EVOLVE COMPREHENSIVE EXAM HESI
COMPREHENSIVE QUESTIONS AND
COMPLETE SOLUTIONS
◉ 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?
Answer: 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?
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 (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?
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 (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. ?
Answer: 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).
◉ 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?
Answer: 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?
Answer: 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?
Answer: 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?
Answer: 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
COMPREHENSIVE QUESTIONS AND
COMPLETE SOLUTIONS
◉ 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?
Answer: 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?
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 (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?
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 (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. ?
Answer: 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).
◉ 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?
Answer: 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?
Answer: 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?
Answer: 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?
Answer: 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
