BSN315 Exam 4 Actual Exam Style V1 |
BSN 315 HESI RN Specialty Pharmacology
Exam | Nightingale
1. A nurse is preparing to administer levothyroxine to a client with hypothyroidism. Which
instruction should the nurse include in the client’s teaching plan?
A. Take the medication with a full glass of milk at bedtime.
B. If you miss a dose, double the next dose to maintain blood levels.
C. Take the medication on an empty stomach 30 to 60 minutes before breakfast.
D. Stop the medication once your energy levels return to normal.
Answer: C
Rationale: Levothyroxine absorption is best achieved when taken on an empty stomach in
the morning before other medications or food. Taking it with minerals like calcium in milk
can decrease its bioavailability. This medication is typically lifelong therapy and should
never be doubled if a dose is missed due to the long half-life.
2. A client is prescribed metformin for type 2 diabetes mellitus. Which laboratory value
should the nurse monitor most closely to prevent lactic acidosis?
A. Serum Potassium
B. Serum Creatinine
C. Alanine aminotransferase (ALT)
,D. Glycosylated hemoglobin (A1C)
Answer: B
Rationale: Metformin is excreted unchanged by the kidneys, so renal impairment can lead
to toxic accumulation and life-threatening lactic acidosis. A serum creatinine level greater
than 1.5 mg/dL in men or 1.4 mg/dL in women often contraindicates its use. While ALT
monitors liver function and A1C monitors long-term glucose control, they do not directly
signal the risk of metformin-induced lactic acidosis.
3. A nurse is caring for a client who is about to receive their morning dose of insulin lispro.
When should the nurse ensure the client’s breakfast tray is available?
A. Exactly 1 hour after administration.
B. Within 15 minutes of administration.
C. 30 to 45 minutes after administration.
D. The tray should be finished before administration.
Answer: B
Rationale: Insulin lispro is a rapid-acting insulin with an onset of 15 to 30 minutes. To
prevent hypoglycemia, the nurse must ensure the client has food immediately available or
is about to eat. Giving it too early without food present poses a significant safety risk for a
sudden drop in blood glucose.
, 4. Which assessment finding in a client taking long-term prednisone should the nurse report
to the provider immediately?
A. Weight gain of 1 lb in a week.
B. A blood glucose level of 140 mg/dL.
C. The presence of a ‘moon face’ appearance.
D. A temperature of 101.2°F (38.4°C).
Answer: D
Rationale: Glucocorticoids like prednisone suppress the immune system and mask signs of
infection, making a fever a critical finding. Weight gain and moon face are common side
effects of long-term steroid use, often referred to as Cushingoid features. Hyperglycemia is
also a known side effect, but an active infection is the highest priority for intervention.
5. A client with a history of peptic ulcer disease is prescribed sucralfate. When should the
nurse administer this medication?
A. With the first bite of each meal.
B. One hour before meals and at bedtime.
C. 30 minutes after taking an antacid.
D. Only when the client experiences epigastric pain.
Answer: B
BSN 315 HESI RN Specialty Pharmacology
Exam | Nightingale
1. A nurse is preparing to administer levothyroxine to a client with hypothyroidism. Which
instruction should the nurse include in the client’s teaching plan?
A. Take the medication with a full glass of milk at bedtime.
B. If you miss a dose, double the next dose to maintain blood levels.
C. Take the medication on an empty stomach 30 to 60 minutes before breakfast.
D. Stop the medication once your energy levels return to normal.
Answer: C
Rationale: Levothyroxine absorption is best achieved when taken on an empty stomach in
the morning before other medications or food. Taking it with minerals like calcium in milk
can decrease its bioavailability. This medication is typically lifelong therapy and should
never be doubled if a dose is missed due to the long half-life.
2. A client is prescribed metformin for type 2 diabetes mellitus. Which laboratory value
should the nurse monitor most closely to prevent lactic acidosis?
A. Serum Potassium
B. Serum Creatinine
C. Alanine aminotransferase (ALT)
,D. Glycosylated hemoglobin (A1C)
Answer: B
Rationale: Metformin is excreted unchanged by the kidneys, so renal impairment can lead
to toxic accumulation and life-threatening lactic acidosis. A serum creatinine level greater
than 1.5 mg/dL in men or 1.4 mg/dL in women often contraindicates its use. While ALT
monitors liver function and A1C monitors long-term glucose control, they do not directly
signal the risk of metformin-induced lactic acidosis.
3. A nurse is caring for a client who is about to receive their morning dose of insulin lispro.
When should the nurse ensure the client’s breakfast tray is available?
A. Exactly 1 hour after administration.
B. Within 15 minutes of administration.
C. 30 to 45 minutes after administration.
D. The tray should be finished before administration.
Answer: B
Rationale: Insulin lispro is a rapid-acting insulin with an onset of 15 to 30 minutes. To
prevent hypoglycemia, the nurse must ensure the client has food immediately available or
is about to eat. Giving it too early without food present poses a significant safety risk for a
sudden drop in blood glucose.
, 4. Which assessment finding in a client taking long-term prednisone should the nurse report
to the provider immediately?
A. Weight gain of 1 lb in a week.
B. A blood glucose level of 140 mg/dL.
C. The presence of a ‘moon face’ appearance.
D. A temperature of 101.2°F (38.4°C).
Answer: D
Rationale: Glucocorticoids like prednisone suppress the immune system and mask signs of
infection, making a fever a critical finding. Weight gain and moon face are common side
effects of long-term steroid use, often referred to as Cushingoid features. Hyperglycemia is
also a known side effect, but an active infection is the highest priority for intervention.
5. A client with a history of peptic ulcer disease is prescribed sucralfate. When should the
nurse administer this medication?
A. With the first bite of each meal.
B. One hour before meals and at bedtime.
C. 30 minutes after taking an antacid.
D. Only when the client experiences epigastric pain.
Answer: B
