Evolve Comprehensive Exam (Hesi) 1 questions with
correct answers
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). Correct Answer-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.
-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? Correct Answer-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?
Correct Answer-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.
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? Correct Answer-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. ?
Correct Answer-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? Correct Answer-
Admister the dose as prescribed
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? Correct Answer-
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? Correct Answer-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. (B) is
nurse-oriented. (C) may be beyond the capabilities of a confused client.
(D) is a long-term goal.
the nursie is caring for a client who is unable to void. The plan of care
establishes an objective for the client to ingest at least 1000 mL of fluid
between 7:00 am and 3:30pm. Which client response should the nurse
correct answers
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). Correct Answer-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.
-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? Correct Answer-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?
Correct Answer-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.
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? Correct Answer-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. ?
Correct Answer-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? Correct Answer-
Admister the dose as prescribed
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? Correct Answer-
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? Correct Answer-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. (B) is
nurse-oriented. (C) may be beyond the capabilities of a confused client.
(D) is a long-term goal.
the nursie is caring for a client who is unable to void. The plan of care
establishes an objective for the client to ingest at least 1000 mL of fluid
between 7:00 am and 3:30pm. Which client response should the nurse
