BSN315 Exam 4 Actual Exam Style V2 |
BSN 315 HESI RN Specialty Pharmacology
Exam | Nightingale
1. A client is prescribed Lispro (Humalog) insulin for mealtime coverage. Which action should
the nurse implement regarding administration?
A. Administer the dose 30 to 60 minutes before the meal is served.
B. Give the insulin only after the client has finished the entire meal.
C. Administer the dose at bedtime to maintain glucose levels overnight.
D. Ensure the client’s meal tray is present before administering the dose.
Answer: D
Rationale: Lispro is a rapid-acting insulin with an onset of action within 15 minutes.
Administering it before the food is present can lead to severe hypoglycemia. The nurse
must verify that the tray is on the unit and the client is ready to eat.
2. A client taking Metformin (Glucophage) is scheduled for a CT scan with intravenous
contrast. What instruction should the nurse provide?
A. Take a double dose of Metformin the morning of the procedure.
B. Discontinue Metformin 48 hours before and after the procedure.
C. Switch to an oral sulfonylurea on the day of the scan.
,D. Continue taking Metformin as scheduled without any changes.
Answer: B
Rationale: Metformin must be withheld prior to and for 48 hours after procedures
involving iodine-based contrast media. This is because the combination increases the risk
of contrast-induced nephropathy and lactic acidosis. Renal function should be evaluated
before resuming the medication.
3. Which laboratory value is most important for the nurse to monitor for a client receiving
Levothyroxine (Synthroid)?
A. Serum Potassium
B. Blood Urea Nitrogen (BUN)
C. Thyroid Stimulating Hormone (TSH)
D. Hemoglobin A1C
Answer: C
Rationale: TSH is the primary indicator used to determine the effectiveness of thyroid
replacement therapy. A high TSH level indicates that the dose is too low, while a low TSH
suggests the dose is too high. Monitoring this value ensures the client maintains a
euthyroid state.
4. A client is prescribed Propylthiouracil (PTU) for hyperthyroidism. Which symptom should
the nurse instruct the client to report immediately?
A. Increased appetite
, B. Weight gain
C. Mild skin rash
D. Sore throat and fever
Answer: D
Rationale: PTU can cause agranulocytosis, which is a significant decrease in white blood
cell count. Sore throat and fever are early signs of infection that may result from this life-
threatening side effect. The client must be monitored for signs of myelosuppression.
5. A client with Addison’s disease is taking Prednisone. What is the most critical instruction
regarding the timing of this medication?
A. Take the medication late at night before sleeping.
B. Never abruptly stop taking the medication.
C. Always take the medication on an empty stomach.
D. Skip the dose if you experience any nausea.
Answer: B
Rationale: Abrupt withdrawal of corticosteroids can lead to acute adrenal insufficiency,
which is a medical emergency. The body’s natural cortisol production is suppressed during
therapy, and tapering is required to allow the adrenal glands to resume function. Stressful
events may require a temporary increase in dosage.
BSN 315 HESI RN Specialty Pharmacology
Exam | Nightingale
1. A client is prescribed Lispro (Humalog) insulin for mealtime coverage. Which action should
the nurse implement regarding administration?
A. Administer the dose 30 to 60 minutes before the meal is served.
B. Give the insulin only after the client has finished the entire meal.
C. Administer the dose at bedtime to maintain glucose levels overnight.
D. Ensure the client’s meal tray is present before administering the dose.
Answer: D
Rationale: Lispro is a rapid-acting insulin with an onset of action within 15 minutes.
Administering it before the food is present can lead to severe hypoglycemia. The nurse
must verify that the tray is on the unit and the client is ready to eat.
2. A client taking Metformin (Glucophage) is scheduled for a CT scan with intravenous
contrast. What instruction should the nurse provide?
A. Take a double dose of Metformin the morning of the procedure.
B. Discontinue Metformin 48 hours before and after the procedure.
C. Switch to an oral sulfonylurea on the day of the scan.
,D. Continue taking Metformin as scheduled without any changes.
Answer: B
Rationale: Metformin must be withheld prior to and for 48 hours after procedures
involving iodine-based contrast media. This is because the combination increases the risk
of contrast-induced nephropathy and lactic acidosis. Renal function should be evaluated
before resuming the medication.
3. Which laboratory value is most important for the nurse to monitor for a client receiving
Levothyroxine (Synthroid)?
A. Serum Potassium
B. Blood Urea Nitrogen (BUN)
C. Thyroid Stimulating Hormone (TSH)
D. Hemoglobin A1C
Answer: C
Rationale: TSH is the primary indicator used to determine the effectiveness of thyroid
replacement therapy. A high TSH level indicates that the dose is too low, while a low TSH
suggests the dose is too high. Monitoring this value ensures the client maintains a
euthyroid state.
4. A client is prescribed Propylthiouracil (PTU) for hyperthyroidism. Which symptom should
the nurse instruct the client to report immediately?
A. Increased appetite
, B. Weight gain
C. Mild skin rash
D. Sore throat and fever
Answer: D
Rationale: PTU can cause agranulocytosis, which is a significant decrease in white blood
cell count. Sore throat and fever are early signs of infection that may result from this life-
threatening side effect. The client must be monitored for signs of myelosuppression.
5. A client with Addison’s disease is taking Prednisone. What is the most critical instruction
regarding the timing of this medication?
A. Take the medication late at night before sleeping.
B. Never abruptly stop taking the medication.
C. Always take the medication on an empty stomach.
D. Skip the dose if you experience any nausea.
Answer: B
Rationale: Abrupt withdrawal of corticosteroids can lead to acute adrenal insufficiency,
which is a medical emergency. The body’s natural cortisol production is suppressed during
therapy, and tapering is required to allow the adrenal glands to resume function. Stressful
events may require a temporary increase in dosage.
