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Evolve Pharmacology hesi practice questions
with simplified solution (pass assured)
1. A client who has been taking phenazopyridine (Pyridium) for symptoms of
urethritis and cystitis comes to the clinic because her urine is reddish-orange. Which question should the practical nurse ask to determine if the medication has been effective?
A) How much water have you been drinking each day?
B) Does the urine color stain your toilet bowl or undergarments?
C) Have you had any relief from urinary pain, burning, or urgency?
D) Did your urine appear cloudy or have a foul odor on voiding?: C) Have you had any
relief from urinary pain, burning, or urgency? Feedback: Phenazopyridine, an over-the-counter urinary analgesic, acts on the mucosa of the urinary tract to relieve urinary pain, burning, itching, or urgency (C) associated with urethritis and cystitis. Although determining if the client is forcing fluids (A), experiencing staining from Pyridium's side ettect (B), or having signs of a urinary infection (D) are worthwhile assessments, the therapeutic response of Pyridium is related to urinary discomforts only.
2. A male client who has been receiving an antineoplastic drug has developed
thrombocytopenia. What instructions should the practical nurse (PN) rein-force?
A) Use suppository form of drugs.
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B) Avoid large public gatherings.
C) Rise slowly when standing up.
D) Shave with an electric razor.: D) Shave with an electric razor.
Feedback: Thrombocytopenia is a common side ettect of bone marrow depression caused by several antineoplastic agents. The client is experiencing a low platelet count and should use an electric razor (D) to reduce his risk of bleeding. (A, B, and C) are not indicated for a client who needs to implement thrombocytopenia precautions.
3. The practical nurse (PN) is caring for a client who has been taking prednisone
(Deltasone) daily for a year. Which adverse effect should the PN document in the client's record?
A) Photosensitvity.
B) Weight gain.
C) Loss of hair.
D) Pale skin color.: B) Weight gain.
Feedback: Long term use of prednisone causes fluid retention and redistribution of fat deposition. Weight gain (B) and moon face reflect adverse ettects of long-term prednisone use and should be documented. (A, C, and D) do not occur with treatment using prednisone.
4. A female client with recurring headaches tells the practical nurse (PN) that she
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A) Encourage the client to swallow.
B) Administer water with medication.
C) Ensure the medication is positioned under the tongue.
D) Place the medication between the upper molar teeth and cheek.: D) Place the medication
between the upper molar teeth and cheek. Feedback: Buccal medications are placed between the upper molar teeth and the cheek (D) for absorption by the capillaries of the oral mucosa. The client should be cautioned against swallowing, not (A). Buccal medications are not administered with water (B). (C) describes sublingual administration.
7. What assessment is most important for the practical nurse (PN) to obtain
prior to initiating medication therapy with phenelzine (Nardil) for a client with depression?
A) Activity level.
B) Mood and affect.
C) Understanding of diet modification.
D) The client's support system.: C) Understanding of diet modification.
Feedback: To prevent a potentially lethal hypertensive crisis, a tyramine-free diet should be maintained during antidepressant therapy with Nardil, a monoamine oxidase inhibitor (MAOI). It is most important to determine if the client understands diet modification (C)
5 / 38 before Nardil is initiated to prevent consumption of foods that interact with Nardil. Although a client's activity level (A) and mood and attect (B) should be monitored during antidepressant therapy, it is most important that the client understand diet modifications. The client's support system (D) and network of family and friends is important, but the client should understand the responsibility of dietary compliance with the medication regimen.
8. The practical nurse (PN) is unable to arouse a client who is receiving meperi-
dine (Demerol) for postoperative pain. The client is stuporous, has constricted pupils, and a respiratory rate of 8 breaths/minute. Which PRN prescription should the PN give the client?
A) Naloxone (Narcan).
B) Promethazine (Phenergan).
C) Metoclopramide (Reglan).
D) Bethanechol (Urecholine).: A) Naloxone (Narcan).
Feedback: Narcan (A) is an opioid antagonist and should be administered to reverse the ettects of a Demerol, an opioid, overdose. (B, C, and D) are common postoperative PRN prescriptions but are not indicated for narcotic overdose.
9. On which therapeutic action should the practical nurse (PN) base an expla-
nation to a client who is receiving a cardiac glycoside?
A) Decreased cardiac output.
B) Increased renal perfusion.
C) Decreased rate of contraction.
7 / 38 Feedback: Epinephrine (Adrenalin), a potent sympathomimetic, is the drug of choice for the treatment of anaphylaxis (B). (A, C, and D) are not used for an acute immunololgical dysfunction that causes cardiovascular ettects.
12. An older adult client receives a prescription for hydrochlorothiazide
(Hy-droDIURIL), a thiazide diuretic for the treatment of heart failure. Which side effect(s) should the practical nurse reinforce with the client? (Select all that apply.)
A) Constipation.
B) Fatigue.
C) Edema.
D) Nausea.
E)Dehydration.
F) Blurred vision.: B) Fatigue.
E) Dehydration. Feedback: Hydrochlorothiazide (HydroDIURIL), a thiazide diuretic, reduces blood pressure by reducing blood volume and reduc-ing arterial resistance. Adverse ettects of thiazides include hypokalemia, fatigue (B), dehydration (E), hyperglycemia, and hyperuricemia. Although (A, C, D and F) may be associated with aging or other pathology, they are not side ettects commonly associated with HydroDIURIL.
13. A client who returns from surgery for bowel resection complains of severe pain
around the incision. Which assessment is most important for the practi-cal nurse
8 / 38 (PN) to obtain prior to the administration of morphine sulfate?
A) Rate of respirations.
B) Core temperature.
C) Appearance of the incision.
D) Presence of bowel sounds.: A) Rate of respirations.
Feedback: Opioids cause respiratory depression, so the respiratory rate (A) should be assessed prior to administration of morphine sulfate. (B, C, and D) do not address the concept of medication safety.
14. A client is receiving the third course of 5-fluorouracil (5FU) therapy
for a tumor of the liver. Which action should the practical nurse implement to reduce the client's risk for stomatitis?
A) Use commercial oral products to reduce the risk of oral infections.
B) Observe for black, tarry stools or bleeding ulcerations.
C) Increase intake of foods containing fiber and citric acid.
D) Examine mouth daily for bleeding, white spots, and ulcerations.: D) Examine mouth
daily for bleeding, white spots, and ulcerations. Feedback: 5-fluorouracil (5FU) is an antimetabolite, antineoplastic agent that causes sloughing of the rapid proliferating epithelial cells of the oral mucosa causing ulceration, bleeding, and oral candidiasis (thrush). Daily examination of the oral mucosa (D) should be implemented to identify signs of stomatitis, such as white spots, ulcerations, and bleeding of the mouth, so early intervention can
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B) Albuterol (Proventil).
C) Zafirlukast (Accolate).
D) Triamcinolone (Azmacort).: B) Albuterol (Proventil).
Feedback: Albuterol (Proventil) (B), an adrenergic agonist, is the first line of treatment for acute episodes of bronchial asthma. (A, C, and D) are maintenance medications used in the prevention of asthmatic episodes and are routinely taken every day, not during an acute episode.
17. The practical nurse (PN) should recommend that oral contraceptives be
avoided in which group of women?
A) Women who smoke.
B) Multigravidous women.
C) Monogamous women.
D) Women with an intrauterine device.: A) Women who smoke.
Feedback: Oral contraceptives pose an increased risk of thromboembolism for women who smoke (A), and this risk is not increased in (B, C, and D).
18. A client with gastroesophageal reflux disease (GERD) is having symptoms
of reflux despite taking omeprazole (Prilosec) 20 mg daily. What action should the practical nurse (PN) implement?
A) Notify the healthcare provider about the symptoms.
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B) Obtain vital signs every 30 minutes until symptoms are alleviated.
C) Instruct the client to stop taking the medication.
D) Tell the client to take an antacid in addition to the omeprazole.: A) Notify the
healthcare provider about the symptoms. Feedback: Omeprazole, a proton pump inhibitor, acts to reduce gastric acid secretion. If once daily dosing fails to control the client's symptoms, the healthcare provider should be notified (A) for dose adjustment. (B) will not help to reduce the client's symptoms. Unless the client shows symptoms of a hypersensitivity to the medication, the client should not stop the medication (C). (D) should not suggested without a prescription from the healthcare provider.
19. The practical nurse (PN) administers isoproterenol (Isuprel) to a client with
heart block. The PN should evaluate the client for which physiological re-sponse?
A) Thirst and dry mucous membranes.
B) Decrease in gastric motility.
C) Increased heart rate.
D) Bronchoconstriction.: C) Increased heart rate.
Feedback: Isoproterenol (Isuprel) acts on beta 1 receptors in the heart, causing an increased cardiac reactivity in AV heart block and an increase in the client's heart rate (C). (A and B) are anticholinergic responses and are not typical with adrenergic agents, such as isoproterenol. By activating beta 2 receptors found in the smooth muscle of bronchioles, isoproterenol causes bronchodilation, not (D).
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D) Water soluble vitamin deficiencies.: B) Liver dysfunction.
Feedback: Antilipemic agents (lipid-regulating agents) are metabolized by the liver and require regular monitoring of liver function studies for hepatic dysfunction (B). Photosensitivity (A), URI (C), and vitamin deficiencies (D) are not side-ettects of antilipemics.
21. A client with Attention Deficit Disorder (ADD) is prescribed amphetamine
(Adderall). Which side effect should the practical nurse (PN) explain is com-monly experienced?
A) Difficulty sleeping.
B) Increased fatigue.
C) Improved appetite.
D) Decreased heart rate.: A) Diflculty sleeping.
Feedback: Adderall is a central nervous system stimulant, which often causes the client to experience diflculty sleeping (A). Due to central nervous stimulation, Adderall causes an increase in energy, a decrease in appetite, and an increase in heart rate, not (B, C, and D).
22. An older client who takes risperidone (Risperdal), an antipsychotic, is com-
plaining of constipation. Which dietary changes should the practical nurse (PN) recommend?
A) Increase daily green vegetables and bran.
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B) Take a laxative and stool softener daily.
C) Eat liver and turnips once a week.
D) Use a retention enema every four days.: A) Increase daily green vegetables and bran.
Feedback: Constipation, a side ettect of antipsychotics, is managed by encouraging the client to drink additional water and in-crease dietary roughage, such as bran and green vegetables daily (A). (B, C, and D) are not routine recommendations for constipation.
23. A client's tissue culture results indicate the wound is infected with methi-
cillin-resistant Staphylococcus aureus (MRSA). What action should the practi-cal nurse (PN) implement first?
A) Provide sterile wound care as prescribed.
B) Give the first dose of Vancomycin (Vancocin).
C) Implement contact isolation precautions.
D) Document wound site appearance and drainage.: C) Implement contact isolation
precautions. Feedback: The risk of transmitting a hospital acquired infectious disease among clients is high with an organism such as MRSA. Infection prevention and control practices, including contact isolation precautions, should be implemented first (C). (A, B, and D) may be implemented after isolation precautions are in place.
24. The practical nurse asks a male client who came to the clinic with an upper
respiratory infection if he has any drug allergies. The client cannot remember if he
16 / 38 Feedback: The intravaginal cream should be instilled each night for 7 days to complete the medication (B) even if symptoms
17 / 38 are relieved. Medication should be continued until it is completed, even during menstruation (A). Douching (C) is contraindicated. Abstinence (D) is not required.
26. A client receives a new prescription for beclomethasone (Beclovent Oral
Inhaler). What information should the practical nurse (PN) reinforce with the client about the use of this medication?
A) Use for rapid results in acute asthmatic attacks.
B) Most effective in preventing upper respiratory infections.
C) Daily use provides prophylaxis in asthma management.
D) Inhale when exposed to allergens in the environment.: C) Daily use provides
prophylaxis in asthma management. Feedback: Beclovent Oral Inhaler, an inhaled glucocorticoid, is used for prophylaxis in the management of chronic asthma (C) and should be administered on a fixed schedule, not (D). Inhaled beta 2 agonists, not a glucocorticoid, work rapidly in acute asthma attacks (A) precipitated by environmental allergen exposure (D).
27. A client with tuberculosis (TB) asks the practical nurse (PN) the value
of prescribed multidrug therapy. What explanation should the PN provide?
A) Required to eradicate TB.
B) Enhances the effect of each drug.
C) Provides a faster effect than single drug therapy.
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B) Hypothermia.
C) Hepatotoxicity.
D) Gastrointestinal distress.: D) Gastrointestinal distress.
Feedback: Salicylates, such as aspirin, commonly irritate the gastric mucosa, causing gastrointestinal distress (D). (A, B, and C) are inaccurate.
30. The healthcare provider prescribes celecoxib (Celebrex), a nonsteroidal
antiinflammatory drug (NSAID), for a client with osteoarthritis. Which finding in the client's history should the practical nurse (PN) report?
A) Gout.
B) Hypertension.
C) Diabetes mellitus.
D) Peptic-ulcer disease.: D) Peptic-ulcer disease.
Feedback: Celecoxib (Celebrex), an NSAID, causes gastrointestinal irritation and bleeding. Peptic-ulcer disease is a contraindi-cation to therapy with NSAIDs (D). (A, B, and C) are inaccurate.
31. What laboratory results should the practical nurse monitor to evaluate the
therapeutic effects of heparin?
A) Platelet count.
B) Hematocrit.
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C) Prothrombin time (PT).
D) Activated partial thromboplastin time (APTT).: D) Activated partial thromboplastin time
(APTT).
Feedback: Ongoing APTT (D) values measure the prolongation times of thromboplastin in the clotting cascade, which is monitored during heparin therapy. (A, B, and C) do not indicate the therapeutic action of heparin.
32. Which information should the practical nurse (PN) provide a client who
receives a new prescription for a benzodiazepine medication?
A) A list of foods to avoid while taking this prescription.
B) Symptoms that indicate increasing the dose of medication.
C) The interactions of alcohol consumption and CNS depressant drugs.
D) Explanations that support taking a work absence during drug therapy.: C) The
interactions of alcohol consumption and CNS depressant drugs. Feedback: The concomitant use of alcohol and benzodiazepines (C), both CNS depressants, causes an increase in sedation, which places the client at risk for injury and should be avoided. (A, B, and D) are not indicated.
33. Which information should the practical nurse (PN) reinforce with a client
who is self-administering insulin injections?
A) Shake the vial of insulin to mix the contents before administration.
