HESI RN
Pharmacology HESI
1. A client who is receiving digoxin (Lanoxin) daily has a serum potassium level of 3.0 mEq/L and is complaining of anorexia. A healthcare provider prescribes a digoxin level to rule out digoxin toxicity. A nurse checks the results, knowing that which of the following is the therapeutic serum level (range) for digoxin?
- A. 3 to 5 ng/mL
- B. 0.5 to 2 ng/mL
- C. 1.2 to 2.8 ng/mL
- D. 3.5 to 5.5 ng/mL
Correct answer: B
Rationale: The therapeutic serum level for digoxin ranges from 0.5 to 2 ng/mL. This range is considered optimal for therapeutic effects while minimizing the risk of toxicity. Levels above 2 ng/mL may lead to digoxin toxicity, which can manifest as anorexia among other symptoms. Therefore, the nurse should be vigilant in monitoring the digoxin levels to ensure the client's safety and therapeutic effectiveness of the medication.
2. At what point is a fetus considered viable?
- A. 26 weeks
- B. 28 weeks
- C. 37 weeks
- D. 12 weeks
Correct answer: C
Rationale: A fetus is considered viable after 37 weeks of gestation. At this stage, the fetus has a higher chance of surviving outside the womb with medical support. Choice A (26 weeks), Choice B (28 weeks), and Choice D (12 weeks) are incorrect because a fetus is not typically considered viable at those earlier gestational ages.
3. During which stage of mitosis do the chromosomes gather on either side of the separating cell?
- A. Metaphase
- B. Telophase
- C. Anaphase
- D. Prophase
Correct answer: B
Rationale: The correct answer is B, Telophase. During telophase, the chromosomes gather at opposite poles of the cell as the nuclear envelopes start to form around them, indicating the end of cell division. Choices A, C, and D are incorrect because during metaphase, the chromosomes align in the middle of the cell; in anaphase, the chromosomes separate and move towards opposite poles; and in prophase, the chromosomes condense and the nuclear envelope breaks down, respectively.
4. A nurse is reinforcing teaching with a client who has COPD. Which of the following instructions by the nurse is appropriate?
- A. Drink carbonated beverages.
- B. Decrease fiber intake.
- C. Use bronchodilators after meals.
- D. Increase protein intake.
Correct answer: D
Rationale: The correct answer is to instruct the client to increase protein intake. This is appropriate because increasing protein intake can help maintain muscle mass and strength in clients with COPD. Option A, 'Drink carbonated beverages,' is incorrect as carbonated beverages can exacerbate COPD symptoms. Option B, 'Decrease fiber intake,' is also incorrect as fiber is important for digestion and should not be decreased unless specifically advised by a healthcare provider. Option C, 'Use bronchodilators after meals,' is incorrect because bronchodilators are typically used before meals to help open the airways for better breathing, not after meals.
5. The health care provider order reads 'aspirate nasogastric feeding (NG) tube every 4 hours and check pH of aspirate.' The pH of the aspirate is 10. Which action should the nurse take?
- A. Hold the tube feeding and notify the provider
- B. Administer the tube feeding as scheduled
- C. Irrigate the tube with diet cola soda
- D. Apply intermittent suction to the feeding tube
Correct answer: A
Rationale: A pH of 10 indicates improper placement of the NG tube, requiring notification of the provider and holding the feeding. Choice B is incorrect because administering the tube feeding could lead to complications due to the improper placement. Choice C is incorrect as irrigating the tube with diet cola soda is not a standard practice for addressing this issue. Choice D is incorrect as applying intermittent suction does not address the problem of improper placement indicated by the high pH level.