HESI RN Pharmacology Test Bank
UPDATED Actual Questions and
CORRECT ANSWERS
A 38-week primigravida who works as a secretary and sits at a computer for 8 hours each day
tells the nurse that her feet have begun to swell. Which instruction would be most effective in
preventing pooling of blood in the lower extremities? - CORRECT ANSWER✔✔- Move
about every hour
Pooling of blood in the lower extremities results from the enlarged uterus exerting pressure
on the pelvic veins. Moving about every hour will straighten out the pelvic veins and increase
venous return.
A 26-year-old, gravida 2, para 1 client is admitted to the hospital at 28-weeks gestation in
preterm labor. She is given 3 doses of terbutaline sulfate (Brethine) 0.25 mg subcutaneously
to stop her labor contractions. The nurse plans to monitor for which primary side effect of
terbutaline sulfate? - CORRECT ANSWER✔✔- Tachycardia and a feeling of nervousness
Terbutaline sulfate (Brethine), a beta-sympathomimetic drug, stimulates beta-adrenergic
receptors in the uterine muscle to stop contractions. The beta-adrenergic agonist properties of
the drug may cause tachycardia, increased cardiac output, restlessness, headache, and a
feeling of "nervousness".
When do the anterior and posterior fontanels close? - CORRECT ANSWER✔✔- anterior
fontanel closes at 12 to 18 months and the posterior by the end of the second month.
When assessing a client who is at 12-weeks gestation, the nurse recommends that she and her
husband consider attending childbirth preparation classes. When is the best time for the
couple to attend these classes? - CORRECT ANSWER✔✔- 30 weeks gestation
at 30 weeks gestation is closest (of the options) to the time parents would be ready for such
classes. Learning is facilitated by an interested pupil! The couple is most interested in
,childbirth toward the end of the pregnancy when they are psychologically ready for the
termination of the pregnancy, and the birth of their child is an immediate concern.
The nurse should encourage the laboring client to begin pushing when... - CORRECT
ANSWER✔✔- the cervix is completely dilated.
Pushing begins with the second stage of labor, i.e., when the cervix is completely dilated at
10 cm (C). If pushing begins before the cervix is completely dilated the cervix can become
edematous and may never completely dilate, necessitating an operative delivery. Many
primigravida's begin active labor 100% effaced and then proceed to dilate.
The nurse instructs a laboring client to use accelerated-blow breathing. The client begins to
complain of tingling fingers and dizziness. What action should the nurse take? - CORRECT
ANSWER✔✔- Have the client breathe into her cupped hands
Tingling fingers and dizziness are signs of hyperventilation (blowing off too much carbon
dioxide). Hyperventilation is treated by retaining carbon dioxide. This can be facilitated by
breathing into a paper bag or cupped hands.
Twenty-four hours after admission to the newborn nursery, a full-term male infant develops
localized edema on the right side of his head. The nurse knows that, in the newborn, an
accumulation of blood between the periosteum and skull which does not cross the suture line
is a newborn variation known as... - CORRECT ANSWER✔✔- a cephalohematoma, caused
by forceps trauma and may last up to 8 weeks.
Cephalohematoma, a slight abnormal variation of the newborn, usually arises within the first
24 hours after delivery. Trauma from delivery causes capillary bleeding between the
periosteum and the skull.
When does the head return to its normal shape? - CORRECT ANSWER✔✔- 7-10 days
,What did Nurse theorist Reva Rubin describe? - CORRECT ANSWER✔✔- The initial
postpartum period as the "taking-in phase," which is characterized by maternal reliance on
others to satisfy the needs for comfort, rest, nourishment, and closeness to families and the
newborn.
A couple, concerned because the woman has not been able to conceive, is referred to a
healthcare provider for a fertility workup and a hysterosalpingography is scheduled. Which
post procedure complaint indicates that the fallopian tubes are patent? - CORRECT
ANSWER✔✔- Shoulder pain
If the tubes are patent (open), pain is referred to the shoulder from a sub diaphragmatic
collection of peritoneal dye/gas.
Which nursing intervention is most helpful in relieving postpartum uterine contractions or
"afterpains?" - CORRECT ANSWER✔✔- Lying prone with a pillow on the abdomen
Lying prone keeps the fundus contracted and is especially useful with multiparas, who
commonly experience afterpains due to lack of uterine tone.
Which maternal behavior is the nurse most likely to see when a new mother receives her
infant for the first time? - CORRECT ANSWER✔✔- Her arms and hands receive the infant
and she then traces the infant's profile with her fingertips.
Attachment/bonding theory indicates that most mothers will demonstrate behaviors described
in during the first visit with the newborn, which may be at delivery or later.
A client at 32-weeks gestation is hospitalized with severe pregnancy-induced hypertension
(PIH), and magnesium sulfate is prescribed to control the symptoms. Which assessment
finding indicates the therapeutic drug level has been achieved? - CORRECT ANSWER✔✔-
A decreased in respiratory rate from 24 to 16
, Magnesium sulfate, a CNS depressant, helps prevent seizures. A decreased respiratory rate
indicates that the drug is effective. (Respiratory rate below 12 indicates toxic effects.)
Urinary output must be monitored when administering magnesium sulfate and should be at
least 30 ml per hour. (The therapeutic level of magnesium sulfate for a PIH client is
4.8 to 9.6 mg/dl.) What is the therapeutic level of magnesium sulfate? - CORRECT
ANSWER✔✔- The therapeutic level of magnesium sulfate for a PIH client is 4.8 to 9.6
mg/dl.
What does it help prevent? helps prevent seizures
What indicates toxic levels? 3
Respiratory rate below 12 indicates toxic effects. Urine output of less than 100 ml/4 hours
Absent DTRs
Twenty minutes after a continuous epidural anesthetic is administered, a laboring client's
blood pressure drops from 120/80 to 90/60. What action should the nurse take? - CORRECT
ANSWER✔✔- Place woman in a lateral position
The nurse should immediately turn the woman to a lateral position, place a pillow or wedge
under the right hip to deflect the uterus, increase the rate of the main line IV infusion, and
administer oxygen by face mask at 10-12 L/min. If the blood pressure remains low, especially
if it further decreases, the anesthesiologist/healthcare provider should be notified
immediately.
A client at 28-weeks gestation calls the antepartum clinic and states that she is experiencing a
small amount of vaginal bleeding which she describes as bright red. She further states that
she is not experiencing any uterine contractions or abdominal pain. What instruction should
the nurse provide? - CORRECT ANSWER✔✔- Come to the clinic today for an ultrasound
Third trimester painless bleeding is characteristic of a placenta previa. Bright red bleeding
may be intermittent, occur in gushes, or be continuous. Rarely is the first incidence life-
threatening, nor cause for hypovolemic shock. Diagnosis is confirmed by transabdominal
ultrasound.
UPDATED Actual Questions and
CORRECT ANSWERS
A 38-week primigravida who works as a secretary and sits at a computer for 8 hours each day
tells the nurse that her feet have begun to swell. Which instruction would be most effective in
preventing pooling of blood in the lower extremities? - CORRECT ANSWER✔✔- Move
about every hour
Pooling of blood in the lower extremities results from the enlarged uterus exerting pressure
on the pelvic veins. Moving about every hour will straighten out the pelvic veins and increase
venous return.
A 26-year-old, gravida 2, para 1 client is admitted to the hospital at 28-weeks gestation in
preterm labor. She is given 3 doses of terbutaline sulfate (Brethine) 0.25 mg subcutaneously
to stop her labor contractions. The nurse plans to monitor for which primary side effect of
terbutaline sulfate? - CORRECT ANSWER✔✔- Tachycardia and a feeling of nervousness
Terbutaline sulfate (Brethine), a beta-sympathomimetic drug, stimulates beta-adrenergic
receptors in the uterine muscle to stop contractions. The beta-adrenergic agonist properties of
the drug may cause tachycardia, increased cardiac output, restlessness, headache, and a
feeling of "nervousness".
When do the anterior and posterior fontanels close? - CORRECT ANSWER✔✔- anterior
fontanel closes at 12 to 18 months and the posterior by the end of the second month.
When assessing a client who is at 12-weeks gestation, the nurse recommends that she and her
husband consider attending childbirth preparation classes. When is the best time for the
couple to attend these classes? - CORRECT ANSWER✔✔- 30 weeks gestation
at 30 weeks gestation is closest (of the options) to the time parents would be ready for such
classes. Learning is facilitated by an interested pupil! The couple is most interested in
,childbirth toward the end of the pregnancy when they are psychologically ready for the
termination of the pregnancy, and the birth of their child is an immediate concern.
The nurse should encourage the laboring client to begin pushing when... - CORRECT
ANSWER✔✔- the cervix is completely dilated.
Pushing begins with the second stage of labor, i.e., when the cervix is completely dilated at
10 cm (C). If pushing begins before the cervix is completely dilated the cervix can become
edematous and may never completely dilate, necessitating an operative delivery. Many
primigravida's begin active labor 100% effaced and then proceed to dilate.
The nurse instructs a laboring client to use accelerated-blow breathing. The client begins to
complain of tingling fingers and dizziness. What action should the nurse take? - CORRECT
ANSWER✔✔- Have the client breathe into her cupped hands
Tingling fingers and dizziness are signs of hyperventilation (blowing off too much carbon
dioxide). Hyperventilation is treated by retaining carbon dioxide. This can be facilitated by
breathing into a paper bag or cupped hands.
Twenty-four hours after admission to the newborn nursery, a full-term male infant develops
localized edema on the right side of his head. The nurse knows that, in the newborn, an
accumulation of blood between the periosteum and skull which does not cross the suture line
is a newborn variation known as... - CORRECT ANSWER✔✔- a cephalohematoma, caused
by forceps trauma and may last up to 8 weeks.
Cephalohematoma, a slight abnormal variation of the newborn, usually arises within the first
24 hours after delivery. Trauma from delivery causes capillary bleeding between the
periosteum and the skull.
When does the head return to its normal shape? - CORRECT ANSWER✔✔- 7-10 days
,What did Nurse theorist Reva Rubin describe? - CORRECT ANSWER✔✔- The initial
postpartum period as the "taking-in phase," which is characterized by maternal reliance on
others to satisfy the needs for comfort, rest, nourishment, and closeness to families and the
newborn.
A couple, concerned because the woman has not been able to conceive, is referred to a
healthcare provider for a fertility workup and a hysterosalpingography is scheduled. Which
post procedure complaint indicates that the fallopian tubes are patent? - CORRECT
ANSWER✔✔- Shoulder pain
If the tubes are patent (open), pain is referred to the shoulder from a sub diaphragmatic
collection of peritoneal dye/gas.
Which nursing intervention is most helpful in relieving postpartum uterine contractions or
"afterpains?" - CORRECT ANSWER✔✔- Lying prone with a pillow on the abdomen
Lying prone keeps the fundus contracted and is especially useful with multiparas, who
commonly experience afterpains due to lack of uterine tone.
Which maternal behavior is the nurse most likely to see when a new mother receives her
infant for the first time? - CORRECT ANSWER✔✔- Her arms and hands receive the infant
and she then traces the infant's profile with her fingertips.
Attachment/bonding theory indicates that most mothers will demonstrate behaviors described
in during the first visit with the newborn, which may be at delivery or later.
A client at 32-weeks gestation is hospitalized with severe pregnancy-induced hypertension
(PIH), and magnesium sulfate is prescribed to control the symptoms. Which assessment
finding indicates the therapeutic drug level has been achieved? - CORRECT ANSWER✔✔-
A decreased in respiratory rate from 24 to 16
, Magnesium sulfate, a CNS depressant, helps prevent seizures. A decreased respiratory rate
indicates that the drug is effective. (Respiratory rate below 12 indicates toxic effects.)
Urinary output must be monitored when administering magnesium sulfate and should be at
least 30 ml per hour. (The therapeutic level of magnesium sulfate for a PIH client is
4.8 to 9.6 mg/dl.) What is the therapeutic level of magnesium sulfate? - CORRECT
ANSWER✔✔- The therapeutic level of magnesium sulfate for a PIH client is 4.8 to 9.6
mg/dl.
What does it help prevent? helps prevent seizures
What indicates toxic levels? 3
Respiratory rate below 12 indicates toxic effects. Urine output of less than 100 ml/4 hours
Absent DTRs
Twenty minutes after a continuous epidural anesthetic is administered, a laboring client's
blood pressure drops from 120/80 to 90/60. What action should the nurse take? - CORRECT
ANSWER✔✔- Place woman in a lateral position
The nurse should immediately turn the woman to a lateral position, place a pillow or wedge
under the right hip to deflect the uterus, increase the rate of the main line IV infusion, and
administer oxygen by face mask at 10-12 L/min. If the blood pressure remains low, especially
if it further decreases, the anesthesiologist/healthcare provider should be notified
immediately.
A client at 28-weeks gestation calls the antepartum clinic and states that she is experiencing a
small amount of vaginal bleeding which she describes as bright red. She further states that
she is not experiencing any uterine contractions or abdominal pain. What instruction should
the nurse provide? - CORRECT ANSWER✔✔- Come to the clinic today for an ultrasound
Third trimester painless bleeding is characteristic of a placenta previa. Bright red bleeding
may be intermittent, occur in gushes, or be continuous. Rarely is the first incidence life-
threatening, nor cause for hypovolemic shock. Diagnosis is confirmed by transabdominal
ultrasound.
