HESI milestone 2024 practice
questions and answers
A nurse is caring for a client with hyperparathyroidism and notes
that the client's serum calcium level is 13 mg/dL. Which medication
should the nurse prepare to administer as prescribed to the client?
A. Calcium chloride
B. Calcium gluconate
C. Calcitonin (Miacalcin)
D. Large doses of Vitamin D
C. Calcitonin (Miacalcin)
The normal serum calcium level is 8.6 to 10.0 mg/dl. This client is
experiencing hypercalcemia. Calcium gluconate and calcium chloride
are medications used for treatment of tetanym which occurs as
reseult of acute hypocalcemia. In hypercalcemia, large doses of
Vitamn D needed to be avoided. Calcitonin a thyroid hormon,
decreases the plasma calcium level by inhibiting bone resorption
and lowering the serum calcium concentration.
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Oral iron supplements are prescribed for a 6-year-old child with iron
deficiency anemia. The nurse instructs the mother to administer the
iron with which best food item?
A. Milk
B. Water
C. Apple Juice
D. Orange Juice
Orange Juice
Vitamin C increases the absorption of iron by the body. The mother
should be instructed to administer the medication with citrus fruit
or a juice that is high in vitamin C. Milk may affect the absorption of
,iron. Water will not assist in absorption. Orange juice contains a
more significant amount of vitamin C than apple juice.
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Salicylic Acid (Aspirin) is prescribed for a client with a diagnosis of
psoriasis. The nurse monitors the client, knowing that which of the
following would indicate the presence of systemic toxicity from this
medication?
A. Tinnitus
B. Diarrhea
C. Constipation
D. Decreased respirations
Tinnitus
Salicylic acid is absorbed readily through the skin, and systemic
toxicity (salicylism) can result. Syptoms include tinnitus, dizziness,
hyperpnea, and psychological disturbances. Constipation and
diarrhea are not associated with salicylism.
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,The camp nurse asks the children preparing to swim in the lake if
they have applied sunscreen. The nurse reminds the children that
chemical sunscreens are most effective when applied:
A. Immediately before swimming
B. 15 minutes before exposure to the sun
C. Immediately before exposure to the sun
D. At least 30 minutes before exposure to the sun
D. At least 30 minutes before exposure to the sun
Sunscreens are most effective when applied at least 30 minutes
before exposure to the sun so that they can penetrate the skin. All
sunscreens should be reapplied after swimming or sweating.
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Mafenide acetate (Sulfamylon) is prescribed for the client with a
burn injury. When applying the medication, the client complains of
local discomfort and burning. Which of the following is the most
appropriate nursing action?
A. Notifying the RN
B. Discontinuing the medication
C. Informing the client that this is normal
D. Applying a thinner film than prescribed to the burn site
C. Informing the client that this is normal
Mafenide acetate is a bacteriostatic for gram-negative and gram-
positive organisms and is used to treat burns to reduce bacteria
present in avascular tissues. The client should be informed that the
medication will cause local discomfort and burning and that this is a
normal reaction; therefore options 1,2, and 4 are incorrect.
The burn client is receiving treatments of topical mafenide acetate
(Sulfamylon) to the site of inury. The nurse monitors the client,
knowing that which of the following indicates that a systemic effect
has occurred?
A. Hyperventilation
B. Elevated BP
, C. Local pain at the burn site
D. Local rash at the burn side
A. Hyperventilation
Mafenide acetate is a carbonic anhydrase inhibitor and can suppress
renal excretion of acid, thereby causing acidosis. Clients receiving
this treatment should be monitored for signs of an acid-base
imbalance (hyperventilation). If this occurs, the medication should
be discontinued for 1-2 days. Options 3 and 4 describe local rather
than systemic effects. An elevated BP may be expected from the
pain that occurs with a burn injury.
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Isotretinoin is prescribed for a client with severe acne. Before the
administration of this medication, the nurse anticipates that which
laboratory test will be prescribed?
1. Platelet count
2. Triglyceride level
3. Complete blood count
4. White blood cell count
1. Triglyceride level
Isotretinoin can elevate triglyceride levels. Blood triglyceride levels
should be measured before treatment and periodically thereafter
until the effect on the triglycerides has been evaluated. Options 1,
3, and 4 do not need to be monitored specifically during this
treatment.
A client with severe acne is seen in the clinic and the health care
provider (HCP) prescribes isotretinoin. The nurse reviews the
client's medication record and would contact the (HCP) if the client
is taking which medication?
1. Vitamin A
2. Digoxin (Lanoxin)
3. Furosemide (Lasix)
4. Phenytoin (Dilantin)
1. Vitamin A
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