PHARMACOLOGY EVOLVE HESI EXAM
WITH VALIDATED CORRECT ANSWERS.
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 - CorreCt Answers -B. Neostigmine bromide
Prior to administering a scheduled dose of digoxin, the nurse reviews the
client's current serum digoxin level, which is 1.3 ng/dL. Which action
should the nurse implement?
A. Administer Digibind to counteract the toxicity.
B. Withhold the drug and notify the health care provider immediately.
C. Withhold the dose and notify the health care provider during rounds that
the dose was held.
D. Give the dose of digoxin if the client's heart rate is within a safe range. -
CorreCt Answers -D. Give the dose of digoxin if the client's heart rate is
within a safe range.
,The client's digoxin level of 1.3 ng/dL is not above the upper range of its
therapeutic index (toxic level is >2.0 ng/dL), so the dose should be
administered after the client's heart rate is evaluated. Digibind is
administered for toxic levels of digoxin, so option A is not indicated.
Options B and C are not necessary.
A 2-month-old infant is scheduled to receive the first DPT immunization.
What is the preferred injection site to administer this immunization?
A. Dorsal gluteal
B. Vastus lateralis
C. Ventral gluteal
D. Deltoid - CorreCt Answers -B. Vastus lateralis
The preferred intramuscular site for children younger than 2 years is the
vastus lateralis. Options A, C, and D are not preferred injection sites for the
infant at 2 months of age.
Which factor is most important to ensure compliance when planning to
teach a client about a drug regimen?
A. Genetics
B. Client age
C. Client education
D. Absorption rate - CorreCt Answers -C. Client education
,The client's educational level is the most important factor when planning
teaching to ensure a client's compliance with taking a prescribed drug.
Options A and D are physiologic responses that do not relate to a client's
compliance. Although maturity level and age contribute to compliance, the
client's basic understanding of instructions, which is best indicated by
educational level, is more significant.
A client is receiving acyclovir sodium IV for a severe herpes simplex
infection. Which intervention should the nurse implement during this drug
therapy?
A. Maintain respiratory isolation precautions.
B. Increase daily fluids to 2000 to 4000 mL/day.
C. Administer with meals to decrease gastric irritation.
D. Assess for signs of severe liver dysfunction. - CorreCt Answers -B.
Increase daily fluids to 2000 to 4000 mL/day.
Increasing fluid intake during treatment prevents precipitation of the drug
in the renal tubules, which could lead to obstructive problems that impair
kidney function. Acute glomerulonephritis is a possible complication of
acyclovir sodium therapy. Options A, C, and D are unrelated interventions
for treatment with acyclovir sodium.
Which physiologic mechanism explains a drug's increased metabolism that
is triggered by a disease process?
A. Selectivity response
B. Pharmacokinetics
, C. Pharmacodynamics
D. Pharmacotherapeutics - CorreCt Answers -B. Pharmacokinetics
Pharmacokinetics describes the physiologic process of a drug's movement
throughout the body and how the drug's interaction is affected by an
underlying disease. Selectivity, or a selective drug, is defined as a drug that
elicits only the response for which it is given. Pharmacodynamics is the
impact of drugs on the body. Pharmacotherapeutics is defined as the use of
drugs to diagnose, prevent, or treat disease or prevent pregnancy.
An older client is receiving a water-soluble drug that is more than the
average dose for a young adult. Which action should the nurse implement
first?
A. Obtain a prescription for lower medication dosages.
B. Determine the drug's serum levels for toxicity.
C. Start IV fluids to decrease the serum drug levels.
D. Hold the next dosage and notify the health care provider. - CorreCt
Answers -B. Determine the drug's serum levels for toxicity.
Neostigmine bromide and atropine sulfate, both anticholinergic drugs,
reverse the respiratory muscle paralysis caused by pancuronium bromide.
Options A, C, and D are not antagonists to pancuronium bromide and
would not be helpful in reversing the effects of the drug compared with the
use of anticholinergics.
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?
WITH VALIDATED CORRECT ANSWERS.
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 - CorreCt Answers -B. Neostigmine bromide
Prior to administering a scheduled dose of digoxin, the nurse reviews the
client's current serum digoxin level, which is 1.3 ng/dL. Which action
should the nurse implement?
A. Administer Digibind to counteract the toxicity.
B. Withhold the drug and notify the health care provider immediately.
C. Withhold the dose and notify the health care provider during rounds that
the dose was held.
D. Give the dose of digoxin if the client's heart rate is within a safe range. -
CorreCt Answers -D. Give the dose of digoxin if the client's heart rate is
within a safe range.
,The client's digoxin level of 1.3 ng/dL is not above the upper range of its
therapeutic index (toxic level is >2.0 ng/dL), so the dose should be
administered after the client's heart rate is evaluated. Digibind is
administered for toxic levels of digoxin, so option A is not indicated.
Options B and C are not necessary.
A 2-month-old infant is scheduled to receive the first DPT immunization.
What is the preferred injection site to administer this immunization?
A. Dorsal gluteal
B. Vastus lateralis
C. Ventral gluteal
D. Deltoid - CorreCt Answers -B. Vastus lateralis
The preferred intramuscular site for children younger than 2 years is the
vastus lateralis. Options A, C, and D are not preferred injection sites for the
infant at 2 months of age.
Which factor is most important to ensure compliance when planning to
teach a client about a drug regimen?
A. Genetics
B. Client age
C. Client education
D. Absorption rate - CorreCt Answers -C. Client education
,The client's educational level is the most important factor when planning
teaching to ensure a client's compliance with taking a prescribed drug.
Options A and D are physiologic responses that do not relate to a client's
compliance. Although maturity level and age contribute to compliance, the
client's basic understanding of instructions, which is best indicated by
educational level, is more significant.
A client is receiving acyclovir sodium IV for a severe herpes simplex
infection. Which intervention should the nurse implement during this drug
therapy?
A. Maintain respiratory isolation precautions.
B. Increase daily fluids to 2000 to 4000 mL/day.
C. Administer with meals to decrease gastric irritation.
D. Assess for signs of severe liver dysfunction. - CorreCt Answers -B.
Increase daily fluids to 2000 to 4000 mL/day.
Increasing fluid intake during treatment prevents precipitation of the drug
in the renal tubules, which could lead to obstructive problems that impair
kidney function. Acute glomerulonephritis is a possible complication of
acyclovir sodium therapy. Options A, C, and D are unrelated interventions
for treatment with acyclovir sodium.
Which physiologic mechanism explains a drug's increased metabolism that
is triggered by a disease process?
A. Selectivity response
B. Pharmacokinetics
, C. Pharmacodynamics
D. Pharmacotherapeutics - CorreCt Answers -B. Pharmacokinetics
Pharmacokinetics describes the physiologic process of a drug's movement
throughout the body and how the drug's interaction is affected by an
underlying disease. Selectivity, or a selective drug, is defined as a drug that
elicits only the response for which it is given. Pharmacodynamics is the
impact of drugs on the body. Pharmacotherapeutics is defined as the use of
drugs to diagnose, prevent, or treat disease or prevent pregnancy.
An older client is receiving a water-soluble drug that is more than the
average dose for a young adult. Which action should the nurse implement
first?
A. Obtain a prescription for lower medication dosages.
B. Determine the drug's serum levels for toxicity.
C. Start IV fluids to decrease the serum drug levels.
D. Hold the next dosage and notify the health care provider. - CorreCt
Answers -B. Determine the drug's serum levels for toxicity.
Neostigmine bromide and atropine sulfate, both anticholinergic drugs,
reverse the respiratory muscle paralysis caused by pancuronium bromide.
Options A, C, and D are not antagonists to pancuronium bromide and
would not be helpful in reversing the effects of the drug compared with the
use of anticholinergics.
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?
