HESI PHARMACOLOGY RN EXIT LATEST 2023 -
2025 /COMMUNITY HEALTH RN HESI EXIT ACT UAL EXAM ALL 55 4 QUESTION S AND CORRECT DETAILED ANSWERS WITH RATIONALE |BRA DNEW!! A nurse is assessing the therapeutic action of drugs classified as tumor necrosis factor (TNF) inhibitors. What client response indicates to the nur se that a drug with this classification is effective? A. Continued remission in a client with ovarian cancer B. Increased insulin production in a client with diabetes mellitus C. Reduction of inflammatory joint pain in a client with rheumatoid arthritis D. Vasodilation of coronary arteries in a client with ischemic heart disease -ANSWER -C The nurse suspects serotonin syndrome in a client prescribed second -generation antidepressants for depression. Which assessment findings observed by the nurse would be be neficial in diagnosing the severity of the syndrome? SATA A. Delirium B. Hyperreflexia C. Hyperthermia D. Rhabdomyolysis -ANSWER -C,D A healthcare provider prescribes enoxaparin 30 mg subcutaneously daily. Which measure would the nurse take when administering this medication? A. Push over 2 minutes. B.Administer in the abdomen . C.Rub site after administration. D. Remove air pocket from prepackaged syringe before administration. -ANSWER -B A client with cirrhosis of the liver and ascites has been taking chlorothiazide, a thiazide diuretic. Why did the provider add spironolactone to the client's medication regimen? A.To stimulate sodium ex cretion B. To help prevent potassium loss C. To increase urine specific gravity D. To reduce arterial blood pressure -ANSWER -B A client with myasthenia gravis improves and is discharged from the hospital. The discharge medications include pyridostigmine b romide 10 mg every 6 hours. The nurse evaluates that the drug regimen is understood when the client makes which statement? A. "I will take the medication on an empty stomach." B. "I need to set an alarm so I take the medication on time." C. "It will be imp ortant to check my heart rate before taking the medication." D. "I should monitor for an increase in blood pressure after taking the medication." -
ANSWER -B A client has been taking 3 mg of risperidone twice a day for the past 8 days. At the follow -up appo intment, the client reports tremors, shortness of breath, a fever, and sweating. What will the nurse do? A. Call 911 and have the client transported to the nearest psychiatric unit. B. Check the number of risperidone tablets left in the prescription bottle to see whether there was an overdose. C. Request a prescription for 2 mg of intramuscular benztropine stat and assess the client in 10 to 15 minutes for symptom relief. D. Take the client's vital signs and arrange for immediate transfer to a hospital -
ANSWER -D The health care provider prescribes an oral hypoglycemic for the patient with type 2 diabetes. What will the nurse need to consider when developing the teaching plan? A. Oral hypoglycemics work by decreasing absorption of carbohydrates. B. Oral hypo glycemics work by stimulating the pancreas to produce insulin. C. Clients taking oral hypoglycemics may subconsciously relax dietary rules to gain a sense of control 1. D. Clients with type 2 diabetes do not need to be concerned about serious adverse effects from oral hypoglycemics. -ANSWER -C A pregnant client states to the nurse, "I have been advised to take an over -the-counter medication for the flu. The drug label say s it is a category B drug." How should the nurse respond to these statements? A. "Because this drug causes fetal abnormalities, you should not take this drug." B. "This drug causes fetal risks when administered and should not be used in pregnancy." C. "Thi s drug has been reported to have adverse effects in animal fetuses so this drug should be avoided." D. "This drug does not show risks to an animal fetus so you can safely take it while pregnant." -ANSWER -D A client who has an adenocarcinoma of the descend ing colon with a partial obstruction is receiving doxorubicin intravenously (IV) to reduce the tumor mass. The nurse monitors the client for signs and symptoms of doxorubicin toxicity. What clinical finding indicates that toxicity has occurred? A. Minor sk in rash B. Blue tinge to the urine C. Alteration in cardiac rhythm D. Increased feeling of nervousness -ANSWER -Alteration in cardiac rhythm Doxorubicin is cardiotoxic and causes dysrhythmias. Doxorubicin toxicity causes severe, not minor, dermatitis. Blue -tinged urine is a side effect of doxorubicin, not a toxic effect. Feelings of nervousness are a side effect of doxorubicin, not a toxic effect . A healthcare provider prescribes aspirin therapy for a client with arthritis, and the nurse provides teaching about the undesirable side effects of this medication. What responses should the client identify as reasons to notify the healthcare provider? SATA A. Nausea B. Constipation C. Easy bruising D. Decreased pulse E. Ringing in the ears -ANSWER -A, C, E Lithiu m is prescribed for a client with bipolar disorder experiencing a manic episode. When teaching the client about this medication, the nurse will emphasize which fact about lithium? Cannot be taken safely with any other antipsychotic medications Can be take n safely with diuretics if the potassium level is maintained Should be discontinued and the primary healthcare provider notified if depression occurs Should temporarily be stopped and the primary healthcare provider notified if diarrhea results -ANSWER -Should temporarily be stopped and the primary healthcare provider notified if diarrhea results A decrease in serum sodium because of diarrhea decreases the excretion of lithium, which can result in a toxic level in the blood. In addition, diarrhea is a sign of lithium toxicity. It is safe to take lithium with other antipsychotics, because the client's behavior may require combination pharmacotherapy. Lith ium should not be taken with diuretics, regardless of the potassium level, because diuretics decrease the sodium level, and lithium is not excreted when the sodium level is decreased. Lithium is useful in both the manic and depressive phases of a bipolar d isorder. At 12 weeks' gestation a client who is Rh negative expels the total products of conception. What is the nursing action after it has been determined that she has not been previously sensitized to Rh -positive red blood cells? Administering Rho(D) immune globulin within 72 hours Making certain that Rho(D) immune globulin is administered at the first clinic visit Withholding the Rho(D) immune globulin because the gestation lasted only 12 weeks Withholding the Rho(D) immune globulin because it is not indicated after fetal death -
ANSWER -Administering Rho(D) immune globulin within 72 hours Rho(D) immune globulin must be given within 72 hours of delivery if the client has not been sensitized previously, regardless of the duration of the gestation . It would not be effective at the first clinic visit, because antibodies have been produced already. Rho(D) immune globulin is always indicated at the termination of a pregnancy, even with a short -term pregnancy or one involving fetal demise. A nurse is providing instructions for a client who is receiving phenytoin but has limited access to health care. What side effect is the basis for the nurse's emphasis on meticulous oral hygiene? Hyperplasia of the gums Alkalinity of the oral secretions Irritation of the gingiva and destruction of tooth enamel Promotion of plaque and bacterial growth at the gum line -ANSWER -Hyperplasia of the gums Gingival hyperplasia is an adverse effect of long -term phenytoin therapy; incidence can be decreased by maintaining therapeutic blood levels and meticulous oral hygiene. Alkalinity is not related to phenytoin or to gingival hyperplasia caused by phenytoin. Irritation of the gingiva and destruction of tooth enamel are not direct effects of phenytoin. Plaque and bacterial growth at the gum line are unrelated to phenytoin or to hyperplasia caused by it. A nurse on the Code Blue/Arrest team responds to a code that is called for a client with hyperkalemia who is experiencing cardiac standstill. What would an appropriate immediate treatment plan include? Defibrillation Furosemide Sodium bicarbonate Anticoagulation therapy -ANSWER -Sodium bicarbonate Sodium bicarbonate decreases the potassium level. It works by increasing the movement of potassium from the blood into the cells. The body stores potassium inside the cells, with only a small amount in the bloodstream. Electrical defibrillation should not be app lied indiscriminately to the patient in asystole. This is not only fruitless but also
2025 /COMMUNITY HEALTH RN HESI EXIT ACT UAL EXAM ALL 55 4 QUESTION S AND CORRECT DETAILED ANSWERS WITH RATIONALE |BRA DNEW!! A nurse is assessing the therapeutic action of drugs classified as tumor necrosis factor (TNF) inhibitors. What client response indicates to the nur se that a drug with this classification is effective? A. Continued remission in a client with ovarian cancer B. Increased insulin production in a client with diabetes mellitus C. Reduction of inflammatory joint pain in a client with rheumatoid arthritis D. Vasodilation of coronary arteries in a client with ischemic heart disease -ANSWER -C The nurse suspects serotonin syndrome in a client prescribed second -generation antidepressants for depression. Which assessment findings observed by the nurse would be be neficial in diagnosing the severity of the syndrome? SATA A. Delirium B. Hyperreflexia C. Hyperthermia D. Rhabdomyolysis -ANSWER -C,D A healthcare provider prescribes enoxaparin 30 mg subcutaneously daily. Which measure would the nurse take when administering this medication? A. Push over 2 minutes. B.Administer in the abdomen . C.Rub site after administration. D. Remove air pocket from prepackaged syringe before administration. -ANSWER -B A client with cirrhosis of the liver and ascites has been taking chlorothiazide, a thiazide diuretic. Why did the provider add spironolactone to the client's medication regimen? A.To stimulate sodium ex cretion B. To help prevent potassium loss C. To increase urine specific gravity D. To reduce arterial blood pressure -ANSWER -B A client with myasthenia gravis improves and is discharged from the hospital. The discharge medications include pyridostigmine b romide 10 mg every 6 hours. The nurse evaluates that the drug regimen is understood when the client makes which statement? A. "I will take the medication on an empty stomach." B. "I need to set an alarm so I take the medication on time." C. "It will be imp ortant to check my heart rate before taking the medication." D. "I should monitor for an increase in blood pressure after taking the medication." -
ANSWER -B A client has been taking 3 mg of risperidone twice a day for the past 8 days. At the follow -up appo intment, the client reports tremors, shortness of breath, a fever, and sweating. What will the nurse do? A. Call 911 and have the client transported to the nearest psychiatric unit. B. Check the number of risperidone tablets left in the prescription bottle to see whether there was an overdose. C. Request a prescription for 2 mg of intramuscular benztropine stat and assess the client in 10 to 15 minutes for symptom relief. D. Take the client's vital signs and arrange for immediate transfer to a hospital -
ANSWER -D The health care provider prescribes an oral hypoglycemic for the patient with type 2 diabetes. What will the nurse need to consider when developing the teaching plan? A. Oral hypoglycemics work by decreasing absorption of carbohydrates. B. Oral hypo glycemics work by stimulating the pancreas to produce insulin. C. Clients taking oral hypoglycemics may subconsciously relax dietary rules to gain a sense of control 1. D. Clients with type 2 diabetes do not need to be concerned about serious adverse effects from oral hypoglycemics. -ANSWER -C A pregnant client states to the nurse, "I have been advised to take an over -the-counter medication for the flu. The drug label say s it is a category B drug." How should the nurse respond to these statements? A. "Because this drug causes fetal abnormalities, you should not take this drug." B. "This drug causes fetal risks when administered and should not be used in pregnancy." C. "Thi s drug has been reported to have adverse effects in animal fetuses so this drug should be avoided." D. "This drug does not show risks to an animal fetus so you can safely take it while pregnant." -ANSWER -D A client who has an adenocarcinoma of the descend ing colon with a partial obstruction is receiving doxorubicin intravenously (IV) to reduce the tumor mass. The nurse monitors the client for signs and symptoms of doxorubicin toxicity. What clinical finding indicates that toxicity has occurred? A. Minor sk in rash B. Blue tinge to the urine C. Alteration in cardiac rhythm D. Increased feeling of nervousness -ANSWER -Alteration in cardiac rhythm Doxorubicin is cardiotoxic and causes dysrhythmias. Doxorubicin toxicity causes severe, not minor, dermatitis. Blue -tinged urine is a side effect of doxorubicin, not a toxic effect. Feelings of nervousness are a side effect of doxorubicin, not a toxic effect . A healthcare provider prescribes aspirin therapy for a client with arthritis, and the nurse provides teaching about the undesirable side effects of this medication. What responses should the client identify as reasons to notify the healthcare provider? SATA A. Nausea B. Constipation C. Easy bruising D. Decreased pulse E. Ringing in the ears -ANSWER -A, C, E Lithiu m is prescribed for a client with bipolar disorder experiencing a manic episode. When teaching the client about this medication, the nurse will emphasize which fact about lithium? Cannot be taken safely with any other antipsychotic medications Can be take n safely with diuretics if the potassium level is maintained Should be discontinued and the primary healthcare provider notified if depression occurs Should temporarily be stopped and the primary healthcare provider notified if diarrhea results -ANSWER -Should temporarily be stopped and the primary healthcare provider notified if diarrhea results A decrease in serum sodium because of diarrhea decreases the excretion of lithium, which can result in a toxic level in the blood. In addition, diarrhea is a sign of lithium toxicity. It is safe to take lithium with other antipsychotics, because the client's behavior may require combination pharmacotherapy. Lith ium should not be taken with diuretics, regardless of the potassium level, because diuretics decrease the sodium level, and lithium is not excreted when the sodium level is decreased. Lithium is useful in both the manic and depressive phases of a bipolar d isorder. At 12 weeks' gestation a client who is Rh negative expels the total products of conception. What is the nursing action after it has been determined that she has not been previously sensitized to Rh -positive red blood cells? Administering Rho(D) immune globulin within 72 hours Making certain that Rho(D) immune globulin is administered at the first clinic visit Withholding the Rho(D) immune globulin because the gestation lasted only 12 weeks Withholding the Rho(D) immune globulin because it is not indicated after fetal death -
ANSWER -Administering Rho(D) immune globulin within 72 hours Rho(D) immune globulin must be given within 72 hours of delivery if the client has not been sensitized previously, regardless of the duration of the gestation . It would not be effective at the first clinic visit, because antibodies have been produced already. Rho(D) immune globulin is always indicated at the termination of a pregnancy, even with a short -term pregnancy or one involving fetal demise. A nurse is providing instructions for a client who is receiving phenytoin but has limited access to health care. What side effect is the basis for the nurse's emphasis on meticulous oral hygiene? Hyperplasia of the gums Alkalinity of the oral secretions Irritation of the gingiva and destruction of tooth enamel Promotion of plaque and bacterial growth at the gum line -ANSWER -Hyperplasia of the gums Gingival hyperplasia is an adverse effect of long -term phenytoin therapy; incidence can be decreased by maintaining therapeutic blood levels and meticulous oral hygiene. Alkalinity is not related to phenytoin or to gingival hyperplasia caused by phenytoin. Irritation of the gingiva and destruction of tooth enamel are not direct effects of phenytoin. Plaque and bacterial growth at the gum line are unrelated to phenytoin or to hyperplasia caused by it. A nurse on the Code Blue/Arrest team responds to a code that is called for a client with hyperkalemia who is experiencing cardiac standstill. What would an appropriate immediate treatment plan include? Defibrillation Furosemide Sodium bicarbonate Anticoagulation therapy -ANSWER -Sodium bicarbonate Sodium bicarbonate decreases the potassium level. It works by increasing the movement of potassium from the blood into the cells. The body stores potassium inside the cells, with only a small amount in the bloodstream. Electrical defibrillation should not be app lied indiscriminately to the patient in asystole. This is not only fruitless but also
