Critical Care HESI Exam
ACCURATE AND VERIFIED FOR GUARANTEED PASS | LATEST UPDATE
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 least likely to exacerbate asthma?
A. Carteolol (Ocupress).
B. Propranolol hydrochloride (Inderal).
C. Pindolol (Visken).
D. Metoprolol tartrate (Lopressor)
- Answer: D. Metoprolol tartrate (Lopressor).
RATIONALE:
The best antihypertensive agent for clients with asthma is metoprolol (Lopressor) (C), a
beta2
blocking agent which is also cardio-selective 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 that the healthcare provider discontinued the medication because his blood
pressure has been normal for the past three months. Which instruction should the
nurse provide?
A. Obtain another antihypertensive prescription to avoid withdrawal symptoms.
B. Stop the medication and keep an accurate record of blood pressure
,C. Report any uncomfortable symptoms after stopping the medication.
D. Ask the healthcare provider about tapering the drug dose over the next week.
- Answer: D. Ask the healthcare provider about tapering the drug dose over the next week.
RATIONALE:
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. (D) is not indicated.
A client who is taking clonidine (Catapres, Duraclon) reports drowsiness. Which
additional assessment should the nurse make?
A. Has the client experienced constipation recently?
B. Did the client miss any doses of the medication?
C. How long has the client been taking the medication?
D. Does the client use any tobacco products?
- Answer: C. How long has the client been taking the medication?
RATIONALE:
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 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? A. Provide a more rapid induction of anesthesia.
B. Induce relaxation before induction of anesthesia.
,C. Decrease the risk of bradycardia during surgery.
D. Minimize the amount of analgesia needed postoperatively.
- Answer: C. Decrease the risk of bradycardia during surgery.
RATIONALE:
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 urinary retention in this geriatric client? A. Antacids.
B. Tricyclic antidepressants.
C. Nonsteroidal anti-inflammatory agents.
D. Insulin.
- Answer: B. Tricyclic antidepressants.
RATIONALE:
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 anti-inflammatory agents (D) can increase the risk for bleeding,
but
do not increase urinary retention with opioids (D).
A client with osteoarthritis is given a new prescription for a nonsteroidal anti-
inflammatory 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? A. Are less expensive.
B. Provide anti-inflammatory response.
C. Increase hepatotoxic side effects.
, D. Cause gastrointestinal bleeding.
- Answer: B. Provide anti-inflammatory response
ACCURATE AND VERIFIED FOR GUARANTEED PASS | LATEST UPDATE
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 least likely to exacerbate asthma?
A. Carteolol (Ocupress).
B. Propranolol hydrochloride (Inderal).
C. Pindolol (Visken).
D. Metoprolol tartrate (Lopressor)
- Answer: D. Metoprolol tartrate (Lopressor).
RATIONALE:
The best antihypertensive agent for clients with asthma is metoprolol (Lopressor) (C), a
beta2
blocking agent which is also cardio-selective 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 that the healthcare provider discontinued the medication because his blood
pressure has been normal for the past three months. Which instruction should the
nurse provide?
A. Obtain another antihypertensive prescription to avoid withdrawal symptoms.
B. Stop the medication and keep an accurate record of blood pressure
,C. Report any uncomfortable symptoms after stopping the medication.
D. Ask the healthcare provider about tapering the drug dose over the next week.
- Answer: D. Ask the healthcare provider about tapering the drug dose over the next week.
RATIONALE:
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. (D) is not indicated.
A client who is taking clonidine (Catapres, Duraclon) reports drowsiness. Which
additional assessment should the nurse make?
A. Has the client experienced constipation recently?
B. Did the client miss any doses of the medication?
C. How long has the client been taking the medication?
D. Does the client use any tobacco products?
- Answer: C. How long has the client been taking the medication?
RATIONALE:
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 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? A. Provide a more rapid induction of anesthesia.
B. Induce relaxation before induction of anesthesia.
,C. Decrease the risk of bradycardia during surgery.
D. Minimize the amount of analgesia needed postoperatively.
- Answer: C. Decrease the risk of bradycardia during surgery.
RATIONALE:
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 urinary retention in this geriatric client? A. Antacids.
B. Tricyclic antidepressants.
C. Nonsteroidal anti-inflammatory agents.
D. Insulin.
- Answer: B. Tricyclic antidepressants.
RATIONALE:
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 anti-inflammatory agents (D) can increase the risk for bleeding,
but
do not increase urinary retention with opioids (D).
A client with osteoarthritis is given a new prescription for a nonsteroidal anti-
inflammatory 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? A. Are less expensive.
B. Provide anti-inflammatory response.
C. Increase hepatotoxic side effects.
, D. Cause gastrointestinal bleeding.
- Answer: B. Provide anti-inflammatory response
