EVOLVE HESI
Pharmacology
3 FULL SET EXAMS
(NGN-STYLE QUESTIONS & CASE “SCENARIOS”)
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➢ Achieve a 900+ or Higher Exam Score
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➢ multiple-choice format with correct answers
➢ Some questions feature “case scenarios”
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"If you require further clarification or in need of any study
resources, feel free to Message me."
,Table of Contents
HESI Evolve Pharmacology Exam 1 ....................................... 2
HESI Evolve Pharmacology Exam 2 ..................................... 39
HESI Evolve Pharmacology Exam 3 ..................................... 72
HESI Evolve Pharmacology Exam 1
1. A client is experiencing an adverse effect of the gastrointestinal stimulant
metoclopramide HCl. Which assessment finding would require immediate
intervention by the nurse?
A. Dizziness when first getting up
B. An unpleasant metallic taste in the mouth
C. Parkinson-like symptoms
D. Inability to see well at night
Parkinson-like symptoms
Metoclopramide HCl blocks dopamine receptors in the brain, which can cause the
extrapyramidal symptoms associated with Parkinson disease.
2. The healthcare provider prescribes the anticonvulsant carbamazepine for an
adolescent client with a seizure disorder. The nurse should instruct the client to
notify the healthcare provider if which condition occurs?
,A. Experiences dry mouth
B. Experiences dizziness
C. Develops a sore throat
D. Develops gingival hyperplasia
Develops a sore throat
Blood dyscrasias (aplastic anemia, leukopenia, anemia, and thrombocytopenia)
can be an adverse effect of carbamazepine. Flulike symptoms, such as pallor,
fatigue, sore throat, and fever, are indications of such dyscrasias.
3. A chemotherapeutic regimen with doxorubicin HCl is being planned for a
client recently diagnosed with cancer. What diagnostic test results should the
nurse review prior to initiating this treatment?
A. Electrocardiogram (ECG)
B. Arterial blood gases (ABGs)
C. Serum cholesterol level
D. Pelvic ultrasound
Electrocardiogram (ECG)
Baseline cardiac function studies are required to monitor the irreversible
cardiotoxic effects of doxorubicin HCl.
,4. The apical heart rate of an infant receiving digoxin for congestive heart failure
is 80 beats/min. Which intervention should the nurse implement first?
A. Administer the next dose of digoxin as scheduled
B. Obtain a serum digoxin level
C. Administer a PRN dose of atropine sulfate
D. Assess for S3 and S4 heart sounds
Obtain a serum digoxin level
Sinus bradycardia (rate <90-110 beats/min in an infant) is an indication of digoxin
toxicity, so assessment of the client's digoxin level is the highest priority. Further
doses of digoxin should be withheld until the serum level is obtained.
5. The nurse is providing care to a 55-year-old client who was diagnosed with
schizophrenia 5 years earlier. Numerous hospitalizations have occurred since the
diagnosis because of noncompliance with the prescribed medication regimen.
The nurse anticipates a prescription for which medication?
A. Chlorpromazine HCl
B. Lithium carbonate
C. Fluphenazine decanoate
D. Diazepam
,Fluphenazine decanoate
Fluphenazine, an antipsychotic drug that can be given IM, has a rapid onset (1-2
hours) and a long duration of action (up to 3 or 4 weeks), so it would be the drug
of choice for a noncompliant psychotic client.
6. A client who is HIV-positive is receiving epoetin alfa for the management of
anemia secondary to zidovudine (AZT) therapy. Which laboratory finding is most
important for the nurse to report to the healthcare provider?
A. Hematocrit (HCT) of 58%
B. Hemoglobin of 10.8 g/dL
C. White blood cell count of 5000 mm3
D. Serum potassium level of 5 mEq/L
Hematocrit (HCT) of 58%
Option A should be reported to the healthcare provider immediately because of
the likelihood of a hypertensive crisis and because seizure activity increases with
an increase in HCT of more than 4 points, or an HCT above 36%. Epoetin alfa
stimulates erythropoiesis (production of red blood cells), thereby decreasing the
need for blood transfusions. Uncontrolled hypertension can occur if
erythropoietin levels are too high. Option B is the reason why the client is
receiving epoetin alpha. Options C and D are within normal limits.
7. A client with viral influenza is receiving vitamin C, 3000 mg PO daily, and
acetaminophen elixir, 650 mg PO every 4 hours PRN. The nurse calls the
healthcare 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
Decrease the dose of vitamin C
Diarrhea is an adverse effect of high doses of vitamin C, so the nurse should
anticipate a reduction in the dose of vitamin C. Acetaminophen does not cause
diarrhea and is not available in an injectable form. Because the client has a viral
infection, option D will not be beneficial.
8. The healthcare provider has prescribed a low-molecular-weight heparin,
enoxaparin prefilled syringe, 30 mg/0.3 mL IV every 12 hours, for a client
following hip replacement. Prior to administering the first dose, what is the
priority nursing action?
A. Assess the client's IV site for signs of inflammation
B. Evaluate the client's degree of mobility
C. Instruct the client regarding medication side effects
D. Contact the healthcare provider to clarify the prescription
Contact the healthcare provider to clarify the prescription
,Enoxaparin is a low-molecular-weight heparin that should be administered
subcutaneously when given as a prophylaxis for deep vein thrombosis, so the
nurse should contact the healthcare provider to clarify the route of
administration.
9. A client with metastatic cancer who has been receiving fentanyl for several
weeks reports to the nurse that the medication is not effectively controlling the
pain. Which action should the nurse initiate?
A. Instruct the client about the indications of opioid dependence
B. Monitor the client for symptoms of opioid withdrawal
C. Notify the healthcare provider of the need to increase the dose
D. Administer naloxone per PRN protocol for reversal
Notify the healthcare provider of the need to increase the dose
Clients can develop a tolerance to the analgesic effect of opioids and may require
an increased dose for effective long-term pain relief. The client is not exhibiting
indications of dependence, withdrawal, or toxicity.
10. Methylphenidate is prescribed for daily administration to a 10-year-old child
with attention-deficit/hyperactivity disorder (ADHD). In preparing a teaching
plan for the parents of this child newly diagnosed with ADHD, which instruction
is most important for the nurse to provide to the parents?
A. Administer the medication in the morning before the child goes to school
B. Plan to implement periodic interruptions in the administration of the drug
,C. Attempt to be consistent when setting limits on inappropriate behavior
D. Seek professional counseling if the child's behavior continues to be disruptive
Administer the medication in the morning before the child goes to school
Methylphenidate is a central nervous system (CNS) stimulant. To be most effective
in affecting the child's behavior, the dose of the drug should be administered in
the morning before the child goes to school. Drug holidays are often prescribed to
assess the child's degree of recovery; however, such interruptions are not
conducted in the early phase of treatment and are usually implemented when
side effects occur over a period of time. Options C and D are worthwhile
instructions but do not have the priority of option A.
11. The nurse is evaluating a client's understanding of the prescribed antilipemic
drug lovastatin. Which client statement indicates that further teaching is
needed?
A. "My bowel habits should not be affected by this drug."
B. "This medication should be taken once a day only."
C. "I will still need to follow a low-cholesterol diet."
D. "I will take the medication every day before breakfast."
"I will take the medication every day before breakfast."
The enzyme that helps metabolize cholesterol is activated at night, so this
, medication should be taken with the evening meal. Options A, B, and C reflect
correct information about lovastatin.
12. An 80-year-old client who had a colon resection yesterday is receiving a
constant dose of hydromorphone via a patient-controlled analgesia (PCA) pump.
Which finding requires immediate nursing action?
A. The client is drowsy and complains of pruritus
B. Pupils are 3 mm; PERRLA
C. The area around the sutures is reddened and swollen
D. Respirations decrease to 10 breaths/min.
Respirations decrease to 10 breaths/min
Hydromorphone is an opioid agonist-analgesic of opiate receptors that inhibits
ascending pathways and can cause respiratory depression. Older adults are more
sensitive to opioids so the "start low and go slow" approach should be taken.
Option A lists common side effects of opioids, particularly the opiates, which are
usually harmless and often transient. Option B is within the normal range (2-6
cm). The suture site may be red and swollen as an inflammatory response, but no
action is required if the skin around the incision is a normal color and
temperature.
13. When providing client teaching about the administration of
methylphenidate to a parent of a child diagnosed with ADHD, which instruction
should the nurse include in the teaching plan?
Pharmacology
3 FULL SET EXAMS
(NGN-STYLE QUESTIONS & CASE “SCENARIOS”)
Pass The Exam Score With Confidence
This Document contains:
➢ Achieve a 900+ or Higher Exam Score
➢ Passing Score Guarantee
➢ multiple-choice format with correct answers
➢ Some questions feature “case scenarios”
,PREVIEW QUESTIONS BELOW
Get the Complete PDF After Purchase
"If you require further clarification or in need of any study
resources, feel free to Message me."
,Table of Contents
HESI Evolve Pharmacology Exam 1 ....................................... 2
HESI Evolve Pharmacology Exam 2 ..................................... 39
HESI Evolve Pharmacology Exam 3 ..................................... 72
HESI Evolve Pharmacology Exam 1
1. A client is experiencing an adverse effect of the gastrointestinal stimulant
metoclopramide HCl. Which assessment finding would require immediate
intervention by the nurse?
A. Dizziness when first getting up
B. An unpleasant metallic taste in the mouth
C. Parkinson-like symptoms
D. Inability to see well at night
Parkinson-like symptoms
Metoclopramide HCl blocks dopamine receptors in the brain, which can cause the
extrapyramidal symptoms associated with Parkinson disease.
2. The healthcare provider prescribes the anticonvulsant carbamazepine for an
adolescent client with a seizure disorder. The nurse should instruct the client to
notify the healthcare provider if which condition occurs?
,A. Experiences dry mouth
B. Experiences dizziness
C. Develops a sore throat
D. Develops gingival hyperplasia
Develops a sore throat
Blood dyscrasias (aplastic anemia, leukopenia, anemia, and thrombocytopenia)
can be an adverse effect of carbamazepine. Flulike symptoms, such as pallor,
fatigue, sore throat, and fever, are indications of such dyscrasias.
3. A chemotherapeutic regimen with doxorubicin HCl is being planned for a
client recently diagnosed with cancer. What diagnostic test results should the
nurse review prior to initiating this treatment?
A. Electrocardiogram (ECG)
B. Arterial blood gases (ABGs)
C. Serum cholesterol level
D. Pelvic ultrasound
Electrocardiogram (ECG)
Baseline cardiac function studies are required to monitor the irreversible
cardiotoxic effects of doxorubicin HCl.
,4. The apical heart rate of an infant receiving digoxin for congestive heart failure
is 80 beats/min. Which intervention should the nurse implement first?
A. Administer the next dose of digoxin as scheduled
B. Obtain a serum digoxin level
C. Administer a PRN dose of atropine sulfate
D. Assess for S3 and S4 heart sounds
Obtain a serum digoxin level
Sinus bradycardia (rate <90-110 beats/min in an infant) is an indication of digoxin
toxicity, so assessment of the client's digoxin level is the highest priority. Further
doses of digoxin should be withheld until the serum level is obtained.
5. The nurse is providing care to a 55-year-old client who was diagnosed with
schizophrenia 5 years earlier. Numerous hospitalizations have occurred since the
diagnosis because of noncompliance with the prescribed medication regimen.
The nurse anticipates a prescription for which medication?
A. Chlorpromazine HCl
B. Lithium carbonate
C. Fluphenazine decanoate
D. Diazepam
,Fluphenazine decanoate
Fluphenazine, an antipsychotic drug that can be given IM, has a rapid onset (1-2
hours) and a long duration of action (up to 3 or 4 weeks), so it would be the drug
of choice for a noncompliant psychotic client.
6. A client who is HIV-positive is receiving epoetin alfa for the management of
anemia secondary to zidovudine (AZT) therapy. Which laboratory finding is most
important for the nurse to report to the healthcare provider?
A. Hematocrit (HCT) of 58%
B. Hemoglobin of 10.8 g/dL
C. White blood cell count of 5000 mm3
D. Serum potassium level of 5 mEq/L
Hematocrit (HCT) of 58%
Option A should be reported to the healthcare provider immediately because of
the likelihood of a hypertensive crisis and because seizure activity increases with
an increase in HCT of more than 4 points, or an HCT above 36%. Epoetin alfa
stimulates erythropoiesis (production of red blood cells), thereby decreasing the
need for blood transfusions. Uncontrolled hypertension can occur if
erythropoietin levels are too high. Option B is the reason why the client is
receiving epoetin alpha. Options C and D are within normal limits.
7. A client with viral influenza is receiving vitamin C, 3000 mg PO daily, and
acetaminophen elixir, 650 mg PO every 4 hours PRN. The nurse calls the
healthcare 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
Decrease the dose of vitamin C
Diarrhea is an adverse effect of high doses of vitamin C, so the nurse should
anticipate a reduction in the dose of vitamin C. Acetaminophen does not cause
diarrhea and is not available in an injectable form. Because the client has a viral
infection, option D will not be beneficial.
8. The healthcare provider has prescribed a low-molecular-weight heparin,
enoxaparin prefilled syringe, 30 mg/0.3 mL IV every 12 hours, for a client
following hip replacement. Prior to administering the first dose, what is the
priority nursing action?
A. Assess the client's IV site for signs of inflammation
B. Evaluate the client's degree of mobility
C. Instruct the client regarding medication side effects
D. Contact the healthcare provider to clarify the prescription
Contact the healthcare provider to clarify the prescription
,Enoxaparin is a low-molecular-weight heparin that should be administered
subcutaneously when given as a prophylaxis for deep vein thrombosis, so the
nurse should contact the healthcare provider to clarify the route of
administration.
9. A client with metastatic cancer who has been receiving fentanyl for several
weeks reports to the nurse that the medication is not effectively controlling the
pain. Which action should the nurse initiate?
A. Instruct the client about the indications of opioid dependence
B. Monitor the client for symptoms of opioid withdrawal
C. Notify the healthcare provider of the need to increase the dose
D. Administer naloxone per PRN protocol for reversal
Notify the healthcare provider of the need to increase the dose
Clients can develop a tolerance to the analgesic effect of opioids and may require
an increased dose for effective long-term pain relief. The client is not exhibiting
indications of dependence, withdrawal, or toxicity.
10. Methylphenidate is prescribed for daily administration to a 10-year-old child
with attention-deficit/hyperactivity disorder (ADHD). In preparing a teaching
plan for the parents of this child newly diagnosed with ADHD, which instruction
is most important for the nurse to provide to the parents?
A. Administer the medication in the morning before the child goes to school
B. Plan to implement periodic interruptions in the administration of the drug
,C. Attempt to be consistent when setting limits on inappropriate behavior
D. Seek professional counseling if the child's behavior continues to be disruptive
Administer the medication in the morning before the child goes to school
Methylphenidate is a central nervous system (CNS) stimulant. To be most effective
in affecting the child's behavior, the dose of the drug should be administered in
the morning before the child goes to school. Drug holidays are often prescribed to
assess the child's degree of recovery; however, such interruptions are not
conducted in the early phase of treatment and are usually implemented when
side effects occur over a period of time. Options C and D are worthwhile
instructions but do not have the priority of option A.
11. The nurse is evaluating a client's understanding of the prescribed antilipemic
drug lovastatin. Which client statement indicates that further teaching is
needed?
A. "My bowel habits should not be affected by this drug."
B. "This medication should be taken once a day only."
C. "I will still need to follow a low-cholesterol diet."
D. "I will take the medication every day before breakfast."
"I will take the medication every day before breakfast."
The enzyme that helps metabolize cholesterol is activated at night, so this
, medication should be taken with the evening meal. Options A, B, and C reflect
correct information about lovastatin.
12. An 80-year-old client who had a colon resection yesterday is receiving a
constant dose of hydromorphone via a patient-controlled analgesia (PCA) pump.
Which finding requires immediate nursing action?
A. The client is drowsy and complains of pruritus
B. Pupils are 3 mm; PERRLA
C. The area around the sutures is reddened and swollen
D. Respirations decrease to 10 breaths/min.
Respirations decrease to 10 breaths/min
Hydromorphone is an opioid agonist-analgesic of opiate receptors that inhibits
ascending pathways and can cause respiratory depression. Older adults are more
sensitive to opioids so the "start low and go slow" approach should be taken.
Option A lists common side effects of opioids, particularly the opiates, which are
usually harmless and often transient. Option B is within the normal range (2-6
cm). The suture site may be red and swollen as an inflammatory response, but no
action is required if the skin around the incision is a normal color and
temperature.
13. When providing client teaching about the administration of
methylphenidate to a parent of a child diagnosed with ADHD, which instruction
should the nurse include in the teaching plan?
