? Select all that apply.
Correct Answer: B,C,F
Rationale: Low responsiveness and respiratory rate suggest morphine overdose. Rescue breaths, naloxone (opioid antagonist), and rapid response address respiratory depression. ECG, oxygen, and compressions are secondary without specific indications.
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 5 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).