HESI PHARMACOLOGY EXIT RN EXAM 2023 -2024 ACTUAL EXAM 455 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ ||BRAND NEW!! Which interventions are included in the nursing care for a client receiving magnesium sulfate for severe preeclampsia? Monitoring deep tendon reflexes Assessing urine output every 8 hours Maintaining a dark, quiet environment Using a pump to regulate the medication Having calcium gluconate available at the bedside Notifying the primary healthcare provider if the respiratory rate is slower than 20 breaths/min - ANSWER - Monitoring deep tendon reflexes Maintaining a dark, quiet environment Using a pump to regulate the medication Having calcium gluconate available at the bedside Rationale: Magnesium sulfate level is monitored closely because toxicity may occur with levels over 8 mg/dL. It works by relaxing skeletal muscle; therefore deep tendon reflexes should be assessed hourly. Maintaining a dark, quiet environment decreases stimulation and reduces the risk of seizures. Magnesium sulfate must be administered with the use of an infusion pump because it can be toxic and cause respirat ory distress. Calcium gluconate is the antidote to magnesium sulfate and should be immediately available for the treatment of overdose. Assessing urine output every 8 hours is not sufficient. Urine output of less than 30 mL/hr must be reported to the prima ry healthcare provider. A respiratory rate slower than 12 breaths/min, not 20, must be reported to the primary healthcare provider. When is the first dose of Rotarix vaccine administered in infants? Birth to 6 weeks 6-12 weeks 12-18 weeks 18-24 weeks - ANSWER - 6-12 weeks Rationale: The Rotarix vaccine prevents rotavirus gastroenteritis and diarrhea -related problems. The vaccination requires two doses. The first dose of Rotarix should be given between 6 and 12 weeks followed by the second dose, which is given four or more weeks after the first dose. Administering the vaccine before the age of 6 weeks is too early, and administering it at 12 -18 weeks or 18 -24 weeks is too late. A client with psychosis is receiving olanzapine. What special information about this drug does the nurse recall? It must be administered by Z -track administration. A special tyramine -free diet is required. It dissolves instantly after oral administration. An empty stomach increases its effectiveness. - ANSWER - It dissolves instantly after oral administration. Rationale: Olanzapine is an orally disintegrating tablet, meaning that it will instantly dissolve on contact with moisture. It can be given intramuscularly, but Z -track administration is not necessary. Tyramine -free diets are necessary with monoamine oxidase inhibito rs, not antipsychotics. An empty stomach is not necessary with this medication. A nurse is interviewing an adolescent who is to start a chemotherapeutic drug regimen that includes vincristine. Which side effect is it most important for the nurse to prepare the adolescent to expect? Alopecia Constipation Loss of appetite Peripheral neuropathy - ANSWER - Alopecia Rationale: A side effect of vincristine is alopecia. To adolescents, who are very concerned with identity, hair loss represents a tremendous threat to self -
image. Constipation, although very serious, is not as important to the adolescent as a side effect that affects appearance. Although anorexia will be a concern while the adolescent is undergoing chemotherapy, it is not as important before the start of the regimen. Although neurologic side effects are serious, they are not as important to the adolescent before the s tart of chemotherapy. Doxepin is prescribed for a 74 -year-old client for treatment of a depressive episode. When the nurse reviews with the client the side effects of doxepin, which effects does the nurse include? Diarrhea Loss of appetite Photosensitivity Urine retention Suicidal ideation - ANSWER - Urine retention
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