2024-2025 HESI Milestone Exam 1 with Answers (162 Solved Questions)

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HESIMilestoneExam#1100% VERIFIED ANSWERS2024/2025Histamine1 blockers action(mine, zine, dine)bind selectively to H1-histaminic receptors, blocking the actions of histamine at thesesitesH1 antagonists are useful in treating-mild allergies(seasonal rhinitis)-severe allergies(anaphylaxis)-motion sickness-insomnia-common coldHistamine (H2)-Receptor Antagonists action(tidine)block the H2 receptors responsible for stimulating the secretion of gastric acidExenatide (Byetta) hypoglycemia-can occur right after meals-for severe hypoglycemia give IV dextroseExenatide (Byetta) hypoglycemia teaching-teach about s/s of hypoglycemia(cold and clammy give them candy)-have glucagon emergency kit available-regular monitoring of A1c levels are required

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Exenatide (Byetta) hypoglycemia causes-insulin overdose-reduced food intake-vomiting and diarrhea-excessive alcohol intake-unaccustomed exercise-termination of pregnancysigns and symptoms of hypoglycemia-tachycardia-palpitations-sweating-nervousness-headache-confusion-drowsiness-fatigueantitussives therapeutic action is toAct on the cough control center in the medulla to suppress the cough reflex; used for acough that is nonproductive and irritatingAnaphylaxis‐PCN-laryngeal edema, bronchoconstriction, severe hypotension= immediate hypersensitivityreactionAnaphylaxis treatmentepinephrine (subQ, IM, or IV) plus respiratory support

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What drugs are effective and safe alternatives for patients with penicillinallergies?vancomycin, erythromycin, and clindamycinTo ensure prompt treatment if anaphylaxis should develop patients should be?observed for at least 30 minutes after drug injection (i.e., until the risk of an anaphylacticreaction has passed).To minimize the chances of an anaphylactic reaction, penicillin should beadministeredan initial small dose is followed at 60-minute intervals by progressively larger doses untilthe full therapeutic dose has been achievedMorphine overdose treatment-Naloxone (narcan)-Intravenous, IM, and subQ. For initial treatment, administer IVCT‐diarrhea‐action-decrease intestinal motility and thereby slow intestinal transit, which allows more timefor absorption of fluid and electrolytes-activation of opioid receptors decreases secretion of fluid into the small intestine andincreases absorption of fluid and salt.ACE inhibitor‐hyperkalemia-Inhibition of aldosterone release (secondary to inhibition of angiotensin II production)can cause potassium retention by the kidney.-significant potassium accumulation is limited to patients taking potassium supplements,salt substitutes (which contain potassium), or a potassium-sparing diuretic.Leukotrienes‐teaching

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1. To take medication 1 hour before or 2 hours aftermeals2. To increase fluid intake3. Not to discontinue the medication and to take it asprescribed, even during symptom-free periodMethadone therapeutic useRelief or prevention of moderate to severe pain while causing minimal respiratorydepression, constipation, urinary retention, and other adverse effects.methadone pain assessment-Assess pain before administration and 1 hour later-Determine the location, time of onset, and quality of pain (e.g., sharp, stabbing, dull)-assess for psychologic factors that can lower pain threshold (anxiety, depression, fear,anger)methadone is givenOral, IM, IV, subQ, rectal, epidural, intrathecal, transdermal (fentanyl), andtransmucosal (fentanyl)Methadone assess for-QT prolongation(dyshythmias)-overdose-respiratory depression-substance abuse-withdrawal symptomsMethadone is used asa replacement medication for opiate dependence and to facilitate withdrawalWhen starting a patient on ACE inhibitors monitor what?

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blood pressure closely for 2 hours after the first dose and periodically thereafter.a major side effect of alpha blocker(osin) is what?orthostatic hypotensiondiclofenac does what to the liver?cause severe injurywhile taking diclofenac patients should?-have periodic liver functions tests-monitor and report for signs of liver damage(jaundice, fatigue, nausea)calcium channel blockers toxicity signs-severe hypotension-cardiac-toxicity(bradycardia and av block)-ventricular tachydhythmiasManaging Acute Toxicity in calcium channel blockers-gastric lavage followed by activated charcoal-Give IV calcium to help counteract excessive vasodilation and reduced myocardialcontractility-To raise blood pressure, give IV norepinephrine-Iv Fluids and Trendelenburg's position-atropine and glucagon to reverse bradycardia and AV blockCalcium Channel Blockers medications-nifedipine (Adalat, Procardia)-amlodipine (Norvasc)-verapamil (Calan)-diltiazem (Cardizem)

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NSAIDS medications-Ibuprofen (Advil, Motrin)-Indomethacin (Indocin)-usually used for GOUT-Naproxen (Aleve, Naproxyn)-COX-2-Inhibitors: Celecoxib (Celebrex)Avoid taking calcium channel blockers with-digoxin(increases risk of partial or complete AV block)-beta blockers(bradicardia,av block, heart failure)-grapefruit juiceNSAIDs should be used with extreme caution by-pregnant women-peptic ulcer disease-bleeding disorders-anticoagulants-glucocorticoids-ACE inhibitors-ARBSNSAID administration teaching-take with food, milk or a glass of water-do not crush or chew enteric-coated or sustained release formulations-discard aspirin preparations that smell like vinegarNSAIDs should be avoided in _________Children with chickenpox or influenza to prevent Reye's syndromeNSAIDs with caution in patients with

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-advanced age-previous intolerance to NSAIDs-heavy cigarette smoking-history of alcoholismAspirin toxicity treatment-sponging with tepid water for external cooling-infusion of fluids-bicarbonate as reversal-mechanical ventilationA high risk of toxicity exists if the client is taking ibuprofen concurrently withCalcium channel blockerEyedrops Administration teaching-Semi prone position-wash hands before and after administration-pull down and place in conjunctival fornix-do not allow the tip of bottle to touch eyeEnema Prep-reinforce misconceptions and concerns-explain procedureand what to expect-provide privacy-position in left side knee chest position-give at room temperature-solution must be retain to be effective-hang 12-18 inch above rectumresiudal volume

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