PHARM HESI EVOLVE NEWEST 2024 VERSION 1 COMPLETE 55 QUESTIONS AND CORRECT DETAILED
ANSWERS
The healthcare provider prescribes digitalis (Digoxin) for a client diagnosed with heart failure. Which
intervention should the nurse implement prior to administering the digoxin?
A. observe the respiratory rate and depth
B. assess the serum potassium level
C. obtain the client blood pressure
D. monitor serum glucose level - (answer) B. Assess the serum potassium level
Rationale:
Hypokalemia (decreased serum potassium) will precipitate digitalis toxicity in persons receiving digoxin.
The nurse should monitor the client's serum potassium levels. Blood pressure and respiratory rate will
not inform the nurse about potential safety issues with digitalis.
Which medications should the nurse caution the client about taking while receiving an opioid analgesic?
A. antiacids
B. benzodiazepines
C. antihypertensives
D. oral antidiabetics - (answer) B. benzodiazepines
Rationale
Respiratory depression increases with the concurrent use of opioid analgesics and other central nervous
system depressant agents, such as alcohol, barbiturates, and benzodiazepines. Antacids and antidiabetic
agents do not interact with opiates to produce adverse effects. Antihypertensives may cause morphine-
induced hypotension, but should not be withheld without notifying the healthcare provider.
The nurse is assessing the effectiveness of high dose aspirin therapy for an 88-year-old client with
arthritis. The client reports that she can't hear the nurse's questions because her ears are ringing. What
action should the nurse implement?
A. Refer the client to an audiologist for evaluation of her hearing.
B. Advise the client that this is a common side effect of aspirin therapy.
C. Notify the healthcare provider of this finding immediately.
D. Ask the client to turn off her hearing aid during the exam - (answer) C. notify the healthcare provider
of this finding immediately
,PHARM HESI EVOLVE NEWEST 2024 VERSION 1 COMPLETE 55 QUESTIONS AND CORRECT DETAILED
ANSWERS
Rationale
Tinnitus is an early sign of salicylate toxicity. The healthcare provider should be notified immediately, and
the medication discontinued
A client asks the nurse if glipizide (Glucotrol) is an oral insulin. Which response should the nurse provide?
A. "Yes, it is an oral insulin and has the same actions and properties as intermediate insulin."
B. "Yes, it is an oral insulin and is distributed, metabolized, and excreted in the same manner as insulin."
C. "No, it is not an oral insulin and can be used only when some beta cell function is present."
D. "No, it is not an oral insulin, but it is effective for those who are resistant to injectable insulins." -
(answer) C. "No, it is not an oral insulin and can be used only when some beta cell function is present."
Rationale
An effective oral form of insulin has not yet been developed because when insulin is taken orally, it is
destroyed by digestive enzymes. Glipizide (Glucotrol) is an oral hypoglycemic agent that enhances
pancreatic production of insulin
In evaluating the effects of lactulose (Cephulac), which outcome would indicate that the drug is
performing as intended?
A. An increase in urine output.
B. Two or three soft stools per day.
C. Watery, diarrhea stools.
D. Increased serum bilirubin. - (answer) B. Two or three soft stools per day
Rationale
The medication lactulose can be administered for either chronic constipation or for portal-systemic
encephalopathy in clients with hepatic disease. Two to three stools a day indicate that lactulose is
performing as intended for chronic constipation. This would also indicate it should be effective for the
clients with encephalopathy because the lactulose's action prevents absorption of ammonia in the colon
as it increases water absorption and softens the stool. The efficacy of the use for ammonia absorption
would have to be verified by a serum ammonia level and observation of clearing of the client's mental
status
, PHARM HESI EVOLVE NEWEST 2024 VERSION 1 COMPLETE 55 QUESTIONS AND CORRECT DETAILED
ANSWERS
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 - (answer) C. maintain a gastric pH of 3.5 or above.
Rationale
The objective of antacids is to neutralize gastric acids and keep pH of 3.5 or above which is necessary for
pepsinogen inactivity
A client is admitted to the hospital for diagnostic testing for possible myasthenia gravis. The nurse
prepares for intravenous administration of edrophonium chloride (Tensilon). What is the expected
outcome for this client following administration of this pharmacologic agent?
A. Progressive difficulty with swallowing.
B. Decreased respiratory effort.
C. Improvement in generalized fatigue.
D. Decreased muscle weakness - (answer) D. Decreased muscle weakness
Rationale
Administration of edrophonium chloride (Tensilon), a cholinergic agent, will temporarily reduce muscle
weakness, the most common complaint of newly-diagnosed clients with myasthenia gravis. This
medication is used to diagnose myasthenia gravis due to its short duration of action. This drug would
temporarily reverse difficulty in swallowing and respiratory effort
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.
ANSWERS
The healthcare provider prescribes digitalis (Digoxin) for a client diagnosed with heart failure. Which
intervention should the nurse implement prior to administering the digoxin?
A. observe the respiratory rate and depth
B. assess the serum potassium level
C. obtain the client blood pressure
D. monitor serum glucose level - (answer) B. Assess the serum potassium level
Rationale:
Hypokalemia (decreased serum potassium) will precipitate digitalis toxicity in persons receiving digoxin.
The nurse should monitor the client's serum potassium levels. Blood pressure and respiratory rate will
not inform the nurse about potential safety issues with digitalis.
Which medications should the nurse caution the client about taking while receiving an opioid analgesic?
A. antiacids
B. benzodiazepines
C. antihypertensives
D. oral antidiabetics - (answer) B. benzodiazepines
Rationale
Respiratory depression increases with the concurrent use of opioid analgesics and other central nervous
system depressant agents, such as alcohol, barbiturates, and benzodiazepines. Antacids and antidiabetic
agents do not interact with opiates to produce adverse effects. Antihypertensives may cause morphine-
induced hypotension, but should not be withheld without notifying the healthcare provider.
The nurse is assessing the effectiveness of high dose aspirin therapy for an 88-year-old client with
arthritis. The client reports that she can't hear the nurse's questions because her ears are ringing. What
action should the nurse implement?
A. Refer the client to an audiologist for evaluation of her hearing.
B. Advise the client that this is a common side effect of aspirin therapy.
C. Notify the healthcare provider of this finding immediately.
D. Ask the client to turn off her hearing aid during the exam - (answer) C. notify the healthcare provider
of this finding immediately
,PHARM HESI EVOLVE NEWEST 2024 VERSION 1 COMPLETE 55 QUESTIONS AND CORRECT DETAILED
ANSWERS
Rationale
Tinnitus is an early sign of salicylate toxicity. The healthcare provider should be notified immediately, and
the medication discontinued
A client asks the nurse if glipizide (Glucotrol) is an oral insulin. Which response should the nurse provide?
A. "Yes, it is an oral insulin and has the same actions and properties as intermediate insulin."
B. "Yes, it is an oral insulin and is distributed, metabolized, and excreted in the same manner as insulin."
C. "No, it is not an oral insulin and can be used only when some beta cell function is present."
D. "No, it is not an oral insulin, but it is effective for those who are resistant to injectable insulins." -
(answer) C. "No, it is not an oral insulin and can be used only when some beta cell function is present."
Rationale
An effective oral form of insulin has not yet been developed because when insulin is taken orally, it is
destroyed by digestive enzymes. Glipizide (Glucotrol) is an oral hypoglycemic agent that enhances
pancreatic production of insulin
In evaluating the effects of lactulose (Cephulac), which outcome would indicate that the drug is
performing as intended?
A. An increase in urine output.
B. Two or three soft stools per day.
C. Watery, diarrhea stools.
D. Increased serum bilirubin. - (answer) B. Two or three soft stools per day
Rationale
The medication lactulose can be administered for either chronic constipation or for portal-systemic
encephalopathy in clients with hepatic disease. Two to three stools a day indicate that lactulose is
performing as intended for chronic constipation. This would also indicate it should be effective for the
clients with encephalopathy because the lactulose's action prevents absorption of ammonia in the colon
as it increases water absorption and softens the stool. The efficacy of the use for ammonia absorption
would have to be verified by a serum ammonia level and observation of clearing of the client's mental
status
, PHARM HESI EVOLVE NEWEST 2024 VERSION 1 COMPLETE 55 QUESTIONS AND CORRECT DETAILED
ANSWERS
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 - (answer) C. maintain a gastric pH of 3.5 or above.
Rationale
The objective of antacids is to neutralize gastric acids and keep pH of 3.5 or above which is necessary for
pepsinogen inactivity
A client is admitted to the hospital for diagnostic testing for possible myasthenia gravis. The nurse
prepares for intravenous administration of edrophonium chloride (Tensilon). What is the expected
outcome for this client following administration of this pharmacologic agent?
A. Progressive difficulty with swallowing.
B. Decreased respiratory effort.
C. Improvement in generalized fatigue.
D. Decreased muscle weakness - (answer) D. Decreased muscle weakness
Rationale
Administration of edrophonium chloride (Tensilon), a cholinergic agent, will temporarily reduce muscle
weakness, the most common complaint of newly-diagnosed clients with myasthenia gravis. This
medication is used to diagnose myasthenia gravis due to its short duration of action. This drug would
temporarily reverse difficulty in swallowing and respiratory effort
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.
