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HESI Pharmacology Evolve Exam With Answers (125 Solved Questions)

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    HESI Pharmacology Evolve Exam 1. A 19-year-old male client who has sustained a severe head injury is in- tubated and placed on assisted mechanical ventilation. To facilitate optimal ventilation and prevent the client from "fighting" the ventilator, the health care provider administers pancuronium bromide IV, with adjunctive opioid analgesia. What medication should be immediately accessible for a potential complication with this drug? A. Dantrolene sodium B. Neostigmine bromide C. Succinylcholine bromide D. Epinephrine: B. Neostigmine bromide Neostigmine bromide and atropine sulfate, both anticholinergic drugs, reverse the respiratory muscle paralysis caused by pancuronium bromide. Options A, C, and D are not antagonists to pancuronium bromide and would not be helpful in reversing the effects of the drug compared with the use of anticholinergics. 2. A client with viral influenza is receiving vitamin C, 1000 mg PO daily, and acetaminophen elixir, 650 mg PO every 4 hours

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    PRN.The nurse calls the health care provider to report that the client has developed diarrhea. Which change in prescriptions should the nurse anticipate? A. Change the acetaminophen to ibuprofen. B. Change the elixir to an injectable route. C. Decrease the dose of vitamin C. D. Begin treatment with an antibiotic.: C. Decrease the dose of vitamin C. 3. When providing nursing care for a client receiving pyridostigmine bromide for myasthenia gravis, which nursing intervention 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 for hypertension. D. Administer most medications after meals to decrease gastrointestinal irri- tation.: B. Assess respiratory status and breath sounds often. 4. A client with a dislocated shoulder is being prepared for a closed manual reduction using conscious sedation. Which

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    medication should the nurse ex- plain as a sedative used during the procedure? A.Inhaled nitrous oxide B.Midazolam IV C.Ketamine IM D.Fentanyl and droperidol IM: B. Midazolam IV 5. A client is being discharged with a prescription for sulfasalazine to treat ulcerative colitis. Which instruction should 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 least eight glasses of fluid a day. 6. The health care provider prescribes carbamazepine for a child whose ton- ic-clonic seizures have been poorly controlled. The nurse informs the mother that the child must have blood tests every week.The mother asks why so many blood tests are necessary. Which complication is assessed through frequent laboratory testing that the nurse should explain to this mother?

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    A. Nephrotoxicity B. Ototoxicity C. Myelosuppression D.Hepatotoxicity: C. Myelosuppression Myelosuppression is the highest priority complication that can potentially affect clients managed with carbamazepine therapy. The client requires close monitoring for this condition by weekly laboratory testing. Hepatic function may be altered, but this complication does not have as great a potential for occurrence as option C. Options A and B are not typical complications of carbamazepine therapy. 7. When developing a written nursing care plan for a client receiving chemotherapy for treatment of cancer, the nurse writes, "Assess each voiding for hematuria." The administration of which type of chemotherapeutic agent would prompt the nurse to add this intervention? A. Vincristine B. Bleomycin sulfate C. Chlorambucil D. Cyclophosphamide: D. Cyclophosphamide

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

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    A. Phenytoin B. Diazepam C. Phenobarbital D. Carbamazepine: B. Diazepam Diazepam is the drug of choice for treatment of status epilepticus. Options A, C, and D are used for the long-term management of seizure disorders but are not as useful in the emergency management of status epilepticus. 10. A client who has trouble swallowing pills intermittently has been pre- scribed venlafaxine (XR) for depression. The medication comes in capsule form. What should the nurse include in the discharge teaching plan for this client? A. Capsule contents can be sprinkled on pudding or applesauce. B. Chew the medication thoroughly to enhance absorption. C. Take the medication with a large glass of water or juice. D. Contact the health care provider for another form of medication.: D. Contact the health care provider for another form of medication.

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    Venlafaxine is administered PO in capsule form. Capsules that are extended-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 the stomach. The client should notify the health care provider about the inability to swallow the capsule. This medication should not be chewed or opened so that the delayed-release, en- teric-coated granules can remain intact. Water or juice will not affect the medication. 11. The nurse is preparing to apply a surface anesthetic agent for a client. Which action should the nurse implement to reduce the risk of systemic absorption? A. Apply the anesthetic to mucous membranes. B. Limit the area 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, the anesthetic agent should be applied to the smallest surface area of intact skin. Application to the mucous membranes poses the greatest risk of systemic absorption because absorption occurs more readily through mucous membranes than through the skin. Inflamed areas generally have an increased blood supply, which increases the risk of systemic absorption, so option B should be

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    avoided. A large surface area increases the amount of topical drug that is available for transdermal absorption, so the smallest area 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 this client for which common side effect associated with the use of this medication? A. Diarrhea B. Hypothermia C. Seizures D. Dysphagia: A. Diarrhea The most common side effects associated with quinidine therapy are 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 antagonist famotidine, 20 mg PO in the morning and at bedtime. Which statement regarding the action of H2 antagonists offers the correct rationale for administering the medication at bedtime?

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

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    A. Assess the client's liver function test results. B. Monitor the client's intake and output. C. Have another nurse check the prescription. D. Assess the client's oral mucosa.: C. Have another nurse check the prescription. Double-checking the prescription is an important intervention because death can occur from an overdose. This medication is administered weekly and in low doses for rheumatoid arthritis and should not be confused with administration of the drug as a chemotherapeutic agent. Options A and B are appropriate interventions for those who are receiving this drug, but they are not the most important interventions. Stomatitis is an expected side effect of this medication. 15. A female client with myasthenia gravis is taking a cholinesterase inhibitor and asks the nurse what can be done to remedy her fatigue and difficulty swallowing. What action should the nurse implement? A. Explore a plan for development of coping strategies for the symptoms with the client. B. Explain to the client that the dosage is too high, so she should skip every other dose of medication.

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

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    in response to symptoms.: D. Develop a teaching plan for the client to self-adjust the dose of medication in response to symptoms. Maintaining optimal dosage for cholinesterase inhibitors can be challenging for clients with myasthenia gravis. Clients should be taught to recognize signs of over- medication and undermedication so that they can modify the dosage themselves based on a prescribed sliding scale. Options A, B, and C do not adequately address the client's concerns. 16. A female client is receiving tetracycline for acne. Which client teaching should the nurse include? A. Oral contraceptives may not be effective. B. Drinking cranberry juice will promote healing. C. Breast tenderness may occur as a side effect. D. The urine will turn a red-orange color.: A. Oral contraceptives may not be effective. Certain antibiotics, such as tetracycline, decrease the effectiveness of oral contra- ceptives. Options B, C, and D do not convey accurate information related to client teaching about this medication.

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    17. A client who is experiencing an acute attack of gouty arthritis is prescribed colchicine USP, 1 mg PO daily. Which information is most important for the nurse to provide the client? 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 to the clinic. The client should be instructed to report signs of colchicine toxicity, such as nau- sea, diarrhea, vomiting, and/or abdominal pain, to the health care provider. Food inhibits the absorption of colchicine when ingested concurrently. Limited fluid intake decreases the excretion of the uric acid crystals, which contributes to painful attacks. Typically, a client should remain on a daily dose of colchicine 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 a client with an infection. The drug is available in a suspension of 125 mg/5 mL. How many milliliters should the nurse administer with each dose?

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    A. 10 B. 15 C. 20 D. 25: C. 20 500 mg/x mL = 125 mg/5 mL 125x = 2500 x = 20 mL 19. Methenamine mandelate is prescribed for a client with a urinary tract infec- tion and renal calculi. Which finding indicates to the nurse that the medication is effective? A. The frequency of urinary tract infections decreases. B. The urine changes color and pain is diminished. C. The dipstick test changes from +1 to trace. D. The daily urinary output increases by 10%.: A. The frequency of urinary tract infections decreases. Mandelamine is prescribed to acidify the urine, decreasing the incidence of calcium phosphate calculi and urinary tract infections. Option B is related to the administra- tion of pyridine. Mandelamine has no effect on option C or D.

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