PHARMACOLOGY EVOLVE HESI WITH
RATIONALIZED ANSWERS YEAR 2024/2025
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 - verified 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. - verified 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. - verified 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 - verified 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. - verified 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 - verified 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 - verified 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." - verified
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 - verified 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.
RATIONALIZED ANSWERS YEAR 2024/2025
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 - verified 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. - verified 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. - verified 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 - verified 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. - verified 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 - verified 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 - verified 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." - verified
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 - verified 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.
