Evolve Comprehensive Exam (Hesi) 1 From Leading
Educators Around the World Expert-Verified
Questions and Answers With Detailed Answer
Rationale Tested and Proven Exam Strategies
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?
A. Pindolol (Visken).
B. Carteolol (Ocupress).
C. Metoprolol tartrate (Lopressor).
D. Propranolol hydrochloride (Inderal). - CORRECT ANSWER- -Metoprolol Tartrate(
Lopressor)
The best antihypertensive agent for clients with asthma is metoprolol (Lopressor) (C), a
beta2 blocking agent which is also cardioselective 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 the
healthcare provider discontinued the medication because his blood pressure has been
,normal for the past three months. Which instruction should the use provide? - CORRECT
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? - CORRECT 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? - CORRECT 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. ? - CORRECT 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? - CORRECT 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? - CORRECT 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? - CORRECT 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? -
CORRECT 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? - CORRECT ANSWER- -Assign the client to a
negative air-flow room
Active tuberculosis requires implementation of airborne precautions, so the client should
be assigned to a negative pressure air-flow room (D). Although (A and C) should be
implemented for clients in isolation with contact precautions, it is most important that air
flow from the room is minimized when the client has TB. (B) should be implemented when
the client leaves the isolation environment.
A client is receiving atonal (tenormin) 25 mg PO after a myocardial infraction. The nurse
determines the clinents apical pulse is 65 beats per minute. What action should the nurse
implement next? - CORRECT ANSWER- -Administer the medication
Educators Around the World Expert-Verified
Questions and Answers With Detailed Answer
Rationale Tested and Proven Exam Strategies
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?
A. Pindolol (Visken).
B. Carteolol (Ocupress).
C. Metoprolol tartrate (Lopressor).
D. Propranolol hydrochloride (Inderal). - CORRECT ANSWER- -Metoprolol Tartrate(
Lopressor)
The best antihypertensive agent for clients with asthma is metoprolol (Lopressor) (C), a
beta2 blocking agent which is also cardioselective 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 the
healthcare provider discontinued the medication because his blood pressure has been
,normal for the past three months. Which instruction should the use provide? - CORRECT
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? - CORRECT 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? - CORRECT 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. ? - CORRECT 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? - CORRECT 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? - CORRECT 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? - CORRECT 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? -
CORRECT 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? - CORRECT ANSWER- -Assign the client to a
negative air-flow room
Active tuberculosis requires implementation of airborne precautions, so the client should
be assigned to a negative pressure air-flow room (D). Although (A and C) should be
implemented for clients in isolation with contact precautions, it is most important that air
flow from the room is minimized when the client has TB. (B) should be implemented when
the client leaves the isolation environment.
A client is receiving atonal (tenormin) 25 mg PO after a myocardial infraction. The nurse
determines the clinents apical pulse is 65 beats per minute. What action should the nurse
implement next? - CORRECT ANSWER- -Administer the medication
