Evolve Pharmacology Hesi /Hesi Pharmacology
Evolve Exam Newest 2025/2026 Complete 200
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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. - ANSWER-B. Obtain a
serum digoxin level.
Rationale; Sinus bradycardia (rate <90 to 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.
Option C is not indicated unless the client exhibits symptoms of
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diminished cardiac output. Option D provides information about
cardiac function but is of less priority than option B.
The nurse performs a client assessment prior to the
administration of a prescribed dose of dipyridamole and aspirin
PO. The nurse notes that the client's carotid bruit is louder than
previously assessed. Which action should the nurse implement?
A. Administer the prescribed dose as scheduled.
B. Hold the dose until the health care provider is contacted.
C. Advise the client to take nothing by mouth until further
assessment is completed.
D. Elevate the head of the bed and apply oxygen by nasal
cannula - ANSWER-A. Administer the prescribed dose as
scheduled.
Rationale; A carotid bruit reflects the degree of blood vessel
turbulence, which is typically the result of atherosclerosis.
Aspirin is prescribed to reduce platelet aggregation and should
be administered to this client, who is at high risk for thrombus
occlusion. Options B, C, and D are not necessary interventions
at this time.
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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 health care 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 - ANSWER-A.
Hematocrit (HCT) of 58%
Rationale; Option A should be reported to the health care
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.
A client is receiving pyridostigmine bromide to control the
symptoms of myasthenia gravis. Which client behavior would
indicate that the drug therapy is effective?
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A. Decreased oral secretions
B. Clear speech
C. Diminished hand tremors
D. Increased ptosis - ANSWER-B. Clear speech
Rationale; Clear speech is the result of increased muscle
strength. Muscle weakness characteristic of myasthenia gravis
often first appears in the muscles of the neck and face. Options
A and D are symptoms of multiple sclerosis that would persist if
the medication was ineffective. Hand tremors are not typical
symptoms of the disease.
A client is experiencing an adverse effect of the gastrointestinal
stimulant metoclopramide HCl. Which assessment finding
would require immediate intervention by the nurse?
A. Reports dizziness when first getting up.
B. Describes an unpleasant metallic taste in the mouth.
C. Demonstrates Parkinson-like symptoms, such as cogwheel
rigidity.