EVOLVE COMPREHENSIVE EXAM (HESI) 1 EXAM
QUESTIONS AND CORRECT ANSWERS WITH WELL-
ELABORATED RATIONALES / EVOLVE MED SURG
HESI LATEST EXAM 2025(BRAND NEW!!)
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). - ✔✔ - 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.
,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? - ✔✔ - 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? -
✔✔ - 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? - ✔✔ - 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 document that indicates a successful outcome? - ✔✔ - Drinks 240 mL
of fluid five times during the shift.
,The nurse should evaluate the client's outcome by observing the client's performance of each
expected behavior, so drinking 240 mL of fluid five or six times during the shift (D) indicates a
fluid intake of 1200 to 1440 mL, which meets the objective of at least 1000 mL during the
designated period. (A) uses the term "adequate," which is not quantified. (B) is not the objective,
which establishes an intake of at least 1000 mL. (C) is not an evaluation of the specific fluid
intake.
a client who has active tuberculosis ( TB) is admitted to the medical unit. What action is most
important for the nurse to implement? - ✔✔ - Assign 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 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? - ✔✔ - Administer 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.
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? - ✔✔ - 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? - ✔✔ - 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? - ✔✔ - 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. ? - ✔✔ - 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).
A 6 year old child is alert but quiet when brought to the emergency center with periobital
ecchymosis and ecchymosis behind the ears. The nurse suspects potential child abuse and
continues to assess the child for additional manifestations of a basilar skull fracture. What
assessment finding would be consistent with the basilar skull fracture? - ✔✔ - Rhinorrhoea or
otorrhoea with halo sign
QUESTIONS AND CORRECT ANSWERS WITH WELL-
ELABORATED RATIONALES / EVOLVE MED SURG
HESI LATEST EXAM 2025(BRAND NEW!!)
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). - ✔✔ - 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.
,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? - ✔✔ - 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? -
✔✔ - 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? - ✔✔ - 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 document that indicates a successful outcome? - ✔✔ - Drinks 240 mL
of fluid five times during the shift.
,The nurse should evaluate the client's outcome by observing the client's performance of each
expected behavior, so drinking 240 mL of fluid five or six times during the shift (D) indicates a
fluid intake of 1200 to 1440 mL, which meets the objective of at least 1000 mL during the
designated period. (A) uses the term "adequate," which is not quantified. (B) is not the objective,
which establishes an intake of at least 1000 mL. (C) is not an evaluation of the specific fluid
intake.
a client who has active tuberculosis ( TB) is admitted to the medical unit. What action is most
important for the nurse to implement? - ✔✔ - Assign 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 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? - ✔✔ - Administer 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.
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? - ✔✔ - 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? - ✔✔ - 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? - ✔✔ - 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. ? - ✔✔ - 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).
A 6 year old child is alert but quiet when brought to the emergency center with periobital
ecchymosis and ecchymosis behind the ears. The nurse suspects potential child abuse and
continues to assess the child for additional manifestations of a basilar skull fracture. What
assessment finding would be consistent with the basilar skull fracture? - ✔✔ - Rhinorrhoea or
otorrhoea with halo sign
