HESI Extra Credit Module 8 Exam Pharmacology and Intravenous Therapies [NEW!!] 2022 (55 Pages)100%
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A client is receiving total parenteral nutrition (TPN) with fat emulsion (lipids) piggybacked to
the TPN solution. For which signs of an adverse reaction to the fat emulsion should the nurse
monitor the client? Select all that apply.
A. Chest and back pain Correct
B. Nausea and vomiting Correct...
hesi extra credit module 8 exam pharmacology and intravenous therapies new 2022 55 pages100
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MODULE 8 - Pharmacology and Intravenous Therapies
Submission Details
Submission Date: 5/2/2021
Submission Time: 10:03 PM
Points Awarded: 9405
Points Missed: 396
Number of Attempts Allowed: 5
Not Scored: 0
Percentage: 95.96%
1.ID: 21553033078
A client is receiving total parenteral nutrition (TPN) with fat emulsion (lipids) piggybacked to
the TPN solution. For which signs of an adverse reaction to the fat emulsion should the nurse
monitor the client? Select all that apply.
A. Chest and back pain Correct
B. Nausea and vomiting Correct
C. Chills Correct
D. Headache Correct
E. Pallor
F. Subnormal temperature
Rationale: Signs of an adverse reaction to fat emulsion include chest and back pain, chills, fever,
dyspnea, cyanosis, diaphoresis, flushing, headache, nausea and vomiting, pressure over the eyes,
vertigo, and thrombophlebitis at the infusion site.
Test-Taking Strategy: Focus on the subject, adverse effects of fat emulsion. Recalling that fever
and flushing occur will assist you in answering correctly. Specific knowledge about these
adverse effects is needed to select the remaining correct options.
Review: the signs of an adverse reaction to fat emulsion
Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Assessment
Content Area: Total Parenteral Nutrition
Giddens Concepts: Clinical Judgment, Immunity
HESI Concepts: Clinical Decision Making-Clinical Judgment-Critical Thinking, Immunity
Reference: Gahart, B., & Nazareno, A. (2015). 2015 Intravenous medications (31 ed., p. 528).
st
St. Louis: Mosby.
Awarded 99.0 points out of 99.0 possible points.
2.ID: 21553033022 A nurse has just hung a transfusion of packed red blood cells and stayed with the
client for the appropriate amount of time. Before leaving the room, the nurse tells the client that it
is most important to immediately report which specific signs if it occurs? Select all that apply.
A. Fatigue
B. Tiredness
, C. Rash Correct
D. Chills Correct
E. Backache Correct
Rationale: The nurse should instruct the client to report signs of a transfusion reaction, such as a
backache, chills, itching, or rash, immediately. If a transfusion reaction occurs, the nurse would stop
the transfusion immediately. Fatigue and tiredness are not specifically related to a transfusion
reaction.
Test-Taking Strategy: Note the strategic words “most important” and “immediately.” Eliminate
the comparable or alike options (fatigue and tiredness).
Review: the signs of a transfusion reaction
Level of Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Implementation
Content Area: Blood Administration
Giddens Concepts: Immunity, Perfusion
HESI Concepts: Immunity, Perfusion
Reference: Perry, A., Potter, P., & Ostendorf, W. (2014). Clinical nursing skills & techniques (8th ed.,
p. 749). St. Louis: Mosby.
Awarded 99.0 points out of 99.0 possible points.
3.ID: 21553032642 Disulfiram is prescribed for a client. Which questions does the nurse make
a priority of asking the client before administering this medication? Select all that apply.
A. “Do you have a history of thyroid problems?” Correct
B. “Do you have a history of cancer in your family?”
C. “Do you have a history of diabetes insipidus?”
D. “When was your last drink of alcohol?” Correct
E. “When did you have your last full meal?”
Rationale: Disulfiram is used as an adjunct treatment for selected clients with alcoholism who want
to remain in a state of enforced sobriety. Clients must abstain from alcohol intake for at least 12
hours before the initial dose of the medication is administered. The most important question is when
the client had his last drink of alcohol. The medication is used with caution in clients with diabetes
mellitus, hypothyroidism, epilepsy, cerebral damage, nephritis, and hepatic disease. It is also
contraindicated in cases of severe heart disease, psychosis, or hypersensitivity to the medication.
Test-Taking Strategy: Note the strategic word, priority. Recalling that the medication is used as an
adjunct treatment for selected clients with alcoholism will help direct you to the option in which the
client is asked when he consumed his last alcoholic drink. To find the other correct options, it is
necessary to know the contraindications to the use of disulfiram.
Review: the effects of disulfiram.
Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Assessment
Content Area: Pharmacology
Giddens Concepts:Addiction, Safety
HESI Concepts: Behaviors, Safety
Reference: Rosenjack Burchum, Rosenthal (2016) pp. 421-422
Awarded 99.0 points out of 99.0 possible points.
,4.ID: 21553033015 A client who needs to receive a blood transfusion has experienced a pruritic rash
during previous transfusions. The client asks the nurse whether it is safe to receive the transfusion.
Which medication does the nurse anticipate will most likely be prescribed before the transfusion?
A. Acetaminophen
B. Diphenhydramine Correct
C. Ibuprofen
D. Acetylsalicylic acid
Rationale: An urticarial reaction is characterized by a rash accompanied by pruritus. This type of
transfusion reaction is prevented by pretreating the client with an antihistamine, such as
diphenhydramine. Acetaminophen and acetylsalicylic acid are analgesics; ibuprofen is a nonsteroidal
antiinflammatory medication.
Test-Taking Strategy: Note the strategic words, most likely. To answer this question correctly, it is
necessary to be familiar with this particular type of reaction and the medication that may be used in
its prevention. Recalling that diphenhydramine is an antihistamine will direct you to the correct
option.
Review: the procedure for administering a blood transfusion
Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Planning
Content Area: Blood Administration
Giddens Concepts: Clinical Judgment, Immunity
HESI Concepts: Clinical Decision Making-Clinical Judgment-Critical Thinking, Immunity
Reference: Ignatavicius, D., & Workman, M. (2013). Medical-surgical nursing: Patient-centered
collaborative care. (7th ed., p. 900). St. Louis: Saunders.
Awarded 99.0 points out of 99.0 possible points.
5.ID: 21553033533 Zidovudine is prescribed for an adult client with HIV infection. The nurse should
provide which instruction to the client about the medication?
A. That the medication must be taken with milk
B. That aspirin can be taken to treat headache
C. To discontinue the medication if nausea occurs
D. To space the doses evenly around the clock Correct
Rationale: The adult dosage of zidovudine is usually 200 mg every 8 hours or 300 mg every 12
hours. The client is instructed to space doses of the medication evenly around the clock. Food or
milk does not affect the gastrointestinal absorption of the medication. The client is instructed to
continue therapy for the full prescribed duration of treatment. The client is also instructed not to take
any medication, including aspirin, without the health care provider’s approval.
Test-Taking Strategy: Focus on the subject, client instructions for taking zidovudine. Knowledge of
the basic principles of medication administration will assist you in eliminating the option referring to
discontinuation of the medication. To select from the remaining options, recall that this medication is
an antiviral, which will direct you to the correct option. Remember that evenly spaced doses are
necessary to maintain virustatic concentrations of the medication.
Review: client teaching points for zidovidine
Level of Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Teaching and Learning
Content Area: Pharmacology
Giddens Concepts:Immunity, Safety
, HESI Concepts: Immunity, Safety
Reference: Hodgson, B., & Kizior, R. (2015). Saunders nursing drug handbook 2015. (pp. 1294-
1295) St. Louis: Saunders.
Awarded 99.0 points out of 99.0 possible points.
6.ID: 21553033518 A client with a thoracic spinal cord injury is receiving dantrolene sodium. Which
statement by the client indicates to the nurse that the client is experiencing an adverse effect of the
medication?
A. “I’m feeling really drowsy.” Correct
B. “I urinate about the same amount as I always did.”
C. “My legs are very relaxed.”
D. “I can’t seem to get enough to eat.”
Rationale: Drowsiness, diarrhea, and hepatotoxicity are the adverse effects of this muscle relaxant,
which is used to treat the chronic spasticity seen with spinal cord injury. The drowsiness may
interfere with the client’s rehabilitation. Relaxed legs are a desired effect. Some clients experience
anorexia and urinary frequency.
Test-Taking Strategy: Focus on the subject, an adverse effect of a medication. Relaxed legs are a
desired effect, so eliminate this option. To select from the remaining options, recall that this
medication is a muscle relaxant. This will direct you to the correct option.
Review: the adverse effects of dantrolene sodium
Level of Cognitive Ability: Evaluating
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Evaluation
Content Area: Pharmacology
Giddens Concepts: Clinical Judgment, Intracranial Regulation
HESI Concepts: Clinical Decision Making-Clinical Judgment-Critical Thinking, Intracranial
Regulation
Reference: Rosenjack Burchum, Rosenthal (2016) p. 244
Awarded 99.0 points out of 99.0 possible points.
7.ID: 21553033578 A home care nurse has been assigned a client who has been discharged home
with a prescription for total parenteral nutrition (TPN). Which parameters does the nurse plan to
check at each visit as a means of identifying complications of the TPN therapy? Select all that
apply.
A. Weight Correct
B. Glucose test Correct
C. Temperature Correct
D. Peripheral pulses
E. Hemoglobin and hematocrit
Rationale: When a client is receiving TPN therapy, the nurse monitors the client’s weight to
determine the effectiveness of the therapy. The nurse should weigh the client at each visit to make
sure that the client has not gained or lost an excessive amount of weight. Because the formula
contains a large amount of dextrose, the health care provider should check the client’s glucose level
frequently. The nurse caring for a client receiving TPN at home should also monitor the temperature
to detect infection, which is a potential complication of this therapy. An infection in the intravenous
line could result in sepsis, because the catheter is in a blood vessel. The peripheral pulses and
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