HESI RN
Pharmacology HESI
1. A healthcare professional prepares to reinforce instructions to a client who is taking allopurinol (Zyloprim). The healthcare professional plans to include which of the following in the instructions?
- A. Instruct the client to drink 3000 mL of fluid per day.
- B. Instruct the client to take the medication with food.
- C. Inform the client that the effect of the medication will occur immediately.
- D. Instruct the client that, if swelling of the lips occurs, this is a normal expected response.
Correct answer: A
Rationale: Allopurinol is an antigout medication that works by reducing the production of uric acid in the body. To prevent kidney stones and promote the excretion of uric acid, increased fluid intake is essential. Instructing the client to drink 3000 mL of fluid per day helps to reduce the risk of kidney stones and assists in the elimination of uric acid, thereby enhancing the effectiveness of allopurinol therapy.
2. In which step of cellular respiration is the most adenosine triphosphate (ATP) created?
- A. Electron transport chain
- B. Glycolysis
- C. Citric acid cycle (the Krebs cycle)
- D. All of these produce equal amounts of ATP
Correct answer: A
Rationale: The electron transport chain is the step in cellular respiration that generates the most ATP. During this step, up to 34 ATP molecules can be produced from a single glucose molecule. Choice B, Glycolysis, produces a smaller amount of ATP (2 ATP molecules per glucose), and choice C, Citric acid cycle, produces some ATP but not as much as the electron transport chain. Choice D is incorrect because different steps of cellular respiration produce varying amounts of ATP, with the electron transport chain being the most efficient in ATP generation.
3. A client with chronic kidney disease (CKD) is admitted with hyperkalemia. Which intervention should the nurse implement first?
- A. Administer intravenous calcium gluconate.
- B. Administer intravenous insulin and glucose.
- C. Administer intravenous sodium bicarbonate.
- D. Administer a loop diuretic as prescribed.
Correct answer: B
Rationale: The correct answer is to administer intravenous insulin and glucose first. This intervention helps drive potassium back into the cells, lowering serum levels effectively. Administering intravenous calcium gluconate (choice A) is used to stabilize cardiac membranes in severe hyperkalemia but does not address the underlying cause. Administering intravenous sodium bicarbonate (choice C) is used in metabolic acidosis, not hyperkalemia. Administering a loop diuretic (choice D) can help eliminate potassium but is not the first-line treatment for hyperkalemia in CKD.
4. The nurse explains to an older adult male the procedure for collecting a 24-hour urine specimen for creatinine clearance. Which action is most important for the nurse to include in their care plan for the shift?
- A. Assess the client for confusion and reteach the procedure
- B. Check the urine for color and texture
- C. Empty the urinal contents into the 24-hour collection container
- D. Discard the contents of the urinal
Correct answer: C
Rationale: To ensure accurate creatinine clearance results, it is crucial to collect all urine within the 24-hour period. The process should begin with discarding the first specimen and then collecting all subsequent urine in the designated 24-hour collection container. This ensures that the sample is complete and accurate for the creatinine clearance calculation.
5. A client at 32-weeks gestation comes to the prenatal clinic with complaints of pedal edema, dyspnea, fatigue, and a moist cough. Which question is most important for the LPN/LVN to ask this client?
- A. Which symptom did you experience first?
- B. Are you consuming large amounts of salty foods?
- C. Have you traveled to a foreign country recently?
- D. Do you have a history of rheumatic fever?
Correct answer: D
Rationale: The correct answer is D. Rheumatic fever can lead to rheumatic heart disease, which may be exacerbated during pregnancy, causing symptoms like pedal edema and dyspnea. Asking about a history of rheumatic fever is crucial in this case to assess the potential impact on the client's current symptoms. Choices A, B, and C are less relevant in this scenario as they do not directly relate to the presenting symptoms and history of rheumatic fever.