HESI Pharmacology Evolve Exam With Answers (125 Solved Questions)

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HESI Pharmacology Evolve Exam1.A 19-year-old male client who has sustained a severe headinjury is in- tubated and placed on assisted mechanicalventilation. To facilitate optimal ventilation and prevent theclient from "fighting" the ventilator, the health care provideradministers pancuronium bromide IV, with adjunctive opioidanalgesia. What medication should be immediatelyaccessible for a potential complication with this drug?A. Dantrolene sodiumB. Neostigmine bromideC. Succinylcholine bromideD. Epinephrine:B. Neostigmine bromideNeostigmine bromide and atropine sulfate, both anticholinergicdrugs, reverse the respiratory muscle paralysis caused bypancuronium bromide. Options A, C, and D are not antagonists topancuronium bromide and would not be helpful in reversing theeffects of the drug compared with the use of anticholinergics.2.A client with viral influenza is receiving vitamin C, 1000 mgPO daily, and acetaminophen elixir, 650 mg PO every 4 hours

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PRN.The nurse calls the health care provider to report thatthe client has developed diarrhea. Which change inprescriptions should the nurse anticipate?A. Change the acetaminophen to ibuprofen. B. Change theelixir to an injectable route. C. Decrease the dose of vitaminC.D. Begin treatment with an antibiotic.:C. Decrease the dose ofvitamin C.3.When providing nursing care for a client receivingpyridostigmine bromide for myasthenia gravis, which nursingintervention has the highest priority?A. Monitor the client frequently for urinary retention.B. Assess respiratory status and breath sounds often.C. Monitor blood pressure each shift to screen forhypertension.D. Administer most medications after meals to decreasegastrointestinal irri- tation.:B. Assess respiratory status andbreath sounds often.4.A client with a dislocated shoulder is being prepared for aclosed manual reduction using conscious sedation. Which

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medication should the nurse ex- plain as a sedative usedduring the procedure?A.Inhaled nitrous oxideB.Midazolam IVC.Ketamine IMD.Fentanyl and droperidol IM:B. Midazolam IV5.Aclientisbeingdischargedwithaprescriptionforsulfasalazinetotreatulcerativecolitis. Whichinstructionshould the nurse provide to this client prior to discharge?A. Maintain good oral hygiene.B. Take the medication 30 minutes before a meal. C.Discontinue use of the drug gradually.D. Drink at least eight glasses of fluid a day.:D. Drink at leasteight glasses of fluid a day.6.The health care provider prescribes carbamazepine for achild whose ton- ic-clonic seizures have been poorlycontrolled. The nurse informs the mother that the child musthave blood tests every week.The mother asks why so manyblood tests are necessary. Which complication is assessedthrough frequent laboratory testing that the nurse shouldexplain to this mother?

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A. NephrotoxicityB. OtotoxicityC. MyelosuppressionD.Hepatotoxicity:C. MyelosuppressionMyelosuppression is the highest priority complication that canpotentially affect clients managed with carbamazepine therapy.The client requires close monitoring for this condition by weeklylaboratory testing. Hepatic function may be altered, but thiscomplication does not have as great a potential for occurrence asoption C. Options A and B are not typical complications ofcarbamazepine therapy.7.When developing a written nursing care plan for a clientreceiving chemotherapy for treatment of cancer, the nursewrites, "Assess each voiding for hematuria." Theadministration of which type of chemotherapeutic agentwould prompt the nurse to add this intervention?A. VincristineB. Bleomycin sulfateC. ChlorambucilD. Cyclophosphamide:D. Cyclophosphamide

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Hemorrhagic cystitis is the characteristic adverse reaction ofcyclophosphamide. Administration of options A, B, and C does nottypically cause hemorrhagic cystitis.8.A client is receiving oral griseofulvin for a persistent tineacorporis infec- tion. Which response by the client indicates anaccurate understanding of the drug teaching conducted bythe nurse?A. "I'll wear sunscreen whenever I mow the lawn."B. "This is the worse bacterial infection I've ever had." C. "Iwill need to take the medication for 7 days."D. "My urine will probably turn brown due to this drug.":A. "I'llwear sunscreen whenever I mow the lawn."Photosensitivity is a side effect of griseofulvin, so clients should becautioned to wear protective sunscreen during sun exposure.Options B, C, and D are not accurate statements about sideeffects of this medication.9.A 6-year-old child is admitted to the emergency departmentwith status epilepticus. His parents report that his seizuredisorder has been managed with phenytoin, 50 mg PO bid,for the past year. Which drug should the nurse plan toadminister in the emergency department?

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A. PhenytoinB. DiazepamC. PhenobarbitalD. Carbamazepine:B. DiazepamDiazepam is the drug of choice for treatment of status epilepticus.Options A, C, and D are used for the long-term management ofseizuredisordersbutarenotasusefulintheemergencymanagement of status epilepticus.10.A client who has trouble swallowing pills intermittentlyhas been pre- scribed venlafaxine (XR) for depression. Themedication comes in capsule form. What should the nurseinclude in the discharge teaching plan for this client?A. Capsule contents can be sprinkled on pudding orapplesauce. B. Chew the medication thoroughly to enhanceabsorption.C. Take the medication with a large glass of water or juice.D. Contact the health care provider for another form ofmedication.:D. Contact the health care provider for another formof medication.

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Venlafaxine is administered PO in capsule form. Capsules that areextended-release(XR) or continuous-release (CR) contain delayed-release, enteric-coated granules

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to prevent decomposition of the drug in the acidic pH of thestomach. The client should notify the health care provider aboutthe inability to swallow the capsule. This medication should not bechewed or opened so that the delayed-release, en- teric-coatedgranules can remain intact. Water or juice will not affect themedication.11.The nurse is preparing to apply a surface anestheticagent for a client. Which action should the nurse implementto reduce the risk of systemic absorption?A. Apply the anesthetic to mucous membranes. B. Limit thearea of application to inflamed areas.C. Avoid abraded skin areas when applying the anesthetic.D. Spread the topical agent over a large surface area.:C.Avoid abraded skin areas when applying the anesthetic.To minimize systemic absorption of topical anesthetics, theanesthetic agent should be applied to the smallest surface area ofintact skin. Application to the mucous membranes poses thegreatest risk of systemic absorption because absorption occursmore readily through mucous membranes than through the skin.Inflamed areas generally have an increased blood supply, whichincreases the risk of systemic absorption, so option B should be

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avoided. A large surface area increases the amount of topicaldrug that is available for transdermal absorption, so the smallestarea should be covered, not option D.12.A client experiencing dysrhythmias is given quinidine,300 mg PO every 6 hours. The nurse plans to observe thisclient for which common side effect associated with the useof this medication?A. DiarrheaB. HypothermiaC. SeizuresD. Dysphagia:A. DiarrheaThe most common side effects associated with quinidine therapyare gastrointestinal complaints, such as diarrhea. Options B, C,and D are not usually associated with quinidine therapy.13.The health care provider prescribes the H2 antagonistfamotidine, 20 mg PO in the morning and at bedtime. Whichstatement regarding the action of H2 antagonists offers thecorrect rationale for administering the medication atbedtime?

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A. Gastric acid secreted at night is buffered, preventingpepsin formation. B. Hydrochloric acid secreted during thenight is blocked.C. The drug relaxes stomach muscles at night to reduce acid.D. Ingestion of the medication at night offers a sedativeeffect, promoting sleep.:B. Hydrochloric acid secreted duringthe night is blocked.H2 antagonists act on the parietal cells to inhibit gastric secretion.Some gastric secretion occurs all the time, even when thestomach is empty, unless medications are taken to inhibit thisaction. Options C and D are not actions of famotidine. Option A isthe action of antacids. Antacids do not affect healing or preventthe recurrence of ulcers; they merely provide symptomatic relief.Knowing the difference between H2 antagonists and antacids isimportant when teaching clients.14.The nurse is preparing to administer the disease-modifying antirheumatic drug (DMARD) methotrexate to aclient diagnosed with rheumatoid arthritis. Whichintervention is most important to implement prior toadministering this medication?

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A. Assess the client's liver function test results. B. Monitorthe client's intake and output.C. Have another nurse check the prescription.D. Assess the client's oral mucosa.:C. Have another nurse checkthe prescription.Double-checking the prescription is an important interventionbecause death can occur from an overdose. This medication isadministered weekly and in low doses for rheumatoid arthritis andshould not be confused with administration of the drug as achemotherapeutic agent. Options A and B are appropriateinterventions for those who are receiving this drug, but they are notthe most important interventions. Stomatitis is an expected sideeffect of this medication.15.A female client with myasthenia gravis is taking acholinesterase inhibitor and asks the nurse what can be doneto remedy her fatigue and difficulty swallowing. What actionshould the nurse implement?A. Explore a plan for development of coping strategies for thesymptoms with the client.B. Explain to the client that the dosage is too high, so sheshould skip every other dose of medication.

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C. Advise the client to contact her health care providerbecause of the devel- opment of tolerance to the medication.D. Develop a teaching plan for the client to self-adjust thedose of medication

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in response to symptoms.:D. Develop a teaching plan for theclient to self-adjust the dose of medication in response tosymptoms.Maintaining optimal dosage for cholinesterase inhibitors can bechallenging for clients with myasthenia gravis. Clients should betaught to recognize signs of over- medication andundermedication so that they can modify the dosage themselvesbased on a prescribed sliding scale. Options A, B, and C do notadequately address the client's concerns.16.A female client is receiving tetracycline for acne. Whichclient teaching should the nurse include?A. Oral contraceptives may not be effective.B. Drinking cranberry juice will promote healing. C. Breasttenderness may occur as a side effect.D. The urine will turn a red-orange color.:A. Oralcontraceptives may not be effective.Certain antibiotics, such as tetracycline, decrease theeffectiveness of oral contra- ceptives. Options B, C, and D do notconvey accurate information related to client teaching about thismedication.

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17.A client who is experiencing an acute attack of goutyarthritis is prescribed colchicine USP, 1 mg PO daily. Whichinformation is most important for the nurse to provide theclient?A. Take the medication with meals.B. Limit fluid intake until the attack subsides.C. Stop the medication when the pain resolves.D. Report any vomiting to the clinic.:D. Report any vomiting tothe clinic.The client should be instructed to report signs of colchicinetoxicity, such as nau- sea, diarrhea, vomiting, and/or abdominalpain, to the health care provider. Food inhibits the absorption ofcolchicine when ingested concurrently. Limited fluid intakedecreases the excretion of the uric acid crystals, which contributesto painful attacks. Typically, a client should remain on a daily dose ofcolchicine to decrease the number and severity of acute attacks,so stopping the medication after the pain resolves is not indicated.18.Amoxicillin, 500 mg PO every 8 hours, is prescribed for aclient with an infection. The drug is available in a suspensionof125mg/5mL.Howmanymillilitersshouldthenurseadminister with each dose?

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A. 10B. 15C. 20D. 25:C. 20500 mg/x mL = 125 mg/5 mL125x = 2500 x = 20 mL19.Methenamine mandelate is prescribed for a client with aurinarytractinfec-tionandrenalcalculi. Whichfindingindicates to the nurse that the medication is effective?A. The frequency of urinary tract infections decreases. B. Theurine changes color and pain is diminished.C. The dipstick test changes from +1 to trace.D. The daily urinary output increases by 10%.:A. Thefrequency of urinary tract infections decreases.Mandelamine is prescribed to acidify the urine, decreasing theincidence of calcium phosphate calculi and urinary tract infections.Option B is related to the administra- tion of pyridine. Mandelaminehas no effect on option C or D.

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