Pharmacology Evolve HESI
Study Guide & Practice
Questions 2026/2027
,A 19-year-old male client who has sustained a severe B. Neostigmine bromide
head injury is intubated and placed on assisted
mechanical ventilation. To facilitate optimal ventilation and Neostigmine bromide and atropine sulfate, both anticholinergic drugs, reverse the
prevent the client from "fighting" the ventilator, the health respiratory muscle paralysis caused by pancuronium bromide. Options A, C, and D
care provider administers pancuronium bromide IV, with are not antagonists to pancuronium bromide and would not be helpful in reversing
adjunctive opioid analgesia. What medication should be the effects of the drug compared with the use of anticholinergics.
immediately accessible for a potential complication with
this drug?
A. Dantrolene sodium
B. Neostigmine bromide
C. Succinylcholine bromide
D. Epinephrine
A client with viral influenza is receiving vitamin C, 1000 mg C. Decrease the dose of vitamin C.
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.
When providing nursing care for a client receiving B. Assess respiratory status and breath sounds often.
pyridostigmine bromide for myasthenia gravis, which
nursing intervention has the highest priority?
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.
A client with a dislocated shoulder is being prepared for a B. Midazolam IV
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
A client is being discharged with a prescription for D. Drink at least eight glasses of fluid a day.
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.
The health care provider prescribes carbamazepine for a C. Myelosuppression
child whose tonic-clonic seizures have been poorly
controlled. The nurse informs the mother that the child Myelosuppression is the highest priority complication that can potentially affect
must have blood tests every week. The mother asks why clients managed with carbamazepine therapy. The client requires close monitoring
so many blood tests are necessary. Which complication is for this condition by weekly laboratory testing. Hepatic function may be altered, but
assessed through frequent laboratory testing that the this complication does not have as great a potential for occurrence as option C.
nurse should explain to this mother? Options A and B are not typical complications of carbamazepine therapy.
A. Nephrotoxicity
B. Ototoxicity
C. Myelosuppression
D.Hepatotoxicity
, When developing a written nursing care plan for a client D. Cyclophosphamide
receiving chemotherapy for treatment of cancer, the nurse
writes, "Assess each voiding for hematuria." The Hemorrhagic cystitis is the characteristic adverse reaction of cyclophosphamide.
administration of which type of chemotherapeutic agent Administration of options A, B, and C does not typically cause hemorrhagic cystitis.
would prompt the nurse to add this intervention?
A. Vincristine
B. Bleomycin sulfate
C. Chlorambucil
D. Cyclophosphamide
A client is receiving oral griseofulvin for a persistent tinea A. "I'll wear sunscreen whenever I mow the lawn."
corporis infection. Which response by the client indicates
an accurate understanding of the drug teaching conducted Photosensitivity is a side effect of griseofulvin, so clients should be cautioned to
by the nurse? wear protective sunscreen during sun exposure. Options B, C, and D are not
accurate statements about side effects of this medication.
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."
A 6-year-old child is admitted to the emergency B. Diazepam
department with status epilepticus. His parents report that
his seizure disorder has been managed with phenytoin, 50 Diazepam is the drug of choice for treatment of status epilepticus. Options A, C, and
mg PO bid, for the past year. Which drug should the nurse D are used for the long-term management of seizure disorders but are not as useful
plan to administer in the emergency department? in the emergency management of status epilepticus.
A. Phenytoin
B. Diazepam
C. Phenobarbital
D. Carbamazepine
A client who has trouble swallowing pills intermittently has D. Contact the health care provider for another form of medication.
been prescribed venlafaxine (XR) for depression. The
medication comes in capsule form. What should the nurse Venlafaxine is administered PO in capsule form. Capsules that are extended-
include in the discharge teaching plan for this client? 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
A. Capsule contents can be sprinkled on pudding or client should notify the health care provider about the inability to swallow the
applesauce. capsule. This medication should not be chewed or opened so that the delayed-
B. Chew the medication thoroughly to enhance absorption. release, enteric-coated granules can remain intact. Water or juice will not affect the
C. Take the medication with a large glass of water or juice. medication.
D. Contact the health care provider for another form of
medication.
The nurse is preparing to apply a surface anesthetic agent C. Avoid abraded skin areas when applying the anesthetic.
for a client. Which action should the nurse implement to
reduce the risk of systemic absorption? 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
A. Apply the anesthetic to mucous membranes. membranes poses the greatest risk of systemic absorption because absorption
B. Limit the area of application to inflamed areas. occurs more readily through mucous membranes than through the skin. Inflamed
C. Avoid abraded skin areas when applying the anesthetic. areas generally have an increased blood supply, which increases the risk of
D. Spread the topical agent over a large surface area. 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 A. Diarrhea
mg PO every 6 hours. The nurse plans to observe this
client for which common side effect associated with the The most common side effects associated with quinidine therapy are
use of this medication? gastrointestinal complaints, such as diarrhea. Options B, C, and D are not usually
associated with quinidine therapy.
A. Diarrhea
B. Hypothermia
C. Seizures
D. Dysphagia
Study Guide & Practice
Questions 2026/2027
,A 19-year-old male client who has sustained a severe B. Neostigmine bromide
head injury is intubated and placed on assisted
mechanical ventilation. To facilitate optimal ventilation and Neostigmine bromide and atropine sulfate, both anticholinergic drugs, reverse the
prevent the client from "fighting" the ventilator, the health respiratory muscle paralysis caused by pancuronium bromide. Options A, C, and D
care provider administers pancuronium bromide IV, with are not antagonists to pancuronium bromide and would not be helpful in reversing
adjunctive opioid analgesia. What medication should be the effects of the drug compared with the use of anticholinergics.
immediately accessible for a potential complication with
this drug?
A. Dantrolene sodium
B. Neostigmine bromide
C. Succinylcholine bromide
D. Epinephrine
A client with viral influenza is receiving vitamin C, 1000 mg C. Decrease the dose of vitamin C.
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.
When providing nursing care for a client receiving B. Assess respiratory status and breath sounds often.
pyridostigmine bromide for myasthenia gravis, which
nursing intervention has the highest priority?
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.
A client with a dislocated shoulder is being prepared for a B. Midazolam IV
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
A client is being discharged with a prescription for D. Drink at least eight glasses of fluid a day.
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.
The health care provider prescribes carbamazepine for a C. Myelosuppression
child whose tonic-clonic seizures have been poorly
controlled. The nurse informs the mother that the child Myelosuppression is the highest priority complication that can potentially affect
must have blood tests every week. The mother asks why clients managed with carbamazepine therapy. The client requires close monitoring
so many blood tests are necessary. Which complication is for this condition by weekly laboratory testing. Hepatic function may be altered, but
assessed through frequent laboratory testing that the this complication does not have as great a potential for occurrence as option C.
nurse should explain to this mother? Options A and B are not typical complications of carbamazepine therapy.
A. Nephrotoxicity
B. Ototoxicity
C. Myelosuppression
D.Hepatotoxicity
, When developing a written nursing care plan for a client D. Cyclophosphamide
receiving chemotherapy for treatment of cancer, the nurse
writes, "Assess each voiding for hematuria." The Hemorrhagic cystitis is the characteristic adverse reaction of cyclophosphamide.
administration of which type of chemotherapeutic agent Administration of options A, B, and C does not typically cause hemorrhagic cystitis.
would prompt the nurse to add this intervention?
A. Vincristine
B. Bleomycin sulfate
C. Chlorambucil
D. Cyclophosphamide
A client is receiving oral griseofulvin for a persistent tinea A. "I'll wear sunscreen whenever I mow the lawn."
corporis infection. Which response by the client indicates
an accurate understanding of the drug teaching conducted Photosensitivity is a side effect of griseofulvin, so clients should be cautioned to
by the nurse? wear protective sunscreen during sun exposure. Options B, C, and D are not
accurate statements about side effects of this medication.
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."
A 6-year-old child is admitted to the emergency B. Diazepam
department with status epilepticus. His parents report that
his seizure disorder has been managed with phenytoin, 50 Diazepam is the drug of choice for treatment of status epilepticus. Options A, C, and
mg PO bid, for the past year. Which drug should the nurse D are used for the long-term management of seizure disorders but are not as useful
plan to administer in the emergency department? in the emergency management of status epilepticus.
A. Phenytoin
B. Diazepam
C. Phenobarbital
D. Carbamazepine
A client who has trouble swallowing pills intermittently has D. Contact the health care provider for another form of medication.
been prescribed venlafaxine (XR) for depression. The
medication comes in capsule form. What should the nurse Venlafaxine is administered PO in capsule form. Capsules that are extended-
include in the discharge teaching plan for this client? 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
A. Capsule contents can be sprinkled on pudding or client should notify the health care provider about the inability to swallow the
applesauce. capsule. This medication should not be chewed or opened so that the delayed-
B. Chew the medication thoroughly to enhance absorption. release, enteric-coated granules can remain intact. Water or juice will not affect the
C. Take the medication with a large glass of water or juice. medication.
D. Contact the health care provider for another form of
medication.
The nurse is preparing to apply a surface anesthetic agent C. Avoid abraded skin areas when applying the anesthetic.
for a client. Which action should the nurse implement to
reduce the risk of systemic absorption? 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
A. Apply the anesthetic to mucous membranes. membranes poses the greatest risk of systemic absorption because absorption
B. Limit the area of application to inflamed areas. occurs more readily through mucous membranes than through the skin. Inflamed
C. Avoid abraded skin areas when applying the anesthetic. areas generally have an increased blood supply, which increases the risk of
D. Spread the topical agent over a large surface area. 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 A. Diarrhea
mg PO every 6 hours. The nurse plans to observe this
client for which common side effect associated with the The most common side effects associated with quinidine therapy are
use of this medication? gastrointestinal complaints, such as diarrhea. Options B, C, and D are not usually
associated with quinidine therapy.
A. Diarrhea
B. Hypothermia
C. Seizures
D. Dysphagia
