Pharmacology Evolve HESI Exam Questions and
Correct Answers (100% COMPLETE ANSWERS)
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Maintaining optimal dosage for cholinesterase inhibitors can be challenging for clients with
myasthenia gravis. Clients should be taught to recognize signs of overmedication and
undermedication so that they can modify the dosage themselves based on a prescribed sliding scale.
Options A, B, and C do not adequately address the client's concerns.
A female client with trichomoniasis (Trichomonas vaginalis) receives a prescription for metronidazole.
Which instruction is most important for the nurse to include in this client's teaching plan?
A. Avoid alcohol consumption.
B. Complete the medication regimen.
C. Use a barrier contraceptive method.
D. Treat partner(s) concurrently. - ✔✔A. Avoid alcohol consumption.
Clients should be instructed to avoid alcohol and products containing alcohol while taking
metronidazole because of the possibility of a disulfiram-like reaction. Option B helps prevent the
development of metronidazole-resistant T. vaginalis. To prevent reinfection, clients should abstain
from sexual contact or use a barrier contraceptive while taking metronidazole, and their partner(s)
should be treated concurrently. The most important instruction for client well-being is option A.
A lidocaine IV infusion at 4 mg/min via infusion pump is prescribed for a client having premature
ventricular contractions (PVCs). The available premixed infusion contains 2 mg/mL of D5W. How many
milliliters per hour should the nurse program the pump to deliver to this client?
A. 20
B. 24
C. 60
D. 120 - ✔✔D. 120
Option D is the correct calculation; 120 mL/hr = 1 mL/2 mg × 4 mg/min × 60 min/hr.
A male client asks the nurse why condoms should not be lubricated with the spermicide nonoxynol-9.
Which response is best for the nurse to provide?
A. The risk of female infertility and spontaneous abortion is linked with nonoxynol-9.
B. Partners can develop intermittent interstitial cystitis if the spermicide is used after the expiration
date.
C. The spermicide decreases the amount of vaginal and penile sensitivity for up to 8 to 12 hours.
D. Nonoxynol-9 provides no protection from STDs and has been linked to the transmission of HIV. -
✔✔D. Nonoxynol-9 provides no protection from STDs and has been linked to the transmission of HIV.
The use of condoms and a water-based spermicide is recommended because nonoxynol-9 can cause a
rash that allows viruses a portal of entry if the condom breaks, which increases the risk of
transmission of sexually transmitted diseases (STDs), such as human immunodeficiency virus (HIV),
herpes, human papillomavirus (HPV), or hepatitis B virus (HBV). Options A and B are inaccurate.
Nonoxynol-9 may cause vaginal irritation, not option C.
A male client with prostatic carcinoma has arrived for his scheduled dose of docetaxel chemotherapy.
What symptom would indicate a need for an immediate response by the nurse prior to implementing
another dose of this chemotherapeutic agent?
,A. A cough that is new and persistent
B. Persistent nausea and vomiting
C. Fingernail and toenail changes
D. Increasing weakness and neuropathy - ✔✔A. A cough that is new and persistent
Option A is an adverse effect that is immediately life threatening. Severe fluid retention can cause
pleural effusion (requiring urgent drainage), dyspnea at rest, cardiac tamponade, or pronounced
abdominal distention (caused by ascites). Options B, C, and D are all adverse effects from
chemotherapy and need to be monitored consistently.
A mother brings her 18-month-old child to the community health center because the child has had
"bad diarrhea" for the last 3 days. She states, "I bought some of this liquid at the pharmacy and gave
my daughter a half-ounce." The nurse sees that the bottle contains loperamide. Which intervention is
most important for the nurse to implement initially?
A. Tell the mother never to give this drug to her toddler.
B. Ask if any other siblings have experienced diarrhea.
C. Take the child's oral and tympanic temperatures.
D. Ask the mother when the child last voided. - ✔✔D. Ask the mother when the child last voided.
Determining when the child last voided is most important because urine output is decreased with
dehydration and an 18-month-old with a 3-day history of diarrhea could be severely dehydrated.
Although the manufacturer states that loperamide should not be given to a child younger than 2 years
except under the direction of a health care provider, option A is not the best answer for this question.
In addition, loperamide causes an anticholinergic effect of urinary retention. Data obtained in options
B and C are not as high a priority as option D in this situation.
A pediatric client is discharged home with multiple prescriptions for medications. Which information
should the nurse provide that is most helpful to the parents when managing the medication regimens?
A. Maintain a drug administration record.
B. Fill all prescriptions at one pharmacy.
C. Allow one person to give the medications.
D. Give all medications in small volumes. - ✔✔A. Maintain a drug administration record.
A written drug administration record provides a consistent plan to ensure safe adherence to multiple
medication dosages and times. Although option B is an important safeguard to monitor for drug
interactions, the parents should be given a tool to enhance their confidence and provide a mechanism
to ensure accurate and timely medication administration without duplicating or omitting a dose.
Using a written record to record medication administration allows more than one person to share the
responsibility of giving medications to the child. Although smaller volumes ensure that all the
medication is taken, it is more important to maintain an accurate administration schedule.
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 psychiatric client is discharged from the hospital with a prescription for haloperidol. Which
instruction should the nurse include in the discharge teaching plan for this client?
A. Take with antacids to reduce gastrointestinal irritation.
B. Use sunglasses and sunscreen when outdoors.
C. Eat foods low in fiber and salt.
D. Count the pulse before each dose. - ✔✔B. Use sunglasses and sunscreen when outdoors.
Photosensitivity is a common adverse effect of haloperidol (Haldol); therefore, the use of sunglasses
and sunscreen should be included in the discharge teaching for this client. Options A, C, and D are not
pertinent to client teaching regarding the use of haloperidol (Haldol).
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.
Amoxicillin, 500 mg PO every 8 hours, is prescribed for a client with an infection. The drug is available
in a suspension of 125 mg/5 mL. How many milliliters should the nurse administer with each dose?
A. 10
B. 15
C. 20
D. 25 - ✔✔C. 20
500 mg/x mL = 125 mg/5 mL
125x = 2500
x = 20 mL
An older client is receiving a water-soluble drug that is more than the average dose for a young adult.
Which action should the nurse implement first?
A. Obtain a prescription for lower medication dosages.
B. Determine the drug's serum levels for toxicity.
C. Start IV fluids to decrease the serum drug levels.
D. Hold the next dosage and notify the health care provider. - ✔✔B. Determine the drug's serum
levels for toxicity.
Older clients usually have a decline in lean body mass and total body water that causes water-soluble
drugs to become distributed in fluid compartments, resulting in an increased concentration, so
determining the drug's serum level for toxicity should be implemented first. Although options A, C,
and D may be indicated, an increased plasma drug level should be the determining factor to consider
when water-soluble drugs warrant a reduced dosage in the older client.
An older client who had a colon resection yesterday is receiving a constant dose of hydromorphone
via a patient-controlled analgesia (PCA) pump. Which assessment finding is most significant and
requires that the nurse intervene?
A. The client is drowsy and complains of pruritus.
B. Pupils are 3 mm; PERRLA.
, C. The area around the sutures is reddened and swollen.
D. Respirations decrease to 14 breaths/min. - ✔✔D. Respirations decrease to 14 breaths/min.
Hydromorphone is an opioid agonist-analgesic of opiate receptors that inhibits ascending pathways
and can cause respiratory depression. Older adults are more sensitive to opioids so the "start low and
go slow" approach should be taken. Option A lists common side effects of opioids, particularly the
opiates, which are usually harmless and often transient. Option B is within the normal range (2 to 6
cm). The suture site may be red and swollen as an inflammatory response, but no action is required if
the skin around the incision is a normal color and temperature.
Dopamine is administered to a client who is hypotensive. Which finding should the nurse identify as a
therapeutic response?
A. Gain in weight
B. Increase in urine output
C. Improved gastric motility
D. Decrease in blood pressure - ✔✔B. Increase in urine output
Intropin activates dopamine receptors in the kidney and dilates blood vessels to improve renal
perfusion, so an increase in urine output indicates an increase in glomerular filtration caused by
increased arterial blood pressure. Option A is related to fluid retention but is not an indicator of a
therapeutic response to dopamine therapy. Option C is not related to the vasopressor effect of
dopamine therapy. Dopamine increases cardiac output, which increases a client's blood pressure, not
option D.
Dopamine, 5 mcg/kg/min, is prescribed for a client who weighs 105 kg. The nurse mixes 400 mg of
dopamine in 250 mL D5W for IV administration via an infusion pump. What is the hourly rate that the
nurse should set on the pump?
A. 5 mL/hr
B. 10 mL/hr
C. 15 mL/hr
D. 20 mL/hr - ✔✔D. 20 mL/hr
400 mg/250 mL equals 1.6 mg/mL, or 1600 mcg/mL. The prescription for 5 mcg/kg/min would result
in 31,500 mcg/hr. Delivery of that dose would be achieved by administering 20 mL/hr, which would
deliver 5.07 mcg/kg/min. Options A, B, and C are not accurate hourly rates for this infusion.
During administration of theophylline, the nurse should monitor for signs of toxicity. Which symptom
would cause the nurse to suspect theophylline toxicity?
A. Dry mouth
B. Urinary retention
C. Restlessness
D. Sedation - ✔✔C. Restlessness
Restlessness is a sign of theophylline intoxication. Other signs of toxicity are anorexia, nausea,
vomiting, insomnia, tachycardia, arrhythmias, and seizures. Options A, B, and D are common side
effects of antihistamines but do not indicate theophylline intoxication.
During the initial nursing assessment history, a client tells the nurse that he is taking tetracycline
hydrochloride for urethritis. The nurse is most concerned if the client reports taking which medication
concurrently?
A. Sucralfate
B. Hydrochlorothiazide
C. Acetaminophen
Correct Answers (100% COMPLETE ANSWERS)
ALREADY GRADED A+ | 100% satisfaction
guaranteed
Maintaining optimal dosage for cholinesterase inhibitors can be challenging for clients with
myasthenia gravis. Clients should be taught to recognize signs of overmedication and
undermedication so that they can modify the dosage themselves based on a prescribed sliding scale.
Options A, B, and C do not adequately address the client's concerns.
A female client with trichomoniasis (Trichomonas vaginalis) receives a prescription for metronidazole.
Which instruction is most important for the nurse to include in this client's teaching plan?
A. Avoid alcohol consumption.
B. Complete the medication regimen.
C. Use a barrier contraceptive method.
D. Treat partner(s) concurrently. - ✔✔A. Avoid alcohol consumption.
Clients should be instructed to avoid alcohol and products containing alcohol while taking
metronidazole because of the possibility of a disulfiram-like reaction. Option B helps prevent the
development of metronidazole-resistant T. vaginalis. To prevent reinfection, clients should abstain
from sexual contact or use a barrier contraceptive while taking metronidazole, and their partner(s)
should be treated concurrently. The most important instruction for client well-being is option A.
A lidocaine IV infusion at 4 mg/min via infusion pump is prescribed for a client having premature
ventricular contractions (PVCs). The available premixed infusion contains 2 mg/mL of D5W. How many
milliliters per hour should the nurse program the pump to deliver to this client?
A. 20
B. 24
C. 60
D. 120 - ✔✔D. 120
Option D is the correct calculation; 120 mL/hr = 1 mL/2 mg × 4 mg/min × 60 min/hr.
A male client asks the nurse why condoms should not be lubricated with the spermicide nonoxynol-9.
Which response is best for the nurse to provide?
A. The risk of female infertility and spontaneous abortion is linked with nonoxynol-9.
B. Partners can develop intermittent interstitial cystitis if the spermicide is used after the expiration
date.
C. The spermicide decreases the amount of vaginal and penile sensitivity for up to 8 to 12 hours.
D. Nonoxynol-9 provides no protection from STDs and has been linked to the transmission of HIV. -
✔✔D. Nonoxynol-9 provides no protection from STDs and has been linked to the transmission of HIV.
The use of condoms and a water-based spermicide is recommended because nonoxynol-9 can cause a
rash that allows viruses a portal of entry if the condom breaks, which increases the risk of
transmission of sexually transmitted diseases (STDs), such as human immunodeficiency virus (HIV),
herpes, human papillomavirus (HPV), or hepatitis B virus (HBV). Options A and B are inaccurate.
Nonoxynol-9 may cause vaginal irritation, not option C.
A male client with prostatic carcinoma has arrived for his scheduled dose of docetaxel chemotherapy.
What symptom would indicate a need for an immediate response by the nurse prior to implementing
another dose of this chemotherapeutic agent?
,A. A cough that is new and persistent
B. Persistent nausea and vomiting
C. Fingernail and toenail changes
D. Increasing weakness and neuropathy - ✔✔A. A cough that is new and persistent
Option A is an adverse effect that is immediately life threatening. Severe fluid retention can cause
pleural effusion (requiring urgent drainage), dyspnea at rest, cardiac tamponade, or pronounced
abdominal distention (caused by ascites). Options B, C, and D are all adverse effects from
chemotherapy and need to be monitored consistently.
A mother brings her 18-month-old child to the community health center because the child has had
"bad diarrhea" for the last 3 days. She states, "I bought some of this liquid at the pharmacy and gave
my daughter a half-ounce." The nurse sees that the bottle contains loperamide. Which intervention is
most important for the nurse to implement initially?
A. Tell the mother never to give this drug to her toddler.
B. Ask if any other siblings have experienced diarrhea.
C. Take the child's oral and tympanic temperatures.
D. Ask the mother when the child last voided. - ✔✔D. Ask the mother when the child last voided.
Determining when the child last voided is most important because urine output is decreased with
dehydration and an 18-month-old with a 3-day history of diarrhea could be severely dehydrated.
Although the manufacturer states that loperamide should not be given to a child younger than 2 years
except under the direction of a health care provider, option A is not the best answer for this question.
In addition, loperamide causes an anticholinergic effect of urinary retention. Data obtained in options
B and C are not as high a priority as option D in this situation.
A pediatric client is discharged home with multiple prescriptions for medications. Which information
should the nurse provide that is most helpful to the parents when managing the medication regimens?
A. Maintain a drug administration record.
B. Fill all prescriptions at one pharmacy.
C. Allow one person to give the medications.
D. Give all medications in small volumes. - ✔✔A. Maintain a drug administration record.
A written drug administration record provides a consistent plan to ensure safe adherence to multiple
medication dosages and times. Although option B is an important safeguard to monitor for drug
interactions, the parents should be given a tool to enhance their confidence and provide a mechanism
to ensure accurate and timely medication administration without duplicating or omitting a dose.
Using a written record to record medication administration allows more than one person to share the
responsibility of giving medications to the child. Although smaller volumes ensure that all the
medication is taken, it is more important to maintain an accurate administration schedule.
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 psychiatric client is discharged from the hospital with a prescription for haloperidol. Which
instruction should the nurse include in the discharge teaching plan for this client?
A. Take with antacids to reduce gastrointestinal irritation.
B. Use sunglasses and sunscreen when outdoors.
C. Eat foods low in fiber and salt.
D. Count the pulse before each dose. - ✔✔B. Use sunglasses and sunscreen when outdoors.
Photosensitivity is a common adverse effect of haloperidol (Haldol); therefore, the use of sunglasses
and sunscreen should be included in the discharge teaching for this client. Options A, C, and D are not
pertinent to client teaching regarding the use of haloperidol (Haldol).
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.
Amoxicillin, 500 mg PO every 8 hours, is prescribed for a client with an infection. The drug is available
in a suspension of 125 mg/5 mL. How many milliliters should the nurse administer with each dose?
A. 10
B. 15
C. 20
D. 25 - ✔✔C. 20
500 mg/x mL = 125 mg/5 mL
125x = 2500
x = 20 mL
An older client is receiving a water-soluble drug that is more than the average dose for a young adult.
Which action should the nurse implement first?
A. Obtain a prescription for lower medication dosages.
B. Determine the drug's serum levels for toxicity.
C. Start IV fluids to decrease the serum drug levels.
D. Hold the next dosage and notify the health care provider. - ✔✔B. Determine the drug's serum
levels for toxicity.
Older clients usually have a decline in lean body mass and total body water that causes water-soluble
drugs to become distributed in fluid compartments, resulting in an increased concentration, so
determining the drug's serum level for toxicity should be implemented first. Although options A, C,
and D may be indicated, an increased plasma drug level should be the determining factor to consider
when water-soluble drugs warrant a reduced dosage in the older client.
An older client who had a colon resection yesterday is receiving a constant dose of hydromorphone
via a patient-controlled analgesia (PCA) pump. Which assessment finding is most significant and
requires that the nurse intervene?
A. The client is drowsy and complains of pruritus.
B. Pupils are 3 mm; PERRLA.
, C. The area around the sutures is reddened and swollen.
D. Respirations decrease to 14 breaths/min. - ✔✔D. Respirations decrease to 14 breaths/min.
Hydromorphone is an opioid agonist-analgesic of opiate receptors that inhibits ascending pathways
and can cause respiratory depression. Older adults are more sensitive to opioids so the "start low and
go slow" approach should be taken. Option A lists common side effects of opioids, particularly the
opiates, which are usually harmless and often transient. Option B is within the normal range (2 to 6
cm). The suture site may be red and swollen as an inflammatory response, but no action is required if
the skin around the incision is a normal color and temperature.
Dopamine is administered to a client who is hypotensive. Which finding should the nurse identify as a
therapeutic response?
A. Gain in weight
B. Increase in urine output
C. Improved gastric motility
D. Decrease in blood pressure - ✔✔B. Increase in urine output
Intropin activates dopamine receptors in the kidney and dilates blood vessels to improve renal
perfusion, so an increase in urine output indicates an increase in glomerular filtration caused by
increased arterial blood pressure. Option A is related to fluid retention but is not an indicator of a
therapeutic response to dopamine therapy. Option C is not related to the vasopressor effect of
dopamine therapy. Dopamine increases cardiac output, which increases a client's blood pressure, not
option D.
Dopamine, 5 mcg/kg/min, is prescribed for a client who weighs 105 kg. The nurse mixes 400 mg of
dopamine in 250 mL D5W for IV administration via an infusion pump. What is the hourly rate that the
nurse should set on the pump?
A. 5 mL/hr
B. 10 mL/hr
C. 15 mL/hr
D. 20 mL/hr - ✔✔D. 20 mL/hr
400 mg/250 mL equals 1.6 mg/mL, or 1600 mcg/mL. The prescription for 5 mcg/kg/min would result
in 31,500 mcg/hr. Delivery of that dose would be achieved by administering 20 mL/hr, which would
deliver 5.07 mcg/kg/min. Options A, B, and C are not accurate hourly rates for this infusion.
During administration of theophylline, the nurse should monitor for signs of toxicity. Which symptom
would cause the nurse to suspect theophylline toxicity?
A. Dry mouth
B. Urinary retention
C. Restlessness
D. Sedation - ✔✔C. Restlessness
Restlessness is a sign of theophylline intoxication. Other signs of toxicity are anorexia, nausea,
vomiting, insomnia, tachycardia, arrhythmias, and seizures. Options A, B, and D are common side
effects of antihistamines but do not indicate theophylline intoxication.
During the initial nursing assessment history, a client tells the nurse that he is taking tetracycline
hydrochloride for urethritis. The nurse is most concerned if the client reports taking which medication
concurrently?
A. Sucralfate
B. Hydrochlorothiazide
C. Acetaminophen
