PHARM HESI PRACTICE QUESTIONS
(EVOLVE)
the healthcare provider prescribes medication for an older adult client who is complaining of
insomnia and instructs the client to return in two weeks. the nurse should question which
prescription?
- zolpidem 10 mg orally at bedtime
- eszopiclone 10 mg orally at bedtime
- temazepam 7.5 mg orally at bedtime
- ramelton 8 mg orally at bedtime - ANS eszopiclone 10 mg orally at bedtime
a client is receiving fentanyl via an epidural infusion. which side effect should the nurse
anticipate in the first 24 hours of epidural analgesia?
- headache
- agitation
- urinary retention
- abdominal cramping and diarrhea - ANS urinary retention
a client who takes a statin and gemfibrozil for hyperlipidemia reports onset of muscle pain and
weakness. what additional assessment is most important for the nurse to obtain?
- serum liver enzymes
- T3 and T4 blood levels
- bowel function
- peripheral sensation - ANS serum liver enzymes
a client is taking danazol for endometriosis and calls the clinic nurse to complain of a dark,
swollen and painful leg. what instructions should the nurse provide the client?
- wear support stockings
- elevate both legs and apply heat
- proceed to closest ER
- walk for 20 to 30 mins to reduce muscle cramps - ANS proceed to the closest emergency room
a client receives a new prescription for pentazocine, a mixed opioid agonist antagonist, after an
opioid agonist is discontinued. what is the advantage for the client when the new prescription is
implemented?
- tolerance does not occur
,- less agitation is experienced
- the analgesic ceiling is higher
- respiratory depression is less - ANS respiratory depression is less
a client beginning therapy with montelukast PO 10 mg once per day in the evening. the client
asks the nurse 'when should i begin to feel better?' how should the nurse respond?
- immediately
- within 24 hours
- in about 12 hours
- 30 minutes to 1 hour - ANS within 24 hours
a client is taking sulfisoxazole for a urinary tract infection and complains of nausea and gastric
upset since starting the med. which additional adverse reaction should the nurse instruct the
client to report?
- rash
- diarrhea
- hematuria
- muscle cramping - ANS rash
when prescribed for a client with hepatic encephalopathy, what is the therapeutic action of
lactulose?
- lowers pH of the colon
- softens the stool
- increase glucose absorption
- stimulates peristalsis - ANS lowers pH of the colon
which findings should the nurse identify in an adult client with possible chronic salicylate
intoxication?
- tinnitus and hearing loss
- photosensitivity and nervousness
- acute gi bleeding and anorexia
- hyperventilation and CNS effects - ANS tinnitus and hearing loss
a client with paget's disease is started on calcitonin 500 mch sub-q daily. during the initial
treatment, what is the priority nursing action?
- assess injection site for inflammation
- evaluate the client's level of pain
- monitor the client's alkaline phosphate levels
- observe client for signs of hypersensitivity - ANS observe the client for signs of hypersensitivity
,38 year old gravida 2 para 2 is diagnosed with bacterial vaginosis 9 months postpartum. a
prescription is written for metronidazole. which info is most important for the nurse to obtain from
the client before initiating treatment?
- sexual history
- use of oral contraceptive
- method of infant feeding
- possibility of pregnancy - ANS method of infant feeding
the nurse receives a unit of blood from the blood bank for a postoperative client who is currently
in the x ray department. which action should the nurse implement?
- return blood to blood bank for refrigeration within 30 mins
- hand the blood transfusion as soon as client returns to the unit
- store blood bag in the nursing unit's refrigerator until client returns
- take unit of blood to the x ray department to initiate the transfusion - ANS return blood to the
blood bank for refrigeration within 30 mins
client who is recently diagnosed with myasthenia gravis receives a prescription for
pyridostigmine, a cholinergic agent. which info should the nurse instruct the client to implement
when taking this medication?
- always take with meals to avoid GI distress
- plan doses close together for maximal therapeutic effect
- take the med at least 30 mins before eating meals
- avoid dairy products 2 hours before and after taking medications - ANS take the medication at
least 30 mins before eating meals
what teaching should the nurse provide a client who has received a new prescription for
sildenafil? (SAA)
- frequent use can lead to development of hypertension
- most effective if taken after at least 6 hours of REM sleep
- take within 30 to 60 mins of sexual stimulation
- report rebound priapism that occurs for 4 hours or more
- can cause facial flushing and headache - ANS - take within 30 to 60 mins of sexual intercourse
- report rebound priapism that occurs for 4 hours or more
- can cause facial flushing and headache
the therapeutic effect of insulin in treating type 1 diabetes mellitus is based on which physiologic
action?
- facilitates transport of glucose into the cells
, - stimulates function of beta cells in the pancreas
- increases intra-cellular receptor site sensitivity
- delays carb digestion and absorption - ANS facilitates transport of glucose into the cells
a client receives a new prescription for nitroglycerin tablets. which instruction should the nurse
include in this client's teaching?
- take the med at least an hour before every meal
- monitor your pulse for 60 seconds before admin
- place under the tongue as needed every 5 minutes up to 3 times
- resume normal activities after chest pain relief is obtained - ANS place under the tongue as
needed every 5 minutes up to 3 times
the nurse should expect the healthcare provider to prescribe what treatment regimen for a client
with a peptic ulcer cause by h pylori? (SAA)
- clarithromycin
- sulfisoxazole
- misoprostol
- omeprazole
- metronidazole
- sucralfate - ANS - clarithromycin
- omeprazole
- metronidazole
a client receives a prescription for sulfamethoxazole trimethoprim for a UTI. what instruction
should the nurse provide the client?
- ingest food prior to taking antibiotic
- drink at least 8 glasses of water a day
- take the med with grapefruit juice
- avoid prolonged exposure to sunlight - ANS drink at least 8 glasses of water a day
the mother of a newborn asks the nurse why her infant needs the vitamin K injection. what info
should the nurse provide?
- bacteria that synthesized vitamin K are not present in newborn's intestinal tract
oral vitamin k impeded the synthesis of clotting factors in the liver
- the maternal diet is often deficient in vitamin K so the infant is deficient in the vitamin
- the synthesis of vitamin k is inadequate for 3 to 4 months in the newborn - ANS bacteria that
synthesize vitamin K are not present in the newborns intestinal tract
the healthcare provider discontinues prednisone, a glucocorticoid, for a client with COPD. what
instructions should the nurse give the client about the regimen to follow?
(EVOLVE)
the healthcare provider prescribes medication for an older adult client who is complaining of
insomnia and instructs the client to return in two weeks. the nurse should question which
prescription?
- zolpidem 10 mg orally at bedtime
- eszopiclone 10 mg orally at bedtime
- temazepam 7.5 mg orally at bedtime
- ramelton 8 mg orally at bedtime - ANS eszopiclone 10 mg orally at bedtime
a client is receiving fentanyl via an epidural infusion. which side effect should the nurse
anticipate in the first 24 hours of epidural analgesia?
- headache
- agitation
- urinary retention
- abdominal cramping and diarrhea - ANS urinary retention
a client who takes a statin and gemfibrozil for hyperlipidemia reports onset of muscle pain and
weakness. what additional assessment is most important for the nurse to obtain?
- serum liver enzymes
- T3 and T4 blood levels
- bowel function
- peripheral sensation - ANS serum liver enzymes
a client is taking danazol for endometriosis and calls the clinic nurse to complain of a dark,
swollen and painful leg. what instructions should the nurse provide the client?
- wear support stockings
- elevate both legs and apply heat
- proceed to closest ER
- walk for 20 to 30 mins to reduce muscle cramps - ANS proceed to the closest emergency room
a client receives a new prescription for pentazocine, a mixed opioid agonist antagonist, after an
opioid agonist is discontinued. what is the advantage for the client when the new prescription is
implemented?
- tolerance does not occur
,- less agitation is experienced
- the analgesic ceiling is higher
- respiratory depression is less - ANS respiratory depression is less
a client beginning therapy with montelukast PO 10 mg once per day in the evening. the client
asks the nurse 'when should i begin to feel better?' how should the nurse respond?
- immediately
- within 24 hours
- in about 12 hours
- 30 minutes to 1 hour - ANS within 24 hours
a client is taking sulfisoxazole for a urinary tract infection and complains of nausea and gastric
upset since starting the med. which additional adverse reaction should the nurse instruct the
client to report?
- rash
- diarrhea
- hematuria
- muscle cramping - ANS rash
when prescribed for a client with hepatic encephalopathy, what is the therapeutic action of
lactulose?
- lowers pH of the colon
- softens the stool
- increase glucose absorption
- stimulates peristalsis - ANS lowers pH of the colon
which findings should the nurse identify in an adult client with possible chronic salicylate
intoxication?
- tinnitus and hearing loss
- photosensitivity and nervousness
- acute gi bleeding and anorexia
- hyperventilation and CNS effects - ANS tinnitus and hearing loss
a client with paget's disease is started on calcitonin 500 mch sub-q daily. during the initial
treatment, what is the priority nursing action?
- assess injection site for inflammation
- evaluate the client's level of pain
- monitor the client's alkaline phosphate levels
- observe client for signs of hypersensitivity - ANS observe the client for signs of hypersensitivity
,38 year old gravida 2 para 2 is diagnosed with bacterial vaginosis 9 months postpartum. a
prescription is written for metronidazole. which info is most important for the nurse to obtain from
the client before initiating treatment?
- sexual history
- use of oral contraceptive
- method of infant feeding
- possibility of pregnancy - ANS method of infant feeding
the nurse receives a unit of blood from the blood bank for a postoperative client who is currently
in the x ray department. which action should the nurse implement?
- return blood to blood bank for refrigeration within 30 mins
- hand the blood transfusion as soon as client returns to the unit
- store blood bag in the nursing unit's refrigerator until client returns
- take unit of blood to the x ray department to initiate the transfusion - ANS return blood to the
blood bank for refrigeration within 30 mins
client who is recently diagnosed with myasthenia gravis receives a prescription for
pyridostigmine, a cholinergic agent. which info should the nurse instruct the client to implement
when taking this medication?
- always take with meals to avoid GI distress
- plan doses close together for maximal therapeutic effect
- take the med at least 30 mins before eating meals
- avoid dairy products 2 hours before and after taking medications - ANS take the medication at
least 30 mins before eating meals
what teaching should the nurse provide a client who has received a new prescription for
sildenafil? (SAA)
- frequent use can lead to development of hypertension
- most effective if taken after at least 6 hours of REM sleep
- take within 30 to 60 mins of sexual stimulation
- report rebound priapism that occurs for 4 hours or more
- can cause facial flushing and headache - ANS - take within 30 to 60 mins of sexual intercourse
- report rebound priapism that occurs for 4 hours or more
- can cause facial flushing and headache
the therapeutic effect of insulin in treating type 1 diabetes mellitus is based on which physiologic
action?
- facilitates transport of glucose into the cells
, - stimulates function of beta cells in the pancreas
- increases intra-cellular receptor site sensitivity
- delays carb digestion and absorption - ANS facilitates transport of glucose into the cells
a client receives a new prescription for nitroglycerin tablets. which instruction should the nurse
include in this client's teaching?
- take the med at least an hour before every meal
- monitor your pulse for 60 seconds before admin
- place under the tongue as needed every 5 minutes up to 3 times
- resume normal activities after chest pain relief is obtained - ANS place under the tongue as
needed every 5 minutes up to 3 times
the nurse should expect the healthcare provider to prescribe what treatment regimen for a client
with a peptic ulcer cause by h pylori? (SAA)
- clarithromycin
- sulfisoxazole
- misoprostol
- omeprazole
- metronidazole
- sucralfate - ANS - clarithromycin
- omeprazole
- metronidazole
a client receives a prescription for sulfamethoxazole trimethoprim for a UTI. what instruction
should the nurse provide the client?
- ingest food prior to taking antibiotic
- drink at least 8 glasses of water a day
- take the med with grapefruit juice
- avoid prolonged exposure to sunlight - ANS drink at least 8 glasses of water a day
the mother of a newborn asks the nurse why her infant needs the vitamin K injection. what info
should the nurse provide?
- bacteria that synthesized vitamin K are not present in newborn's intestinal tract
oral vitamin k impeded the synthesis of clotting factors in the liver
- the maternal diet is often deficient in vitamin K so the infant is deficient in the vitamin
- the synthesis of vitamin k is inadequate for 3 to 4 months in the newborn - ANS bacteria that
synthesize vitamin K are not present in the newborns intestinal tract
the healthcare provider discontinues prednisone, a glucocorticoid, for a client with COPD. what
instructions should the nurse give the client about the regimen to follow?
