EVOLVE HESI PHARMACOLOGY EXAM 2025
VERSION 1,2,3 AND 4 WITH ACTUAL
CORRECT QUESTIONS AND VERIFIED
DETAILED RATIONALES ANSWERS
|FREQUENTLY TESTED QUESTIONS AND
SOLUTIONS |ALREADY GRADED A+|BRAND
NEW!!|GUARANTEED PASS|LATEST UPDATE
A primigravida at 34 weeks of gestation is admitted to labor and delivery in preterm labor. She is started
on a terbutaline sulfate continuous IV infusion via pump. This therapy is ineffective, and the baby is
delivered vaginally. For which complication should the nurse monitor in this infant during the first few
hours after delivery?
A. Hypokalemia
B. Hypermagnesia
C. Hypoglycemia
D. Hypernatremia
C. Hypoglycemia
Hypoglycemia may occur in the neonate because a side effect of terbutaline sulfate is increased
maternal serum glucose levels. Although monitoring for imbalances in options A, B, and D is
important, option C is the priority following the maternal administration of terbutaline sulfate.
A client with metastatic cancer who has been receiving fentanyl for several weeks reports to the nurse
that the medication is not effectively controlling the pain. Which intervention should the nurse initiate?
A. Instruct the client about the indications of opioid dependence.
B. Monitor the client for symptoms of opioid withdrawal.
C. Notify the health care provider of the need to increase the dose.
D. Administer naloxone per PRN protocol for reversal.
C. Notify the health care provider of the need to increase the dose.
1|Page
,Clients can develop a tolerance to the analgesic effect of opioids and may require an increased dose
for effective long-term pain relief. The client is not exhibiting indications of dependence, withdrawal,
or toxicity.
The charge nurse is reviewing the admission history and physical data for four clients newly admitted to
the unit. Which client is at greatest risk for adverse reactions to medications?
A. 30-year-old man with a fracture
B. 7-year-old child with an ear infection
C. 75-year-old woman with liver disease
D. 50-year-old man with an upper respiratory tract infection
C. 75-year-old woman with liver disease
Impaired hepatic metabolic pathways for drug and chemical degradation place option C at greatest
risk for adverse reactions to medications based on advancing age and liver disease. Options A and D
have no predisposing factors, such as genetics, pathophysiologic dysfunction, or drug allergies, that
would increase the risk for cumulative toxicity or adverse drug reactions. Option B is at risk for dose-
related adverse reactions but is at less risk than option C.
A client is ordered 22 mg of gentamicin by IM injection. The drug is available in 20 mg/2 mL. How many
milliliters should be administered?
A. 1.8
B. 2.0
C. 2.4
D. 2.2
D. 2.2
(22 mg/20 mg) × (x mL/2 mL) = 22x = 40
x = 2.2 mL
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?
A. Sodium bicarbonate
B. Naloxone
C. Phentolamine mesylate
D. Atropine sulfate
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.
2|Page
,Which response best supports the observations that the nurse identifies in a client who is experiencing a
placebo effect?
A. Beneficial response or cure for disease
B. Behavioral or psychotropic responses
C. Malingering or drug-seeking behaviors
D. Psychological response to inert medication
D. Psychological response to inert medication
The placebo effect is a response in the client that is caused by the psychological impact of taking an
inert drug that has no biochemical properties. A placebo effect can be therapeutic, negative, or
ineffective but provides no cure or benefit to the client's progress. The placebo effect may evoke
behavioral changes but does not affect neurochemical psychotropic changes. Malingering and drug
seeking are behaviors that a client exhibits to obtain treatment for nonexistent disorders or obtain
prescription medications.
A client with Tourette syndrome takes haloperidol to control tics and vocalizations. The client has
become increasingly drowsy over the past 2 days and reports becoming dizzy when changing from a
supine to sitting position. Which action should the nurse take?
A. Assess for poor skin turgor, sunken eyeballs, and concentrated urine output.
B. Recognize that a sedative effect is expected and continue monitoring the client.
C. Have the caregiver hold the next two doses of the medication to reduce the drug toxicity.
D. Determine whether the client's urine is pink or reddish brown, and report findings to the health care
provider.
A. Assess for poor skin turgor, sunken eyeballs, and concentrated urine output.
Because haloperidol causes CNS effects of sedation and decreased thirst, the nurse should assess for
signs of dehydration. Although sedation may occur with haloperidol administration, this side effect
may signal an adverse CNS reaction; therefore, option B is not a sufficient intervention when client
safety is threatened. Option C could precipitate withdrawal-emergent dyskinesia, which is potentially
life threatening. Option D is expected.
A client who arrives in the postanesthesia care unit (PACU) after surgery is not awake from general
anesthesia. Which action should the nurse implement first?
A. Assess for deep tendon reflexes.
B. Observe urinary output.
C. Review the medication administration record (MAR).
D. Administer naloxone.
C. Review the medication administration record (MAR).
Most general anesthetics produce cardiovascular and respiratory depression, so a review of the
client's MAR identifies all the medications received during surgery and helps the nurse anticipate the
3|Page
, client's response and emergence from anesthesia. Options A and B are ongoing postoperative
assessments. Based on the medications that the client has received, naloxone may need to be
administered if indicated by the client's vital signs and delayed spontaneous reactivity.
Alteration of which laboratory finding represents the achievement of a therapeutic goal for heparin
administration?
A. Prothrombin time (PT)
B. Fibrin split products
C. Platelet count
D. Partial thromboplastin time (PTT)
D. Partial thromboplastin time (PTT)
Heparin therapy is guided by changes in the partial thromboplastin time (PTT). Options A, B, and C are
not used to track the therapeutic effect of heparin administration.
Methylphenidate is prescribed for daily administration to a 10-year-old child with attention-
deficit/hyperactivity disorder (ADHD). In preparing a teaching plan for the parents of this child newly
diagnosed with ADHD, which instruction is most important for the nurse to provide to the parents?
A. Administer the medication in the morning before the child goes to school.
B. Plan to implement periodic interruptions in the administration of the drug.
C. Attempt to be consistent when setting limits on inappropriate behavior.
D. Seek professional counseling if the child's behavior continues to be disruptive.
A. Administer the medication in the morning before the child goes to school.
Methylphenidate is a central nervous system (CNS) stimulant. To be most effective in affecting the
child's behavior, the dose of the drug should be administered in the morning before the child goes to
school. Drug holidays are often prescribed to assess the child's degree of recovery; however, such
interruptions are not conducted in the early phase of treatment and are usually implemented when
side effects occur over a period of time. Options C and D are worthwhile instructions but do not have
the priority of option A.
When caring for a client on digoxin therapy, the nurse knows to be alert for digoxin toxicity. Which
finding would predispose this client to developing digoxin toxicity?
A. Low serum sodium level
B. High serum sodium level
C. Low serum potassium level
D. High serum potassium level
C. Low serum potassium level
Hypokalemia predisposes the client on digoxin to digoxin toxicity, which usually presents as
abdominal pain, anorexia, nausea, vomiting, visual disturbances, bradycardia, and atrioventricular
4|Page
VERSION 1,2,3 AND 4 WITH ACTUAL
CORRECT QUESTIONS AND VERIFIED
DETAILED RATIONALES ANSWERS
|FREQUENTLY TESTED QUESTIONS AND
SOLUTIONS |ALREADY GRADED A+|BRAND
NEW!!|GUARANTEED PASS|LATEST UPDATE
A primigravida at 34 weeks of gestation is admitted to labor and delivery in preterm labor. She is started
on a terbutaline sulfate continuous IV infusion via pump. This therapy is ineffective, and the baby is
delivered vaginally. For which complication should the nurse monitor in this infant during the first few
hours after delivery?
A. Hypokalemia
B. Hypermagnesia
C. Hypoglycemia
D. Hypernatremia
C. Hypoglycemia
Hypoglycemia may occur in the neonate because a side effect of terbutaline sulfate is increased
maternal serum glucose levels. Although monitoring for imbalances in options A, B, and D is
important, option C is the priority following the maternal administration of terbutaline sulfate.
A client with metastatic cancer who has been receiving fentanyl for several weeks reports to the nurse
that the medication is not effectively controlling the pain. Which intervention should the nurse initiate?
A. Instruct the client about the indications of opioid dependence.
B. Monitor the client for symptoms of opioid withdrawal.
C. Notify the health care provider of the need to increase the dose.
D. Administer naloxone per PRN protocol for reversal.
C. Notify the health care provider of the need to increase the dose.
1|Page
,Clients can develop a tolerance to the analgesic effect of opioids and may require an increased dose
for effective long-term pain relief. The client is not exhibiting indications of dependence, withdrawal,
or toxicity.
The charge nurse is reviewing the admission history and physical data for four clients newly admitted to
the unit. Which client is at greatest risk for adverse reactions to medications?
A. 30-year-old man with a fracture
B. 7-year-old child with an ear infection
C. 75-year-old woman with liver disease
D. 50-year-old man with an upper respiratory tract infection
C. 75-year-old woman with liver disease
Impaired hepatic metabolic pathways for drug and chemical degradation place option C at greatest
risk for adverse reactions to medications based on advancing age and liver disease. Options A and D
have no predisposing factors, such as genetics, pathophysiologic dysfunction, or drug allergies, that
would increase the risk for cumulative toxicity or adverse drug reactions. Option B is at risk for dose-
related adverse reactions but is at less risk than option C.
A client is ordered 22 mg of gentamicin by IM injection. The drug is available in 20 mg/2 mL. How many
milliliters should be administered?
A. 1.8
B. 2.0
C. 2.4
D. 2.2
D. 2.2
(22 mg/20 mg) × (x mL/2 mL) = 22x = 40
x = 2.2 mL
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?
A. Sodium bicarbonate
B. Naloxone
C. Phentolamine mesylate
D. Atropine sulfate
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.
2|Page
,Which response best supports the observations that the nurse identifies in a client who is experiencing a
placebo effect?
A. Beneficial response or cure for disease
B. Behavioral or psychotropic responses
C. Malingering or drug-seeking behaviors
D. Psychological response to inert medication
D. Psychological response to inert medication
The placebo effect is a response in the client that is caused by the psychological impact of taking an
inert drug that has no biochemical properties. A placebo effect can be therapeutic, negative, or
ineffective but provides no cure or benefit to the client's progress. The placebo effect may evoke
behavioral changes but does not affect neurochemical psychotropic changes. Malingering and drug
seeking are behaviors that a client exhibits to obtain treatment for nonexistent disorders or obtain
prescription medications.
A client with Tourette syndrome takes haloperidol to control tics and vocalizations. The client has
become increasingly drowsy over the past 2 days and reports becoming dizzy when changing from a
supine to sitting position. Which action should the nurse take?
A. Assess for poor skin turgor, sunken eyeballs, and concentrated urine output.
B. Recognize that a sedative effect is expected and continue monitoring the client.
C. Have the caregiver hold the next two doses of the medication to reduce the drug toxicity.
D. Determine whether the client's urine is pink or reddish brown, and report findings to the health care
provider.
A. Assess for poor skin turgor, sunken eyeballs, and concentrated urine output.
Because haloperidol causes CNS effects of sedation and decreased thirst, the nurse should assess for
signs of dehydration. Although sedation may occur with haloperidol administration, this side effect
may signal an adverse CNS reaction; therefore, option B is not a sufficient intervention when client
safety is threatened. Option C could precipitate withdrawal-emergent dyskinesia, which is potentially
life threatening. Option D is expected.
A client who arrives in the postanesthesia care unit (PACU) after surgery is not awake from general
anesthesia. Which action should the nurse implement first?
A. Assess for deep tendon reflexes.
B. Observe urinary output.
C. Review the medication administration record (MAR).
D. Administer naloxone.
C. Review the medication administration record (MAR).
Most general anesthetics produce cardiovascular and respiratory depression, so a review of the
client's MAR identifies all the medications received during surgery and helps the nurse anticipate the
3|Page
, client's response and emergence from anesthesia. Options A and B are ongoing postoperative
assessments. Based on the medications that the client has received, naloxone may need to be
administered if indicated by the client's vital signs and delayed spontaneous reactivity.
Alteration of which laboratory finding represents the achievement of a therapeutic goal for heparin
administration?
A. Prothrombin time (PT)
B. Fibrin split products
C. Platelet count
D. Partial thromboplastin time (PTT)
D. Partial thromboplastin time (PTT)
Heparin therapy is guided by changes in the partial thromboplastin time (PTT). Options A, B, and C are
not used to track the therapeutic effect of heparin administration.
Methylphenidate is prescribed for daily administration to a 10-year-old child with attention-
deficit/hyperactivity disorder (ADHD). In preparing a teaching plan for the parents of this child newly
diagnosed with ADHD, which instruction is most important for the nurse to provide to the parents?
A. Administer the medication in the morning before the child goes to school.
B. Plan to implement periodic interruptions in the administration of the drug.
C. Attempt to be consistent when setting limits on inappropriate behavior.
D. Seek professional counseling if the child's behavior continues to be disruptive.
A. Administer the medication in the morning before the child goes to school.
Methylphenidate is a central nervous system (CNS) stimulant. To be most effective in affecting the
child's behavior, the dose of the drug should be administered in the morning before the child goes to
school. Drug holidays are often prescribed to assess the child's degree of recovery; however, such
interruptions are not conducted in the early phase of treatment and are usually implemented when
side effects occur over a period of time. Options C and D are worthwhile instructions but do not have
the priority of option A.
When caring for a client on digoxin therapy, the nurse knows to be alert for digoxin toxicity. Which
finding would predispose this client to developing digoxin toxicity?
A. Low serum sodium level
B. High serum sodium level
C. Low serum potassium level
D. High serum potassium level
C. Low serum potassium level
Hypokalemia predisposes the client on digoxin to digoxin toxicity, which usually presents as
abdominal pain, anorexia, nausea, vomiting, visual disturbances, bradycardia, and atrioventricular
4|Page
