PHARMACOLOGY EVOLVE HESI EXAMINERS SET
ANSWERS AND QUESTIONS SET A+
✔✔A client with HIV who was recently diagnosed with tuberculosis (TB) asks the nurse,
"Why do I need to take all of these medications for TB?" What information should the
nurse provide?
A. Antiretroviral medications decrease the efficacy of the TB drugs.
B. Multiple drugs prevent the development of resistant organisms.
C. Duration of the medication regimen is shortened.
D. Potential adverse drug reactions are minimized. - ✔✔B. Multiple drugs prevent the
development of resistant organisms.
A multidrug regimen is prescribed for a client with HIV and TB to prevent the
development of resistance of the tubercle bacilli. Although antitubercular medications
can inhibit some antiretrovirals, a multidrug regimen is needed to inhibit the proliferation
of the virulent tubercle bacilli. The duration of antitubercular therapy is typically 6 to 9
months and is not shortened by the use of multiple medications. A client who is
receiving HIV and TB therapy is at an increased risk of adverse reactions because of
the complex medication regimens and complications secondary to immunosuppression.
✔✔A 67-year-old client is discharged from the hospital with a prescription for digoxin,
0.25 mg daily. Which instruction should the nurse include in this client's discharge
teaching plan?
A. Take the medication in the morning before rising.
B. Take and record radial pulse rate daily.
C. Expect some vision changes caused by the medication.
D. Increase intake of foods rich in vitamin K. - ✔✔B. Take and record radial pulse rate
daily.
Monitoring pulse rate is very important when taking digoxin. The client should be further
instructed to report pulse rates <60 or >110 beats/min and to withhold the dosage until
,consulting with the health care provider in such a case. Options A and D are not
necessary. Option C is an indication of drug toxicity, and the client should be instructed
to report this immediately.
✔✔A client is prescribed a cholinesterase inhibitor, and a family member asks the nurse
how this medication works. Which pharmacophysiologic explanation should the nurse
use to describe this class of drug?
A. Promotes excretion of neurotoxins.
B. Slows nerve cell degeneration.
C. Improves nerve impulse transmission.
D. Stimulates nerve cell regeneration. - ✔✔C. Improves nerve impulse transmission.
Cholinesterase inhibitors work to increase the availability of acetylcholine at cholinergic
synapses, which aids in neuronal transmission and assists in memory formation. Basing
an explanation on this concept, option C should provide an accurate explanation that
the family can understand. Options A, B, and D are incorrect.
✔✔In developing a nursing care plan for a 9-month-old infant with cystic fibrosis, the
nurse writes a nursing diagnosis of alteration in nutrition: less than body requirements,
related to inadequate digestion of nutrients. Which intervention would best meet this
child's needs?
A. Give aluminum hydroxide and magnesium hydroxide after meals.
B. Give pancrelipase capsule mixed with applesauce before each meal.
C. Administer cholestyramine resin before each meal and at bedtime.
D. Administer omeprazole for gastroesophageal reflux. - ✔✔B. Give pancrelipase
capsule mixed with applesauce before each meal.
Pancreatic enzyme replacement with pancrelipase is a major component of cystic
fibrosis nutritional management. Aluminum hydroxide and magnesium hydroxide may
be given before meals with enzymes to reduce gastric acidity and prevent enzyme
destruction but are ineffective when used alone to promote enzyme replacement.
Options C and D are used to treat steatorrhea in cystic fibrosis.
✔✔The nurse is preparing a teaching plan for a client who has received a new
prescription for levothyroxine sodium. Which instruction should be included?
A. "Take this medication with a high-protein snack at bedtime."
B. "You may change at any time to a less expensive generic brand."
C. "Take your pulse daily, and if it exceeds 100 beats/min, contact the health care
provider."
D. "Return to the clinic weekly for serum blood glucose testing." - ✔✔C. "Take your
pulse daily, and if it exceeds 100 beats/min, contact the health care provider."
, Levothyroxine sodium should be withheld if the pulse is over 100 beats/min. To prevent
insomnia, the daily dose should be taken early in the morning before breakfast, not at
bedtime. Product brands should not be changed without consulting the health care
provider because the intended effects and side effects of different formulations of the
medication can vary. The serum glucose level is not affected by thyroid preparations, so
option D is not required.
✔✔Dopamine is administered to a client who is hypotensive. Which finding should the
nurse identify as a therapeutic response?
A. Gain in weight
B. Increase in urine output
C. Improved gastric motility
D. Decrease in blood pressure - ✔✔B. Increase in urine output
Intropin activates dopamine receptors in the kidney and dilates blood vessels to improve
renal perfusion, so an increase in urine output indicates an increase in glomerular
filtration caused by increased arterial blood pressure. Option A is related to fluid
retention but is not an indicator of a therapeutic response to dopamine therapy. Option
C is not related to the vasopressor effect of dopamine therapy. Dopamine increases
cardiac output, which increases a client's blood pressure, not option D.
✔✔A client receives pancuronium, a long-acting, nondepolarizing neuromuscular
blocker, during surgical anesthesia. Which client situation should alert the nurse to
evaluate the client for a prolonged muscle relaxation response to this medication?
A. Hepatitis
B. Heart failure
C. Renal insufficiency
D. History of emphysema - ✔✔C. Renal insufficiency
Pancuronium is eliminated via the kidneys, so a client with renal failure is at risk for
prolonged muscle relaxation. Although hepatitis can interfere with this drug's
metabolism, it does not place a client at increased risk for prolonged muscle relaxation.
Options B and D do not cause prolonged muscle relaxation in a client who receives
pancuronium.
✔✔The health care provider prescribes the anticonvulsant carbamazepine for an
adolescent client with a seizure disorder. The nurse should instruct the client to notify
the health care provider if which condition occurs?
A. Experiences dry mouth.
B. Experiences dizziness.
C. Develops a sore throat.
D. Develops gingival hyperplasia. - ✔✔C. Develops a sore throat.
ANSWERS AND QUESTIONS SET A+
✔✔A client with HIV who was recently diagnosed with tuberculosis (TB) asks the nurse,
"Why do I need to take all of these medications for TB?" What information should the
nurse provide?
A. Antiretroviral medications decrease the efficacy of the TB drugs.
B. Multiple drugs prevent the development of resistant organisms.
C. Duration of the medication regimen is shortened.
D. Potential adverse drug reactions are minimized. - ✔✔B. Multiple drugs prevent the
development of resistant organisms.
A multidrug regimen is prescribed for a client with HIV and TB to prevent the
development of resistance of the tubercle bacilli. Although antitubercular medications
can inhibit some antiretrovirals, a multidrug regimen is needed to inhibit the proliferation
of the virulent tubercle bacilli. The duration of antitubercular therapy is typically 6 to 9
months and is not shortened by the use of multiple medications. A client who is
receiving HIV and TB therapy is at an increased risk of adverse reactions because of
the complex medication regimens and complications secondary to immunosuppression.
✔✔A 67-year-old client is discharged from the hospital with a prescription for digoxin,
0.25 mg daily. Which instruction should the nurse include in this client's discharge
teaching plan?
A. Take the medication in the morning before rising.
B. Take and record radial pulse rate daily.
C. Expect some vision changes caused by the medication.
D. Increase intake of foods rich in vitamin K. - ✔✔B. Take and record radial pulse rate
daily.
Monitoring pulse rate is very important when taking digoxin. The client should be further
instructed to report pulse rates <60 or >110 beats/min and to withhold the dosage until
,consulting with the health care provider in such a case. Options A and D are not
necessary. Option C is an indication of drug toxicity, and the client should be instructed
to report this immediately.
✔✔A client is prescribed a cholinesterase inhibitor, and a family member asks the nurse
how this medication works. Which pharmacophysiologic explanation should the nurse
use to describe this class of drug?
A. Promotes excretion of neurotoxins.
B. Slows nerve cell degeneration.
C. Improves nerve impulse transmission.
D. Stimulates nerve cell regeneration. - ✔✔C. Improves nerve impulse transmission.
Cholinesterase inhibitors work to increase the availability of acetylcholine at cholinergic
synapses, which aids in neuronal transmission and assists in memory formation. Basing
an explanation on this concept, option C should provide an accurate explanation that
the family can understand. Options A, B, and D are incorrect.
✔✔In developing a nursing care plan for a 9-month-old infant with cystic fibrosis, the
nurse writes a nursing diagnosis of alteration in nutrition: less than body requirements,
related to inadequate digestion of nutrients. Which intervention would best meet this
child's needs?
A. Give aluminum hydroxide and magnesium hydroxide after meals.
B. Give pancrelipase capsule mixed with applesauce before each meal.
C. Administer cholestyramine resin before each meal and at bedtime.
D. Administer omeprazole for gastroesophageal reflux. - ✔✔B. Give pancrelipase
capsule mixed with applesauce before each meal.
Pancreatic enzyme replacement with pancrelipase is a major component of cystic
fibrosis nutritional management. Aluminum hydroxide and magnesium hydroxide may
be given before meals with enzymes to reduce gastric acidity and prevent enzyme
destruction but are ineffective when used alone to promote enzyme replacement.
Options C and D are used to treat steatorrhea in cystic fibrosis.
✔✔The nurse is preparing a teaching plan for a client who has received a new
prescription for levothyroxine sodium. Which instruction should be included?
A. "Take this medication with a high-protein snack at bedtime."
B. "You may change at any time to a less expensive generic brand."
C. "Take your pulse daily, and if it exceeds 100 beats/min, contact the health care
provider."
D. "Return to the clinic weekly for serum blood glucose testing." - ✔✔C. "Take your
pulse daily, and if it exceeds 100 beats/min, contact the health care provider."
, Levothyroxine sodium should be withheld if the pulse is over 100 beats/min. To prevent
insomnia, the daily dose should be taken early in the morning before breakfast, not at
bedtime. Product brands should not be changed without consulting the health care
provider because the intended effects and side effects of different formulations of the
medication can vary. The serum glucose level is not affected by thyroid preparations, so
option D is not required.
✔✔Dopamine is administered to a client who is hypotensive. Which finding should the
nurse identify as a therapeutic response?
A. Gain in weight
B. Increase in urine output
C. Improved gastric motility
D. Decrease in blood pressure - ✔✔B. Increase in urine output
Intropin activates dopamine receptors in the kidney and dilates blood vessels to improve
renal perfusion, so an increase in urine output indicates an increase in glomerular
filtration caused by increased arterial blood pressure. Option A is related to fluid
retention but is not an indicator of a therapeutic response to dopamine therapy. Option
C is not related to the vasopressor effect of dopamine therapy. Dopamine increases
cardiac output, which increases a client's blood pressure, not option D.
✔✔A client receives pancuronium, a long-acting, nondepolarizing neuromuscular
blocker, during surgical anesthesia. Which client situation should alert the nurse to
evaluate the client for a prolonged muscle relaxation response to this medication?
A. Hepatitis
B. Heart failure
C. Renal insufficiency
D. History of emphysema - ✔✔C. Renal insufficiency
Pancuronium is eliminated via the kidneys, so a client with renal failure is at risk for
prolonged muscle relaxation. Although hepatitis can interfere with this drug's
metabolism, it does not place a client at increased risk for prolonged muscle relaxation.
Options B and D do not cause prolonged muscle relaxation in a client who receives
pancuronium.
✔✔The health care provider prescribes the anticonvulsant carbamazepine for an
adolescent client with a seizure disorder. The nurse should instruct the client to notify
the health care provider if which condition occurs?
A. Experiences dry mouth.
B. Experiences dizziness.
C. Develops a sore throat.
D. Develops gingival hyperplasia. - ✔✔C. Develops a sore throat.
