HESI PN Evolve Elsevier Pharmacology V1

Free preview · Original latest version

Sample questions from HESI PN Evolve Elsevier Pharmacology V1

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.During a clinic visit, a client asks why an oral medication dose is larger than the dose previously given intravenously. Which explanation should the practical nurse reinforce?

   • A.Oral medications are always eliminated faster by the kidneys.
   • B.Food prevents most oral medications from being absorbed.
   • C.Some medication is metabolized before it reaches the systemic circulation.
   • D.Intravenous medications bind completely to plasma proteins.

   Rationale: First-pass metabolism in the intestinal wall and liver can reduce the amount of an oral drug reaching systemic circulation. The route does not make renal elimination universally faster, and intravenous drugs do not bind completely to plasma proteins. Food effects vary by medication and do not explain the general difference between oral and intravenous doses.

2. 2.The provider prescribes amoxicillin 30 mg/kg/day orally in three equally divided doses for a 14-month-old who weighs 10 kg. The suspension contains 125 mg/5 mL. How many mL should the practical nurse administer per dose?

   • A.2 mL
   • B.6 mL
   • C.12 mL
   • D.4 mL

   Rationale: The daily dose is 30 mg multiplied by 10 kg, or 300 mg/day, which becomes 100 mg per dose when divided into three doses. At 125 mg/5 mL, a 100-mg dose requires 4 mL. The 2-mL and 6-mL amounts provide incorrect doses, while 12 mL represents the entire daily volume rather than one dose.

3. 3.Refer to the client's chart. Which action should the practical nurse take first?

   • A.Stimulate the client and immediately summon emergency assistance.
   • B.Offer oral fluids to improve medication elimination.
   • C.Document expected sedation and recheck in one hour.
   • D.Administer the next analgesic dose at a reduced amount.

   Rationale: The decline from RR 16/min and SpO2 97% to RR 8/min and SpO2 86%, with difficult arousal after morphine, indicates dangerous opioid-induced respiratory depression. Stimulation and immediate emergency assistance prioritize ventilation and access to oxygen, airway support, and an opioid antagonist. Oral fluids pose an aspiration risk, delayed reassessment is unsafe, and further opioid administration can worsen respiratory failure.

4. 4.An older adult resident has difficulty swallowing an extended-release tablet. Which action is safest?

   • A.Dissolve the tablet in warm water.
   • B.Ask the pharmacist and provider about an appropriate alternative formulation.
   • C.Crush the tablet and mix it with applesauce.
   • D.Have the resident chew the tablet before swallowing.

   Answer and rationale are in the full material.

5. 5.Before administering medications through a gastrostomy tube to a client receiving continuous enteral nutrition, which actions are appropriate? Select all that apply.

   • A.Mix all medications together with the feeding formula.
   • B.Verify that each medication is suitable for tube administration.
   • C.Administer each medication separately.
   • D.Flush the tube before and after medication administration as prescribed.
   • E.Crush enteric-coated tablets into a fine powder.

   Answer and rationale are in the full material.