HESI RN
HESI Pharmacology Practice Exam
1. A client is receiving meperidine (Demerol) for pain management. Which assessment finding requires immediate action?
- A. Constipation
- B. Drowsiness
- C. Respiratory rate of 10 breaths per minute
- D. Nausea
Correct answer: C
Rationale: A respiratory rate of 10 breaths per minute indicates respiratory depression, a severe side effect of meperidine (Demerol) that necessitates immediate intervention to prevent further complications. Constipation, drowsiness, and nausea are common but less urgent side effects that do not pose an immediate life-threatening risk. Respiratory depression can lead to respiratory arrest and must be addressed promptly to ensure the client's safety and well-being.
2. A client with a peptic ulcer is diagnosed with a Helicobacter pylori infection. The nurse is reinforcing teaching for the client about the medications prescribed, including clarithromycin (Biaxin), esomeprazole (Nexium), and amoxicillin (Amoxil). Which statement by the client indicates the best understanding of the medication regimen?
- A. My ulcer will heal because these medications will kill the bacteria.
- B. These medications are only taken when I have pain from my ulcer.
- C. The medications will kill the bacteria and stop the acid production.
- D. These medications will coat the ulcer and decrease the acid production in my stomach.
Correct answer: C
Rationale: Triple therapy for Helicobacter pylori infection usually includes two antibacterial drugs and a proton pump inhibitor. These medications will kill the bacteria and decrease acid production.
3. Intravenous heparin therapy is prescribed for a client. While implementing this prescription, a nurse ensures that which of the following medications is available on the nursing unit?
- A. Protamine sulfate
- B. Potassium chloride
- C. Phytonadione (vitamin K)
- D. Aminocaproic acid (Amicar)
Correct answer: A
Rationale: Protamine sulfate is the antidote for heparin, working to reverse its effects in case of excessive bleeding. It should be readily available when administering heparin to manage any potential bleeding complications effectively. Potassium chloride is not the antidote for heparin and is typically used to correct low potassium levels. Phytonadione (vitamin K) is used to reverse the effects of warfarin, not heparin. Aminocaproic acid (Amicar) is used to treat or prevent excessive bleeding but is not the antidote for heparin.
4. The clinic nurse is reviewing a teaching plan for a client receiving antineoplastic medication. When implementing the plan, the nurse should advise the client:
- A. To take aspirin (acetylsalicylic acid) as needed for a headache
- B. To avoid drinking beverages containing alcohol
- C. To consult with healthcare providers (HCPs) before receiving immunizations
- D. That it is necessary to consult HCPs before receiving a flu vaccine at the local health fair
Correct answer: C
Rationale: The correct advice for a client receiving antineoplastic medication is to consult with healthcare providers (HCPs) before receiving immunizations. Antineoplastic medications can lower the body's resistance, making it crucial to seek guidance from healthcare providers to prevent potential complications that may arise due to the medication's impact on the immune system. Choices A, B, and D are incorrect because taking aspirin for a headache, avoiding alcohol, and consulting only before a flu vaccine at a local health fair do not directly address the specific risk related to antineoplastic medications and immunizations.
5. The client with non-Hodgkin's lymphoma is receiving daunorubicin (DaunoXome). Which of the following would indicate to the nurse that the client is experiencing a toxic effect related to the medication?
- A. Fever
- B. Diarrhea
- C. Complaints of nausea and vomiting
- D. Crackles on auscultation of the lungs
Correct answer: D
Rationale: Crackles on auscultation of the lungs would indicate a toxic effect related to daunorubicin, known to cause cardiotoxicity. Cardiotoxicity can manifest as heart failure, abnormal ECG findings, or cardiomyopathy. It is crucial for the nurse to monitor for signs of cardiotoxicity to ensure timely intervention and prevent further complications. Fever, diarrhea, and complaints of nausea and vomiting are common side effects of daunorubicin but do not specifically indicate a toxic effect like cardiotoxicity.
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