HESI PHARMACOLOGY NCLEX RN EXAM

HESI PHARMACOLOGY NCLEX RN EXAM

• The nurse is assessing a stuporous client in the emergency department

who is suspected of overdosing with opioids. Which agent should the nurse prepare to administer if the client becomes comatose?A.Naloxone hydrochloride B.Atropine sulfate C.Vitamin K D.

Flumazenil:

Answer:

A.Naloxone hydrochloride

Rationale:Naloxone is an opioid antidote used in opioid overdose to reverse CNS

and respiratory depression. Atropine is used for bradycardia, intestinal hypertonici- ty and hypermotility, muscarinic agonist poisoning, peptic ulcer disease, and biliary colic. Vitamin K is used to manage warfarin overdose and vitamin K deficiency in newborns. Flumazenil reduces the sedative effects of benzodiazepines following general anesthesia or overdose.

• Two hours after taking the first dose of penicillin, a client arrives at

the emergency department complaining of feeling ill, exhibiting hives, having difficulty breathing, and experiencing hypotension. The nurse will develop an immediate plan of care based on which finding?A.Severe acute anaphylactic response B.Side reaction that should resolve C.Idiosyncratic reaction D.

Cumulative drug response:

Answer:

A.Severe acute anaphylactic response Rationale:Anaphylaxis related to penicillin can cause a life-threatening allergic response characterized by bronchospasm, laryngeal edema, and a precipitous drop in blood pressure. This client's ingestion of penicillin and presenting clinical picture indicate the client is having an acute reaction with respiratory difficulty. 1 / 4

Options B, C, and D are other physiologic responses to medications, but immediate action is required for a potential loss of airway, breathing, and circulation.

• The nurse is providing care to a 55-year-old client was diagnosed with

schizophrenia 5 years earlier. Numerous hospitalizations have occurred since the diagnosis because of noncompliance with the prescribed medication regimen. The nurse anticipates a prescription for which medication?A.Chlorpromazine HCl B.Lithium carbonate C.Fluphenazine decanoate D.

Diazepam:

Answer:

C.Fluphenazine decanoate

Rationale:Fluphenazine, an antipsychotic drug that can be given IM, has a rapid

onset (1 to 2 hours) and a long duration of action (up to 3 or 4 weeks), so it would be the drug of choice for a noncompliant psychotic client. Option A is an antipsychotic drug used to treat schizophrenia and is usually administered PO (IM doses are short-acting). The client must be compliant in taking this drug for it to be effective.Option B is most effective with manic and depressive bipolar affective disorders.Option D is an antianxiety drug and would not be effective for a psychotic disorder.

• A client who arrives in the postanesthesia care unit (PACU) after surgery

is not awake from general anesthesia. Which action should the nurse take first?A.Assess for deep tendon reflexes.B.Observe urinary output.C.Review the medication administration record (MAR).D.

Administer naloxone.:

Answer:

C.Review the medication administration record (MAR).

Rationale:Most general anesthetics produce cardiovascular and respiratory

depression, so a review of the client's MAR identifies all the medications received 2 / 4

during surgery and helps the nurse anticipate the client's response and emergence from anesthesia. Options A and B are ongoing postoperative assessments. Based on the medications that the client has received, naloxone may need to be administered if indicated by the client's vital signs and delayed spontaneous reactivity.

• The health care provider prescribes ipratropium for a client. An allergic

reaction to which other medication would cause the nurse to question the prescription for ipratropium?A.Albuterol B.Theophylline C.Metaproterenol D.

Atropine sulfate:

Answer:

D.Atropine sulfate Rationale:Clients who have experienced allergic reactions to atropine sulfate and belladonna alkaloids may also be allergic to ipratropium, so the prescription for Atrovent should be questioned. Allergies to options A, B, and C would not cause the nurse to question a prescription for ipratropium.

• Following the administration of sublingual nitroglycerin, which assessment

finding indicates to the nurse that the medication was effective?A.Decrease in level of chest pain B.Clear bilateral breath sounds C.Increase in blood pressure D.

Increase in urinary output:

Answer:

A.Decrease in level of chest pain

Rationale:Nitroglycerin reduces myocardial oxygen consumption, which decreases

ischemia and reduces chest pain. Options B, C, and D are not expected outcomes of sublingual nitroglycerin.

• A client who is HIV-positive is receiving epoetin alfa for the management 3 / 4

of anemia secondary to zidovudine (AZT) therapy. Which laboratory finding is most important for the nurse to report to the health care provider?A.Hematocrit (HCT) of 58% B.Hemoglobin of 10.8 g/dL C.White blood cell count of 5000 mm3 D.

Serum potassium level of 5 mEq/L:

Answer:

A.Hematocrit (HCT) of 58%

Rationale:Option A should be reported to the health care provider immediately

because of the likelihood of a hypertensive crisis and because seizure activity increases with an increase in HCT of more than 4 points, or an HCT above 36%. Epoetin alfa stimulates erythropoiesis (production of red blood cells), thereby decreasing the need for blood transfusions. Uncontrolled hypertension can occur if erythropoietin levels are too high. Option B is the reason why the client is receiving epoetin alpha. Options C and D are within normal limits.

• Which parameter is most important for the nurse to check prior to

administering a subcutaneous injection of heparin?A.Heart rate B.Urinary output C.Activated partial thromboplastin time (aPTT) D.

Prothrombin time (PT) and international normalized ratio (INR):

Answer:

C.Activated partial thromboplastin time (aPTT) Rationale:The laboratory value that measures heparin's therapeutic anticoagulation time is the aPTT. Option A should be checked before the administration of digoxin. Option B is valuable information but not a parameter measured for heparin therapy. Option D is evaluated during anticoagulation therapy using sodium warfarin.

• In administering the antiinfective agent chloramphenicol IV to a client

with bacterial meningitis, the nurse observes the client closely for signs of bone marrow depression. Which laboratory data would be most important for the nurse to monitor?

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