HESI PHARMACOLOGY EVOLVE EXAM LATEST EXAM 2025 |
QUESTIONS AND CORRECT ANSWERS | VERIFIED ANSWERS |
ALREADY GRADED A+
Question 1
A client who has been taking phenazopyridine (Pyridium) for symptoms of urethritis and cystitis
comes to the clinic because her urine is reddish-orange. Which question should the practical
nurse ask to determine if the medication has been effective?
A) How much water have you been drinking each day?
B) Does the urine color stain your toilet bowl or undergarments?
C) Have you had any relief from urinary pain, burning, or urgency?
D) Did your urine appear cloudy or have a foul odor on voiding?
E) Are you still having a fever?
Correct Answer: C) Have you had any relief from urinary pain, burning, or urgency?
Rationale: Phenazopyridine is a urinary analgesic. Its therapeutic effect is to relieve
the discomfort associated with urinary tract irritation, so assessing the relief of
these symptoms directly measures its effectiveness.
Question 2
A male client who has been receiving an antineoplastic drug has developed thrombocytopenia.
What instructions should the practical nurse (PN) reinforce?
A) Use suppository form of drugs.
B) Avoid large public gatherings.
C) Rise slowly when standing up.
D) Shave with an electric razor.
E) Brush teeth vigorously to prevent infection.
Correct Answer: D) Shave with an electric razor.
Rationale: Thrombocytopenia is a low platelet count, which increases the risk of
bleeding. Using an electric razor reduces the risk of nicks and cuts compared to a
straight blade razor.
Question 3
The practical nurse (PN) is caring for a client who has been taking prednisone (Deltasone) daily
for a year. Which adverse effect should the PN document in the client's record?
A) Photosensitivity.
,B) Weight gain.
C) Loss of hair.
D) Pale skin color.
E) Hyperactivity.
Correct Answer: B) Weight gain.
Rationale: Long-term prednisone use (a corticosteroid) can cause fluid retention and
redistribution of fat (e.g., moon face, buffalo hump), leading to weight gain.
Question 4
A female client with recurring headaches tells the practical nurse (PN) that she has been taking
at least 4 grams of acetaminophen a day. Which laboratory studies should the PN review for
this client?
A) Creatinine clearance.
B) Hepatic enzymes.
C) Coagulation values.
D) Arterial blood gases.
E) Complete blood count.
Correct Answer: B) Hepatic enzymes.
Rationale: Acetaminophen is primarily metabolized by the liver. Doses exceeding 4
grams a day can cause hepatotoxicity, which would be indicated by elevated
hepatic enzymes (ALT, AST).
Question 5
A client receives a prescription for an oral opioid analgesic for post-operative pain. Which
adverse effect should the practical nurse (PN) monitor for with the client?
A) Constipation.
B) Photosensitivity.
C) Decreased heart rate.
D) Frequent urination.
E) Hypothermia.
Correct Answer: A) Constipation.
,Rationale: Opioid analgesics slow gastrointestinal motility, leading to constipation,
which is a very common side effect that often requires prophylactic management.
Question 6
Which action should the practical nurse implement when administering a buccal medication?
A) Encourage the client to swallow.
B) Administer water with medication.
C) Ensure the medication is positioned under the tongue.
D) Place the medication between the upper molar teeth and cheek.
E) Apply the medication to the gums.
Correct Answer: D) Place the medication between the upper molar teeth and cheek.
Rationale: Buccal medications are designed to dissolve slowly and be absorbed
through the capillaries of the oral mucosa in the cheek, avoiding first-pass
metabolism.
Question 7
What assessment is most important for the practical nurse (PN) to obtain prior to initiating
medication therapy with phenelzine (Nardil) for a client with depression?
A) Activity level.
B) Mood and affect.
C) Understanding of diet modification.
D) The client's support system.
E) Family history of depression.
Correct Answer: C) Understanding of diet modification.
Rationale: Phenelzine is a monoamine oxidase inhibitor (MAOI). It is critical to
ensure the client understands the strict tyramine-restricted diet to prevent a
potentially lethal hypertensive crisis caused by interaction with tyramine-
containing foods.
Question 8
The practical nurse (PN) is unable to arouse a client who is receiving meperidine (Demerol) for
postoperative pain. The client is stuporous, has constricted pupils, and a respiratory rate of 8
breaths/minute. Which PRN prescription should the PN give the client?
, A) Naloxone (Narcan).
B) Promethazine (Phenergan).
C) Metoclopramide (Reglan).
D) Bethanechol (Urecholine).
E) Diphenhydramine (Benadryl).
Correct Answer: A) Naloxone (Narcan).
Rationale: These signs (stuporous, constricted pupils, respiratory depression) are
classic for opioid overdose. Naloxone is an opioid antagonist that rapidly reverses
these effects.
Question 9
On which therapeutic action should the practical nurse (PN) base an explanation to a client
who is receiving a cardiac glycoside (e.g., digoxin)?
A) Decreased cardiac output.
B) Increased renal perfusion.
C) Decreased rate of contraction.
D) Increased blood volume.
E) Increased heart rate.
Correct Answer: C) Decreased rate of contraction.
Rationale: Cardiac glycosides like digoxin increase the force of myocardial
contraction (positive inotropic effect) and decrease the heart rate (negative
chronotropic effect) and the speed of conduction through the AV node (negative
dromotropic effect).
Question 10
A client with type 1 diabetes mellitus received an early AM dose of regular insulin per sliding
scale. At 10:00 AM, the practical nurse (PN) should report which signs indicative of
hypoglycemia?
A) Urticaria and rash.
B) Nausea and diarrhea.
C) Irritability and confusion.
D) Fruity, acetone odor to the breath.
QUESTIONS AND CORRECT ANSWERS | VERIFIED ANSWERS |
ALREADY GRADED A+
Question 1
A client who has been taking phenazopyridine (Pyridium) for symptoms of urethritis and cystitis
comes to the clinic because her urine is reddish-orange. Which question should the practical
nurse ask to determine if the medication has been effective?
A) How much water have you been drinking each day?
B) Does the urine color stain your toilet bowl or undergarments?
C) Have you had any relief from urinary pain, burning, or urgency?
D) Did your urine appear cloudy or have a foul odor on voiding?
E) Are you still having a fever?
Correct Answer: C) Have you had any relief from urinary pain, burning, or urgency?
Rationale: Phenazopyridine is a urinary analgesic. Its therapeutic effect is to relieve
the discomfort associated with urinary tract irritation, so assessing the relief of
these symptoms directly measures its effectiveness.
Question 2
A male client who has been receiving an antineoplastic drug has developed thrombocytopenia.
What instructions should the practical nurse (PN) reinforce?
A) Use suppository form of drugs.
B) Avoid large public gatherings.
C) Rise slowly when standing up.
D) Shave with an electric razor.
E) Brush teeth vigorously to prevent infection.
Correct Answer: D) Shave with an electric razor.
Rationale: Thrombocytopenia is a low platelet count, which increases the risk of
bleeding. Using an electric razor reduces the risk of nicks and cuts compared to a
straight blade razor.
Question 3
The practical nurse (PN) is caring for a client who has been taking prednisone (Deltasone) daily
for a year. Which adverse effect should the PN document in the client's record?
A) Photosensitivity.
,B) Weight gain.
C) Loss of hair.
D) Pale skin color.
E) Hyperactivity.
Correct Answer: B) Weight gain.
Rationale: Long-term prednisone use (a corticosteroid) can cause fluid retention and
redistribution of fat (e.g., moon face, buffalo hump), leading to weight gain.
Question 4
A female client with recurring headaches tells the practical nurse (PN) that she has been taking
at least 4 grams of acetaminophen a day. Which laboratory studies should the PN review for
this client?
A) Creatinine clearance.
B) Hepatic enzymes.
C) Coagulation values.
D) Arterial blood gases.
E) Complete blood count.
Correct Answer: B) Hepatic enzymes.
Rationale: Acetaminophen is primarily metabolized by the liver. Doses exceeding 4
grams a day can cause hepatotoxicity, which would be indicated by elevated
hepatic enzymes (ALT, AST).
Question 5
A client receives a prescription for an oral opioid analgesic for post-operative pain. Which
adverse effect should the practical nurse (PN) monitor for with the client?
A) Constipation.
B) Photosensitivity.
C) Decreased heart rate.
D) Frequent urination.
E) Hypothermia.
Correct Answer: A) Constipation.
,Rationale: Opioid analgesics slow gastrointestinal motility, leading to constipation,
which is a very common side effect that often requires prophylactic management.
Question 6
Which action should the practical nurse implement when administering a buccal medication?
A) Encourage the client to swallow.
B) Administer water with medication.
C) Ensure the medication is positioned under the tongue.
D) Place the medication between the upper molar teeth and cheek.
E) Apply the medication to the gums.
Correct Answer: D) Place the medication between the upper molar teeth and cheek.
Rationale: Buccal medications are designed to dissolve slowly and be absorbed
through the capillaries of the oral mucosa in the cheek, avoiding first-pass
metabolism.
Question 7
What assessment is most important for the practical nurse (PN) to obtain prior to initiating
medication therapy with phenelzine (Nardil) for a client with depression?
A) Activity level.
B) Mood and affect.
C) Understanding of diet modification.
D) The client's support system.
E) Family history of depression.
Correct Answer: C) Understanding of diet modification.
Rationale: Phenelzine is a monoamine oxidase inhibitor (MAOI). It is critical to
ensure the client understands the strict tyramine-restricted diet to prevent a
potentially lethal hypertensive crisis caused by interaction with tyramine-
containing foods.
Question 8
The practical nurse (PN) is unable to arouse a client who is receiving meperidine (Demerol) for
postoperative pain. The client is stuporous, has constricted pupils, and a respiratory rate of 8
breaths/minute. Which PRN prescription should the PN give the client?
, A) Naloxone (Narcan).
B) Promethazine (Phenergan).
C) Metoclopramide (Reglan).
D) Bethanechol (Urecholine).
E) Diphenhydramine (Benadryl).
Correct Answer: A) Naloxone (Narcan).
Rationale: These signs (stuporous, constricted pupils, respiratory depression) are
classic for opioid overdose. Naloxone is an opioid antagonist that rapidly reverses
these effects.
Question 9
On which therapeutic action should the practical nurse (PN) base an explanation to a client
who is receiving a cardiac glycoside (e.g., digoxin)?
A) Decreased cardiac output.
B) Increased renal perfusion.
C) Decreased rate of contraction.
D) Increased blood volume.
E) Increased heart rate.
Correct Answer: C) Decreased rate of contraction.
Rationale: Cardiac glycosides like digoxin increase the force of myocardial
contraction (positive inotropic effect) and decrease the heart rate (negative
chronotropic effect) and the speed of conduction through the AV node (negative
dromotropic effect).
Question 10
A client with type 1 diabetes mellitus received an early AM dose of regular insulin per sliding
scale. At 10:00 AM, the practical nurse (PN) should report which signs indicative of
hypoglycemia?
A) Urticaria and rash.
B) Nausea and diarrhea.
C) Irritability and confusion.
D) Fruity, acetone odor to the breath.
