HESI RN
HESI Pharmacology Practice Exam
1. A client with Crohn's disease is scheduled to receive an infusion of infliximab (Remicade). The nurse assisting in caring for the client should take which action to monitor the effectiveness of treatment?
- A. Monitoring the leukocyte count for 2 days after the infusion
- B. Checking the frequency and consistency of bowel movements
- C. Checking serum liver enzyme levels before and after the infusion
- D. Carrying out a Hematest on gastric fluids after the infusion is completed
Correct answer: B
Rationale: To monitor the effectiveness of infliximab (Remicade) treatment in a client with Crohn's disease, the nurse should observe the frequency and consistency of bowel movements. Infliximab is an immunomodulator that works to reduce inflammation in the colon, leading to improvements in bowel symptoms such as frequency and consistency. Monitoring these bowel patterns can provide valuable insight into the response to the medication and the overall management of Crohn's disease. Checking the leukocyte count (Choice A) is not specific to monitoring the effectiveness of infliximab for Crohn's disease. Checking serum liver enzyme levels (Choice C) may be important for liver function but does not directly monitor the effectiveness of infliximab. Carrying out a Hematest on gastric fluids (Choice D) is not relevant to monitoring the effectiveness of infliximab in Crohn's disease.
2. A child has a nosebleed (epistaxis) while playing soccer. In what position should the nurse place the child?
- A. Position the child lying flat and apply pressure to the bridge of the nose.
- B. Position the child sitting up and leaning forward.
- C. Have the child tilt the head back and pinch the nose.
- D. Position the child lying on their side and apply ice to the nose.
Correct answer: B
Rationale: The correct answer is to position the child sitting up and leaning forward. This position helps prevent blood from flowing down the throat, reducing the risk of choking or vomiting. Choice A is incorrect because lying flat can cause blood to flow down the throat. Choice C is wrong as tilting the head back may lead to blood entering the throat. Choice D is also incorrect as applying ice is not recommended for nosebleeds and lying on the side may not prevent blood from flowing down the throat.
3. The nurse is caring for a client with end-stage renal disease (ESRD) who is scheduled for hemodialysis. Which assessment finding is most concerning?
- A. Blood pressure of 110/70 mmHg
- B. Heart rate of 110 beats per minute
- C. Fever of 100.4°F
- D. Respiratory rate of 24 breaths per minute
Correct answer: C
Rationale: A fever of 100.4°F is the most concerning assessment finding in a client with ESRD scheduled for hemodialysis. This elevation in temperature may indicate an underlying infection, which can lead to serious complications in individuals with compromised renal function. Prompt intervention is necessary to prevent the spread of infection and deterioration of the client's condition. The other vital signs mentioned, such as blood pressure, heart rate, and respiratory rate, while important to monitor, are within acceptable ranges and do not pose an immediate threat like a fever indicative of infection.
4. Following a motor vehicle collision, a 3-year-old girl has a spica cast applied. Which toy is best for the nurse to offer this child?
- A. Duck that squeaks.
- B. Fashion doll and clothes.
- C. Set of cloth and hand puppets.
- D. Handheld video game.
Correct answer: C
Rationale: In this scenario, a set of cloth and hand puppets is the best choice for a 3-year-old with a spica cast. Hand puppets encourage imaginative play, creativity, and interaction, which are developmentally appropriate for a child of this age. The soft materials are safe for the child and can provide entertainment and engagement without posing a risk of injury. The other options, such as a duck that squeaks, a fashion doll and clothes, and a handheld video game, may not be as suitable for a child in a spica cast due to safety concerns, lack of interactive play, or developmental appropriateness.
5. The practical nurse (PN) is caring for an adolescent who has been diagnosed with mononucleosis. Which activity should the PN advise the adolescent to avoid?
- A. Playing video games.
- B. Drinking caffeinated beverages.
- C. Participating in contact sports.
- D. Eating spicy foods.
Correct answer: C
Rationale: Contact sports should be avoided in mononucleosis due to the risk of spleen rupture, which is a serious complication of the disease. The spleen can enlarge in mononucleosis, making it more susceptible to injury from contact sports, potentially leading to a life-threatening situation if rupture occurs.