1|Page
EVOLVE HESI PHARM EXAM | {LATEST 2026/ 2027
UPDATE} COMPLETE ACTUAL AND AUTHENTIC
EXAM | BRAND NEW!
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 ......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
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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. ......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. ......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?
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A.Inhaled nitrous oxide
B.Midazolam IV
C.Ketamine IM
D.Fentanyl and droperidol IM ......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. ......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
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C. Myelosuppression
D.Hepatotoxicity ......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 ......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.
pg. 4
EVOLVE HESI PHARM EXAM | {LATEST 2026/ 2027
UPDATE} COMPLETE ACTUAL AND AUTHENTIC
EXAM | BRAND NEW!
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 ......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
pg. 1
,2|Page
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. ......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. ......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?
pg. 2
,3|Page
A.Inhaled nitrous oxide
B.Midazolam IV
C.Ketamine IM
D.Fentanyl and droperidol IM ......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. ......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
pg. 3
, 4|Page
C. Myelosuppression
D.Hepatotoxicity ......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 ......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.
pg. 4
