EVOLVE HESI PHARM
COMPREHENSIVE STUDY GUIDE
WITH TESTED SOLUTIONS
⫸ 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.
⫸ 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.
,⫸ 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
⫸ 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.
⫸ 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.
⫸ 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.
, ⫸ 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.
⫸ 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
COMPREHENSIVE STUDY GUIDE
WITH TESTED SOLUTIONS
⫸ 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.
⫸ 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.
,⫸ 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
⫸ 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.
⫸ 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.
⫸ 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.
, ⫸ 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.
⫸ 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
