HESI comp exam 1 detailed solutions
HESI comp exam 1 detailed solutions
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?
- ANSWER Metoprolol tartrate (Lopressor)
Best antihypertensive med for asthmatics. Beta2 blocking agent -- also a cardioselective and less likely to
cause bronchoconstriction.
A male client who has been taking propranolol (Inderal) for 18 months tells the nurse that the
healthcare provider discontinued the medication because his blood pressure has been normal for the
past 3 months. Which instruction should the nurse provide? - ANSWER Ask the healthcare provider
about tapering the drug dose over the next week.
HCP discontinued drug BUT measures to prevent rebound cardiac excitation, such as progressively
reducing the dose over 1 or 2 weeks, should be recommended to prevent rebound tachycardia,
hypertension, and ventricular dysrhythmias.
A client who is taking clonidine ( Catapres, Duraclon) reports drowsiness. Which additional assessment
should the nurse make? - 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 provides information to direct
additional instruction.
The nurse is preparing to administer atropine, an anticholinergic, to a client who is scheduled for a
cholecystectomy. The client asks the nurse to explain the reason for the prescribed medication. What
response is best for the nurse to provide? - 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 during surgical anesthesia.
,HESI comp exam 1 detailed solutions
An 80-year old client is given morphine sulfate for post-op pain. Which concomitant med should the
nurse question that poses a potential development of urinary retention in this geriatric client? -
ANSWER Tricyclic antidepressants
Drugs with anticholinergic properties can exacerbate urinary retention associated with opioids in the
older client.
A client with osteoarthritis is given a new script for a NSAID. The client asks the nurse, "How is this med
different from the acetaminophen I have been taking?" Which information about the therapeutic action
of NSAIDs should the nurse provide? - ANSWER Provide anti-inflammatory response
NSAIDs relieve pain associated with osteoarthritis and differs from acetaminophen(a non-narcotic &
antipyretic). Also potentially hepatotoxic.
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? - ANSWER Liver
Acetaminophen & alcohol both metabolized in the liver. Pt at risk of hepatotoxicity & potentially fatal
liver damage.
The nurse obtains a heart rate of 92 and a BP of 110/76 prior to administering a scheduled does of
verapamil (Calan) for a client with atrial flutter. Which action should the nurse implement? - ANSWER
Administer the dose as prescribed.
Verapamil slows SA nodal automaticity, delays AV nodal conduction, slowing ventricular rate & treats
atrial flutter. HR is above 60 and BP is WNL.
A client is admitted to the hospital with a diagnosis of Type 2 diabetes mellitus and influenza. Which
categories of illness should the nurse develop goals for the client's plan of care? - ANSWER One chronic
and one acute illness
Adult onset DM is life-long chronic disease. Influenza is acute illness with short term duration.
, HESI comp exam 1 detailed solutions
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? -
ANSWER Stimulate contraction of the uterus
Infant suckling breast releases oxytocin by the posterior pituitary and stimulates the "letdown" reflex.
Causing release of colostrum & contracts the uterus to prevent uterine hemorrhage.
Which intervention should the nurse include in the plan of care for a female client with severe
postpartum depression who is admitted to the inpatient psychiatric unit? - ANSWER Supervised and
guided visits with infant.
Structured visits provide an opportunity for the mother and infant to bond and should be facilitated and
encouraged according to the client's pace of progress.
A 16-year-old male client is admitted to the hospital after falling off a bike and sustaining a fractured
bone. The HCP explains the surgery needed to immobilize the fracture. Which action should be
implemented to obtain a valid informed consent? - ANSWER Obtain the permission of the custodial
parent for the surgery.
Pt is a minor and cannot legally sign his own consent unless he is an emancipated minor. Consent should
be obtained from the guardian, custodial parent.
During a client assessment, the client says, "I can't walk very well." Which action should the nurse
implement first? - ANSWER Identify the problem
Sequential problem solving steps: 1) Identify the problem, 2) consider alternatives, 3) consider
outcomes of the alternatives, 4) predict the likelihood of the outcomes occurring and choose best
chance of success.
The nurse identifies a client's needs and formulates the nursing problem of, "Imbalanced nutrition: less
than body requirements, related to mental impairment and decreased intake, as evidenced by
increasing confusion and weight loss of more than 30 lbs over the last 6 months." Which short term goal
is best for this pt? - ANSWER Eat 50% of six small meals each day by the end of one week
HESI comp exam 1 detailed solutions
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?
- ANSWER Metoprolol tartrate (Lopressor)
Best antihypertensive med for asthmatics. Beta2 blocking agent -- also a cardioselective and less likely to
cause bronchoconstriction.
A male client who has been taking propranolol (Inderal) for 18 months tells the nurse that the
healthcare provider discontinued the medication because his blood pressure has been normal for the
past 3 months. Which instruction should the nurse provide? - ANSWER Ask the healthcare provider
about tapering the drug dose over the next week.
HCP discontinued drug BUT measures to prevent rebound cardiac excitation, such as progressively
reducing the dose over 1 or 2 weeks, should be recommended to prevent rebound tachycardia,
hypertension, and ventricular dysrhythmias.
A client who is taking clonidine ( Catapres, Duraclon) reports drowsiness. Which additional assessment
should the nurse make? - 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 provides information to direct
additional instruction.
The nurse is preparing to administer atropine, an anticholinergic, to a client who is scheduled for a
cholecystectomy. The client asks the nurse to explain the reason for the prescribed medication. What
response is best for the nurse to provide? - 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 during surgical anesthesia.
,HESI comp exam 1 detailed solutions
An 80-year old client is given morphine sulfate for post-op pain. Which concomitant med should the
nurse question that poses a potential development of urinary retention in this geriatric client? -
ANSWER Tricyclic antidepressants
Drugs with anticholinergic properties can exacerbate urinary retention associated with opioids in the
older client.
A client with osteoarthritis is given a new script for a NSAID. The client asks the nurse, "How is this med
different from the acetaminophen I have been taking?" Which information about the therapeutic action
of NSAIDs should the nurse provide? - ANSWER Provide anti-inflammatory response
NSAIDs relieve pain associated with osteoarthritis and differs from acetaminophen(a non-narcotic &
antipyretic). Also potentially hepatotoxic.
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? - ANSWER Liver
Acetaminophen & alcohol both metabolized in the liver. Pt at risk of hepatotoxicity & potentially fatal
liver damage.
The nurse obtains a heart rate of 92 and a BP of 110/76 prior to administering a scheduled does of
verapamil (Calan) for a client with atrial flutter. Which action should the nurse implement? - ANSWER
Administer the dose as prescribed.
Verapamil slows SA nodal automaticity, delays AV nodal conduction, slowing ventricular rate & treats
atrial flutter. HR is above 60 and BP is WNL.
A client is admitted to the hospital with a diagnosis of Type 2 diabetes mellitus and influenza. Which
categories of illness should the nurse develop goals for the client's plan of care? - ANSWER One chronic
and one acute illness
Adult onset DM is life-long chronic disease. Influenza is acute illness with short term duration.
, HESI comp exam 1 detailed solutions
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? -
ANSWER Stimulate contraction of the uterus
Infant suckling breast releases oxytocin by the posterior pituitary and stimulates the "letdown" reflex.
Causing release of colostrum & contracts the uterus to prevent uterine hemorrhage.
Which intervention should the nurse include in the plan of care for a female client with severe
postpartum depression who is admitted to the inpatient psychiatric unit? - ANSWER Supervised and
guided visits with infant.
Structured visits provide an opportunity for the mother and infant to bond and should be facilitated and
encouraged according to the client's pace of progress.
A 16-year-old male client is admitted to the hospital after falling off a bike and sustaining a fractured
bone. The HCP explains the surgery needed to immobilize the fracture. Which action should be
implemented to obtain a valid informed consent? - ANSWER Obtain the permission of the custodial
parent for the surgery.
Pt is a minor and cannot legally sign his own consent unless he is an emancipated minor. Consent should
be obtained from the guardian, custodial parent.
During a client assessment, the client says, "I can't walk very well." Which action should the nurse
implement first? - ANSWER Identify the problem
Sequential problem solving steps: 1) Identify the problem, 2) consider alternatives, 3) consider
outcomes of the alternatives, 4) predict the likelihood of the outcomes occurring and choose best
chance of success.
The nurse identifies a client's needs and formulates the nursing problem of, "Imbalanced nutrition: less
than body requirements, related to mental impairment and decreased intake, as evidenced by
increasing confusion and weight loss of more than 30 lbs over the last 6 months." Which short term goal
is best for this pt? - ANSWER Eat 50% of six small meals each day by the end of one week
