HESI RN
HESI Pharmacology Practice Exam
1. A client is learning how to mix regular insulin and NPH insulin in the same syringe. Which action, if performed by the client, indicates the need for further teaching?
- A. Withdraws the NPH insulin first
- B. Withdraws the regular insulin first
- C. Injects air into the NPH insulin vial first
- D. Injects an amount of air equal to the desired dose of insulin into the vial
Correct answer: A
Rationale: When mixing regular insulin with another insulin preparation, it is crucial to withdraw the regular insulin first to prevent contamination. NPH insulin should be drawn after the regular insulin to maintain the integrity of each insulin type. Therefore, if the client withdraws the NPH insulin first, it indicates the need for further teaching. Choice B is correct as withdrawing regular insulin first is the appropriate step. Choice C is incorrect as air should be injected into the vial containing the regular insulin to maintain pressure. Choice D is incorrect as injecting air equal to the desired dose of insulin into the vial is a correct step in preparing the insulin for withdrawal.
2. A client is receiving intravenous gentamicin (Garamycin). Which of the following findings should prompt the nurse to notify the healthcare provider immediately?
- A. Nausea
- B. Hearing loss
- C. Headache
- D. Diarrhea
Correct answer: B
Rationale: Gentamicin (Garamycin) is an aminoglycoside antibiotic known to cause ototoxicity, which can manifest as hearing loss. Hearing loss is a serious adverse effect that should be reported promptly to the healthcare provider to prevent further complications or adjust the treatment regimen. Nausea, headache, and diarrhea are common side effects of gentamicin but are not as severe or urgent as hearing loss in this context.
3. A client with Crohn's disease is scheduled to receive an infusion of infliximab (Remicade). The nurse assisting in caring for the client should take which action to monitor the effectiveness of treatment?
- A. Monitoring the leukocyte count for 2 days after the infusion
- B. Checking the frequency and consistency of bowel movements
- C. Checking serum liver enzyme levels before and after the infusion
- D. Carrying out a Hematest on gastric fluids after the infusion is completed
Correct answer: B
Rationale: To monitor the effectiveness of infliximab (Remicade) treatment in a client with Crohn's disease, the nurse should observe the frequency and consistency of bowel movements. Infliximab is an immunomodulator that works to reduce inflammation in the colon, leading to improvements in bowel symptoms such as frequency and consistency. Monitoring these bowel patterns can provide valuable insight into the response to the medication and the overall management of Crohn's disease. Checking the leukocyte count (Choice A) is not specific to monitoring the effectiveness of infliximab for Crohn's disease. Checking serum liver enzyme levels (Choice C) may be important for liver function but does not directly monitor the effectiveness of infliximab. Carrying out a Hematest on gastric fluids (Choice D) is not relevant to monitoring the effectiveness of infliximab in Crohn's disease.
4. A client is receiving furosemide (Lasix) and is being discharged. What should the nurse include in the teaching plan?
- A. Consume potassium-rich foods.
- B. Take the medication in the morning.
- C. Change positions slowly to prevent dizziness.
- D. Maintain an adequate fluid intake.
Correct answer: C
Rationale: The correct answer is to instruct the client to change positions slowly to prevent dizziness. Furosemide (Lasix) is a diuretic that can lead to orthostatic hypotension, causing dizziness. Consuming potassium-rich foods is essential to prevent hypokalemia when taking furosemide. Taking the medication in the morning helps reduce the need for frequent urination at night. Encouraging the client to maintain an adequate fluid intake is crucial to prevent dehydration while on this medication.
5. A client is taking cetirizine hydrochloride (Zyrtec). The nurse checks for which of the following side effects of this medication?
- A. Diarrhea
- B. Excitability
- C. Drowsiness
- D. Excess salivation
Correct answer: C
Rationale: Cetirizine hydrochloride (Zyrtec) is known to commonly cause drowsiness or sedation as a side effect. Therefore, the nurse should monitor the client for signs of drowsiness when administering this medication. Choice A, Diarrhea, is not a common side effect of cetirizine. Choice B, Excitability, is not a typical side effect of this antihistamine; instead, it tends to cause drowsiness. Choice D, Excess salivation, is not associated with cetirizine use.
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