EVOLVE PHARMACOLOGY HESI UPDATED ACTUAL EXAM QUESTIONS CORRECT
ANSWERS GRADED A PLUS
Question:
A male client who has been receiving an antineoplastic drug has developed thrombocytopenia. What
instructions should the practical nurse (PN) reinforce? A) Use suppository form of drugs. B) Avoid
large public gatherings. C) Rise slowly when standing up. D) Shave with an electric razor.
Answer:
D) Shave with an electric razor. Feedback: Thrombocytopenia is a common side effect of bone
marrow depression caused by several antineoplastic agents. The client is experiencing a low platelet
count and should use an electric razor (D) to reduce his risk of bleeding. (A, B, and C) are not
indicated for a client who needs to implement thrombocytopenia precautions.
Question:
The practical nurse (PN) is caring for a client who has been taking prednisone (Deltasone) daily for
a year. Which adverse effect should the PN document in the client's record? A) Photosensitvity. B)
Weight gain. C) Loss of hair. D) Pale skin color.
Answer:
B) Weight gain. Feedback: Long term use of prednisone causes fluid retention and redistribution of
fat deposition. Weight gain (B) and moon face reflect adverse effects of long-term prednisone use
and should be documented. (A, C, and D) do not occur with treatment using prednisone.
Question:
A female client with recurring headaches tells the practical nurse (PN) that she has been taking at
least 4 grams of acetaminophen a day. Which laboratory studies should the PN review for this
client? A) Creatinine clearance. B) Hepatic enzymes. C) Coagulation values. D) Arterial blood
gases.
Answer:
B) Hepatic enzymes. Feedback: Liver toxicity can occur when doses of acetaminophen exceed 4
grams a day, resulting in an elevation in hepatic enzyme values (B). (A, C, and D) do not reveal
,findings related to acetaminophen toxicity.
Question:
A client receives a prescription for an oral opioid analgesic for post-operative pain. Which adverse
effect should the practical nurse (PN) monitor for with the client? A) Constipation. B)
Photosensitivity. C) Decreased heart rate. D) Frequent urination.
Answer:
A) Constipation. Feedback: Opioid analgesics slow peristalsis, which leads to constipation (A), a
common side effect of opiates. (B, C, and D) are not associated with opioid analgesics.
Question:
Which action should the practical nurse implement when administering a buccal medication? A)
Encourage the client to swallow. B) Administer water with medication. C) Ensure the medication is
positioned under the tongue. D) Place the medication between the upper molar teeth and cheek.
Answer:
D) Place the medication between the upper molar teeth and cheek. Feedback: Buccal medications
are placed between the upper molar teeth and the cheek (D) for absorption by the capillaries of the
oral mucosa. The client should be cautioned against swallowing, not (A). Buccal medications are
not administered with water (B). (C) describes sublingual administration.
Question:
What assessment is most important for the practical nurse (PN) to obtain prior to initiating
medication therapy with phenelzine (Nardil) for a client with depression? A) Activity level. B)
Mood and affect. C) Understanding of diet modification. D) The client's support system.
Answer:
C) Understanding of diet modification. Feedback: To prevent a potentially lethal hypertensive crisis,
a tyramine-free diet should be maintained during antidepressant therapy with Nardil, a monoamine
oxidase inhibitor (MAOI). It is most important to determine if the client understands diet
modification (C) before Nardil is initiated to prevent consumption of foods that interact with Nardil.
Although a client's activity level (A) and mood and affect (B) should be monitored during
antidepressant therapy, it is most important that the client understand diet modifications. The client's
support system (D) and network of family and friends is important, but the client should understand
the responsibility of dietary compliance with the medication regimen.
, Question:
The practical nurse (PN) is unable to arouse a client who is receiving meperidine (Demerol) for
postoperative pain. The client is stuporous, has constricted pupils, and a respiratory rate of 8
breaths/minute. Which PRN prescription should the PN give the client? A) Naloxone (Narcan). B)
Promethazine (Phenergan). C) Metoclopramide (Reglan). D) Bethanechol (Urecholine).
Answer:
A) Naloxone (Narcan). Feedback: Narcan (A) is an opioid antagonist and should be administered to
reverse the effects of a Demerol, an opioid, overdose. (B, C, and D) are common postoperative PRN
prescriptions but are not indicated for narcotic overdose.
Question:
On which therapeutic action should the practical nurse (PN) base an explanation to a client who is
receiving a cardiac glycoside? A) Decreased cardiac output. B) Increased renal perfusion. C)
Decreased rate of contraction. D) Increased blood volume.
Answer:
C) Decreased rate of contraction. Feedback: Cardiac glycosides increase the force of cardiac
contraction (inotropy) and decrease the heart rate (chronotropy) (C) by decreasing the speed of
conduction through the heart (dromotropy). (A, B, and D) are incorrect.
Question:
A client with type 1 diabetes mellitus received an early AM dose of regular insulin per sliding scale.
At 10:00 AM, the practical nurse (PN) should report which signs indicative of hypoglycemia? A)
Urticaria and rash. B) Nausea and diarrhea. C) Irritability and confusion. D) Fruity, acetone odor to
the breath.
Answer:
C) Irritability and confusion. Feedback: Irritability and confusion (C) are early signs of
hypoglycemia. (A, B, and D) are not signs of hypoglycemia.
Question:
Which prescription should the practical nurse (PN) administer for a client who is experiencing an
anaphylactic reaction to an antibiotic? A) Ephedra (ma-huang). B) Epinephrine (Adrenalin). C)
ANSWERS GRADED A PLUS
Question:
A male client who has been receiving an antineoplastic drug has developed thrombocytopenia. What
instructions should the practical nurse (PN) reinforce? A) Use suppository form of drugs. B) Avoid
large public gatherings. C) Rise slowly when standing up. D) Shave with an electric razor.
Answer:
D) Shave with an electric razor. Feedback: Thrombocytopenia is a common side effect of bone
marrow depression caused by several antineoplastic agents. The client is experiencing a low platelet
count and should use an electric razor (D) to reduce his risk of bleeding. (A, B, and C) are not
indicated for a client who needs to implement thrombocytopenia precautions.
Question:
The practical nurse (PN) is caring for a client who has been taking prednisone (Deltasone) daily for
a year. Which adverse effect should the PN document in the client's record? A) Photosensitvity. B)
Weight gain. C) Loss of hair. D) Pale skin color.
Answer:
B) Weight gain. Feedback: Long term use of prednisone causes fluid retention and redistribution of
fat deposition. Weight gain (B) and moon face reflect adverse effects of long-term prednisone use
and should be documented. (A, C, and D) do not occur with treatment using prednisone.
Question:
A female client with recurring headaches tells the practical nurse (PN) that she has been taking at
least 4 grams of acetaminophen a day. Which laboratory studies should the PN review for this
client? A) Creatinine clearance. B) Hepatic enzymes. C) Coagulation values. D) Arterial blood
gases.
Answer:
B) Hepatic enzymes. Feedback: Liver toxicity can occur when doses of acetaminophen exceed 4
grams a day, resulting in an elevation in hepatic enzyme values (B). (A, C, and D) do not reveal
,findings related to acetaminophen toxicity.
Question:
A client receives a prescription for an oral opioid analgesic for post-operative pain. Which adverse
effect should the practical nurse (PN) monitor for with the client? A) Constipation. B)
Photosensitivity. C) Decreased heart rate. D) Frequent urination.
Answer:
A) Constipation. Feedback: Opioid analgesics slow peristalsis, which leads to constipation (A), a
common side effect of opiates. (B, C, and D) are not associated with opioid analgesics.
Question:
Which action should the practical nurse implement when administering a buccal medication? A)
Encourage the client to swallow. B) Administer water with medication. C) Ensure the medication is
positioned under the tongue. D) Place the medication between the upper molar teeth and cheek.
Answer:
D) Place the medication between the upper molar teeth and cheek. Feedback: Buccal medications
are placed between the upper molar teeth and the cheek (D) for absorption by the capillaries of the
oral mucosa. The client should be cautioned against swallowing, not (A). Buccal medications are
not administered with water (B). (C) describes sublingual administration.
Question:
What assessment is most important for the practical nurse (PN) to obtain prior to initiating
medication therapy with phenelzine (Nardil) for a client with depression? A) Activity level. B)
Mood and affect. C) Understanding of diet modification. D) The client's support system.
Answer:
C) Understanding of diet modification. Feedback: To prevent a potentially lethal hypertensive crisis,
a tyramine-free diet should be maintained during antidepressant therapy with Nardil, a monoamine
oxidase inhibitor (MAOI). It is most important to determine if the client understands diet
modification (C) before Nardil is initiated to prevent consumption of foods that interact with Nardil.
Although a client's activity level (A) and mood and affect (B) should be monitored during
antidepressant therapy, it is most important that the client understand diet modifications. The client's
support system (D) and network of family and friends is important, but the client should understand
the responsibility of dietary compliance with the medication regimen.
, Question:
The practical nurse (PN) is unable to arouse a client who is receiving meperidine (Demerol) for
postoperative pain. The client is stuporous, has constricted pupils, and a respiratory rate of 8
breaths/minute. Which PRN prescription should the PN give the client? A) Naloxone (Narcan). B)
Promethazine (Phenergan). C) Metoclopramide (Reglan). D) Bethanechol (Urecholine).
Answer:
A) Naloxone (Narcan). Feedback: Narcan (A) is an opioid antagonist and should be administered to
reverse the effects of a Demerol, an opioid, overdose. (B, C, and D) are common postoperative PRN
prescriptions but are not indicated for narcotic overdose.
Question:
On which therapeutic action should the practical nurse (PN) base an explanation to a client who is
receiving a cardiac glycoside? A) Decreased cardiac output. B) Increased renal perfusion. C)
Decreased rate of contraction. D) Increased blood volume.
Answer:
C) Decreased rate of contraction. Feedback: Cardiac glycosides increase the force of cardiac
contraction (inotropy) and decrease the heart rate (chronotropy) (C) by decreasing the speed of
conduction through the heart (dromotropy). (A, B, and D) are incorrect.
Question:
A client with type 1 diabetes mellitus received an early AM dose of regular insulin per sliding scale.
At 10:00 AM, the practical nurse (PN) should report which signs indicative of hypoglycemia? A)
Urticaria and rash. B) Nausea and diarrhea. C) Irritability and confusion. D) Fruity, acetone odor to
the breath.
Answer:
C) Irritability and confusion. Feedback: Irritability and confusion (C) are early signs of
hypoglycemia. (A, B, and D) are not signs of hypoglycemia.
Question:
Which prescription should the practical nurse (PN) administer for a client who is experiencing an
anaphylactic reaction to an antibiotic? A) Ephedra (ma-huang). B) Epinephrine (Adrenalin). C)
