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Evolve Comprehensive Exam (Hesi) 1 Preparation With
Complete Questions And Correct Answers With Rationales |
Already Graded A+||Brand New Version!!
A client with asthma receives a prescription for high blood pressure
during a clinic visit. Which prescription should the nurse anticipate
the client to receive that is at least likely to exacerbate asthma?
A. Pindolol (Visken).
B. Carteolol (Ocupress).
C. Metoprolol tartrate (Lopressor).
D. Propranolol hydrochloride (Inderal). - ANSWERS~~~Metoprolol
Tartrate( Lopressor)
The best antihypertensive agent for clients with asthma is
metoprolol (Lopressor) (C), a beta2 blocking agent which is also
cardioselective and less likely to cause bronchoconstriction.
-Pindolol (A) is a beta2 blocker that can cause bronchoconstriction
and increase asthmatic symptoms.
-Although carteolol (B) is a beta blocking agent and an effective
antihypertensive agent used in managing angina, it can increase a
client's risk for bronchoconstriction due to its nonselective beta
blocker action.
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-Propranolol (D) also blocks the beta2 receptors in the lungs, causing
bronchoconstriction, and is not indicated in clients with asthma and
other obstructive pulmonary disorders.
A male client who has been taking propranolol ( inderal) for 18
months tells the nurse the healthcare provider discontinued the
medication because his blood pressure has been normal for the past
three months. Which instruction should the use provide? -
ANSWERS~~~Ask the health care provider about tapering the drug
dose over the next week.
Although the healthcare provider discontinued the propranolol,
measures to prevent rebound cardiac excitation, such as
progressively reducing the dose over one to two weeks (C), should be
recommended to prevent rebound tachycardia, hypertension, and
ventricular dysrhythmias. Abrupt cessation (A and B) of the beta-
blocking agent may precipitate tachycardia and rebound
hypertension, so gradual weaning should be recommended.
A client who is taking clonidine ( Catapres, Duraclon) reports
drowsiness. Which additional assessment should the nurse make? -
ANSWERS~~~How long has the client been taking the medication
Drowsiness can occur in the early weeks of treatment with clonidine
and with continued use becomes less intense, so the length of time
the client has been on the medication (A) provides information to
direct additional instruction. (B, C, and D) are not relevant.
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The nurse is preparing to admister atropine, an anticholinergic, to a
client who is scheduled for a cholecystectomy. The client asks the
nurse to explain th reason for the prescribed medication. What
response is best for the nurse to provide? - ANSWERS~~~Decrease
the risk of bradycardia during surgery
Atropine may be prescribed preoperatively to increase the
automaticity of the sinoatrial node and prevent a dangerous
reduction in heart rate (B) during surgical anesthesia. (A, C and D) do
not address the therapeutic action of atropine use perioperatively.
An 80 year old client is given morphine sulphate for postoperative
pain. Which concomitant medication should the nurse question that
poses a potential development of urniary retention in this geriatric
client. ? - ANSWERS~~~Tricyclic antidepressants
Drugs with anticholinergic properties, such as tricyclic
antidepressants (C), can exacerbate urinary retention associated with
opioids in the older client. Although tricyclic antidepressants and
antihistamines with opioids can exacerbate urinary retention, the
concurrent use of (A and B) with opioids do not. Nonsteroidal
antiinflammatory agents (D) can increase the risk for bleeding, but
do not increase urinary retention with opioids (D).
The nurse obtains a heart rate of 92 and a blood pressure of 110/76
prior to administering a scheduled dose of verapamil (Calan) for a
client with atrial flutter Which action should the nurse implement? -
ANSWERS~~~Admister the dose as prescribed
, 4|Page
Verapamil slows sinoatrial (SA) nodal automaticity, delays
atrioventricular (AV) nodal conduction, which slows the ventricular
rate, and is used to treat atrial flutter, so (A) should be implemented,
based on the client's heart rate and blood pressure. (B and C) are not
indicated. (D) delays the administration of the scheduled dose.
following an emergency Cesarean delivery the nurse encourages the
new mother to breastfed her newborn . the client asks why she
should breastfeed now. Which info should the nurse provide? -
ANSWERS~~~Stimulate contraction of the uterus
When the infant suckles at the breast, oxytocin is released by the
posterior pituitary to stimulates the "letdown" reflex, which causes
the release of colostrum, and contracts the uterus (C) to prevent
uterine hemorrhage. (A and B) do not support the client's need in the
immediate period after the emergency delivery. Although maternal-
newborn bonding (D) is facilitated by early breastfeeding, the priority
is uterine contraction stimulation.
The nurse identifies a clients needs and formulates th nursing
problem of " Imbalancee nutrition: Less than body requirements,
related to mental impairment and decreased intkae, as evidence by
increasing confusion and weight loss of more than 30 pounds over
the last 6 months. " which short-term goal is best for this client? -
ANSWERS~~~Eat 50% of six small meals each day by the end of the
week
Short-term goals should be realistic and attainable and should have a
timeline of 7 to 10 days before discharge. (A) meets those criteria.
Evolve Comprehensive Exam (Hesi) 1 Preparation With
Complete Questions And Correct Answers With Rationales |
Already Graded A+||Brand New Version!!
A client with asthma receives a prescription for high blood pressure
during a clinic visit. Which prescription should the nurse anticipate
the client to receive that is at least likely to exacerbate asthma?
A. Pindolol (Visken).
B. Carteolol (Ocupress).
C. Metoprolol tartrate (Lopressor).
D. Propranolol hydrochloride (Inderal). - ANSWERS~~~Metoprolol
Tartrate( Lopressor)
The best antihypertensive agent for clients with asthma is
metoprolol (Lopressor) (C), a beta2 blocking agent which is also
cardioselective and less likely to cause bronchoconstriction.
-Pindolol (A) is a beta2 blocker that can cause bronchoconstriction
and increase asthmatic symptoms.
-Although carteolol (B) is a beta blocking agent and an effective
antihypertensive agent used in managing angina, it can increase a
client's risk for bronchoconstriction due to its nonselective beta
blocker action.
,2|Page
-Propranolol (D) also blocks the beta2 receptors in the lungs, causing
bronchoconstriction, and is not indicated in clients with asthma and
other obstructive pulmonary disorders.
A male client who has been taking propranolol ( inderal) for 18
months tells the nurse the healthcare provider discontinued the
medication because his blood pressure has been normal for the past
three months. Which instruction should the use provide? -
ANSWERS~~~Ask the health care provider about tapering the drug
dose over the next week.
Although the healthcare provider discontinued the propranolol,
measures to prevent rebound cardiac excitation, such as
progressively reducing the dose over one to two weeks (C), should be
recommended to prevent rebound tachycardia, hypertension, and
ventricular dysrhythmias. Abrupt cessation (A and B) of the beta-
blocking agent may precipitate tachycardia and rebound
hypertension, so gradual weaning should be recommended.
A client who is taking clonidine ( Catapres, Duraclon) reports
drowsiness. Which additional assessment should the nurse make? -
ANSWERS~~~How long has the client been taking the medication
Drowsiness can occur in the early weeks of treatment with clonidine
and with continued use becomes less intense, so the length of time
the client has been on the medication (A) provides information to
direct additional instruction. (B, C, and D) are not relevant.
,3|Page
The nurse is preparing to admister atropine, an anticholinergic, to a
client who is scheduled for a cholecystectomy. The client asks the
nurse to explain th reason for the prescribed medication. What
response is best for the nurse to provide? - ANSWERS~~~Decrease
the risk of bradycardia during surgery
Atropine may be prescribed preoperatively to increase the
automaticity of the sinoatrial node and prevent a dangerous
reduction in heart rate (B) during surgical anesthesia. (A, C and D) do
not address the therapeutic action of atropine use perioperatively.
An 80 year old client is given morphine sulphate for postoperative
pain. Which concomitant medication should the nurse question that
poses a potential development of urniary retention in this geriatric
client. ? - ANSWERS~~~Tricyclic antidepressants
Drugs with anticholinergic properties, such as tricyclic
antidepressants (C), can exacerbate urinary retention associated with
opioids in the older client. Although tricyclic antidepressants and
antihistamines with opioids can exacerbate urinary retention, the
concurrent use of (A and B) with opioids do not. Nonsteroidal
antiinflammatory agents (D) can increase the risk for bleeding, but
do not increase urinary retention with opioids (D).
The nurse obtains a heart rate of 92 and a blood pressure of 110/76
prior to administering a scheduled dose of verapamil (Calan) for a
client with atrial flutter Which action should the nurse implement? -
ANSWERS~~~Admister the dose as prescribed
, 4|Page
Verapamil slows sinoatrial (SA) nodal automaticity, delays
atrioventricular (AV) nodal conduction, which slows the ventricular
rate, and is used to treat atrial flutter, so (A) should be implemented,
based on the client's heart rate and blood pressure. (B and C) are not
indicated. (D) delays the administration of the scheduled dose.
following an emergency Cesarean delivery the nurse encourages the
new mother to breastfed her newborn . the client asks why she
should breastfeed now. Which info should the nurse provide? -
ANSWERS~~~Stimulate contraction of the uterus
When the infant suckles at the breast, oxytocin is released by the
posterior pituitary to stimulates the "letdown" reflex, which causes
the release of colostrum, and contracts the uterus (C) to prevent
uterine hemorrhage. (A and B) do not support the client's need in the
immediate period after the emergency delivery. Although maternal-
newborn bonding (D) is facilitated by early breastfeeding, the priority
is uterine contraction stimulation.
The nurse identifies a clients needs and formulates th nursing
problem of " Imbalancee nutrition: Less than body requirements,
related to mental impairment and decreased intkae, as evidence by
increasing confusion and weight loss of more than 30 pounds over
the last 6 months. " which short-term goal is best for this client? -
ANSWERS~~~Eat 50% of six small meals each day by the end of the
week
Short-term goals should be realistic and attainable and should have a
timeline of 7 to 10 days before discharge. (A) meets those criteria.
