EVOLVE HESI PHARM FINAL PAPER EXAM QUESTIONS ACCURATE ANSWERS FULL
SOLUTION
Question:
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? 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.
Answer:
C. Decrease the dose of vitamin C.
Question:
When providing nursing care for a client receiving 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.
Answer:
B. Assess respiratory status and breath sounds often.
Question:
A client with a dislocated shoulder is being prepared for a 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
Answer:
B. Midazolam IV
,Question:
A client is being discharged with a prescription for 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.
Answer:
D. Drink at least eight glasses of fluid a day.
Question:
The health care provider prescribes carbamazepine for a child whose tonic-clonic seizures have been
poorly controlled. The nurse informs the mother that the child must have blood tests every week.
The mother asks why so many blood tests are necessary. Which complication is assessed through
frequent laboratory testing that the nurse should explain to this mother? A. Nephrotoxicity B.
Ototoxicity C. Myelosuppression D.Hepatotoxicity
Answer:
C. Myelosuppression Myelosuppression is the highest priority complication that can potentially
affect clients managed with carbamazepine therapy. The client requires close monitoring for this
condition by weekly laboratory testing. Hepatic function may be altered, but this complication does
not have as great a potential for occurrence as option C. Options A and B are not typical
complications of carbamazepine therapy.
Question:
When developing a written nursing care plan for a client receiving chemotherapy for treatment of
cancer, the nurse writes, "Assess each voiding for hematuria." The administration of which type of
chemotherapeutic agent would prompt the nurse to add this intervention? A. Vincristine B.
Bleomycin sulfate C. Chlorambucil D. Cyclophosphamide
Answer:
D. Cyclophosphamide Hemorrhagic cystitis is the characteristic adverse reaction of
cyclophosphamide. Administration of options A, B, and C does not typically cause hemorrhagic
cystitis.
Question:
,A client is receiving oral griseofulvin for a persistent tinea corporis infection. Which response by the
client indicates an accurate understanding of the drug teaching conducted by the nurse? 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."
Answer:
A. "I'll wear sunscreen whenever I mow the lawn." Photosensitivity is a side effect of griseofulvin,
so clients should be cautioned to wear protective sunscreen during sun exposure. Options B, C, and
D are not accurate statements about side effects of this medication.
Question:
A 6-year-old child is admitted to the emergency department with status epilepticus. His parents
report that his seizure disorder has been managed with phenytoin, 50 mg PO bid, for the past year.
Which drug should the nurse plan to administer in the emergency department? A. Phenytoin B.
Diazepam C. Phenobarbital D. Carbamazepine
Answer:
B. Diazepam Diazepam is the drug of choice for treatment of status epilepticus. Options A, C, and D
are used for the long-term management of seizure disorders but are not as useful in the emergency
management of status epilepticus.
Question:
A client who has trouble swallowing pills intermittently has been prescribed venlafaxine (XR) for
depression. The medication comes in capsule form. What should the nurse include in the discharge
teaching plan for this client? A. Capsule contents can be sprinkled on pudding or applesauce. B.
Chew the medication thoroughly to enhance absorption. C. Take the medication with a large glass of
water or juice. D. Contact the health care provider for another form of medication.
Answer:
D. Contact the health care provider for another form of medication. Venlafaxine is administered PO
in capsule form. Capsules that are extended-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 client should notify the health care provider about the inability to swallow the
capsule. This medication should not be chewed or opened so that the delayed-release, enteric-
coated granules can remain intact. Water or juice will not affect the medication.
, Question:
The nurse is preparing to apply a surface anesthetic agent for a client. Which action should the nurse
implement to reduce the risk of systemic absorption? A. Apply the anesthetic to mucous
membranes. B. Limit the area of application to inflamed areas. C. Avoid abraded skin areas when
applying the anesthetic. D. Spread the topical agent over a large surface area.
Answer:
C. Avoid abraded skin areas when applying the anesthetic. 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 membranes poses the greatest risk of systemic absorption because
absorption occurs more readily through mucous membranes than through the skin. Inflamed areas
generally have an increased blood supply, which increases the risk of 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.
Question:
A client experiencing dysrhythmias is given quinidine, 300 mg PO every 6 hours. The nurse plans to
observe this client for which common side effect associated with the use of this medication? A.
Diarrhea B. Hypothermia C. Seizures D. Dysphagia
Answer:
A. Diarrhea The most common side effects associated with quinidine therapy are gastrointestinal
complaints, such as diarrhea. Options B, C, and D are not usually associated with quinidine therapy.
Question:
The health care provider prescribes the H2 antagonist famotidine, 20 mg PO in the morning and at
bedtime. Which statement regarding the action of H2 antagonists offers the correct rationale for
administering the medication at bedtime? A. Gastric acid secreted at night is buffered, preventing
pepsin formation. B. Hydrochloric acid secreted during the night is blocked. C. The drug relaxes
stomach muscles at night to reduce acid. D. Ingestion of the medication at night offers a sedative
effect, promoting sleep.
Answer:
B. Hydrochloric acid secreted during the night is blocked. H2 antagonists act on the parietal cells to
inhibit gastric secretion. Some gastric secretion occurs all the time, even when the stomach is empty,
unless medications are taken to inhibit this action. Options C and D are not actions of famotidine.
Option A is the action of antacids. Antacids do not affect healing or prevent the recurrence of ulcers;
SOLUTION
Question:
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? 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.
Answer:
C. Decrease the dose of vitamin C.
Question:
When providing nursing care for a client receiving 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.
Answer:
B. Assess respiratory status and breath sounds often.
Question:
A client with a dislocated shoulder is being prepared for a 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
Answer:
B. Midazolam IV
,Question:
A client is being discharged with a prescription for 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.
Answer:
D. Drink at least eight glasses of fluid a day.
Question:
The health care provider prescribes carbamazepine for a child whose tonic-clonic seizures have been
poorly controlled. The nurse informs the mother that the child must have blood tests every week.
The mother asks why so many blood tests are necessary. Which complication is assessed through
frequent laboratory testing that the nurse should explain to this mother? A. Nephrotoxicity B.
Ototoxicity C. Myelosuppression D.Hepatotoxicity
Answer:
C. Myelosuppression Myelosuppression is the highest priority complication that can potentially
affect clients managed with carbamazepine therapy. The client requires close monitoring for this
condition by weekly laboratory testing. Hepatic function may be altered, but this complication does
not have as great a potential for occurrence as option C. Options A and B are not typical
complications of carbamazepine therapy.
Question:
When developing a written nursing care plan for a client receiving chemotherapy for treatment of
cancer, the nurse writes, "Assess each voiding for hematuria." The administration of which type of
chemotherapeutic agent would prompt the nurse to add this intervention? A. Vincristine B.
Bleomycin sulfate C. Chlorambucil D. Cyclophosphamide
Answer:
D. Cyclophosphamide Hemorrhagic cystitis is the characteristic adverse reaction of
cyclophosphamide. Administration of options A, B, and C does not typically cause hemorrhagic
cystitis.
Question:
,A client is receiving oral griseofulvin for a persistent tinea corporis infection. Which response by the
client indicates an accurate understanding of the drug teaching conducted by the nurse? 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."
Answer:
A. "I'll wear sunscreen whenever I mow the lawn." Photosensitivity is a side effect of griseofulvin,
so clients should be cautioned to wear protective sunscreen during sun exposure. Options B, C, and
D are not accurate statements about side effects of this medication.
Question:
A 6-year-old child is admitted to the emergency department with status epilepticus. His parents
report that his seizure disorder has been managed with phenytoin, 50 mg PO bid, for the past year.
Which drug should the nurse plan to administer in the emergency department? A. Phenytoin B.
Diazepam C. Phenobarbital D. Carbamazepine
Answer:
B. Diazepam Diazepam is the drug of choice for treatment of status epilepticus. Options A, C, and D
are used for the long-term management of seizure disorders but are not as useful in the emergency
management of status epilepticus.
Question:
A client who has trouble swallowing pills intermittently has been prescribed venlafaxine (XR) for
depression. The medication comes in capsule form. What should the nurse include in the discharge
teaching plan for this client? A. Capsule contents can be sprinkled on pudding or applesauce. B.
Chew the medication thoroughly to enhance absorption. C. Take the medication with a large glass of
water or juice. D. Contact the health care provider for another form of medication.
Answer:
D. Contact the health care provider for another form of medication. Venlafaxine is administered PO
in capsule form. Capsules that are extended-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 client should notify the health care provider about the inability to swallow the
capsule. This medication should not be chewed or opened so that the delayed-release, enteric-
coated granules can remain intact. Water or juice will not affect the medication.
, Question:
The nurse is preparing to apply a surface anesthetic agent for a client. Which action should the nurse
implement to reduce the risk of systemic absorption? A. Apply the anesthetic to mucous
membranes. B. Limit the area of application to inflamed areas. C. Avoid abraded skin areas when
applying the anesthetic. D. Spread the topical agent over a large surface area.
Answer:
C. Avoid abraded skin areas when applying the anesthetic. 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 membranes poses the greatest risk of systemic absorption because
absorption occurs more readily through mucous membranes than through the skin. Inflamed areas
generally have an increased blood supply, which increases the risk of 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.
Question:
A client experiencing dysrhythmias is given quinidine, 300 mg PO every 6 hours. The nurse plans to
observe this client for which common side effect associated with the use of this medication? A.
Diarrhea B. Hypothermia C. Seizures D. Dysphagia
Answer:
A. Diarrhea The most common side effects associated with quinidine therapy are gastrointestinal
complaints, such as diarrhea. Options B, C, and D are not usually associated with quinidine therapy.
Question:
The health care provider prescribes the H2 antagonist famotidine, 20 mg PO in the morning and at
bedtime. Which statement regarding the action of H2 antagonists offers the correct rationale for
administering the medication at bedtime? A. Gastric acid secreted at night is buffered, preventing
pepsin formation. B. Hydrochloric acid secreted during the night is blocked. C. The drug relaxes
stomach muscles at night to reduce acid. D. Ingestion of the medication at night offers a sedative
effect, promoting sleep.
Answer:
B. Hydrochloric acid secreted during the night is blocked. H2 antagonists act on the parietal cells to
inhibit gastric secretion. Some gastric secretion occurs all the time, even when the stomach is empty,
unless medications are taken to inhibit this action. Options C and D are not actions of famotidine.
Option A is the action of antacids. Antacids do not affect healing or prevent the recurrence of ulcers;
