BSN315 Exam 3 Actual Exam Style V1 |
BSN 315 HESI RN Specialty Pharmacology
Exam | Nightingale
1. A nurse is preparing to administer insulin glargine and regular insulin to a client. Which
action should the nurse take?
A. Draw up the regular insulin then the glargine in the same syringe.
B. Draw up the glargine then the regular insulin in the same syringe.
C. Administer the medications in two separate syringes.
D. Mix both in a vial before drawing the dose.
Answer: C
Rationale: Insulin glargine is a long-acting insulin that cannot be mixed in the same
syringe with any other insulin. Mixing it can alter its onset and peak action, leading to
unpredictable blood glucose levels. The nurse should always use separate syringes and
different injection sites for these two types of insulin.
2. A client is prescribed metformin for type 2 diabetes. Which diagnostic test requires the
nurse to hold this medication for 48 hours?
A. Chest X-ray
B. Ultrasound of the gallbladder
C. Electrocardiogram (ECG)
,D. CT scan with intravenous contrast
Answer: D
Rationale: Metformin must be withheld 48 hours before and after procedures involving
iodinated contrast media. The combination of contrast dye and metformin increases the
risk of developing lactic acidosis, especially in patients with renal impairment. Renal
function must be verified as normal before resuming the medication.
3. Which instruction should the nurse include when teaching a client about levothyroxine
therapy?
A. Take the medication with a full meal.
B. Take the medication at bedtime with a snack.
C. Take the medication in the morning on an empty stomach.
D. Take the medication only when feeling fatigued.
Answer: C
Rationale: Levothyroxine absorption is most effective when taken on an empty stomach, at
least 30 to 60 minutes before breakfast. Food and certain minerals like calcium or iron can
significantly decrease its absorption. Consistent timing every morning helps maintain
steady thyroid hormone levels in the blood.
4. A client taking prednisone for several weeks is being discharged. What is the most
important instruction regarding this medication?
A. Stop the medication immediately if you feel better.
, B. Taper the dose gradually as directed by the provider.
C. Double the dose if you miss a day.
D. Avoid drinking water while taking the pill.
Answer: B
Rationale: Abrupt withdrawal of corticosteroids like prednisone can lead to acute adrenal
insufficiency because the body’s natural cortisol production is suppressed. Gradual
tapering allows the adrenal glands to resume normal function. Patients must be warned
that sudden cessation can be life-threatening.
5. The nurse is monitoring a client on an SSRI for depression. Which symptoms would indicate
Serotonin Syndrome?
A. Bradycardia and hypotension
B. Rigidity, fever, and mental status changes
C. Urinary retention and constipation
D. Weight gain and sedation
Answer: B
Rationale: Serotonin syndrome is a potentially fatal condition characterized by
neuromuscular hyperactivity, autonomic instability, and altered mental status. Key signs
include muscle rigidity, hyperreflexia, tremors, and high fever. It often occurs when SSRIs
are combined with other serotonergic agents or if doses are escalated too quickly.
BSN 315 HESI RN Specialty Pharmacology
Exam | Nightingale
1. A nurse is preparing to administer insulin glargine and regular insulin to a client. Which
action should the nurse take?
A. Draw up the regular insulin then the glargine in the same syringe.
B. Draw up the glargine then the regular insulin in the same syringe.
C. Administer the medications in two separate syringes.
D. Mix both in a vial before drawing the dose.
Answer: C
Rationale: Insulin glargine is a long-acting insulin that cannot be mixed in the same
syringe with any other insulin. Mixing it can alter its onset and peak action, leading to
unpredictable blood glucose levels. The nurse should always use separate syringes and
different injection sites for these two types of insulin.
2. A client is prescribed metformin for type 2 diabetes. Which diagnostic test requires the
nurse to hold this medication for 48 hours?
A. Chest X-ray
B. Ultrasound of the gallbladder
C. Electrocardiogram (ECG)
,D. CT scan with intravenous contrast
Answer: D
Rationale: Metformin must be withheld 48 hours before and after procedures involving
iodinated contrast media. The combination of contrast dye and metformin increases the
risk of developing lactic acidosis, especially in patients with renal impairment. Renal
function must be verified as normal before resuming the medication.
3. Which instruction should the nurse include when teaching a client about levothyroxine
therapy?
A. Take the medication with a full meal.
B. Take the medication at bedtime with a snack.
C. Take the medication in the morning on an empty stomach.
D. Take the medication only when feeling fatigued.
Answer: C
Rationale: Levothyroxine absorption is most effective when taken on an empty stomach, at
least 30 to 60 minutes before breakfast. Food and certain minerals like calcium or iron can
significantly decrease its absorption. Consistent timing every morning helps maintain
steady thyroid hormone levels in the blood.
4. A client taking prednisone for several weeks is being discharged. What is the most
important instruction regarding this medication?
A. Stop the medication immediately if you feel better.
, B. Taper the dose gradually as directed by the provider.
C. Double the dose if you miss a day.
D. Avoid drinking water while taking the pill.
Answer: B
Rationale: Abrupt withdrawal of corticosteroids like prednisone can lead to acute adrenal
insufficiency because the body’s natural cortisol production is suppressed. Gradual
tapering allows the adrenal glands to resume normal function. Patients must be warned
that sudden cessation can be life-threatening.
5. The nurse is monitoring a client on an SSRI for depression. Which symptoms would indicate
Serotonin Syndrome?
A. Bradycardia and hypotension
B. Rigidity, fever, and mental status changes
C. Urinary retention and constipation
D. Weight gain and sedation
Answer: B
Rationale: Serotonin syndrome is a potentially fatal condition characterized by
neuromuscular hyperactivity, autonomic instability, and altered mental status. Key signs
include muscle rigidity, hyperreflexia, tremors, and high fever. It often occurs when SSRIs
are combined with other serotonergic agents or if doses are escalated too quickly.
