HESI RN
HESI Pharmacology Practice Exam
1. An older client recently has been taking cimetidine (Tagamet). The nurse monitors the client for which most frequent central nervous system side effect of this medication?
- A. Tremors
- B. Dizziness
- C. Confusion
- D. Hallucinations
Correct answer: C
Rationale: Older clients are particularly vulnerable to central nervous system side effects of cimetidine. The most frequent side effect is confusion. It is crucial for nurses to be vigilant in monitoring for confusion as it can impact the client's safety and well-being. While tremors, dizziness, and hallucinations are possible side effects, confusion is the most common in older clients taking cimetidine.
2. A client with asthma receives a prescription for high blood pressure during a clinic visit. Which prescription should the nurse anticipate the client to receive that is least likely to exacerbate asthma?
- A. Pindolol (Visken)
- B. Carteolol (Ocupress)
- C. Metoprolol tartrate (Lopressor)
- D. Propranolol hydrochloride (Inderal)
Correct answer: C
Rationale: The correct answer is C, Metoprolol tartrate (Lopressor). Metoprolol is a beta2 blocking agent that is cardioselective and less likely to cause bronchoconstriction, making it a suitable antihypertensive option for clients with asthma. Choices A, B, and D are non-selective beta-blockers which can potentially exacerbate asthma symptoms by causing bronchoconstriction.
3. The term pleiotropy is best defined as which of the following?
- A. A situation in which one gene remains unexpressed
- B. One gene influencing multiple, seemingly unrelated phenotypic traits
- C. Two genes affected by a single allele
- D. A condition in which multiple genes are missing
Correct answer: B
Rationale: Pleiotropy is best defined as one gene influencing multiple, seemingly unrelated phenotypic traits. This phenomenon showcases the multifunctionality of genes, where a single gene can have effects on various aspects of an organism's phenotype. Choices A, C, and D do not accurately capture the concept of pleiotropy. Option A refers to gene expression, not pleiotropy. Option C describes genetic interactions but not in the context of pleiotropy. Option D talks about missing genes, which is unrelated to the definition of pleiotropy.
4. Nurse managers need several qualities to be effective. A nurse manager is working hard to fully understand how patient outcomes are measured on the unit and how budget changes could impact patient outcomes. Which of the following qualities does this best describe?
- A. Leadership
- B. Business sense
- C. Clinical expertise
- D. Financial management
Correct answer: B
Rationale: The correct answer is 'Business sense.' Nurse managers need to understand how financial decisions impact patient outcomes, which requires a strong understanding of business principles. Leadership (choice A) is important but doesn't specifically address understanding financial and outcome-based impacts. Clinical expertise (choice C) is essential for patient care but doesn't directly relate to understanding budget changes and their impact. Financial management (choice D) is more about managing finances directly rather than understanding the broader implications of budget changes on patient outcomes.
5. The nurse believes that a client who frequently requests pain medication may have a substance abuse problem. Which intervention reflects the nurse's value of client autonomy over veracity?
- A. Administer the prescribed analgesic when requested
- B. Enroll the client in a substance abuse program
- C. Collaborate with the healthcare provider to provide a placebo
- D. Document the frequency of medication requests
Correct answer: A
Rationale: Administering the prescribed analgesic when requested reflects the nurse's value of client autonomy over veracity. This choice respects the client's right to manage their pain as they see fit. Enrolling the client in a substance abuse program (Choice B) assumes substance abuse without evidence and infringes on the client's autonomy. Providing a placebo (Choice C) violates the principle of beneficence and autonomy by deceiving the client. Documenting the frequency of medication requests (Choice D) is important for assessment but does not directly address the client's autonomy in managing their pain.