HESI RN
Pharmacology HESI
1. A clinic nurse prepares to administer an MMR (measles, mumps, rubella) vaccine to a child. How is this vaccine best administered?
- A. Intramuscularly in the deltoid muscle
- B. Subcutaneously in the gluteal muscle
- C. Subcutaneously in the outer aspect of the upper arm
- D. Intramuscularly in the anterolateral aspect of the thigh
Correct answer: C
Rationale: The MMR vaccine is best administered subcutaneously in the outer aspect of the upper arm. This route allows for proper absorption and efficacy of the vaccine while minimizing the risk of injury or discomfort to the child.
2. The nurse is assessing a client with right-sided heart failure. Which finding requires immediate intervention?
- A. Jugular venous distention
- B. Peripheral edema
- C. Crackles in the lungs
- D. Elevated liver enzymes
Correct answer: C
Rationale: In a client with right-sided heart failure, crackles in the lungs are the most concerning finding as they indicate pulmonary congestion, which requires immediate intervention. Crackles suggest fluid accumulation in the lungs, leading to impaired gas exchange and potential respiratory distress. Jugular venous distention (Choice A) and peripheral edema (Choice B) are common findings in right-sided heart failure but do not indicate acute deterioration requiring immediate intervention. Elevated liver enzymes (Choice D) may be seen in chronic heart failure but do not warrant immediate action compared to the urgent need to address pulmonary congestion indicated by crackles in the lungs.
3. A client with type 2 diabetes is admitted with hyperglycemic hyperosmolar syndrome (HHS). Which clinical finding is most concerning to the nurse?
- A. Serum glucose of 500 mg/dL
- B. Blood pressure of 140/90 mmHg
- C. Serum osmolarity of 320 mOsm/kg
- D. Serum pH of 7.30
Correct answer: C
Rationale: A serum osmolarity of 320 mOsm/kg is the most concerning finding in a client with hyperglycemic hyperosmolar syndrome (HHS) as it indicates severe dehydration and hypertonicity. This high serum osmolarity level can lead to neurological complications and requires immediate intervention to prevent further deterioration. Serum glucose levels, blood pressure, and serum pH are important parameters to monitor in HHS, but a significantly elevated serum osmolarity poses a higher risk of complications and warrants urgent attention. High serum glucose levels, like 500 mg/dL, are expected in HHS but do not directly indicate the severity of dehydration. Blood pressure of 140/90 mmHg is within normal limits and may not be directly related to the acute complications of HHS. A serum pH of 7.30 suggests acidosis, which is important to address but may not be as immediately concerning as severe dehydration indicated by high serum osmolarity.
4. What percentage of the offspring of the parents is predicted to have a cleft chin?
- A. 25%
- B. 50%
- C. 0%
- D. 75%
Correct answer: A
Rationale: When one parent carries the recessive gene for a cleft chin and the other does not, there is a 25% chance of the offspring inheriting the cleft chin. This is due to the fact that the trait follows a simple Mendelian inheritance pattern, where the offspring would need to inherit the recessive gene from both parents to express the trait. Therefore, 25% of the offspring are predicted to have a cleft chin. Choices B, C, and D are incorrect because the likelihood of inheriting a cleft chin in this specific scenario is 25%, not 50%, 0%, or 75%.
5. A pregnant woman in her first trimester is experiencing watery vaginal discharge. What should the nurse tell her?
- A. Inform her that it is normal.
- B. Advise her to see a doctor immediately.
- C. Suggest using panty liners.
- D. Suggest a change in diet.
Correct answer: A
Rationale: Informing the pregnant woman that watery vaginal discharge is normal during the first trimester is crucial to providing reassurance and reducing anxiety. This discharge, known as leukorrhea, is common during pregnancy due to increased estrogen levels and increased blood flow to the pelvic area. It helps maintain a healthy balance of bacteria in the vagina and protects the birth canal from infection. Advising the woman to see a doctor immediately may cause unnecessary alarm, while suggesting the use of panty liners can help manage the discharge comfortably. Suggesting a change in diet is not relevant to addressing watery vaginal discharge in this scenario.