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HESI Comprehensive Exam 2020
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HESI Comprehensive Exam 20201) A nurse is caring for a client with hyperparathyroidism and notes that the client's serum
calcium level is 13 mg/dL. Which medication should the nurse prepare to administer as
prescribed to the client?
1. Calcium chloride
2. Calcium gluconate
3. Calcitonin (Miacalcin)
4. Large doses of vitamin D 3. Calcitonin (Miacalcin)
Rationale:
The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is experiencing hypercalcemia.
Calcium gluconate and calcium chloride are medications used for the treatment of tetany, which
occurs as a result of acute hypocalcemia. In hypercalcemia, large doses of vitamin D need to be
avoided. Calcitonin, a thyroid hormone, decreases the plasma calcium level by inhibiting bone
resorption and lowering the serum calcium concentration.
10.) The clinic nurse is performing an admission assessment on a client. The nurse notes that the
client is taking azelaic acid (Azelex). Because of the medication prescription, the nurse would
suspect that the client is being treated for:
1. Acne
2. Eczema
3. Hair loss
4. Herpes simplex 1. Acne
Rationale:
Azelaic acid is a topical medication used to treat mild to moderate acne. The acid appears to
work by suppressing the growth of Propionibacterium acnes and decreasing the proliferation of
keratinocytes. Options 2, 3, and 4 are incorrect.
100.) Saquinavir (Invirase) is prescribed for the client who is human immunodeficiency virus
seropositive. The nurse reinforces medication instructions and tells the client to:
1. Avoid sun exposure.
2. Eat low-calorie foods.
3. Eat foods that are low in fat.
4. Take the medication on an empty stomach. 1. Avoid sun exposure.
,HESI Comprehensive Exam 2020
Rationale:
Saquinavir (Invirase) is an antiretroviral (protease inhibitor) used with other antiretroviral
medications to manage human immunodeficiency virus infection. Saquinavir is administered
with meals and is best absorbed if the client consumes high-calorie, high-fat meals. Saquinavir
can cause photosensitivity, and the nurse should instruct the client to avoid sun exposure.
101.) Ketoconazole is prescribed for a client with a diagnosis of candidiasis. Select the
interventions that the nurse includes when administering this medication. Select all that apply.
1. Restrict fluid intake.
2. Instruct the client to avoid alcohol.
3. Monitor hepatic and liver function studies.
4. Administer the medication with an antacid.
5. Instruct the client to avoid exposure to the sun.
6. Administer the medication on an empty stomach. 2. Instruct the client to avoid alcohol.
3. Monitor hepatic and liver function studies.
5. Instruct the client to avoid exposure to the sun.
Rationale:
Ketoconazole is an antifungal medication. It is administered with food (not on an empty
stomach) and antacids are avoided for 2 hours after taking the medication to ensure absorption.
The medication is hepatotoxic and the nurse monitors liver function studies. The client is
instructed to avoid exposure to the sun because the medication increases photosensitivity. The
client is also instructed to avoid alcohol. There is no reason for the client to restrict fluid intake.
In fact, this could be harmful to the client.
102.) A client with human immunodeficiency virus is taking nevirapine (Viramune). The nurse
should monitor for which adverse effects of the medication? Select all that apply.
1. Rash
2. Hepatotoxicity
3. Hyperglycemia
4. Peripheral neuropathy
5. Reduced bone mineral density 1. Rash
,HESI Comprehensive Exam 2020
2. Hepatotoxicity
Rationale:
Nevirapine (Viramune) is a non-nucleoside reverse transcriptase inhibitors (NRTI) that is used to
treat HIV infection. It is used in combination with other antiretroviral medications to treat HIV.
Adverse effects include rash, Stevens-Johnson syndrome, hepatitis, and increased transaminase
levels. Hyperglycemia, peripheral neuropathy, and reduced bone density are not adverse effects
of this medication.
103.) A nurse is caring for a hospitalized client who has been taking clozapine (Clozaril) for the
treatment of a schizophrenic disorder. Which laboratory study prescribed for the client will the
nurse specifically review to monitor for an adverse effect associated with the use of this
medication?
1. Platelet count
2. Cholesterol level
3. White blood cell count
4. Blood urea nitrogen level 3. White blood cell count
Rationale:
Hematological reactions can occur in the client taking clozapine and include agranulocytosis and
mild leukopenia. The white blood cell count should be checked before initiating treatment and
should be monitored closely during the use of this medication. The client should also be
monitored for signs indicating agranulocytosis, which may include sore throat, malaise, and
fever. Options 1, 2, and 4 are unrelated to this medication.
104.) Disulfiram (Antabuse) is prescribed for a client who is seen in the psychiatric health care
clinic. The nurse is collecting data on the client and is providing instructions regarding the use of
this medication. Which is most important for the nurse to determine before administration of
this medication?
1. A history of hyperthyroidism
2. A history of diabetes insipidus
3. When the last full meal was consumed
4. When the last alcoholic drink was consumed 4. When the last alcoholic drink was consumed
Rationale:
Disulfiram is used as an adjunct treatment for selected clients with chronic alcoholism who want
, HESI Comprehensive Exam 2020
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 data are to
determine when the last alcoholic drink was consumed. The medication is used with caution in
clients with diabetes mellitus, hypothyroidism, epilepsy, cerebral damage, nephritis, and hepatic
disease. It is also contraindicated in severe heart disease, psychosis, or hypersensitivity related to
the medication.
105.) A nurse is collecting data from a client and the client's spouse reports that the client is
taking donepezil hydrochloride (Aricept). Which disorder would the nurse suspect that this client
may have based on the use of this medication?
1. Dementia
2. Schizophrenia
3. Seizure disorder
4. Obsessive-compulsive disorder 1. Dementia
Rationale:
Donepezil hydrochloride is a cholinergic agent used in the treatment of mild to moderate
dementia of the Alzheimer type. It enhances cholinergic functions by increasing the
concentration of acetylcholine. It slows the progression of Alzheimer's disease. Options 2, 3, and
4 are incorrect.
106.) Fluoxetine (Prozac) is prescribed for the client. The nurse reinforces instructions to the
client regarding the administration of the medication. Which statement by the client indicates an
understanding about administration of the medication?
1. "I should take the medication with my evening meal."
2. "I should take the medication at noon with an antacid."
3. "I should take the medication in the morning when I first arise."
4. "I should take the medication right before bedtime with a snack." 3. "I should take the
medication in the morning when I first arise."
Rationale:
Fluoxetine hydrochloride is administered in the early morning without consideration to meals.
**Eliminate options 1, 2, and 4 because they are comparable or alike and indicate taking the
medication with an antacid or food.**
107.) A client receiving a tricyclic antidepressant arrives at the mental health clinic. Which
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