EXAM QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) EVOLVE COMPREHENSIVE HESI
EXAM ALREADY GRADED A+
To assess a client's pupillary response to accommodation, a nurse should perform
which activity? - ANSWER-Ask the client to look at a distant object and then at an
object held 10 cm from the nose.
To check the accommodation response, the client should gaze and fixate on an
object 2 to 3 feet away, then bring the object closer until the client is fixated on
the object at 6 to 8 inches (10 cm) and identify pupillary constriction as the client
focuses on the near object (D). (A and B) evaluate pupillary reactivity to light
(PERL). (C) evaluates pupil and blink reflexes (Cranial Nerve III).
A male client, who has been smoking 1 pack of cigarettes every day for the last 20
years, is scheduled for surgery and will be unable to smoke after surgery. During
preoperative teaching, the client asks the nurse what symptoms he may expect
,after surgery from nicotine withdrawal. Which response is best for the nurse to
provide? - ANSWER-Headache and hyperirritability are common
Withdrawal from nicotine causes cravings, restlessness and hyperirritability,
headache (B), insomnia, depression, decreased blood pressure, and increased
appetite. Nicotine is a highly addictive substance that precipitates an intense
withdrawal syndrome, not (A). Nicotine causes vasoconstriction which increases
peripheral resistance and blood pressure (C), but withdrawal is likely to relax
peripheral blood vessels and reduce blood pressure. Many individuals experience
an increased appetite, not (D).
The nurse is caring for a client who is the daughter of a local politician. When the
nurse approaches a man who is reading the names on the hall doors, he identifies
himself as a reporter for the local newspaper and requests information about the
client's status. Which standard of nursing practice should the nurse use to
respond? - ANSWER-Confidentiality
Confidentiality (D) is the nurse's primary responsibility and is supported by HIPAA,
which mandates that personal information is not disclosed and access to sensitive
client information is limited. Caring (A) involves the nurse's concern about how
the client experiences the world. Veracity (B) is the nurse's duty to tell the truth
and not deceive others. Advocacy (C) is support of the client's best interests.
Prior to transferring a client to a chair using a mechanical lift, what is the most
important client characteristic the nurse should assess? - ANSWER-Tolerance of
exertion.
,Awareness of the client's ability to tolerate exertion (D) allows the nurse to plan
how to prepare the client for the use of the lift. (A, B and C) are not needed when
using a lift.
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? - ANSWER-Metoprolol Tartrate (Lopressor)
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 caretook (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? - 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, Dracon) 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 ad mister 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? -
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 urinary retention in this geriatric client.? - ANSWER-Tricyclic
antidepressants