HESI Pharmacology 315 Study Guide

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Sample questions from HESI Pharmacology 315 Study Guide

This material has 18 questions with answers and rationales. Here are the first 5.

1. 1.A client receiving a first dose of an IV antibiotic develops wheezing, tongue swelling, and a blood pressure of 78/42 mm Hg. The nurse stops the infusion and activates emergency assistance. Which medication should the nurse prepare to administer first under the emergency protocol?

   • A.A. Intramuscular epinephrine
   • B.D. Nebulized inhaled corticosteroid
   • C.C. Intravenous furosemide
   • D.B. Oral diphenhydramine

   Rationale: A is correct because IM epinephrine is first-line treatment for anaphylaxis with airway and circulatory compromise. B is an adjunct at most, is not first-line, and oral administration is unsafe with airway swelling. C can worsen hypotension and does not treat anaphylaxis. D does not rapidly reverse airway edema or shock. Airway support and resuscitation continue alongside medication treatment.

2. 2.Before administering digoxin, the nurse obtains an apical pulse of 50/min. The client reports nausea and new blurred vision. Potassium is 3.0 mEq/L, and the prescription states to hold for a pulse below 60/min. What should the nurse do?

   • A.D. Recheck the pulse after ambulation
   • B.A. Administer digoxin with food
   • C.B. Give digoxin after an oral potassium dose
   • D.C. Withhold digoxin, assess rhythm and perfusion, and notify the prescriber

   Rationale: C is correct because the client meets the prescribed hold parameter and has findings concerning for digoxin toxicity, with hypokalemia increasing risk. A does not address toxicity. B assumes potassium replacement immediately makes digoxin safe and ignores bradycardia. D delays evaluation and could increase risk in a client with impaired cardiac conduction.

3. 3.A client with type 1 diabetes is NPO for a morning procedure. The medication record includes basal insulin and mealtime rapid-acting insulin. Which action is best?

   • A.D. Replace basal insulin with an oral diabetes medication
   • B.B. Clarify and implement the fasting insulin plan while continuing glucose monitoring
   • C.A. Omit both insulins until the client eats
   • D.C. Give both insulins at their usual doses without reviewing orders

   Rationale: B is correct because fasting requires an individualized plan, and clients with type 1 diabetes usually still need basal insulin. A can precipitate ketoacidosis. C risks hypoglycemia, especially from usual mealtime coverage without nutrition. D is not an equivalent replacement and cannot be independently prescribed by the nurse.

4. 4.A hospitalized client is awake, can swallow safely, and reports shakiness. The bedside glucose is 58 mg/dL. Which action should the nurse take first?

   • A.B. Give a high-fat snack and recheck in two hours
   • B.A. Administer the scheduled rapid-acting insulin
   • C.D. Give 15 g of rapid-acting carbohydrate and recheck in 15 minutes
   • D.C. Obtain a routine laboratory glucose before treating

   Answer and rationale are in the full material.

5. 5.A client has received heparin for seven days. Platelets have decreased from 286,000/mm3 to 128,000/mm3, and the client reports new calf pain. Which action is the priority?

   • A.A. Continue heparin because the platelet count exceeds 100,000/mm3
   • B.C. Stop heparin exposure and notify the prescriber about possible HIT
   • C.B. Massage the calf and reassess in one hour
   • D.D. Substitute enoxaparin without obtaining a prescription

   Answer and rationale are in the full material.