EVOLVE COMPREHENSIVE EXAM (HESI) 1
QUESTIONS AND ANSWERS LATEST VERSION 2024
VERIFIED RATIONALE GRADED A+
The plan of care should include goals that are specific for chronic and acute illnesses. Adult-onset diabetes is a life-
long chronic disease, whereas influenza is an acute illness with a short term duration (C). (A, B, and D) do not include
the correct duration categories for this situation.
A client is admitted with a medical diagnosis of addisonian crisis. When completing the admission assessment, the
nurse expects this client to exhibit which clinical manifestations? - ansHypotension, rapid weak pulse, and rapid
respiratory rate
The clinical manifestations of Addisonian crisis are often the manifestations of shock (C); the client is at risk for
circulatory collapse and shock. (A) indicates clinical manifestations of Cushing's syndrome, (B) of pheochromocytoma
(tumor of adrenal medulla), and (D) of thyroid storm (thyrotoxic crisis).
A client is being admitted to the medical unit form the emergency department after having a chest tube inserted. What
equipment should be brought to this client's room? - ansRubber-tipped clamps
Rubber-tipped clamps (C) should be kept at the client's bedside for assessment of possible chest tube air leaks, with
the prescription of the healthcare provider. (A), used during a respiratory or cardiac arrest, does not need to be
brought to the client's room as a routine precaution. (B) is used to intubate a client and is not indicated for routine
care of the client with a chest tube. (D) is indicated by the client's oxygen saturation or arterial blood gases, and is not
routinely placed in the room of a client with a chest tube.
A client is brought into the emergency department following a sudden cardiac arrest. A full code is started. Five
minutes later the family arrives with a durable power of attorney signed by the client requesting that no extraordinary
measures be taken, including intubation, to save the client's life. What action should the nurse take? - ansStop the
code immediately.
A durable power of attorney documents the client's wishes and supersedes the wishes of the medical staff (A). (B)
violates the client's rights. The code should be stopped (C). The family's support (D) is not relevant. The client's
wishes are most important.
A client is receiving atonal (tenormin) 25 mg PO after a myocardial infraction. The nurse determines the clinents
apical pulse is 65 beats per minute. What action should the nurse implement next? - ansAdminister the medication
Atenolol, a beta-blocker, blocks the beta receptors of the sinoatrial node to reduce the heart rate, so the medication
should be administered (C) because the client's apical pulse is greater than 60. (A, B, and D) are not indicated at this
time.
,EVOLVE COMPREHENSIVE EXAM (HESI) 1
QUESTIONS AND ANSWERS LATEST VERSION 2024
VERIFIED RATIONALE GRADED A+
a client who has active tuberculosis ( TB) is admitted to the medical unit. What action is most important for the nurse
to implement? - ansAssign the client to a negative air-flow room
Active tuberculosis requires implementation of airborne precautions, so the client should be assigned to a negative
pressure air-flow room (D). Although (A and C) should be implemented for clients in isolation with contact
precautions, it is most important that air flow from the room is minimized when the client has TB. (B) should be
implemented when the client leaves the isolation environment.
A client who is one week postoperative after an aortic valve replacement suddenly develops severe pain in the left
leg. On assessment, the nurse determines that the client's leg is pale and cool, and no pulses are palpable in the left
leg. After notifying the healthcare provider, which action should the nurse take? - ansKeep the client in bed in the
supine position
A common postoperative complication after valve replacement is arterial occlusion from a clot, which requires
anticoagulant therapy to prevent further enlargement of the thrombus and reduce the risk of embolization. Recently
formed thrombi can also be effectively treated with an intraarterial infusion of a thrombolytic agent, followed by bed
rest (C) and periodic angiography to monitor the dissolution of the clot. (A, B, and D) are contraindicated due to the
risk of vascular occlusion and embolization.
A client who is taking clonidine ( Catapres, Duraclon) reports drowsiness. Which additional assessment should the
nurse make? - ansHow 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.
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). - ansMetoprolol 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.
, EVOLVE COMPREHENSIVE EXAM (HESI) 1
QUESTIONS AND ANSWERS LATEST VERSION 2024
VERIFIED RATIONALE GRADED A+
-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 client with cancer has a history of alcohol abuse and is taking acetaminophen (Tylenol) for pain. Which organ
function is most important for the nurse to monitor? - ansLiver.
Acetaminophen and alcohol are both metabolized in the liver. This places the client at risk for hepatotoxicity, so
monitoring liver (A) function is the most important assessment because the combination of acetaminophen and
alcohol, even in moderate amounts, can cause potentially fatal liver damage. Other non-narcotic analgesics, such as
n onsteroidal anti-inflammatory drugs (NSAIDs), are more likely to promote adverse renal effects (B). Acetaminophen
does not place the client at risk for toxic reactions related to (C or D).
A client with metastatic cancer is preparing to make a decisions about end-of-life issues. When the nurse explains a
durable power of attorney for health care, which description is accurate? - ansIt will identify someone that can make
the decisions for you health care if you are ever in a coma or vegetative state.
This is a legal document that allows individuals to identify someone to make decisions for health care, identifies how
aggressive treatment should be if the client should ever be in a coma or persistent vegetative state, and lists any
medical treatments they would never want performed (B). (A) is the definition of the "Living Will"; some states and
Canada do not consider Living Wills legal documents. A durable power of attorney is a legal document (C), and it is
not a hospital form (D).
A client with osteoarthritis is given a new prescription for a nonsteroidal antiinflammatory drug (NSAID). The client
asks the nurse, "How is this medication different from the acetaminophen I have been taking?" Which information
about the therapeutic action of NSAIDs should the nurse provide? - ansProvide antiinflammatory response
Nonsteroidal antiinflammatory drugs (NSAIDs) have antiinflammatory properties (B), which relieves pain associated
with osteoarthritis and differs from acetaminophen, a non-narcotic analgesic and antipyretic. (A) does not teach the
client about the medication's actions. Although NSAIDs are irritating to the gastrointestinal (GI) system and can cause
GI bleeding (C), instructions to take with food in the stomach to manage this as an expected side effect should be
included, but this does not answer the client's question. Acetaminophen is potentially hepatotoxic (D), not NSAIDs.
A client with osteomyelitis is scheduled for surgery to treat the infection which has not responded to three months of
intravenous antibiotic therapy. The client asks the nurse why surgery is necessary. Which is the best response for the
nurse to provide? - ansThe infection has walled off into an area of infected bone creating a barrier to antibiotics
QUESTIONS AND ANSWERS LATEST VERSION 2024
VERIFIED RATIONALE GRADED A+
The plan of care should include goals that are specific for chronic and acute illnesses. Adult-onset diabetes is a life-
long chronic disease, whereas influenza is an acute illness with a short term duration (C). (A, B, and D) do not include
the correct duration categories for this situation.
A client is admitted with a medical diagnosis of addisonian crisis. When completing the admission assessment, the
nurse expects this client to exhibit which clinical manifestations? - ansHypotension, rapid weak pulse, and rapid
respiratory rate
The clinical manifestations of Addisonian crisis are often the manifestations of shock (C); the client is at risk for
circulatory collapse and shock. (A) indicates clinical manifestations of Cushing's syndrome, (B) of pheochromocytoma
(tumor of adrenal medulla), and (D) of thyroid storm (thyrotoxic crisis).
A client is being admitted to the medical unit form the emergency department after having a chest tube inserted. What
equipment should be brought to this client's room? - ansRubber-tipped clamps
Rubber-tipped clamps (C) should be kept at the client's bedside for assessment of possible chest tube air leaks, with
the prescription of the healthcare provider. (A), used during a respiratory or cardiac arrest, does not need to be
brought to the client's room as a routine precaution. (B) is used to intubate a client and is not indicated for routine
care of the client with a chest tube. (D) is indicated by the client's oxygen saturation or arterial blood gases, and is not
routinely placed in the room of a client with a chest tube.
A client is brought into the emergency department following a sudden cardiac arrest. A full code is started. Five
minutes later the family arrives with a durable power of attorney signed by the client requesting that no extraordinary
measures be taken, including intubation, to save the client's life. What action should the nurse take? - ansStop the
code immediately.
A durable power of attorney documents the client's wishes and supersedes the wishes of the medical staff (A). (B)
violates the client's rights. The code should be stopped (C). The family's support (D) is not relevant. The client's
wishes are most important.
A client is receiving atonal (tenormin) 25 mg PO after a myocardial infraction. The nurse determines the clinents
apical pulse is 65 beats per minute. What action should the nurse implement next? - ansAdminister the medication
Atenolol, a beta-blocker, blocks the beta receptors of the sinoatrial node to reduce the heart rate, so the medication
should be administered (C) because the client's apical pulse is greater than 60. (A, B, and D) are not indicated at this
time.
,EVOLVE COMPREHENSIVE EXAM (HESI) 1
QUESTIONS AND ANSWERS LATEST VERSION 2024
VERIFIED RATIONALE GRADED A+
a client who has active tuberculosis ( TB) is admitted to the medical unit. What action is most important for the nurse
to implement? - ansAssign the client to a negative air-flow room
Active tuberculosis requires implementation of airborne precautions, so the client should be assigned to a negative
pressure air-flow room (D). Although (A and C) should be implemented for clients in isolation with contact
precautions, it is most important that air flow from the room is minimized when the client has TB. (B) should be
implemented when the client leaves the isolation environment.
A client who is one week postoperative after an aortic valve replacement suddenly develops severe pain in the left
leg. On assessment, the nurse determines that the client's leg is pale and cool, and no pulses are palpable in the left
leg. After notifying the healthcare provider, which action should the nurse take? - ansKeep the client in bed in the
supine position
A common postoperative complication after valve replacement is arterial occlusion from a clot, which requires
anticoagulant therapy to prevent further enlargement of the thrombus and reduce the risk of embolization. Recently
formed thrombi can also be effectively treated with an intraarterial infusion of a thrombolytic agent, followed by bed
rest (C) and periodic angiography to monitor the dissolution of the clot. (A, B, and D) are contraindicated due to the
risk of vascular occlusion and embolization.
A client who is taking clonidine ( Catapres, Duraclon) reports drowsiness. Which additional assessment should the
nurse make? - ansHow 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.
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). - ansMetoprolol 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.
, EVOLVE COMPREHENSIVE EXAM (HESI) 1
QUESTIONS AND ANSWERS LATEST VERSION 2024
VERIFIED RATIONALE GRADED A+
-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 client with cancer has a history of alcohol abuse and is taking acetaminophen (Tylenol) for pain. Which organ
function is most important for the nurse to monitor? - ansLiver.
Acetaminophen and alcohol are both metabolized in the liver. This places the client at risk for hepatotoxicity, so
monitoring liver (A) function is the most important assessment because the combination of acetaminophen and
alcohol, even in moderate amounts, can cause potentially fatal liver damage. Other non-narcotic analgesics, such as
n onsteroidal anti-inflammatory drugs (NSAIDs), are more likely to promote adverse renal effects (B). Acetaminophen
does not place the client at risk for toxic reactions related to (C or D).
A client with metastatic cancer is preparing to make a decisions about end-of-life issues. When the nurse explains a
durable power of attorney for health care, which description is accurate? - ansIt will identify someone that can make
the decisions for you health care if you are ever in a coma or vegetative state.
This is a legal document that allows individuals to identify someone to make decisions for health care, identifies how
aggressive treatment should be if the client should ever be in a coma or persistent vegetative state, and lists any
medical treatments they would never want performed (B). (A) is the definition of the "Living Will"; some states and
Canada do not consider Living Wills legal documents. A durable power of attorney is a legal document (C), and it is
not a hospital form (D).
A client with osteoarthritis is given a new prescription for a nonsteroidal antiinflammatory drug (NSAID). The client
asks the nurse, "How is this medication different from the acetaminophen I have been taking?" Which information
about the therapeutic action of NSAIDs should the nurse provide? - ansProvide antiinflammatory response
Nonsteroidal antiinflammatory drugs (NSAIDs) have antiinflammatory properties (B), which relieves pain associated
with osteoarthritis and differs from acetaminophen, a non-narcotic analgesic and antipyretic. (A) does not teach the
client about the medication's actions. Although NSAIDs are irritating to the gastrointestinal (GI) system and can cause
GI bleeding (C), instructions to take with food in the stomach to manage this as an expected side effect should be
included, but this does not answer the client's question. Acetaminophen is potentially hepatotoxic (D), not NSAIDs.
A client with osteomyelitis is scheduled for surgery to treat the infection which has not responded to three months of
intravenous antibiotic therapy. The client asks the nurse why surgery is necessary. Which is the best response for the
nurse to provide? - ansThe infection has walled off into an area of infected bone creating a barrier to antibiotics
