RN EXIT HESI- PHARM 2024
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1. A client taking atorvastatin develops an in- A. Muscle tenderness.
creased serum creatine phosphokinase (CK)
level. The nurse should assess the client for the
onset of which problem?
A. Muscle tenderness.
B. Nausea and vomiting.
C. Excessive bruising.
D. Peripheral edema.
2. An increase in which serum laboratory value C. HDL (High-density
indicates to the nurse that a prescription for lipoprotein)
atorvastatin is having the desired effect for a
client at risk for coronary artery disease?
A. LDL (Low-density lipoprotein)
B. Triglycerides (Type of fat)
C. HDL (High-density lipoprotein)
D. VLDL (Very low-density lipoprotein)
3. NGN - Patient Data Potential Condition:
History and Physical: Methemoglobinemia
The client is a 36-year-old female with mod-
erate persistent asthma. She takes fluticas- Actions to Take:
one/salmeterol 250 mcg/50 mcg 1 inhalation 1. Draw blood for a com-
twice daily and albuterol 90 mcg/inhalation 2 plete blood count
inhalations every 4-6 hours as needed. 2. Administer methylene
blue
Nurses notes:
The client states that she has had more severe Parameters to Monitor:
asthma symptoms than usual in the past week. 1. Methemoglobin level
Her forced expiratory volume has been 60-65% 2. Heart rate and rhythm
even with multiple doses of albuterol for sev-
eral days in a row. She came to the hospi-
tal feeling dizzy, lightheaded, and complaining
of "heart palpitations". Upon assessment, no
wheezes were found. Her oxygen saturation is
99%.
, RN EXIT HESI- PHARM 2024
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Review H and P, and nurse's note. Identify from
the choices below which condition the client
is most likely experiencing, two actions the
nurse should take to address that condition,
and two parameters the nurse should monitor
to assess the client's progress.
4. The nurse provide discharge instructions to a B. Gastric irritation
client who has been prescribed gabapentin 300
mg by mouth three times a day for post her-
petic neuralgia. Which symptoms should the
nurse tell the client to report to the healthcare
provider?
A. Sexual dysfunction
B. Gastric irritation
C. Rapid weight gain
D. Photosensitivity
5. A client with chronic lower back pain has been C. Determine presence of
taking non steroidal anti-inflammatory (NSAID) abdominal pain
drug ibuprofen by mouth twice a day for sever-
al months. Which assessment is most impor-
tant for the nurse to complete?
A. Assess back pain using numeric scale
B. Palpate volume of pedal pulses
C. Determine presence of abdominal pain
D. Evaluate ongoing sleep patterns
6. The nurse administers risedrineate to a client A. Instruct the client that
with osteoporosis at 0700. The client asks for it is necessary to take
a glass of milk to drink with the medication. nothing but water with the
Which action should the nurse take? medication.
A. Instruct the client that it is necessary to take
nothing but water with the medication.
B. Assign an unlicensed assistive personnel
(UAP) to bring the client a glass of low fat milk.
, RN EXIT HESI- PHARM 2024
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C. Withhold the medication until the client's
breakfast tray is available on the unit.
D. Consult with a pharmacist about scheduling
the dose one hour after the client eats.
7. Which action should the nurse implement to D. Measure the clients
assess the effectiveness of calcium channel blood pressure
blocker amlodipine?
A. Note the clients serum calcium levels
B. Monitor the clients serum electrolytes
C. Review the clients intake and output
D. Measure the clients blood pressure
8. A client is receiving tamsulosin an alpha B. Stand and sit up slowly
adrenergic - blocking agent for the manage-
ment of urinary retention due to benign pro-
static hyperplasia (BPH). Which instruction is
most important for the nurse to provide?
A. Use a twice a week dosing schedule
B. Stand and sit up slowly
C. Take the medication early in the day
D. Reduce daily fluid intake
9. A client with chemotherapy induced nausea B. Involuntary move-
receives a prescription for metoclopramide. ments
Which adverse effect is most important for the
nurse to report?
A. Nausea
B. Involuntary movements
C. Diarrhea
D. Unusual irritability
10. A client is receiving orlistat as part of a weight A. Body mass index
management program. Which ongoing assess-
ment should be included in the plan of care to
determine the effectiveness of the medication?
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A. Body mass index
B. Depression screening
C. Daily calorie count
D. Serum protein levels
11. Before administering the initial dose of suma- D. Coronary artery dis-
triptan succinate to a client with a migraine ease
headache, it is most important to determine if
the client's history includes which problem?
A. Type 2 diabetes mellitus
B. Seasonal allergic rhinitis
C. Irritable bowel syndrome
D. Coronary artery disease
12. A client receives a prescription for 200 mL/hr
ciprofloxacin 400 mg intravenously (IV) every
12 hours which is to be infused over an hour.
The IV bag contains ciprofloxacin 400 mg in Rationale:
dextrose 5%in water (D5W) 200 mL. How many xmL/hr =
mL/hr should the nurse program the infusion
pump to deliver? 200 mL x 400 mg =
80,000 = 200 mL/hr
400 mg 1 hr 400
13. Before administering a laxative to a bed fast A. Determine the fre-
client, it is most important for the nurse to quency and consistency
perform which assessment? of bowel movements
A. Determine the frequency and consistency of
bowel movements
B. Observe the skin integrity of the clients rec-
tal and sacral areas
C. Assess the clients strength in moving and
turning the bed
D. Evaluate the clients ability to recognize the
urge to defecate
14. The nurse is caring for a client who takes A. Have a chest x-ray pri-
methotrexate for rheumatoid arthritis and is or to your first dose
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