Pharmacology Evolve HESI questions and answers
2025\2026 A+ Grade
A 19-year-old male client who has sustained a severe head injury is intubated 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
- correct answer 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.
A client with viral influenza is receiving vitamin C, 1000 mg PO daily, and acetaminophen elixir, 650 mg
PO every 4 hours 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.
- correct answer C. Decrease the dose of vitamin C.
,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 irritation.
- correct answer B. Assess respiratory status and breath sounds often.
A client with a dislocated shoulder is being prepared for a closed manual reduction using conscious
sedation. Which medication should the nurse explain as a sedative used during the procedure?
A.Inhaled nitrous oxide
B.Midazolam IV
C.Ketamine IM
D.Fentanyl and droperidol IM
- correct answer B. Midazolam IV
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.
- correct answer D. Drink at least eight glasses of fluid a day.
The health care provider prescribes carbamazepine for a child whose tonic-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?
,A. Nephrotoxicity
B. Ototoxicity
C. Myelosuppression
D.Hepatotoxicity
- correct answer 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.
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
- correct answer D. Cyclophosphamide
Hemorrhagic cystitis is the characteristic adverse reaction of cyclophosphamide. Administration of
options A, B, and C does not typically cause hemorrhagic cystitis.
A client is receiving oral griseofulvin for a persistent tinea corporis infection. 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."
- correct answer 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.
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?
A. Phenytoin
B. Diazepam
C. Phenobarbital
D. Carbamazepine
- correct answer 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.
A client who has trouble swallowing pills intermittently has been prescribed 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.
- correct answer D. Contact the health care provider for another form of medication.
Venlafaxine is administered PO in capsule form. Capsules that are extended-release (XR) or continuous-
release (CR) contain delayed-release, enteric-coated granules 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,
enteric-coated granules can remain intact. Water or juice will not affect the medication.
2025\2026 A+ Grade
A 19-year-old male client who has sustained a severe head injury is intubated 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
- correct answer 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.
A client with viral influenza is receiving vitamin C, 1000 mg PO daily, and acetaminophen elixir, 650 mg
PO every 4 hours 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.
- correct answer C. Decrease the dose of vitamin C.
,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 irritation.
- correct answer B. Assess respiratory status and breath sounds often.
A client with a dislocated shoulder is being prepared for a closed manual reduction using conscious
sedation. Which medication should the nurse explain as a sedative used during the procedure?
A.Inhaled nitrous oxide
B.Midazolam IV
C.Ketamine IM
D.Fentanyl and droperidol IM
- correct answer B. Midazolam IV
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.
- correct answer D. Drink at least eight glasses of fluid a day.
The health care provider prescribes carbamazepine for a child whose tonic-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?
,A. Nephrotoxicity
B. Ototoxicity
C. Myelosuppression
D.Hepatotoxicity
- correct answer 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.
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
- correct answer D. Cyclophosphamide
Hemorrhagic cystitis is the characteristic adverse reaction of cyclophosphamide. Administration of
options A, B, and C does not typically cause hemorrhagic cystitis.
A client is receiving oral griseofulvin for a persistent tinea corporis infection. 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."
- correct answer 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.
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?
A. Phenytoin
B. Diazepam
C. Phenobarbital
D. Carbamazepine
- correct answer 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.
A client who has trouble swallowing pills intermittently has been prescribed 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.
- correct answer D. Contact the health care provider for another form of medication.
Venlafaxine is administered PO in capsule form. Capsules that are extended-release (XR) or continuous-
release (CR) contain delayed-release, enteric-coated granules 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,
enteric-coated granules can remain intact. Water or juice will not affect the medication.
