HESI RN
HESI Pharmacology Practice Exam
1. A client is receiving dietary instructions from a nurse regarding warfarin sodium (Coumadin) therapy. The nurse advises the client to avoid which food item?
- A. Grapes
- B. Spinach
- C. Watermelon
- D. Cottage cheese
Correct answer: B
Rationale: The correct answer is B: Spinach. Spinach is high in vitamin K, which antagonizes the effects of warfarin sodium, an anticoagulant medication. Clients taking warfarin should avoid consuming foods rich in vitamin K, like spinach, to maintain the medication's effectiveness. Grapes (choice A), watermelon (choice C), and cottage cheese (choice D) do not interfere with the effects of warfarin, so they are safe for the client to consume while on warfarin therapy.
2. A healthcare professional assesses clients on the medical-surgical unit. Which client is at greatest risk for the development of bacterial cystitis?
- A. A 36-year-old female who has never been pregnant
- B. A 42-year-old male who is prescribed cyclophosphamide
- C. A 58-year-old female who is not taking estrogen replacement
- D. A 77-year-old male with mild congestive heart failure
Correct answer: C
Rationale: Females are at higher risk of developing bacterial cystitis due to their shorter urethra compared to males. Postmenopausal women not on estrogen replacement therapy are particularly susceptible to cystitis because of changes in vaginal and urethral cells. This increases the risk of bacterial infection. The other options do not have the same level of risk as the postmenopausal woman not using hormone replacement therapy. A never-pregnant middle-aged woman does not have the same increased risk as a postmenopausal woman with hormonal changes.
3. The healthcare provider finds a 6-month-old infant unresponsive and calls for help. After opening the airway and finding the infant is still not breathing, which action should the provider take?
- A. Palpate femoral pulse and check for regularity.
- B. Deliver cycles of 30 chest compressions and 2 breaths.
- C. Give two breaths that make the chest rise.
- D. Feel the carotid pulse and check for adequate breathing.
Correct answer: C
Rationale: In pediatric basic life support, for an unresponsive infant who is not breathing normally, the correct action is to give two breaths that make the chest rise. This helps provide oxygen to the infant's body and is a crucial step in resuscitation efforts for infants in distress. Choices A, B, and D are incorrect. Palpating the femoral pulse or feeling the carotid pulse is not indicated in this scenario where the infant is unresponsive and not breathing. Delivering cycles of chest compressions and breaths is not the immediate action to take; the priority is to provide two breaths to help with oxygenation.
4. A client with a deep vein thrombosis (DVT) is prescribed enoxaparin. What teaching should the nurse provide?
- A. Rotate injection sites to prevent bruising.
- B. Administer the injection in the abdomen only.
- C. Report any unusual bleeding or bruising.
- D. Avoid contact sports to prevent injury.
Correct answer: C
Rationale: The correct teaching for a client prescribed enoxaparin for deep vein thrombosis (DVT) is to report any unusual bleeding or bruising. Enoxaparin is an anticoagulant, and these symptoms could indicate excessive anticoagulation. Choice A is incorrect because with enoxaparin, injections are usually given in the abdomen, not rotated to different sites. Choice D is not directly related to the medication but is a general precaution for individuals at risk of injury.
5. The nurse is caring for a patient who develops marked edema and a low urine output as a result of heart failure. Which medication will the nurse expect the provider to order for this patient?
- A. Digoxin (Lanoxin)
- B. Furosemide (Lasix)
- C. Hydrochlorothiazide (HydroDIURIL)
- D. Spironolactone (Aldactone)
Correct answer: B
Rationale: In heart failure with marked edema and low urine output, the nurse can expect the provider to order Furosemide (Lasix). Furosemide is a loop diuretic that acts quickly to remove excess fluid from the body, making it an appropriate choice for this patient's condition. Digoxin is used to improve heart function but does not directly address fluid overload. Hydrochlorothiazide is a thiazide diuretic that is not as potent as Furosemide in managing acute fluid retention. Spironolactone is a potassium-sparing diuretic that is typically used in heart failure for its aldosterone-blocking effects and not for immediate fluid removal.