HESI Exam RN Pharmacology V2

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Sample questions from HESI Exam RN Pharmacology V2

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.A client receiving a medication by continuous IV infusion has a new prescription for a drug that binds extensively to albumin. Which factor should the nurse consider when assessing the risk of an increased drug effect?

   • A.A high serum albumin level always increases renal excretion of the drug.
   • B.Protein binding prevents the drug from reaching its receptor.
   • C.The drug will be absorbed more slowly from the gastrointestinal tract.
   • D.A low serum albumin level may increase the free, active fraction of the drug.

   Rationale: With less albumin available, a greater proportion of a highly protein-bound drug may remain unbound and pharmacologically active. High albumin does not necessarily increase renal excretion, and gastrointestinal absorption is not the issue for a continuous IV infusion. Protein binding is often reversible and does not prevent all drug from reaching its receptor.

2. 2.A toddler is prescribed an oral liquid medication. Which action best promotes safe administration?

   • A.Use a kitchen tablespoon if the oral syringe is unavailable.
   • B.Estimate the dose using a household teaspoon.
   • C.Measure the dose with an oral syringe marked in milliliters.
   • D.Mix the entire dose into a full bottle of formula.

   Rationale: An oral syringe provides an accurate measurement of a liquid dose, which is especially important for children. Household spoons vary in volume and can cause dosing errors. Mixing medicine into a full bottle risks an incomplete dose if the child does not finish it.

3. 3.Refer to the client's chart. Which findings require the nurse to clarify the next dose of digoxin? Select all that apply.

   • A.The temperature is 37.1 C at 1000.
   • B.The apical pulse is 54 beats/min at 1000.
   • C.The client reports nausea and seeing yellow halos at 1000.
   • D.The blood pressure is 118/72 mm Hg at 1000.
   • E.The potassium level is 3.0 mEq/L.

   Rationale: The pulse has fallen to 54 beats/min, below the usual adult hold parameter of 60, and nausea with yellow halos suggests digoxin toxicity. A potassium of 3.0 mEq/L is low and increases myocardial sensitivity to digoxin. The stable blood pressure and temperature do not independently indicate a need to hold the dose.

4. 4.A client with reduced kidney function is prescribed a medication that is primarily excreted unchanged in the urine. Which prescription-related concern is most important to address?

   • A.The medication should always be given with a high-fat meal.
   • B.The dose or dosing interval may need adjustment to prevent accumulation.
   • C.The drug will not be absorbed through the gastrointestinal tract.
   • D.The medication will be metabolized too rapidly by the liver.

   Answer and rationale are in the full material.

5. 5.A client reports taking an herbal supplement and an anticoagulant at home. Which nursing action is the priority before administering a newly prescribed medication?

   • A.Reconcile all prescription drugs, over-the-counter products, and supplements.
   • B.Assume supplements cannot interact with prescribed medications.
   • C.Document the supplement only if the client reports an adverse effect.
   • D.Ask the client to stop every medication until discharge.

   Answer and rationale are in the full material.