PHARMACOLOGY EVOLVE HESI
ACTUAL EXAM WITH CORRECT
DETAILED ANSWERS AND
CORRECT SOLUTIONS
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. - 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 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 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 - 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
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.
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 - 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. - 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.
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.
ACTUAL EXAM WITH CORRECT
DETAILED ANSWERS AND
CORRECT SOLUTIONS
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. - 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 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 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 - 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
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.
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 - 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. - 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.
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.
