PHARMACOLOGY EVOLVE HESI ANSWERS AND
QUESTIONS SET A+
✔✔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 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 (AV) dissociation. Assessment of serum potassium
, levels with prompt correction of hypokalemia is an important intervention for the client
taking digoxin. Options A, B, and D are not relevant.
✔✔In addition to nitrate therapy, a client is receiving nifedipine, 10 mg PO every 6
hours. The nurse should plan to observe for which common side effect of this treatment
regimen?
A. Hypotension
B. Hyperkalemia
C. Hypocalcemia
D. Seizures - ✔✔A. Hypotension
Nifedipine reduces peripheral vascular resistance and nitrates produce vasodilation, so
concurrent use of nitrates with nifedipine can cause hypotension with the initial
administration of these agents. Options B, C, and D are not side effects of this treatment
regimen.
✔✔The nurse is preparing to administer amphotericin B IV to a client. What laboratory
data is most important for the nurse to assess before initiating an IV infusion of this
medication?
A. Serum potassium level
B. Platelet count
C. Serum creatinine level
D. Hemoglobin level - ✔✔A. Serum potassium level
The nurse should obtain baseline potassium levels prior to beginning drug therapy
because amphotericin B changes cellular permeability, allowing potassium to escape
from the cell, which could lead to a decrease in the serum potassium level and severe
hypokalemia. Options B, C, and D are helpful laboratory values, but they do not have
the importance of option A in determining if amphotericin B can be administered safely
via IV infusion.
✔✔A client receives a prescription for theophylline PO to be initiated in the morning
after the dose of theophylline IV is complete. The nurse determines that a theophylline
level drawn yesterday was 22 mcg/mL. Based on this information, which action should
the nurse implement?
A. Hold the theophylline dose and notify the health care provider.
B. Start the client on a half-dose of theophylline PO.
C. The theophylline dose can be initiated as planned.
D. The client is not ready to be weaned from the IV to the PO route. - ✔✔A. Hold the
theophylline dose and notify the health care provider.
QUESTIONS SET A+
✔✔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 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 (AV) dissociation. Assessment of serum potassium
, levels with prompt correction of hypokalemia is an important intervention for the client
taking digoxin. Options A, B, and D are not relevant.
✔✔In addition to nitrate therapy, a client is receiving nifedipine, 10 mg PO every 6
hours. The nurse should plan to observe for which common side effect of this treatment
regimen?
A. Hypotension
B. Hyperkalemia
C. Hypocalcemia
D. Seizures - ✔✔A. Hypotension
Nifedipine reduces peripheral vascular resistance and nitrates produce vasodilation, so
concurrent use of nitrates with nifedipine can cause hypotension with the initial
administration of these agents. Options B, C, and D are not side effects of this treatment
regimen.
✔✔The nurse is preparing to administer amphotericin B IV to a client. What laboratory
data is most important for the nurse to assess before initiating an IV infusion of this
medication?
A. Serum potassium level
B. Platelet count
C. Serum creatinine level
D. Hemoglobin level - ✔✔A. Serum potassium level
The nurse should obtain baseline potassium levels prior to beginning drug therapy
because amphotericin B changes cellular permeability, allowing potassium to escape
from the cell, which could lead to a decrease in the serum potassium level and severe
hypokalemia. Options B, C, and D are helpful laboratory values, but they do not have
the importance of option A in determining if amphotericin B can be administered safely
via IV infusion.
✔✔A client receives a prescription for theophylline PO to be initiated in the morning
after the dose of theophylline IV is complete. The nurse determines that a theophylline
level drawn yesterday was 22 mcg/mL. Based on this information, which action should
the nurse implement?
A. Hold the theophylline dose and notify the health care provider.
B. Start the client on a half-dose of theophylline PO.
C. The theophylline dose can be initiated as planned.
D. The client is not ready to be weaned from the IV to the PO route. - ✔✔A. Hold the
theophylline dose and notify the health care provider.
