HESI Pathophysiology: Patho &
Pharmacology Evolve Questions –
Comprehensive Exam Practice &
Detailed Rationales
The nurse hears short, high-pitched sounds Crackles in the right and
left lower lobes. just before the end of inspiration in the right
and left lower lobes when auscultating a Rationale: Fine crackles are short, high-pitched sounds
client's lungs. How should this finding be heard just before the end of inspiration that are the result of
recorded? rapid equalization of pressure when collapsed alveoli
or terminal bronchioles suddenly snap open.
-Inspiratory wheezes in both lungs.
-Crackles in the right and left lower lobes.
-Abnormal lung sounds in the bases of
both lungs.
-Pleural friction rub in the right and
left lower lobes.
,The nurse is planning care for a client who Risk for injury related to denial of deficits and
impulsiveness. has a right hemispheric stroke. Which
nursing diagnosis should the nurse include Rationale: With right-brain damage, a client experience
in the plan of care? difficulty in judgment and spatial perception and is
more likely to be impulsive and move quickly, which
places the
-Impaired physical mobility related to right- client at risk for falls.
sided hemiplegia.
-Risk for injury related to denial of
deficits and impulsiveness.
-Impaired verbal communication
related to speech-language deficits.
-Ineffective coping related to
depression and distress about
disability.
The nurse is assessing a postmenopausal
Cystocele woman who is complaining of urinary
urgency and frequency and stress Rationale: This constellation of signs in a postmenopausal
incontinence. She also reports difficulty in woman are characteristic of a cystocele. These
symptoms emptying her bladder. These complaints are are not characteristic of the other
options.
most likely due to which condition?
-Cystocele.
-Bladder infection.
-Pyelonephritis.
-Irritable bladder.
The nurse is caring for a client with Loss of thirst, weight
gain syndrome of inappropriate antidiuretic
hormone (SIADH), which is manifested by Rationale: SIADH occurs when the posterior pituitary gland
which symptoms? releases too much ADH, causing water retention, a urine
output of less than 20 ml/hour, and dilutional hyponatremia.
-Loss of thirst, weight gain. Other indications of SIADH are loss of thirst, weight gain,
-Dependent edema, fever. irritability, muscle weakness, and decreased level of
-Polydipsia, polyuria. consciousness.
-Hypernatremia, tachypnea.
The nurse is teaching a client with maple Both genes of a pair must be abnormal for the
disorder to syrup urine disease (MSUD), an autosomal occur
recessive disorder, about the inheritance
pattern. Which information should the nurse Rationale: Maple syrup urine disease (MSUD) is a type
of
provide? autosomal recessive inheritance disorder in which
both genes of a pair must be abnormal for the
disorder to be
-This recessive disorder is carried only on expressed.
the X chromosome.
-Occurrences mainly affect males and
heterozygous females.
-Both genes of a pair must be
abnormal for the disorder to occur.
-One copy of the abnormal gene is
required for this disorder.
,What information should the nurse -Smoking
include in a teaching plan about the -early menarche
onset of -genetic influence
menopause? (Select all that apply). -chemotherapy exposure
-Smoking. Rationale: Menopausal symptoms are related to the
-Oophorectomy with hysterectomy. cessation of ovarian function. Factors influencing the onset
-Early menarche. of menopause include smoking, genetic influences, early
-Cardiac disease. men
-Genetic influence.
-Chemotherapy exposure.
The nurse reviews the complete blood risk for injury
count (CBC) findings of an adolescent
with acute myelogenous leukemia Rationale: A client with AML is at risk for anemia,
(AML). The neutropenia, and thrombocytopenia. These CBC findings
hemoglobin is 13.8 g/dl, hematocrit is indicate that the platelet count is low (normal 250,000 to
36.7%, white blood cell count is 8,200 400,000 mm3), which places this client at an increased risk
mm3, and for injury, usually manifested as bruising or bleeding.
platelet count is 115,000 mm3. Based
on these findings, what is the priority
nursing diagnosis for this client's plan
of care?
-Impaired gas exchange.
-Risk for infection.
-Risk for injury.
-Risk for activity intolerance.
A mother is crying as she holds and lay the child down and ask the mother to stay near
rocks her child with tetanus who is the child in the crib
having
muscular spasms and crying. After Rationale: Controlling environmental stimulation such as
administering diazepam (Valium) to noise, light, or tactile stimuli helps reduce CNS irritability
the child, what action should the related to acute tetanus. The mother should be instructed to
nurse minimize handling of the child during episodes of muscle
implement? spasticity and to stay calmly near the child. The mother's
presence with the child provides security and support to the
-Lay the child down and ask the child.
mother to stay near the child in the
crib.
-Encourage the mother to take a
break and leave the room to stop
crying.
-Keep all light sources off and close
the window blinds to the room.
-Use calm, reassurance and
understanding to comfort the mother.
, A man who was recently Genetic counseling should be obtained prior to
diagnosed with Huntington's undertaking any genetic testing procedure.
disease asks the nurse if his
adolescent son should be tested Rationale: Genetic counseling provides clients and
for the families with facts to assist them in making informed
disease. What response is best for the decisions
nurse to provide? before any genetic testing procedure is undertaken. It
also ensures that the client has voluntarily opted for the
-Autosomal dominant disorders, such as testing and not coerced and is also able to weigh the
Huntington's, cannot be inherited risks and
from the parent. benefits of knowing the result.
-Genetic counseling should be
obtained prior to undertaking any
genetic testing procedure.
-Testing is needed in adolescents
because of the risk of passing the
gene to each offspring.
-Positive genetic testing may contribute
to insurance discrimination that denies
coverage.
Which pathophysiological response Spasmodic reflex of respiratory and gastric movements
supports a client's vomiting results from stimulation of the chemoreceptor trigger
experience? zone.
-Sensory input of noxious stimuli Rationale: Vomiting is a reflex of spasmodic respiratory
relayed to the cognitive centers is movements against the glottis causing the forceful
associated with disgust and illicits expulsion of the contents of the stomach through the mouth.
vomiting. Stimulation of the emetic center results from afferent vagal
-Response of stimulation of the and sympathetic nerve pathways that activate the
posterior oropharynx results in chemoreceptor trigger zone (CTZ).
reverse peristalsis of the
gastrointestinal tract.
-Spasmodic reflex of respiratory and
gastric movements results from
stimulation of the
chemoreceptor trigger zone.
-Increased gastric and colonic
pressures move gastrointestinal
contents to the orifice of least
resistance.
A client is admitted to the Emergency A deviation of the trachea toward the side opposite the
Department with a tension pneumothorax.
pneumothorax. Which assessment
should the nurse expect to identify? Rationale: Tension pneumothorax is caused by rapid
accumulation of air in the pleural space, causing severely
-An absence of lung sounds on the high intrapleural pressure. This results in collapse of the
affected side. lung, and the mediastinum shifts toward the unaffected side,
-An inability to auscultate tracheal which is subsequently compressed. The other options are
breath sounds. not demonstrated with a tension pneumothorax.
-A deviation of the trachea toward the
side opposite the pneumothorax.
-A shift of the point of maximal
impulse to the left, with bounding
pulses.
Pharmacology Evolve Questions –
Comprehensive Exam Practice &
Detailed Rationales
The nurse hears short, high-pitched sounds Crackles in the right and
left lower lobes. just before the end of inspiration in the right
and left lower lobes when auscultating a Rationale: Fine crackles are short, high-pitched sounds
client's lungs. How should this finding be heard just before the end of inspiration that are the result of
recorded? rapid equalization of pressure when collapsed alveoli
or terminal bronchioles suddenly snap open.
-Inspiratory wheezes in both lungs.
-Crackles in the right and left lower lobes.
-Abnormal lung sounds in the bases of
both lungs.
-Pleural friction rub in the right and
left lower lobes.
,The nurse is planning care for a client who Risk for injury related to denial of deficits and
impulsiveness. has a right hemispheric stroke. Which
nursing diagnosis should the nurse include Rationale: With right-brain damage, a client experience
in the plan of care? difficulty in judgment and spatial perception and is
more likely to be impulsive and move quickly, which
places the
-Impaired physical mobility related to right- client at risk for falls.
sided hemiplegia.
-Risk for injury related to denial of
deficits and impulsiveness.
-Impaired verbal communication
related to speech-language deficits.
-Ineffective coping related to
depression and distress about
disability.
The nurse is assessing a postmenopausal
Cystocele woman who is complaining of urinary
urgency and frequency and stress Rationale: This constellation of signs in a postmenopausal
incontinence. She also reports difficulty in woman are characteristic of a cystocele. These
symptoms emptying her bladder. These complaints are are not characteristic of the other
options.
most likely due to which condition?
-Cystocele.
-Bladder infection.
-Pyelonephritis.
-Irritable bladder.
The nurse is caring for a client with Loss of thirst, weight
gain syndrome of inappropriate antidiuretic
hormone (SIADH), which is manifested by Rationale: SIADH occurs when the posterior pituitary gland
which symptoms? releases too much ADH, causing water retention, a urine
output of less than 20 ml/hour, and dilutional hyponatremia.
-Loss of thirst, weight gain. Other indications of SIADH are loss of thirst, weight gain,
-Dependent edema, fever. irritability, muscle weakness, and decreased level of
-Polydipsia, polyuria. consciousness.
-Hypernatremia, tachypnea.
The nurse is teaching a client with maple Both genes of a pair must be abnormal for the
disorder to syrup urine disease (MSUD), an autosomal occur
recessive disorder, about the inheritance
pattern. Which information should the nurse Rationale: Maple syrup urine disease (MSUD) is a type
of
provide? autosomal recessive inheritance disorder in which
both genes of a pair must be abnormal for the
disorder to be
-This recessive disorder is carried only on expressed.
the X chromosome.
-Occurrences mainly affect males and
heterozygous females.
-Both genes of a pair must be
abnormal for the disorder to occur.
-One copy of the abnormal gene is
required for this disorder.
,What information should the nurse -Smoking
include in a teaching plan about the -early menarche
onset of -genetic influence
menopause? (Select all that apply). -chemotherapy exposure
-Smoking. Rationale: Menopausal symptoms are related to the
-Oophorectomy with hysterectomy. cessation of ovarian function. Factors influencing the onset
-Early menarche. of menopause include smoking, genetic influences, early
-Cardiac disease. men
-Genetic influence.
-Chemotherapy exposure.
The nurse reviews the complete blood risk for injury
count (CBC) findings of an adolescent
with acute myelogenous leukemia Rationale: A client with AML is at risk for anemia,
(AML). The neutropenia, and thrombocytopenia. These CBC findings
hemoglobin is 13.8 g/dl, hematocrit is indicate that the platelet count is low (normal 250,000 to
36.7%, white blood cell count is 8,200 400,000 mm3), which places this client at an increased risk
mm3, and for injury, usually manifested as bruising or bleeding.
platelet count is 115,000 mm3. Based
on these findings, what is the priority
nursing diagnosis for this client's plan
of care?
-Impaired gas exchange.
-Risk for infection.
-Risk for injury.
-Risk for activity intolerance.
A mother is crying as she holds and lay the child down and ask the mother to stay near
rocks her child with tetanus who is the child in the crib
having
muscular spasms and crying. After Rationale: Controlling environmental stimulation such as
administering diazepam (Valium) to noise, light, or tactile stimuli helps reduce CNS irritability
the child, what action should the related to acute tetanus. The mother should be instructed to
nurse minimize handling of the child during episodes of muscle
implement? spasticity and to stay calmly near the child. The mother's
presence with the child provides security and support to the
-Lay the child down and ask the child.
mother to stay near the child in the
crib.
-Encourage the mother to take a
break and leave the room to stop
crying.
-Keep all light sources off and close
the window blinds to the room.
-Use calm, reassurance and
understanding to comfort the mother.
, A man who was recently Genetic counseling should be obtained prior to
diagnosed with Huntington's undertaking any genetic testing procedure.
disease asks the nurse if his
adolescent son should be tested Rationale: Genetic counseling provides clients and
for the families with facts to assist them in making informed
disease. What response is best for the decisions
nurse to provide? before any genetic testing procedure is undertaken. It
also ensures that the client has voluntarily opted for the
-Autosomal dominant disorders, such as testing and not coerced and is also able to weigh the
Huntington's, cannot be inherited risks and
from the parent. benefits of knowing the result.
-Genetic counseling should be
obtained prior to undertaking any
genetic testing procedure.
-Testing is needed in adolescents
because of the risk of passing the
gene to each offspring.
-Positive genetic testing may contribute
to insurance discrimination that denies
coverage.
Which pathophysiological response Spasmodic reflex of respiratory and gastric movements
supports a client's vomiting results from stimulation of the chemoreceptor trigger
experience? zone.
-Sensory input of noxious stimuli Rationale: Vomiting is a reflex of spasmodic respiratory
relayed to the cognitive centers is movements against the glottis causing the forceful
associated with disgust and illicits expulsion of the contents of the stomach through the mouth.
vomiting. Stimulation of the emetic center results from afferent vagal
-Response of stimulation of the and sympathetic nerve pathways that activate the
posterior oropharynx results in chemoreceptor trigger zone (CTZ).
reverse peristalsis of the
gastrointestinal tract.
-Spasmodic reflex of respiratory and
gastric movements results from
stimulation of the
chemoreceptor trigger zone.
-Increased gastric and colonic
pressures move gastrointestinal
contents to the orifice of least
resistance.
A client is admitted to the Emergency A deviation of the trachea toward the side opposite the
Department with a tension pneumothorax.
pneumothorax. Which assessment
should the nurse expect to identify? Rationale: Tension pneumothorax is caused by rapid
accumulation of air in the pleural space, causing severely
-An absence of lung sounds on the high intrapleural pressure. This results in collapse of the
affected side. lung, and the mediastinum shifts toward the unaffected side,
-An inability to auscultate tracheal which is subsequently compressed. The other options are
breath sounds. not demonstrated with a tension pneumothorax.
-A deviation of the trachea toward the
side opposite the pneumothorax.
-A shift of the point of maximal
impulse to the left, with bounding
pulses.
