EVOLVE COMPREHENSIVE HESI
EXAM REVIEW WITH VERIFIED
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 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? Answer:
Assign the client to a negative air-flow room
EXAM REVIEW WITH VERIFIED
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 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? Answer:
Assign the client to a negative air-flow room
