Hesi Rn 301 pharmacology Exam
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Free Hesi Rn 301 pharmacology Exam Questions
The nurse is caring for a client receiving regular insulin prescribed per a sliding scale. If a dose of regular insulin is administered at 0730, which additional nursing action is indicated for this client
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Ensure that the client eats breakfast.
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Provide a mid-afternoon snack for the client.
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Assess the client for hypoglycemia around 1500.
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Perform a glucometer reading at 1000.
Explanation
Correct Answer A. Ensure that the client eats breakfast.
Explanation:
Regular insulin has an onset of 30–60 minutes and a peak effect at 2–4 hours after administration. Administering insulin without ensuring food intake can cause hypoglycemia during its peak action. Giving breakfast soon after the 0730 injection ensures that circulating glucose is available when the insulin begins working, preventing dangerous drops in blood sugar levels.
Why Other Options Are Wrong:
A. Provide a mid-afternoon snack for the client.
Mid-afternoon snacks may help prevent late-day hypoglycemia for some regimens, but the more immediate concern after a morning insulin dose is to ensure the client eats breakfast to match the insulin's onset and peak.
B. Assess the client for hypoglycemia around 1500.
By 1500, the action of regular insulin given at 0730 would largely have worn off. The highest hypoglycemia risk is during its peak (around 0930–1130), making earlier monitoring more critical.
C. Perform a glucometer reading at 1000.
While checking blood glucose can be important, the immediate priority is ensuring the client eats to prevent hypoglycemia. Blood sugar monitoring alone does not prevent the drop in glucose if no food is consumed.
A 60-year-old client has been taking high-dose aspirin daily for chronic arthritis pain. During a follow-up visit, the nurse assesses for potential adverse effects. Which finding indicates aspirin toxicity?
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Tinnitus
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Constipation
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Hyperglycemia
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Polyuria
Explanation
Correct Answer:
Tinnitus
Explanation:
Tinnitus (ringing in the ears) is a classic early sign of salicylate (aspirin) toxicity. It may be accompanied by dizziness, headache, or hearing loss. If untreated, toxicity can progress to metabolic acidosis, hyperthermia, and organ failure. Prompt recognition is essential to prevent severe complications.
Why Other Options Are Incorrect:
Constipation
Constipation is not typically associated with aspirin toxicity; gastrointestinal upset and bleeding are more common.
Hyperglycemia
Aspirin does not typically cause hyperglycemia; in some cases, it may even lower blood glucose slightly.
Polyuria
Polyuria is not a hallmark sign of aspirin toxicity; fluid loss is more likely due to vomiting or fever in severe cases.
Aminoglycosides are primarily used for infections by what type of pathogen
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Gram positive bacteria only
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Gram negative bacteria only
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Both Gram negative and Gram positive bacteria
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Yeast and Fungi
Explanation
Correct Answer B. Gram negative bacteria only
Explanation:
B. Gram negative bacteria only
Aminoglycosides, such as gentamicin, tobramycin, and amikacin, are most effective against aerobic gram-negative bacteria, including Pseudomonas, E. coli, and Klebsiella. They are bactericidal and often used for severe systemic infections. In some cases, they are combined with other antibiotics to cover gram-positive organisms, but their primary use is gram-negative coverage.
Why the other options are incorrect:
A. Gram positive bacteria only
Aminoglycosides are not primarily used for gram-positive infections; they may be combined with other drugs for these, but they are not the main choice.
C. Both Gram negative and Gram positive bacteria
While combination therapy can provide broad coverage, aminoglycosides alone do not effectively target both types equally, especially gram-positives.
D. Yeast and Fungi
Aminoglycosides are antibacterial, not antifungal, so they are ineffective against yeast and fungi.
A patient with open-angle glaucoma asks the nurse how long the prescribed medication will need to be used. Which is the most appropriate response
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Until a smaller angle can be restored.
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For long-term control of normal eye pressure.
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For long-term control of pain and swelling.
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Until the excess pressure is reduced.
Explanation
Correct Answer B. For long-term control of normal eye pressure.
Explanation:
Open-angle glaucoma is a chronic condition caused by impaired drainage of aqueous humor, leading to increased intraocular pressure (IOP). Medications, such as prostaglandin analogs or beta-blockers, do not cure glaucoma but control IOP to prevent optic nerve damage. Treatment is lifelong to maintain normal eye pressure and preserve vision. Discontinuing therapy can lead to irreversible vision loss.
Why Other Options Are Wrong:
A. Until a smaller angle can be restored.
Open-angle glaucoma is not caused by a narrow angle; this describes a different condition (angle-closure glaucoma). There is no surgical or medication-based “angle restoration” in open-angle cases.
C. For long-term control of pain and swelling.
Glaucoma medications are not intended for pain or swelling control. Most open-angle glaucoma patients are asymptomatic until late stages, making pressure control—not pain relief—the treatment focus.
D. Until the excess pressure is reduced.
While medications reduce intraocular pressure, stopping them after an initial reduction will allow pressure to rise again. Long-term continuous therapy is required, not just short-term use until pressure drops.
A client with a deep vein thrombosis is prescribed a continuous heparin infusion at 18 units/kg/hr. The client weighs 80 kg. The IV solution contains 25,000 units of heparin in 250 mL of fluid. The nurse must calculate the infusion rate in mL/hr. What is the infusion rate (mL/hr)
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14 mL/hr
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12 mL/hr
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16 mL/hr
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18 mL/hr
Explanation
Step-by-Step Calculation:
Find the dose in units per hour:
18 units × 80 kg = 1,440 units/hr
Find concentration in units per mL:
25,000 units ÷ 250 mL = 100 units/mL
Calculate mL/hr:
1,440 units/hr ÷ 100 units/mL = 14.4 mL/hr
Round appropriately:
14 mL/hr
Correct Answer:
A. 14 mL/hr
Explanation:
Accurate calculation ensures the client receives the prescribed heparin dose safely, minimizing the risk of bleeding or clot progression.
Why Other Options Are Incorrect:
B. 12 mL/hr
Underdoses the client, risking clot growth.
C. 16 mL/hr
Overdoses the client, increasing bleeding risk.
D. 18 mL/hr
Significantly overdoses the client and is unsafe.
A client with asthma is prescribed albuterol. Which finding indicates the medication is effective
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Clear lung sounds and decreased wheezing
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Increased heart rate
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Tremors
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Dry mouth
Explanation
Correct Answer A. Clear lung sounds and decreased wheezing
Explanation:
Albuterol is a short-acting beta-2 agonist that relaxes bronchial smooth muscle, improving airflow and reducing wheezing. Clinical improvement in breath sounds confirms effectiveness. Increased heart rate and tremors are side effects, not indicators of therapeutic success.
Why Other Options Are Incorrect:
B. Increased heart rate
Expected side effect, not therapeutic goal.
C. Tremors
Side effect from beta-2 stimulation.
D. Dry mouth
More common with anticholinergics than beta-agonists.
A 67-year-old client with osteoporosis is prescribed alendronate, a bisphosphonate, to reduce bone loss and fracture risk. The nurse is providing medication teaching to ensure proper administration and minimize complications. Which instruction is correct for alendronate?
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Take with food to reduce GI upset
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Lie down after taking it to prevent dizziness
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Take first thing in the morning with a full glass of water and stay upright 30 minutes
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Crush and mix with applesauce for better absorption
Explanation
Correct Answer:
Take first thing in the morning with a full glass of water and stay upright 30 minutes
Explanation:
Alendronate can cause severe esophageal irritation if not taken correctly. It should be taken first thing in the morning on an empty stomach with a full glass (6–8 oz) of plain water, followed by remaining upright for at least 30 minutes. This ensures proper absorption and reduces the risk of esophagitis. Food, beverages (other than water), and other medications should be avoided during this period.
Why Other Options Are Incorrect:
Take with food to reduce GI upset
Food interferes with alendronate absorption and should be avoided for at least 30 minutes after taking the medication.
Lie down after taking it to prevent dizziness
Lying down immediately increases the risk of esophageal irritation and reflux. The client must stay upright.
Crush and mix with applesauce for better absorption
Alendronate tablets should not be crushed or chewed because this increases the risk of oropharyngeal and esophageal irritation.
When preparing to apply a scheduled fentanyl transdermal patch, the nurse notes that the previously applied patch is intact on the client's upper back and the client denies pain. Which action should the nurse take?
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Administer an oral analgesic and evaluate its effectiveness before applying the new patch.
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Apply the new patch in a different location after removing the original patch.
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Remove the patch and consult with the healthcare provider about the client's pain resolution.
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Place the patch on the client's shoulder and leave both patches in place for 12 hours.
Explanation
Correct Answer:
Apply the new patch in a different location after removing the original patch.
Explanation:
Fentanyl patches deliver a continuous dose of medication over a set time period, usually 72 hours. When changing the patch, the old one must be removed to avoid overdose. The new patch should be applied to a different intact skin site to prevent skin irritation and ensure proper absorption. Rotating sites also reduces the risk of localized skin reactions.
Why Other Options Are Wrong:
Administer an oral analgesic and evaluate its effectiveness before applying the new patch.
This approach delays the scheduled administration of fentanyl and does not follow standard protocol for patch changes. Oral analgesics are not necessary if the patient is already adequately managed on fentanyl.
Remove the patch and consult with the healthcare provider about the client's pain resolution.
Consultation is unnecessary unless there are adverse effects or the patient’s pain management needs have changed significantly. The nurse should follow the scheduled replacement process unless contraindicated.
Place the patch on the client's shoulder and leave both patches in place for 12 hours.
Leaving both patches on can lead to dangerous fentanyl overdose and severe respiratory depression. This practice is unsafe and violates medication administration guidelines.
A 63-year-old client with heart failure has been taking furosemide daily. During a clinic visit, the client reports experiencing frequent muscle cramps over the past few days. The nurse reviews potential electrolyte imbalances associated with this medication. Which lab abnormality is most likely?
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Hyperkalemia
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Hypokalemia
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Hypernatremia
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Hypermagnesemia
Explanation
Correct Answer:
Hypokalemia
Explanation:
Furosemide is a loop diuretic that promotes sodium, potassium, and water excretion in the ascending loop of Henle. Excessive potassium loss can cause hypokalemia, which often presents with muscle cramps, weakness, and potentially dangerous cardiac arrhythmias. Clients on furosemide may require potassium supplementation or dietary adjustments to maintain normal potassium levels.
Why Other Options Are Incorrect:
Hyperkalemia
Furosemide causes potassium loss, not retention, so hyperkalemia is unlikely.
Hypernatremia
Although sodium is excreted with furosemide, water loss can sometimes increase sodium levels, but hypokalemia is more common and fits the symptoms better.
Hypermagnesemia
Loop diuretics increase magnesium excretion, so magnesium levels may decrease—not increase—during therapy.
A client is prescribed levothyroxine for hypothyroidism. Which statement by the client indicates correct understanding of the medication?
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“I will take it on an empty stomach in the morning.”
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“I should take it with my calcium supplement.”
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“I can stop taking it when I feel better.”
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“I’ll take it at night for better absorption.”
Explanation
Correct Answer:
“I will take it on an empty stomach in the morning.”
Explanation:
Levothyroxine absorption is best on an empty stomach, typically 30–60 minutes before breakfast, with water only. It should be taken consistently at the same time daily. Therapy is lifelong, and absorption can be reduced by calcium, iron, and certain antacids.
Why Other Options Are Incorrect:
“I should take it with my calcium supplement.”
Calcium interferes with absorption.
“I can stop taking it when I feel better.”
Discontinuing can cause hypothyroid symptoms to return.
“I’ll take it at night for better absorption.”
Morning dosing is preferred to mimic natural hormone rhythm.
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