HESI RN
HESI Pharmacology Practice Exam
1. A client with chronic renal failure is receiving ferrous sulfate (Feosol). The nurse monitors the client for which common side effect associated with this medication?
- A. Diarrhea
- B. Weakness
- C. Headache
- D. Constipation
Correct answer: D
Rationale: Constipation is a common side effect of iron supplements such as ferrous sulfate. Iron can cause constipation by slowing down the movement of the digestive system and hardening the stool. Patients should be advised to increase their fluid intake, dietary fiber, and physical activity to help alleviate this side effect. Diarrhea (Choice A) is not a common side effect associated with ferrous sulfate. Weakness (Choice B) and headache (Choice C) are not typically linked to this medication.
2. The healthcare provider is assessing a client with chronic renal failure who is receiving hemodialysis. Which of the following findings would indicate that the client is experiencing a complication of the treatment?
- A. Clear dialysate outflow.
- B. Blood pressure of 150/90 mm Hg.
- C. Increased heart rate.
- D. Fatigue.
Correct answer: B
Rationale: A blood pressure of 150/90 mm Hg during hemodialysis may indicate fluid overload or an ineffective dialysis session, which can lead to complications such as heart failure or pulmonary edema. This finding should be reported promptly for further evaluation and intervention. Clear dialysate outflow is a normal and expected finding during hemodialysis, indicating proper filtration of waste products. Increased heart rate can be a normal compensatory response to hemodialysis due to fluid shifts and should be monitored but does not necessarily indicate a complication. Fatigue is a common symptom in clients with chronic renal failure undergoing hemodialysis and is not specific to complications of the treatment.
3. The caregiver is caring for a 10-year-old child with a history of frequent ear infections. The parents are concerned about their child’s hearing and speech development. What is the caregiver’s best response?
- A. Let’s schedule a hearing test and refer to a speech therapist if needed
- B. Most children outgrow ear infections and speech delays
- C. There is no need to worry unless the infections persist into adolescence
- D. Your child’s hearing and speech should be normal by now
Correct answer: A
Rationale: The appropriate response for the caregiver is to address the parents' concerns by suggesting scheduling a hearing test and potentially referring the child to a speech therapist if necessary. This proactive approach can help evaluate and support the child's hearing and speech development effectively. Choice B is incorrect as assuming that most children outgrow ear infections and speech delays may overlook potential issues that need intervention. Choice C is wrong because waiting until adolescence to address concerns may lead to missed opportunities for early intervention. Choice D is incorrect as it dismisses the parents' valid concerns without offering a solution or further evaluation.
4. Before administering digoxin to a client with heart failure, what is the most important assessment for the nurse to perform?
- A. Check the client's blood pressure
- B. Monitor the client's heart rate
- C. Assess the client's respiratory rate
- D. Review the client's potassium level
Correct answer: B
Rationale: The correct answer is to monitor the client's heart rate. Digoxin slows the heart rate, so it is crucial to assess the heart rate before administering the medication. If the heart rate is below 60 beats per minute, the dose should be held, and the healthcare provider should be notified. Checking the blood pressure (Choice A) is important but not as crucial as monitoring the heart rate in this case. Assessing the respiratory rate (Choice C) is not directly related to the action of digoxin. Reviewing the client's potassium level (Choice D) is important for clients taking digoxin due to the risk of hypokalemia, but assessing the heart rate takes priority.
5. The healthcare provider plans to administer 10 mcg/kg of digoxin elixir as a loading dose to a child who weighs 55 pounds. Digoxin is available as an elixir of 50 mcg/ml. How many milliliters of the digoxin elixir should the healthcare provider administer to this child?
- A. 5 ml
- B. 10 ml
- C. 15 ml
- D. 20 ml
Correct answer: A
Rationale: To calculate the dose, first, convert the child's weight to kilograms by dividing 55 pounds by 2.2, which equals approximately 25 kg. Then, multiply the weight by the dose (10 mcg/kg) to get the total dose needed, which is 250 mcg. Next, divide the total dose by the concentration of the elixir (50 mcg/ml) to determine the volume needed, which is 5 ml. Therefore, the correct dose is 5 ml based on the child's weight and the concentration of the elixir.