Evolve HESI Pharmacology Exam 2026 | Newest
Actual Study Guide with Actual Exam Questions
with Verified Answers (100% Correct) and
Rationales | Latest Update - Graded A+
Question 1
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
Rationale: Neostigmine bromide and atropine sulfate, both anticholinergic drugs,
reverse the respiratory muscle paralysis caused by pancuronium bromide.
Question 2
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
Rationale: High doses of vitamin C can cause diarrhea. Decreasing the dose should
resolve the symptom.
Question 3
When providing nursing care for a client receiving pyridostigmine bromide for
myasthenia gravis, which nursing intervention has the highest priority?
pg. 1
,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
Rationale: Assessing respiratory status and breath sounds is the highest priority
because myasthenia gravis can affect respiratory muscles, and pyridostigmine is used to
improve muscle strength.
Question 4
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
Rationale: Midazolam is a benzodiazepine commonly used for conscious sedation due
to its anxiolytic, amnestic, and sedative properties.
Question 5
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
Rationale: Sulfasalazine can cause crystalluria and kidney stones. Adequate fluid
intake (at least 8 glasses/day) helps prevent these complications.
Question 6
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?
pg. 2
,A. Nephrotoxicity
B. Ototoxicity
C. Myelosuppression
D. Hepatotoxicity
Answer: C
Rationale: 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.
Question 7
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
Rationale: Hemorrhagic cystitis is the characteristic adverse reaction of
cyclophosphamide.
Question 8
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."
Answer: A
Rationale: Photosensitivity is a side effect of griseofulvin, so clients should be
cautioned to wear protective sunscreen during sun exposure.
Question 9
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
pg. 3
, department?
A. Phenytoin
B. Diazepam
C. Phenobarbital
D. Carbamazepine
Answer: B
Rationale: Diazepam is the drug of choice for treatment of status epilepticus.
Question 10
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
Rationale: Venlafaxine XR is an extended-release capsule that should not be chewed
or opened. The client should contact the health care provider for another form of
medication.
Question 11
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.
Answer: C
Rationale: To minimize systemic absorption of topical anesthetics, the anesthetic
agent should be applied to the smallest surface area of intact skin.
Question 12
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
pg. 4
Actual Study Guide with Actual Exam Questions
with Verified Answers (100% Correct) and
Rationales | Latest Update - Graded A+
Question 1
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
Rationale: Neostigmine bromide and atropine sulfate, both anticholinergic drugs,
reverse the respiratory muscle paralysis caused by pancuronium bromide.
Question 2
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
Rationale: High doses of vitamin C can cause diarrhea. Decreasing the dose should
resolve the symptom.
Question 3
When providing nursing care for a client receiving pyridostigmine bromide for
myasthenia gravis, which nursing intervention has the highest priority?
pg. 1
,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
Rationale: Assessing respiratory status and breath sounds is the highest priority
because myasthenia gravis can affect respiratory muscles, and pyridostigmine is used to
improve muscle strength.
Question 4
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
Rationale: Midazolam is a benzodiazepine commonly used for conscious sedation due
to its anxiolytic, amnestic, and sedative properties.
Question 5
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
Rationale: Sulfasalazine can cause crystalluria and kidney stones. Adequate fluid
intake (at least 8 glasses/day) helps prevent these complications.
Question 6
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?
pg. 2
,A. Nephrotoxicity
B. Ototoxicity
C. Myelosuppression
D. Hepatotoxicity
Answer: C
Rationale: 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.
Question 7
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
Rationale: Hemorrhagic cystitis is the characteristic adverse reaction of
cyclophosphamide.
Question 8
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."
Answer: A
Rationale: Photosensitivity is a side effect of griseofulvin, so clients should be
cautioned to wear protective sunscreen during sun exposure.
Question 9
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
pg. 3
, department?
A. Phenytoin
B. Diazepam
C. Phenobarbital
D. Carbamazepine
Answer: B
Rationale: Diazepam is the drug of choice for treatment of status epilepticus.
Question 10
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
Rationale: Venlafaxine XR is an extended-release capsule that should not be chewed
or opened. The client should contact the health care provider for another form of
medication.
Question 11
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.
Answer: C
Rationale: To minimize systemic absorption of topical anesthetics, the anesthetic
agent should be applied to the smallest surface area of intact skin.
Question 12
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
pg. 4
