Pharmacology Evolve HESI Questions with Accurate
Answers.
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 - accurate answers-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 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. - accurate answers-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. - accurate answers-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 - accurate answers-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. - accurate answers-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 - accurate answers-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 - accurate answers-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." - accurate answers-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 - accurate answers-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 client who has trouble swallowing pills intermittently has been prescribed
venlafaxine (XR) for depression. The medication comes in capsule form. What
should the nurse include in the discharge teaching plan for this client?
A. Capsule contents can be sprinkled on pudding or applesauce.
B. Chew the medication thoroughly to enhance absorption.
C. Take the medication with a large glass of water or juice.
D. Contact the health care provider for another form of medication. - accurate
answers-D. Contact the health care provider for another form of medication.
Venlafaxine is administered PO in capsule form. Capsules that are extended-
release (XR) or continuous-release (CR) contain delayed-release, enteric-
coated granules to prevent decomposition of the drug in the acidic pH of the
stomach. The client should notify the health care provider about the inability
to swallow the capsule. This medication should not be chewed or opened so
that the delayed-release, enteric-coated granules can remain intact. Water or
juice will not affect the medication.
The nurse is preparing to apply a surface anesthetic agent for a client. Which
action should the nurse implement to reduce the risk of systemic absorption?
A. Apply the anesthetic to mucous membranes.
B. Limit the area of application to inflamed areas.
C. Avoid abraded skin areas when applying the anesthetic.
D. Spread the topical agent over a large surface area. - accurate answers-C.
Avoid abraded skin areas when applying the anesthetic.
To minimize systemic absorption of topical anesthetics, the anesthetic agent
should be applied to the smallest surface area of intact skin. Application to the
mucous membranes poses the greatest risk of systemic absorption because
absorption occurs more readily through mucous membranes than through the
skin. Inflamed areas generally have an increased blood supply, which
increases the risk of systemic absorption, so option B should be avoided. A
Answers.
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 - accurate answers-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 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. - accurate answers-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. - accurate answers-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 - accurate answers-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. - accurate answers-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 - accurate answers-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 - accurate answers-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." - accurate answers-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 - accurate answers-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 client who has trouble swallowing pills intermittently has been prescribed
venlafaxine (XR) for depression. The medication comes in capsule form. What
should the nurse include in the discharge teaching plan for this client?
A. Capsule contents can be sprinkled on pudding or applesauce.
B. Chew the medication thoroughly to enhance absorption.
C. Take the medication with a large glass of water or juice.
D. Contact the health care provider for another form of medication. - accurate
answers-D. Contact the health care provider for another form of medication.
Venlafaxine is administered PO in capsule form. Capsules that are extended-
release (XR) or continuous-release (CR) contain delayed-release, enteric-
coated granules to prevent decomposition of the drug in the acidic pH of the
stomach. The client should notify the health care provider about the inability
to swallow the capsule. This medication should not be chewed or opened so
that the delayed-release, enteric-coated granules can remain intact. Water or
juice will not affect the medication.
The nurse is preparing to apply a surface anesthetic agent for a client. Which
action should the nurse implement to reduce the risk of systemic absorption?
A. Apply the anesthetic to mucous membranes.
B. Limit the area of application to inflamed areas.
C. Avoid abraded skin areas when applying the anesthetic.
D. Spread the topical agent over a large surface area. - accurate answers-C.
Avoid abraded skin areas when applying the anesthetic.
To minimize systemic absorption of topical anesthetics, the anesthetic agent
should be applied to the smallest surface area of intact skin. Application to the
mucous membranes poses the greatest risk of systemic absorption because
absorption occurs more readily through mucous membranes than through the
skin. Inflamed areas generally have an increased blood supply, which
increases the risk of systemic absorption, so option B should be avoided. A
