EVOLVE HESI PHARM RN VERSION 3
EXAMS 2024 WITH ACTUAL CORRECT
QUESTIONS AND VERIFIED DETAILED
RATIONALES ANSWERS BY EXPERTS
|FREQUENTLY TESTED QUESTIONS AND
SOLUTIONS |ALREADY GRADED A+
|NEWEST|GUARANTEED PASS |LATEST
UPDATE
An older client with a decreased percentage of lean body mass is likely to receive a prescription that is
adjusted based on which pharmacokinetic process?
A) Absorption.
B) Metabolism.
C) Elimination.
D) Distribution.
A decreased lean body mass in an older adult affects the distribution of drugs (D), which affects the
pharmacokinetics of drugs. Decreased gastric pH, delayed gastric emptying, decreased splanchnic
blood flow, decreased gastrointestinal absorption surface areas and motility affect (A) in the older
adult population. Decreased hepatic blood flow, decreased hepatic mass, and decreased activity of
hepatic enzymes affect (B) in older adults. Decreased renal blood flow, decreased glomerular filtration
rate, decreased tubular secretion, and decreased number of nephrons affects (C) in an older adult.
Correct Answer(s): D
The healthcare provider prescribes naproxen (Naproxen) twice daily for a client with osteoarthritis of
the hands. The client tells the nurse that the drug does not seem to be effective after three weeks.
Which is the best response for the nurse to provide?
A) The frequency of the dosing is necessary to increase the effectiveness.
B) Therapeutic blood levels of this drug are reached in 4 to 6 weeks.
C) Another type of nonsteroidal antiinflammatory drug may be indicated.
D) Systemic corticosteroids are the next drugs of choice for pain relief.
Individual responses to nonsteroidal antiinflammatory drugs are variable, so (C) is the best response.
Naproxen is usually prescribed every 8 hours, so (A) is not indicated. The peak for naproxen is one to
two hours, not (B). Corticosteroids are not indicated for osteoarthritis (D).
Correct Answer(s): C
,An antacid (Maalox) is prescribed for a client with peptic ulcer disease. The nurse knows that the
purpose of this medication is to
A) decrease production of gastric secretions.
B) produce an adherent barrier over the ulcer.
C) maintain a gastric pH of 3.5 or above.
D) decrease gastric motor activity.
The objective of antacids is to neutralize gastric acids and keep pH of 3.5 or above (C) which is
necessary for pepsinogen inactivity. (A) is the purpose of H2 receptor antagonists (cimetidine,
ranitidine). (B) is the purpose of sucralfate (Carafate). (D) is the purpose of anticholinergic drugs which
are often used in conjunction with antacids to allow the antacid to remain in the stomach longer.
Correct Answer(s): C
After abdominal surgery, a male client is prescribed low molecular weight heparin (LMWH). During
administration of the medication, the client asks the nurse why he is receiving this medication. Which is
the best response for the nurse to provide?
A) This medication is a blood thinner given to prevent blood clot formation.
B) This medication enhances antibiotics to prevent infection.
C) This medication dissolves any clots that develop in the legs.
D) This abdominal injection assists in the healing of the abdominal wound.
Unfractionated heparin or low molecular weight heparin (LMWH) is an anticoagulant that inhibits
thrombin-mediated conversion of fibrinogen to fibrin and is given prophylactically to prevent
postoperative venous thrombosis (A) or to treat pulmonary embolism or deep vein thrombosis
following knee and abdominal surgeries. Heparin does not dissolve clots but prevents clot extension
or further clot formation (C). The anticoagulant heparin does not prevent infection (B) or influence
operative wound healing (D).
Correct Answer(s): A
Which instruction(s) should the nurse give to a female client who just received a prescription for oral
metronidazole (Flagyl) for treatment of trichomonas vaginalis? (Select all that apply.)
A) Increase fluid intake, especially cranberry juice.
B) Do not abruptly discontinue the medication; taper use.
C) Check blood pressure daily to detect hypertension.
D) Avoid drinking alcohol while taking this medication.
E) Use condoms until treatment is completed.
F) Ensure that all sexual partners are treated at the same time.
Correct selections are (A, D, E, and F). Increased fluid intake and cranberry juice (A) are recommended
for prevention and treatment of urinary tract infections, which frequently accompany vaginal
infections. It is not necessary to taper use of this drug (B) or to check the blood pressure daily (C), as
this condition is not related to hypertension. Flagyl can cause a disulfiram-like reaction if taken in
conjunction with ingestion of alcohol, so the client should be instructed to avoid alcohol (D). All sexual
partners should be treated at the same time (E) and condoms should be used until after treatment is
,completed to avoid reinfection (F).
Correct Answer(s): A, D, E, F
A client is receiving ampicillin sodium (Omnipen) for a sinus infection. The nurse should instruct the
client to notify the healthcare provider immediately if which symptom occurs?
A) Rash.
B) Nausea.
C) Headache.
D) Dizziness.
Rash (A) is the most common adverse effect of all penicillins, indicating an allergy to the medication
which could result in anaphylactic shock, a medical emergency. (B, C, and D) are common side effects
of penicillins that should subside after the body adjusts to the medication. These would not require
immediate medical care unless the symptoms persist beyond the first few days or become extremely
severe.
Correct Answer(s): A
A client with giardiasis is taking metronidazole (Flagyl) 2 grams PO. Which information should the nurse
include in the client's instruction?
A) Notify the clinic of any changes in the color of urine.
B) Avoid overexposure to the sun.
C) Stop the medication after the diarrhea resolves.
D) Take the medication with food.
Correct Answer(s): D
Flagyl, an amoebicide and antibacterial agent, may cause gastric distress, so the client should be
instructed to take the medication on a full stomach (D). Urine may be red-brown or dark from Flagyl,
but this side effect is not necessary to report (A). Photosensitivity (B) is not a side effect associated
with Flagyl. Despite the resolution of clinical symptoms, antiinfective medications should be taken for
their entire course because stopping the medication (C) can increase the risk of resistant organisms.
While taking a nursing history, the client states, "I am allergic to penicillin." What related allergy to
another type of antiinfective agent should the nurse ask the client about when taking the nursing
history?
A) Aminoglycosides.
B) Cephalosporins.
C) Sulfonamides.
D) Tetracyclines.
Correct Answer(s): B
Cross allergies exist between penicillins and cephalosporins (B). Penicillin allergies are unrelated to
allergies associated with (A, C, or D).
, Following heparin treatment for a pulmonary embolism, a client is being discharged with a prescription
for warfarin (Coumadin). In conducting discharge teaching, the nurse advises the client to have which
diagnostic test monitored regularly after discharge?
A) Perfusion scan.
B) Prothrombin Time (PT/INR).
C) Activated partial thromboplastin (APTT).
D) Serum Coumadin level (SCL).
Correct Answer(s): B
When used for a client with pulmonary embolus, the therapeutic goal for warfarin therapy is a PT 1½
to 2½ times greater than the control, or an INR of 2 to 3 (B). A perfusion might be performed to
monitor lung function, but not monthly (A). APTT is monitored for the client receiving heparin therapy
(C). A blood level for Coumadin cannot be measured (D).
A category X drug is prescribed for a young adult female client. Which instruction is most important for
the nurse to teach this client?
A) Use a reliable form of birth control.
B) Avoid exposure to ultra violet light.
C) Refuse this medication if planning pregnancy.
D) Abstain from intercourse while on this drug.
Correct Answer(s): A
Drugs classified in the category X place a client who is in the first trimester of pregnancy at risk for
teratogenesis, so women in the childbearing years should be counseled to use a reliable form of birth
control (A) during drug therapy. (B) is not a specific precaution with Category X drugs. The client
should be encouraged to discuss plans for pregnancy with the healthcare provider, so a safer
alternative prescription (C) can be provided if pregnancy occurs. Although the risk of birth defects
during pregnancy explains the restriction of these drugs during pregnancy, (D) is not indicated.
The nitrate isosorbide dinitrate (Isordil) is prescribed for a client with angina. Which instruction should
the nurse include in this client's discharge teaching plan?
A) Quit taking the medication if dizziness occurs.
B) Do not get up quickly. Always rise slowly.
C) Take the medication with food only.
D) Increase your intake of potassium-rich foods.
Correct Answer(s): B
An expected side effect of nitrates is orthostatic hypotension and the nurse should address how to
prevent it--by rising slowly (B). Dizziness is expected, and the client should not quit taking the
medication without notifying the healthcare provider (A). (C and D) are not indicated when taking this
medication.
A client is being treated for osteoporosis with alendronate (Fosamax), and the nurse has completed
discharge teaching regarding medication administration. Which morning schedule would indicate to the
EXAMS 2024 WITH ACTUAL CORRECT
QUESTIONS AND VERIFIED DETAILED
RATIONALES ANSWERS BY EXPERTS
|FREQUENTLY TESTED QUESTIONS AND
SOLUTIONS |ALREADY GRADED A+
|NEWEST|GUARANTEED PASS |LATEST
UPDATE
An older client with a decreased percentage of lean body mass is likely to receive a prescription that is
adjusted based on which pharmacokinetic process?
A) Absorption.
B) Metabolism.
C) Elimination.
D) Distribution.
A decreased lean body mass in an older adult affects the distribution of drugs (D), which affects the
pharmacokinetics of drugs. Decreased gastric pH, delayed gastric emptying, decreased splanchnic
blood flow, decreased gastrointestinal absorption surface areas and motility affect (A) in the older
adult population. Decreased hepatic blood flow, decreased hepatic mass, and decreased activity of
hepatic enzymes affect (B) in older adults. Decreased renal blood flow, decreased glomerular filtration
rate, decreased tubular secretion, and decreased number of nephrons affects (C) in an older adult.
Correct Answer(s): D
The healthcare provider prescribes naproxen (Naproxen) twice daily for a client with osteoarthritis of
the hands. The client tells the nurse that the drug does not seem to be effective after three weeks.
Which is the best response for the nurse to provide?
A) The frequency of the dosing is necessary to increase the effectiveness.
B) Therapeutic blood levels of this drug are reached in 4 to 6 weeks.
C) Another type of nonsteroidal antiinflammatory drug may be indicated.
D) Systemic corticosteroids are the next drugs of choice for pain relief.
Individual responses to nonsteroidal antiinflammatory drugs are variable, so (C) is the best response.
Naproxen is usually prescribed every 8 hours, so (A) is not indicated. The peak for naproxen is one to
two hours, not (B). Corticosteroids are not indicated for osteoarthritis (D).
Correct Answer(s): C
,An antacid (Maalox) is prescribed for a client with peptic ulcer disease. The nurse knows that the
purpose of this medication is to
A) decrease production of gastric secretions.
B) produce an adherent barrier over the ulcer.
C) maintain a gastric pH of 3.5 or above.
D) decrease gastric motor activity.
The objective of antacids is to neutralize gastric acids and keep pH of 3.5 or above (C) which is
necessary for pepsinogen inactivity. (A) is the purpose of H2 receptor antagonists (cimetidine,
ranitidine). (B) is the purpose of sucralfate (Carafate). (D) is the purpose of anticholinergic drugs which
are often used in conjunction with antacids to allow the antacid to remain in the stomach longer.
Correct Answer(s): C
After abdominal surgery, a male client is prescribed low molecular weight heparin (LMWH). During
administration of the medication, the client asks the nurse why he is receiving this medication. Which is
the best response for the nurse to provide?
A) This medication is a blood thinner given to prevent blood clot formation.
B) This medication enhances antibiotics to prevent infection.
C) This medication dissolves any clots that develop in the legs.
D) This abdominal injection assists in the healing of the abdominal wound.
Unfractionated heparin or low molecular weight heparin (LMWH) is an anticoagulant that inhibits
thrombin-mediated conversion of fibrinogen to fibrin and is given prophylactically to prevent
postoperative venous thrombosis (A) or to treat pulmonary embolism or deep vein thrombosis
following knee and abdominal surgeries. Heparin does not dissolve clots but prevents clot extension
or further clot formation (C). The anticoagulant heparin does not prevent infection (B) or influence
operative wound healing (D).
Correct Answer(s): A
Which instruction(s) should the nurse give to a female client who just received a prescription for oral
metronidazole (Flagyl) for treatment of trichomonas vaginalis? (Select all that apply.)
A) Increase fluid intake, especially cranberry juice.
B) Do not abruptly discontinue the medication; taper use.
C) Check blood pressure daily to detect hypertension.
D) Avoid drinking alcohol while taking this medication.
E) Use condoms until treatment is completed.
F) Ensure that all sexual partners are treated at the same time.
Correct selections are (A, D, E, and F). Increased fluid intake and cranberry juice (A) are recommended
for prevention and treatment of urinary tract infections, which frequently accompany vaginal
infections. It is not necessary to taper use of this drug (B) or to check the blood pressure daily (C), as
this condition is not related to hypertension. Flagyl can cause a disulfiram-like reaction if taken in
conjunction with ingestion of alcohol, so the client should be instructed to avoid alcohol (D). All sexual
partners should be treated at the same time (E) and condoms should be used until after treatment is
,completed to avoid reinfection (F).
Correct Answer(s): A, D, E, F
A client is receiving ampicillin sodium (Omnipen) for a sinus infection. The nurse should instruct the
client to notify the healthcare provider immediately if which symptom occurs?
A) Rash.
B) Nausea.
C) Headache.
D) Dizziness.
Rash (A) is the most common adverse effect of all penicillins, indicating an allergy to the medication
which could result in anaphylactic shock, a medical emergency. (B, C, and D) are common side effects
of penicillins that should subside after the body adjusts to the medication. These would not require
immediate medical care unless the symptoms persist beyond the first few days or become extremely
severe.
Correct Answer(s): A
A client with giardiasis is taking metronidazole (Flagyl) 2 grams PO. Which information should the nurse
include in the client's instruction?
A) Notify the clinic of any changes in the color of urine.
B) Avoid overexposure to the sun.
C) Stop the medication after the diarrhea resolves.
D) Take the medication with food.
Correct Answer(s): D
Flagyl, an amoebicide and antibacterial agent, may cause gastric distress, so the client should be
instructed to take the medication on a full stomach (D). Urine may be red-brown or dark from Flagyl,
but this side effect is not necessary to report (A). Photosensitivity (B) is not a side effect associated
with Flagyl. Despite the resolution of clinical symptoms, antiinfective medications should be taken for
their entire course because stopping the medication (C) can increase the risk of resistant organisms.
While taking a nursing history, the client states, "I am allergic to penicillin." What related allergy to
another type of antiinfective agent should the nurse ask the client about when taking the nursing
history?
A) Aminoglycosides.
B) Cephalosporins.
C) Sulfonamides.
D) Tetracyclines.
Correct Answer(s): B
Cross allergies exist between penicillins and cephalosporins (B). Penicillin allergies are unrelated to
allergies associated with (A, C, or D).
, Following heparin treatment for a pulmonary embolism, a client is being discharged with a prescription
for warfarin (Coumadin). In conducting discharge teaching, the nurse advises the client to have which
diagnostic test monitored regularly after discharge?
A) Perfusion scan.
B) Prothrombin Time (PT/INR).
C) Activated partial thromboplastin (APTT).
D) Serum Coumadin level (SCL).
Correct Answer(s): B
When used for a client with pulmonary embolus, the therapeutic goal for warfarin therapy is a PT 1½
to 2½ times greater than the control, or an INR of 2 to 3 (B). A perfusion might be performed to
monitor lung function, but not monthly (A). APTT is monitored for the client receiving heparin therapy
(C). A blood level for Coumadin cannot be measured (D).
A category X drug is prescribed for a young adult female client. Which instruction is most important for
the nurse to teach this client?
A) Use a reliable form of birth control.
B) Avoid exposure to ultra violet light.
C) Refuse this medication if planning pregnancy.
D) Abstain from intercourse while on this drug.
Correct Answer(s): A
Drugs classified in the category X place a client who is in the first trimester of pregnancy at risk for
teratogenesis, so women in the childbearing years should be counseled to use a reliable form of birth
control (A) during drug therapy. (B) is not a specific precaution with Category X drugs. The client
should be encouraged to discuss plans for pregnancy with the healthcare provider, so a safer
alternative prescription (C) can be provided if pregnancy occurs. Although the risk of birth defects
during pregnancy explains the restriction of these drugs during pregnancy, (D) is not indicated.
The nitrate isosorbide dinitrate (Isordil) is prescribed for a client with angina. Which instruction should
the nurse include in this client's discharge teaching plan?
A) Quit taking the medication if dizziness occurs.
B) Do not get up quickly. Always rise slowly.
C) Take the medication with food only.
D) Increase your intake of potassium-rich foods.
Correct Answer(s): B
An expected side effect of nitrates is orthostatic hypotension and the nurse should address how to
prevent it--by rising slowly (B). Dizziness is expected, and the client should not quit taking the
medication without notifying the healthcare provider (A). (C and D) are not indicated when taking this
medication.
A client is being treated for osteoporosis with alendronate (Fosamax), and the nurse has completed
discharge teaching regarding medication administration. Which morning schedule would indicate to the
