PHARM HESI PRACTICE QUESTIONS
(EVOLVE)2026 With Correct Answers
& Questions
the healthcare provider prescribes a medication for an older adult client who is
complaining of insomnia and instructs the client to return in two weeks. the nurse
should question which prescription?
- zolpidem 10 mg orally at bedtime
- eszopiclone 10 mg orally at bedtime
- temazepam 7.5 mg orally at bedtime
- ramelton 8 mg orally at bedtime - Answer--eszopiclone 10 mg orally at bedtime
a client is receiving fentanyl via an epidural infusion. which side effect should the
nurse anticipate in the first 24 hours of epidural analgesia?
- headache
- agitation
- urinary retention
- abdominal cramping and diarrhea - Answer--urinary retention
a client who takes a statin and gemfibrozil for hyperlipidemia reports onset of muscle
pain and weakness. what additional assessment is most important for the nurse to
obtain?
- serum liver enzymes
- T3 and T4 blood levels
- bowel function
- peripheral sensation - Answer--serum liver enzymes
a client is taking danazol for endometriosis and calls the clinic nurse to complain of a
dark, swollen and painful leg. what instructions should the nurse provide the client?
- wear support stockings
- elevate both legs and apply heat
- proceed to closest ER
- walk for 20 to 30 mins to reduce muscle cramps - Answer--proceed to the closest
emergency room
,a client receives a new prescription for pentazocine, a mixed opioid agonist
antagonist, after an opioid agonist is discontinued. what is the advantage for the
client when the new prescription is implemented?
- tolerance does not occur
- less agitation is experienced
- the analgesic ceiling is higher
- respiratory depression is less - Answer--respiratory depression is less
a client beginning therapy with montelukast PO 10 mg once per day in the evening.
the client asks the nurse 'when should i begin to feel better?' how should the nurse
respond?
- immediately
- within 24 hours
- in about 12 hours
- 30 minutes to 1 hour - Answer--within 24 hours
a client is taking sulfisoxazole for a urinary tract infection and complains of nausea
and gastric upset since starting the med. which additional adverse reaction should
the nurse instruct the client to report?
- rash
- diarrhea
- hematuria
- muscle cramping - Answer--rash
when prescribed for a client with hepatic encephalopathy, what is the therapeutic
action of lactulose?
- lowers pH of the colon
- softens the stool
- increase glucose absorption
- stimulates peristalsis - Answer--lowers pH of the colon
which findings should the nurse identify in an adult client with possible chronic
salicylate intoxication?
- tinnitus and hearing loss
- photosensitivity and nervousness
- acute gi bleeding and anorexia
- hyperventilation and CNS effects - Answer--tinnitus and hearing loss
,a client with paget's disease is started on calcitonin 500 mch sub-q daily. during the
initial treatment, what is the priority nursing action?
- assess injection site for inflammation
- evaluate the client's level of pain
- monitor the client's alkaline phosphate levels
- observe client for signs of hypersensitivity - Answer--observe the client for signs of
hypersensitivity
38 year old gravida 2 para 2 is diagnosed with bacterial vaginosis 9 months
postpartum. a prescription is written for metronidazole. which info is most important
for the nurse to obtain from the client before initiating treatment?
- sexual history
- use of oral contraceptive
- method of infant feeding
- possibility of pregnancy - Answer--method of infant feeding
the nurse receives a unit of blood from the blood bank for a postoperative client who
is currently in the x ray department. which action should the nurse implement?
- return blood to blood bank for refrigeration within 30 mins
- hand the blood transfusion as soon as client returns to the unit
- store blood bag in the nursing unit's refrigerator until client returns
- take unit of blood to the x ray department to initiate the transfusion - Answer--return
blood to the blood bank for refrigeration within 30 mins
client who is recently diagnosed with myasthenia gravis receives a prescription for
pyridostigmine, a cholinergic agent. which info should the nurse instruct the client to
implement when taking this medication?
- always take with meals to avoid GI distress
- plan doses close together for maximal therapeutic effect
- take the med at least 30 mins before eating meals
- avoid dairy products 2 hours before and after taking medications - Answer--take the
medication at least 30 mins before eating meals
what teaching should the nurse provide a client who has received a new prescription
for sildenafil? (SAA)
- frequent use can lead to development of hypertension
- most effective if taken after at least 6 hours of REM sleep
- take within 30 to 60 mins of sexual stimulation
- report rebound priapism that occurs for 4 hours or more
, - can cause facial flushing and headache - Answer--- take within 30 to 60 mins of
sexual intercourse
- report rebound priapism that occurs for 4 hours or more
- can cause facial flushing and headache
the therapeutic effect of insulin in treating type 1 diabetes mellitus is based on which
physiologic action?
- facilitates transport of glucose into the cells
- stimulates function of beta cells in the pancreas
- increases intra-cellular receptor site sensitivity
- delays carb digestion and absorption - Answer--facilitates transport of glucose into
the cells
a client receives a new prescription for nitroglycerin tablets. which instruction should
the nurse include in this client's teaching?
- take the med at least an hour before every meal
- monitor your pulse for 60 seconds before admin
- place under the tongue as needed every 5 minutes up to 3 times
- resume normal activities after chest pain relief is obtained - Answer--place under
the tongue as needed every 5 minutes up to 3 times
the nurse should expect the healthcare provider to prescribe what treatment regimen
for a client with a peptic ulcer cause by h pylori? (SAA)
- clarithromycin
- sulfisoxazole
- misoprostol
- omeprazole
- metronidazole
- sucralfate - Answer--- clarithromycin
- omeprazole
- metronidazole
a client receives a prescription for sulfamethoxazole trimethoprim for a UTI. what
instruction should the nurse provide the client?
- ingest food prior to taking antibiotic
- drink at least 8 glasses of water a day
- take the med with grapefruit juice
- avoid prolonged exposure to sunlight - Answer--drink at least 8 glasses of water a
day
(EVOLVE)2026 With Correct Answers
& Questions
the healthcare provider prescribes a medication for an older adult client who is
complaining of insomnia and instructs the client to return in two weeks. the nurse
should question which prescription?
- zolpidem 10 mg orally at bedtime
- eszopiclone 10 mg orally at bedtime
- temazepam 7.5 mg orally at bedtime
- ramelton 8 mg orally at bedtime - Answer--eszopiclone 10 mg orally at bedtime
a client is receiving fentanyl via an epidural infusion. which side effect should the
nurse anticipate in the first 24 hours of epidural analgesia?
- headache
- agitation
- urinary retention
- abdominal cramping and diarrhea - Answer--urinary retention
a client who takes a statin and gemfibrozil for hyperlipidemia reports onset of muscle
pain and weakness. what additional assessment is most important for the nurse to
obtain?
- serum liver enzymes
- T3 and T4 blood levels
- bowel function
- peripheral sensation - Answer--serum liver enzymes
a client is taking danazol for endometriosis and calls the clinic nurse to complain of a
dark, swollen and painful leg. what instructions should the nurse provide the client?
- wear support stockings
- elevate both legs and apply heat
- proceed to closest ER
- walk for 20 to 30 mins to reduce muscle cramps - Answer--proceed to the closest
emergency room
,a client receives a new prescription for pentazocine, a mixed opioid agonist
antagonist, after an opioid agonist is discontinued. what is the advantage for the
client when the new prescription is implemented?
- tolerance does not occur
- less agitation is experienced
- the analgesic ceiling is higher
- respiratory depression is less - Answer--respiratory depression is less
a client beginning therapy with montelukast PO 10 mg once per day in the evening.
the client asks the nurse 'when should i begin to feel better?' how should the nurse
respond?
- immediately
- within 24 hours
- in about 12 hours
- 30 minutes to 1 hour - Answer--within 24 hours
a client is taking sulfisoxazole for a urinary tract infection and complains of nausea
and gastric upset since starting the med. which additional adverse reaction should
the nurse instruct the client to report?
- rash
- diarrhea
- hematuria
- muscle cramping - Answer--rash
when prescribed for a client with hepatic encephalopathy, what is the therapeutic
action of lactulose?
- lowers pH of the colon
- softens the stool
- increase glucose absorption
- stimulates peristalsis - Answer--lowers pH of the colon
which findings should the nurse identify in an adult client with possible chronic
salicylate intoxication?
- tinnitus and hearing loss
- photosensitivity and nervousness
- acute gi bleeding and anorexia
- hyperventilation and CNS effects - Answer--tinnitus and hearing loss
,a client with paget's disease is started on calcitonin 500 mch sub-q daily. during the
initial treatment, what is the priority nursing action?
- assess injection site for inflammation
- evaluate the client's level of pain
- monitor the client's alkaline phosphate levels
- observe client for signs of hypersensitivity - Answer--observe the client for signs of
hypersensitivity
38 year old gravida 2 para 2 is diagnosed with bacterial vaginosis 9 months
postpartum. a prescription is written for metronidazole. which info is most important
for the nurse to obtain from the client before initiating treatment?
- sexual history
- use of oral contraceptive
- method of infant feeding
- possibility of pregnancy - Answer--method of infant feeding
the nurse receives a unit of blood from the blood bank for a postoperative client who
is currently in the x ray department. which action should the nurse implement?
- return blood to blood bank for refrigeration within 30 mins
- hand the blood transfusion as soon as client returns to the unit
- store blood bag in the nursing unit's refrigerator until client returns
- take unit of blood to the x ray department to initiate the transfusion - Answer--return
blood to the blood bank for refrigeration within 30 mins
client who is recently diagnosed with myasthenia gravis receives a prescription for
pyridostigmine, a cholinergic agent. which info should the nurse instruct the client to
implement when taking this medication?
- always take with meals to avoid GI distress
- plan doses close together for maximal therapeutic effect
- take the med at least 30 mins before eating meals
- avoid dairy products 2 hours before and after taking medications - Answer--take the
medication at least 30 mins before eating meals
what teaching should the nurse provide a client who has received a new prescription
for sildenafil? (SAA)
- frequent use can lead to development of hypertension
- most effective if taken after at least 6 hours of REM sleep
- take within 30 to 60 mins of sexual stimulation
- report rebound priapism that occurs for 4 hours or more
, - can cause facial flushing and headache - Answer--- take within 30 to 60 mins of
sexual intercourse
- report rebound priapism that occurs for 4 hours or more
- can cause facial flushing and headache
the therapeutic effect of insulin in treating type 1 diabetes mellitus is based on which
physiologic action?
- facilitates transport of glucose into the cells
- stimulates function of beta cells in the pancreas
- increases intra-cellular receptor site sensitivity
- delays carb digestion and absorption - Answer--facilitates transport of glucose into
the cells
a client receives a new prescription for nitroglycerin tablets. which instruction should
the nurse include in this client's teaching?
- take the med at least an hour before every meal
- monitor your pulse for 60 seconds before admin
- place under the tongue as needed every 5 minutes up to 3 times
- resume normal activities after chest pain relief is obtained - Answer--place under
the tongue as needed every 5 minutes up to 3 times
the nurse should expect the healthcare provider to prescribe what treatment regimen
for a client with a peptic ulcer cause by h pylori? (SAA)
- clarithromycin
- sulfisoxazole
- misoprostol
- omeprazole
- metronidazole
- sucralfate - Answer--- clarithromycin
- omeprazole
- metronidazole
a client receives a prescription for sulfamethoxazole trimethoprim for a UTI. what
instruction should the nurse provide the client?
- ingest food prior to taking antibiotic
- drink at least 8 glasses of water a day
- take the med with grapefruit juice
- avoid prolonged exposure to sunlight - Answer--drink at least 8 glasses of water a
day
