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 healthcare provider notes that a client is receiving lamivudine (Epivir). The healthcare provider determines that this medication has been prescribed to treat which of the following?
- A. Pancreatitis
- B. Pharyngitis
- C. Tonic-clonic seizures
- D. Human immunodeficiency virus (HIV) infection
Correct answer: D
Rationale: Lamivudine, known by the brand name Epivir, is an antiretroviral medication used in the treatment of human immunodeficiency virus (HIV) infection. This medication helps to inhibit the replication of HIV and improve the immune system function in individuals with HIV. Therefore, the correct answer is option D, Human immunodeficiency virus (HIV) infection.
3. A client with trigeminal neuralgia tells the nurse that acetaminophen (Tylenol) is taken on a frequent daily basis for relief of generalized discomfort. The nurse reviews the client's laboratory results and determines that which of the following indicates toxicity associated with the medication?
- A. Sodium of 140 mEq/L
- B. Prothrombin time of 12 seconds
- C. Platelet count of 400,000 cells/mm³
- D. A direct bilirubin level of 2 mg/dL
Correct answer: D
Rationale: A direct bilirubin level of 2 mg/dL indicates liver damage, which can be caused by an overdose of acetaminophen. Acetaminophen toxicity can lead to liver injury, manifesting as elevated bilirubin levels and other liver function test abnormalities.
4. A client taking fexofenadine (Allegra) is scheduled for allergy skin testing and tells the nurse in the healthcare provider's office that a dose was taken this morning. The nurse determines that:
- A. The client should reschedule the appointment.
- B. A lower dose of allergen will need to be injected.
- C. A higher dose of allergen will need to be injected.
- D. The client should have the skin test read a day later than usual.
Correct answer: A
Rationale: Fexofenadine, an antihistamine, can cause false-negative readings in allergy skin testing and should be discontinued 3 days prior. Therefore, the client should reschedule the appointment to ensure accurate test results.
5. A client with diabetes mellitus is prescribed Humulin NPH insulin. The client asks the nurse how to store unopened vials of insulin. The nurse instructs the client to:
- A. Freeze the insulin.
- B. Refrigerate the insulin.
- C. Store the insulin in a dark, dry place.
- D. Keep the insulin at room temperature.
Correct answer: B
Rationale: Unopened vials of insulin should be stored in the refrigerator until needed. Freezing insulin can damage it, affecting its efficacy. Storing insulin in a dark, dry place or at room temperature is not recommended as it can lead to degradation of the insulin. Refrigeration helps maintain the stability and effectiveness of insulin.
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