PHARMACOLOGY EVOLVE HESI
1.A 19-year-old male client who has sustained a severe head injury is in-
tubated and placed on assisted mechanical ventilation. To facilitate optimal
ventilation and prevent the client from "fighting" the ventilator, the health
care provider administers pancuronium bromide IV, with adjunctive opioid
analgesia. What medication should be immediately accessible for a
potential complication with this drug?
A. Dantrolene sodium
B. Neostigmine bromide
C. Succinylcholine bromide
D. Epinephrine
ANS B. Neostigmine bromide
Neostigmine bromide and atropine sulfate, both anticholinergic drugs,
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,reverse the respiratory muscle paralysis caused by pancuronium
bromide. Options A, C, and D are not antagonists to pancuronium
bromide and would not be helpful in reversing the effects of the drug
compared with the use of anticholinergics.
2.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.
ANS C. Decrease the dose of vitamin C.
3.When providing nursing care for a client receiving pyridostigmine
bromide for myasthenia gravis, which nursing intervention has the highest
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,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
irri- tation.
ANS B. Assess respiratory status and breath sounds often.
4.A client with a dislocated shoulder is being prepared for a closed manual
reduction using conscious sedation. Which medication should the nurse
ex- plain as a sedative used during the procedure?
A. Inhaled nitrous
oxide B.Midazolam IV
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, C. Ketamine IM
D. Fentanyl and droperidol IM
ANS B. Midazolam IV
5.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.
ANS D. Drink at least eight glasses of fluid a day.
6.The health care provider prescribes carbamazepine for a child whose ton-
ic-clonic seizures have been poorly controlled. The nurse informs the
mother that the child must have blood tests every week. The mother asks
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141
1.A 19-year-old male client who has sustained a severe head injury is in-
tubated and placed on assisted mechanical ventilation. To facilitate optimal
ventilation and prevent the client from "fighting" the ventilator, the health
care provider administers pancuronium bromide IV, with adjunctive opioid
analgesia. What medication should be immediately accessible for a
potential complication with this drug?
A. Dantrolene sodium
B. Neostigmine bromide
C. Succinylcholine bromide
D. Epinephrine
ANS B. Neostigmine bromide
Neostigmine bromide and atropine sulfate, both anticholinergic drugs,
1/
141
,reverse the respiratory muscle paralysis caused by pancuronium
bromide. Options A, C, and D are not antagonists to pancuronium
bromide and would not be helpful in reversing the effects of the drug
compared with the use of anticholinergics.
2.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.
ANS C. Decrease the dose of vitamin C.
3.When providing nursing care for a client receiving pyridostigmine
bromide for myasthenia gravis, which nursing intervention has the highest
2/
141
,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
irri- tation.
ANS B. Assess respiratory status and breath sounds often.
4.A client with a dislocated shoulder is being prepared for a closed manual
reduction using conscious sedation. Which medication should the nurse
ex- plain as a sedative used during the procedure?
A. Inhaled nitrous
oxide B.Midazolam IV
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141
, C. Ketamine IM
D. Fentanyl and droperidol IM
ANS B. Midazolam IV
5.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.
ANS D. Drink at least eight glasses of fluid a day.
6.The health care provider prescribes carbamazepine for a child whose ton-
ic-clonic seizures have been poorly controlled. The nurse informs the
mother that the child must have blood tests every week. The mother asks
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