HESI RN
HESI Pharmacology Practice Exam
1. A nurse preparing a client for surgery reviews the client's medication record. The client is to be nothing per mouth (NPO) after midnight. Which of the following medications, if noted on the client's record, should the nurse question?
- A. Cyclobenzaprine (Flexeril)
- B. Alendronate (Fosamax)
- C. Allopurinol (Zyloprim)
- D. Prednisone
Correct answer: D
Rationale: Prednisone is a corticosteroid that can cause adrenal atrophy, reducing the body's ability to withstand stress. During surgery, the dosage may need to be adjusted due to its impact on the body's stress response. Choices A, B, and C are not typically contraindicated before surgery and do not have the same potential impact on the body's stress response.
2. A client with trigeminal neuralgia tells the nurse that acetaminophen (Tylenol) is taken on a frequent daily basis for relief of generalized discomfort. The nurse reviews the client's laboratory results and determines that which of the following indicates toxicity associated with the medication?
- A. Sodium of 140 mEq/L
- B. Prothrombin time of 12 seconds
- C. Platelet count of 400,000 cells/mm³
- D. A direct bilirubin level of 2 mg/dL
Correct answer: D
Rationale: A direct bilirubin level of 2 mg/dL indicates liver damage, which can be caused by an overdose of acetaminophen. Acetaminophen toxicity can lead to liver injury, manifesting as elevated bilirubin levels and other liver function test abnormalities.
3. Before administering furosemide (Lasix) to a client with heart failure, what is the most important laboratory test result for the nurse to check?
- A. Potassium level
- B. Creatinine level
- C. Cholesterol level
- D. Blood urea nitrogen
Correct answer: A
Rationale: The correct answer is to check the potassium level before administering furosemide (Lasix) to a client with heart failure. Furosemide is a loop diuretic that can cause hypokalemia, so it is crucial to assess the potassium level to prevent complications like cardiac arrhythmias associated with low potassium levels.
4. Before initiating a client with tuberculosis on anti-tuberculosis therapy with isoniazid (INH), a nurse ensures that which of the following baseline study has been completed?
- A. Electrolyte levels
- B. Coagulation times
- C. Liver enzyme levels
- D. Serum creatinine level
Correct answer: C
Rationale: Before starting INH therapy for tuberculosis, it is essential to assess liver enzyme levels as INH can cause hepatotoxicity. Monitoring liver enzyme levels before and during the initial 3 months of therapy is crucial to detect any liver damage early and prevent further complications. Choice A, electrolyte levels, are not directly impacted by INH therapy. Choice B, coagulation times, are not routinely monitored before starting INH therapy. Choice D, serum creatinine level, is not specifically required as a baseline study before initiating INH therapy for tuberculosis.
5. A client is prescribed phenytoin (Dilantin) for seizure control. Which statement by the client indicates an understanding of the medication?
- A. I should brush and floss my teeth regularly.
- B. I should take the medication with antacids.
- C. I can stop taking the medication once my seizures are controlled.
- D. I should avoid drinking milk while taking this medication.
Correct answer: A
Rationale: The correct statement is 'I should brush and floss my teeth regularly.' Phenytoin (Dilantin) can cause gingival hyperplasia, so maintaining good oral hygiene is essential. Taking the medication with antacids can affect its absorption, so it should not be done. It is crucial not to stop taking the medication abruptly, even if seizures are controlled. There is no specific requirement to avoid milk while taking phenytoin (Dilantin).
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