Pharmacology Evolve HESI Latest Update
A 19-year-old male client who has sustained a severe head injury is intubated 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 - ANSWER-B. Neostigmine bromide
Neostigmine bromide and atropine sulfate, both anticholinergic drugs, 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.
A 2-month-old infant is scheduled to receive the first DPT immunization. What is the preferred injection
site to administer this immunization?
A. Dorsal gluteal
B. Vastus lateralis
C. Ventral gluteal
D. Deltoid - ANSWER-B. Vastus lateralis
The preferred intramuscular site for children younger than 2 years is the vastus lateralis. Options A, C,
and D are not preferred injection sites for the infant at 2 months of age.
A 26-year-old primigravida client is experiencing increasing discomfort and anxiety during the active
phase of labor. She requests something for pain. Which analgesic should the nurse anticipate
administering?
A. Butorphanol
B. Hydromorphone
C. Morphine sulfate
,Pharmacology Evolve HESI Latest Update
D. Codeine sulfate - ANSWER-A. Butorphanol
Butorphanol is a mixed agonist-antagonist analgesic resulting in good analgesia but with less respiratory
depression, nausea, and vomiting compared with opioid agonist analgesics.
A 3-year-old boy is admitted to the emergency department after ingesting an unknown amount of
phenobarbital elixir prescribed for his brother's seizure disorder. Which nursing intervention should the
nurse implement first?
A. Administer syrup of ipecac.
B. Take the child's vital signs.
C. Draw a blood specimen for a phenobarbital level.
D. Teach the mother safe medication storage practices. - ANSWER-B. Take the child's vital signs.
Phenobarbital causes respiratory depression, so the priority intervention is assessment of vital signs.
Options A, C, and D are actions that may all be used in the treatment of this child, but they do not have
the priority of option B.
A 4-year-old child is receiving chemotherapy for acute lymphocytic leukemia. Which laboratory result
should the nurse examine to assess the child's risk for infection?
A. Neutrophil count
B. Platelet count
C. Reticulocyte count
D. Lymphocyte count - ANSWER-A. Neutrophil
During chemotherapy, granulocytes are significantly suppressed. Because neutrophils comprise 60% to
70% of the granulocyte count, these levels are the most useful laboratory results of the options
presented to determine the child's risk for infection. Options B, C, and D are not as useful as option A in
determining risk of infection.
A 42-year-old client is admitted to the emergency department after taking an overdose of amitriptyline
in a suicide attempt. Which drug should the nurse plan to administer to reverse the cardiac and central
nervous system effects of amitriptyline?
,Pharmacology Evolve HESI Latest Update
A. Sodium bicarbonate
B. Naloxone
C. Phentolamine mesylate
D. Atropine sulfate - ANSWER-A. Sodium bicarbonate
Sodium bicarbonate is an effective treatment for an overdose of tricyclic antidepressants such as
amitriptyline to reverse QRS prolongation. Options B, C, and D are not the preferred agents for treating
this drug overdose.
A 45-year-old female client is receiving alprazolam for anxiety. Which client behavior would indicate that
the drug is effective?
A. Personal hygiene is maintained by the client for the first time in a week.
B. The client has an average resting heart rate of 120 beats/min.
C. The staff observes the client sitting in the day room reading a book.
D. The nurse records that the client lost 2 lb of body weight in the past week. - ANSWER-C. The staff
observes the client sitting in the day room reading a book.
The ability to sit and concentrate on reading indicates decreased anxiety. Options A, B, and D are not
related to the use of alprazolam for anxiety.
A 55-year-old client was diagnosed with schizophrenia 5 years earlier. Numerous hospitalizations have
occurred since the diagnosis because of noncompliance with the prescribed medication regimen. Which
drug might work best for this particular client?
A. Chlorpromazine HCl
B. Lithium carbonate
C. Fluphenazine decanoate
D. Diazepam - ANSWER-C. Fluphenazine decanoate
Fluphenazine, an antipsychotic drug that can be given IM, has a rapid onset (1 to 2 hours) and a long
duration of action (up to 3 or 4 weeks), so it would be the drug of choice for a noncompliant psychotic
client. Option A is an antipsychotic drug used to treat schizophrenia and is usually administered PO (IM
, Pharmacology Evolve HESI Latest Update
doses are short-acting). The client must be compliant in taking this drug for it to be effective. Option B is
most effective with manic and depressive bipolar affective disorders. Option D is an antianxiety drug and
would not be effective for a psychotic disorder.
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.
A 67-year-old client is discharged from the hospital with a prescription for digoxin, 0.25 mg daily. Which
instruction should the nurse include in this client's discharge teaching plan?
A. Take the medication in the morning before rising.
B. Take and record radial pulse rate daily.
C. Expect some vision changes caused by the medication.
D. Increase intake of foods rich in vitamin K. - ANSWER-B. Take and record radial pulse rate daily.
Monitoring pulse rate is very important when taking digoxin. The client should be further instructed to
report pulse rates <60 or >110 beats/min and to withhold the dosage until consulting with the health
care provider in such a case. Options A and D are not necessary. Option C is an indication of drug
toxicity, and the client should be instructed to report this immediately.
A chemotherapeutic regimen with doxorubicin HCl is being planned for a client recently diagnosed with
cancer. What diagnostic test results should the nurse review prior to initiating this treatment?
A. Electrocardiogram (ECG)
B. Arterial blood gases (ABGs)
A 19-year-old male client who has sustained a severe head injury is intubated 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 - ANSWER-B. Neostigmine bromide
Neostigmine bromide and atropine sulfate, both anticholinergic drugs, 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.
A 2-month-old infant is scheduled to receive the first DPT immunization. What is the preferred injection
site to administer this immunization?
A. Dorsal gluteal
B. Vastus lateralis
C. Ventral gluteal
D. Deltoid - ANSWER-B. Vastus lateralis
The preferred intramuscular site for children younger than 2 years is the vastus lateralis. Options A, C,
and D are not preferred injection sites for the infant at 2 months of age.
A 26-year-old primigravida client is experiencing increasing discomfort and anxiety during the active
phase of labor. She requests something for pain. Which analgesic should the nurse anticipate
administering?
A. Butorphanol
B. Hydromorphone
C. Morphine sulfate
,Pharmacology Evolve HESI Latest Update
D. Codeine sulfate - ANSWER-A. Butorphanol
Butorphanol is a mixed agonist-antagonist analgesic resulting in good analgesia but with less respiratory
depression, nausea, and vomiting compared with opioid agonist analgesics.
A 3-year-old boy is admitted to the emergency department after ingesting an unknown amount of
phenobarbital elixir prescribed for his brother's seizure disorder. Which nursing intervention should the
nurse implement first?
A. Administer syrup of ipecac.
B. Take the child's vital signs.
C. Draw a blood specimen for a phenobarbital level.
D. Teach the mother safe medication storage practices. - ANSWER-B. Take the child's vital signs.
Phenobarbital causes respiratory depression, so the priority intervention is assessment of vital signs.
Options A, C, and D are actions that may all be used in the treatment of this child, but they do not have
the priority of option B.
A 4-year-old child is receiving chemotherapy for acute lymphocytic leukemia. Which laboratory result
should the nurse examine to assess the child's risk for infection?
A. Neutrophil count
B. Platelet count
C. Reticulocyte count
D. Lymphocyte count - ANSWER-A. Neutrophil
During chemotherapy, granulocytes are significantly suppressed. Because neutrophils comprise 60% to
70% of the granulocyte count, these levels are the most useful laboratory results of the options
presented to determine the child's risk for infection. Options B, C, and D are not as useful as option A in
determining risk of infection.
A 42-year-old client is admitted to the emergency department after taking an overdose of amitriptyline
in a suicide attempt. Which drug should the nurse plan to administer to reverse the cardiac and central
nervous system effects of amitriptyline?
,Pharmacology Evolve HESI Latest Update
A. Sodium bicarbonate
B. Naloxone
C. Phentolamine mesylate
D. Atropine sulfate - ANSWER-A. Sodium bicarbonate
Sodium bicarbonate is an effective treatment for an overdose of tricyclic antidepressants such as
amitriptyline to reverse QRS prolongation. Options B, C, and D are not the preferred agents for treating
this drug overdose.
A 45-year-old female client is receiving alprazolam for anxiety. Which client behavior would indicate that
the drug is effective?
A. Personal hygiene is maintained by the client for the first time in a week.
B. The client has an average resting heart rate of 120 beats/min.
C. The staff observes the client sitting in the day room reading a book.
D. The nurse records that the client lost 2 lb of body weight in the past week. - ANSWER-C. The staff
observes the client sitting in the day room reading a book.
The ability to sit and concentrate on reading indicates decreased anxiety. Options A, B, and D are not
related to the use of alprazolam for anxiety.
A 55-year-old client was diagnosed with schizophrenia 5 years earlier. Numerous hospitalizations have
occurred since the diagnosis because of noncompliance with the prescribed medication regimen. Which
drug might work best for this particular client?
A. Chlorpromazine HCl
B. Lithium carbonate
C. Fluphenazine decanoate
D. Diazepam - ANSWER-C. Fluphenazine decanoate
Fluphenazine, an antipsychotic drug that can be given IM, has a rapid onset (1 to 2 hours) and a long
duration of action (up to 3 or 4 weeks), so it would be the drug of choice for a noncompliant psychotic
client. Option A is an antipsychotic drug used to treat schizophrenia and is usually administered PO (IM
, Pharmacology Evolve HESI Latest Update
doses are short-acting). The client must be compliant in taking this drug for it to be effective. Option B is
most effective with manic and depressive bipolar affective disorders. Option D is an antianxiety drug and
would not be effective for a psychotic disorder.
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.
A 67-year-old client is discharged from the hospital with a prescription for digoxin, 0.25 mg daily. Which
instruction should the nurse include in this client's discharge teaching plan?
A. Take the medication in the morning before rising.
B. Take and record radial pulse rate daily.
C. Expect some vision changes caused by the medication.
D. Increase intake of foods rich in vitamin K. - ANSWER-B. Take and record radial pulse rate daily.
Monitoring pulse rate is very important when taking digoxin. The client should be further instructed to
report pulse rates <60 or >110 beats/min and to withhold the dosage until consulting with the health
care provider in such a case. Options A and D are not necessary. Option C is an indication of drug
toxicity, and the client should be instructed to report this immediately.
A chemotherapeutic regimen with doxorubicin HCl is being planned for a client recently diagnosed with
cancer. What diagnostic test results should the nurse review prior to initiating this treatment?
A. Electrocardiogram (ECG)
B. Arterial blood gases (ABGs)
