HESI MILESTONE EXAM SCRIPT 2025/2026 QUESTIONS
WITH ANSWERS GRADED A+
✔✔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)
✔✔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
WITH ANSWERS GRADED A+
✔✔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)
✔✔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
