HESI RN
Biology Test
1. What percentage of the parents' offspring is predicted to have a cleft chin if one parent carries the recessive gene for a cleft chin (c) while the other parent does not?
- A. 25%
- B. 50%
- C. 0%
- D. 75%
Correct answer: C
Rationale: The correct answer is C (0%). If one parent carries the recessive gene for a cleft chin while the other parent does not carry it, none of their offspring is predicted to have a cleft chin. This is because the cleft chin trait is recessive, so for an offspring to express this trait, they would need to inherit the gene from both parents. In this scenario, none of the offspring will inherit the recessive gene from both parents, so the percentage of offspring predicted to have a cleft chin is 0%. Choices A, B, and D are incorrect because in this situation, the offspring will not express the cleft chin phenotype, although they could be carriers of the recessive gene.
2. The nurse is preparing to administer clarithromycin to a patient. When performing a medication history, the nurse learns that the patient takes warfarin to treat atrial fibrillation. The nurse will perform which action?
- A. Ask the provider if azithromycin may be used instead of clarithromycin.
- B. Obtain an order for continuous cardiovascular monitoring.
- C. Request an order for periodic serum warfarin levels.
- D. Withhold the clarithromycin and notify the provider.
Correct answer: C
Rationale: When a patient taking warfarin also needs to receive clarithromycin, it is essential to monitor periodic serum warfarin levels. Macrolides, including clarithromycin, can increase serum levels of drugs like warfarin. Monitoring serum drug levels helps ensure that the patient's warfarin dose can be adjusted, if necessary, to maintain therapeutic levels. Asking about using azithromycin instead is not the most appropriate action in this situation, as all macrolides can interact with warfarin. Continuous cardiovascular monitoring is not indicated solely based on the use of clarithromycin. Withholding the clarithromycin without proper assessment could delay necessary treatment and is not the best initial action.
3. A client with a history of chronic kidney disease (CKD) is receiving erythropoietin therapy. Which assessment finding is most concerning?
- A. Increased fatigue
- B. Headache
- C. Elevated blood pressure
- D. Low urine output
Correct answer: C
Rationale: In a client with chronic kidney disease receiving erythropoietin therapy, elevated blood pressure is the most concerning assessment finding. Erythropoietin can increase red blood cell production, leading to thicker blood, which in turn can elevate blood pressure. Elevated blood pressure in this scenario may indicate worsening hypertension, which requires prompt intervention to prevent complications such as stroke, heart attack, or further kidney damage. Increased fatigue (choice A) is a common symptom in CKD patients and can be expected with erythropoietin therapy. Headache (choice B) can occur but is less concerning than elevated blood pressure in this context. Low urine output (choice D) is a significant finding in CKD, but in a client receiving erythropoietin, elevated blood pressure takes precedence due to its potential for immediate adverse effects.
4. A child is diagnosed with acquired aplastic anemia. The nurse knows that this child has the best prognosis with which treatment regimen?
- A. blood transfusion
- B. chemotherapy
- C. bone marrow transplantation
- D. immunosuppressive therapy
Correct answer: C
Rationale: In the case of acquired aplastic anemia, bone marrow transplantation offers the best chance of cure as it replaces the abnormal stem cells with healthy ones. Blood transfusion may provide temporary relief by replacing blood cells, but it does not address the root cause of the condition. Chemotherapy may be used in some cases, but it is not the preferred treatment for acquired aplastic anemia. While immunosuppressive therapy can be effective, especially in patients who are not candidates for a bone marrow transplant, it is not the first-line treatment and does not offer the same potential for a cure as bone marrow transplantation.
5. A child with pertussis is receiving azithromycin (Zithromax Injection) IV. Which intervention is most important for the nurse to include in the child's plan of care?
- A. Obtain vital signs to monitor for fluid overload
- B. Change IV site dressing every 3 days and as needed
- C. Monitor for signs of facial swelling or urticaria
- D. Assess for abdominal pain and vomiting
Correct answer: C
Rationale: When administering azithromycin IV, monitoring for signs of an allergic reaction, such as facial swelling or urticaria, is crucial. This helps in early detection of potential adverse reactions and ensures prompt intervention to prevent complications associated with the medication. The other options are not directly related to the administration of azithromycin IV in this scenario. Monitoring for fluid overload would be more relevant for fluid administration, changing IV site dressing is important but not the priority in this case, and assessing for abdominal pain and vomiting may be important but not as critical as monitoring for signs of an allergic reaction.