PHARMACOLOGY EVOLVE HESI ACTUAL
QUESTIONS AND VERIFIED ANSWERS WITH
RATIOLES LATEST UPDATE ALREADY GRADED A+
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 - ANS... -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. - ANS... -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.
C. Avoid abraded skin areas when applying the anesthetic.
D. Spread the topical agent over a large surface area. - ANS... -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 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.
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 - ANS... -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.
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?
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. -
ANS... -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.
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?
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. - ANS... -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.
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.
C. Advise the client to contact her health care provider because of the development
of tolerance to the medication.
D. Develop a teaching plan for the client to self-adjust the dose of medication in
response to symptoms. - ANS... -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
overmedication 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.
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. - ANS... -A. Oral contraceptives may not
be effective.
Certain antibiotics, such as tetracycline, decrease the effectiveness of oral
contraceptives. Options B, C, and D do not convey accurate information related to
client teaching about this medication.
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. - ANS... -D. Report any vomiting to the
clinic.
The client should be instructed to report signs of colchicine toxicity, such as
nausea, 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.
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
QUESTIONS AND VERIFIED ANSWERS WITH
RATIOLES LATEST UPDATE ALREADY GRADED A+
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 - ANS... -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. - ANS... -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.
C. Avoid abraded skin areas when applying the anesthetic.
D. Spread the topical agent over a large surface area. - ANS... -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 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.
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 - ANS... -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.
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?
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. -
ANS... -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.
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?
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. - ANS... -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.
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.
C. Advise the client to contact her health care provider because of the development
of tolerance to the medication.
D. Develop a teaching plan for the client to self-adjust the dose of medication in
response to symptoms. - ANS... -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
overmedication 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.
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. - ANS... -A. Oral contraceptives may not
be effective.
Certain antibiotics, such as tetracycline, decrease the effectiveness of oral
contraceptives. Options B, C, and D do not convey accurate information related to
client teaching about this medication.
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. - ANS... -D. Report any vomiting to the
clinic.
The client should be instructed to report signs of colchicine toxicity, such as
nausea, 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.
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
