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

Name: 2024-2025 HESI Milestone Exam 1 with Answers (162 Solved Questions)
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HESI Milestone Exam #1
100% VERIFIED ANSWERS
2024/2025
Histamine1 blockers action(mine, zine, dine)
bind selectively to H1-histaminic receptors, blocking the actions of histamine at these
sites
H1 antagonists are useful in treating
-mild allergies(seasonal rhinitis)
-severe allergies(anaphylaxis)
-motion sickness
-insomnia
-common cold
Histamine (H2)-Receptor Antagonists action(tidine)
block the H2 receptors responsible for stimulating the secretion of gastric acid
Exenatide (Byetta) hypoglycemia
-can occur right after meals
-for severe hypoglycemia give IV dextrose
Exenatide (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

Exenatide (Byetta) hypoglycemia causes
-insulin overdose
-reduced food intake
-vomiting and diarrhea
-excessive alcohol intake
-unaccustomed exercise
-termination of pregnancy
signs and symptoms of hypoglycemia
-tachycardia
-palpitations
-sweating
-nervousness
-headache
-confusion
-drowsiness
-fatigue
antitussives therapeutic action is to
Act on the cough control center in the medulla to suppress the cough reflex; used for a
cough that is nonproductive and irritating
Anaphylaxis‐PCN
-laryngeal edema, bronchoconstriction, severe hypotension= immediate hypersensitivity
reaction
Anaphylaxis treatment
epinephrine (subQ, IM, or IV) plus respiratory support

What drugs are effective and safe alternatives for patients with penicillin
allergies?
vancomycin, erythromycin, and clindamycin
To 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 anaphylactic
reaction has passed).
To minimize the chances of an anaphylactic reaction, penicillin should be
administered
an initial small dose is followed at 60-minute intervals by progressively larger doses until
the full therapeutic dose has been achieved
Morphine overdose treatment
-Naloxone (narcan)
-Intravenous, IM, and subQ. For initial treatment, administer IV
CT‐diarrhea‐action
-decrease intestinal motility and thereby slow intestinal transit, which allows more time
for absorption of fluid and electrolytes
-activation of opioid receptors decreases secretion of fluid into the small intestine and
increases 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

1. To take medication 1 hour before or 2 hours after
meals
2. To increase fluid intake
3. Not to discontinue the medication and to take it as
prescribed, even during symptom-free period
Methadone therapeutic use
Relief or prevention of moderate to severe pain while causing minimal respiratory
depression, 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 given
Oral, IM, IV, subQ, rectal, epidural, intrathecal, transdermal (fentanyl), and
transmucosal (fentanyl)
Methadone assess for
-QT prolongation(dyshythmias)
-overdose
-respiratory depression
-substance abuse
-withdrawal symptoms
Methadone is used as
a replacement medication for opiate dependence and to facilitate withdrawal
When starting a patient on ACE inhibitors monitor what?

blood pressure closely for 2 hours after the first dose and periodically thereafter.
a major side effect of alpha blocker(osin) is what?
orthostatic hypotension
diclofenac does what to the liver?
cause severe injury
while 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 tachydhythmias
Managing Acute Toxicity in calcium channel blockers
-gastric lavage followed by activated charcoal
-Give IV calcium to help counteract excessive vasodilation and reduced myocardial
contractility
-To raise blood pressure, give IV norepinephrine
-Iv Fluids and Trendelenburg's position
-atropine and glucagon to reverse bradycardia and AV block
Calcium 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 juice
NSAIDs should be used with extreme caution by
-pregnant women
-peptic ulcer disease
-bleeding disorders
-anticoagulants
-glucocorticoids
-ACE inhibitors
-ARBS
NSAID 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 vinegar
NSAIDs should be avoided in _________
Children with chickenpox or influenza to prevent Reye's syndrome
NSAIDs with caution in patients with

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-advanced age
-previous intolerance to NSAIDs
-heavy cigarette smoking
-history of alcoholism
Aspirin toxicity treatment
-sponging with tepid water for external cooling
-infusion of fluids
-bicarbonate as reversal
-mechanical ventilation
A high risk of toxicity exists if the client is taking ibuprofen concurrently with
Calcium channel blocker
Eyedrops 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 eye
Enema Prep
-reinforce misconceptions and concerns
-explain procedure and 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 rectum
resiudal volume

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

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