SPECIALISTS EXAM
1|P a g e
EVOLVE HESI COMPREHENSIVE EXAM
LATEST AND COMPLETE UPDATED
✓ 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)- ANS : 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 bronchocon-
striction, and is not indicated in clients with asthma and other obstructive
pulmonary disorders.
2|P a g e
SPECIALISTS EXAM
, SPECIALISTS EXAM
✓ 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- ANS : 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- ANS : 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- ANS : 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.
SPECIALISTS EXAM
, SPECIALISTS EXAM
✓ 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. - ANS : Tricyclic
antidepressants
Drugs with anticholinergic properties, such as tricyclic antidepressants (C), can
exacerbate urinary retention associated with opioids in the older client. Although
SPECIALISTS EXAM
, SPECIALISTS EXAM
3|P a g e
tricyclic antidepressants and antihistamines with opioids can exacerbate urinary
retention, the concurrent use of (A and B) with opioids do not. Nonsteroidal anti-
inflammatory 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- ANS : 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- ANS : 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 client’s needs and formulates the nursing problem of "
Imbalances nutrition: Less than body requirements, related to mental impairment
and decreased intake, as evidence by increasing confusion and
SPECIALISTS EXAM
1|P a g e
EVOLVE HESI COMPREHENSIVE EXAM
LATEST AND COMPLETE UPDATED
✓ 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)- ANS : 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 bronchocon-
striction, and is not indicated in clients with asthma and other obstructive
pulmonary disorders.
2|P a g e
SPECIALISTS EXAM
, SPECIALISTS EXAM
✓ 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- ANS : 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- ANS : 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- ANS : 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.
SPECIALISTS EXAM
, SPECIALISTS EXAM
✓ 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. - ANS : Tricyclic
antidepressants
Drugs with anticholinergic properties, such as tricyclic antidepressants (C), can
exacerbate urinary retention associated with opioids in the older client. Although
SPECIALISTS EXAM
, SPECIALISTS EXAM
3|P a g e
tricyclic antidepressants and antihistamines with opioids can exacerbate urinary
retention, the concurrent use of (A and B) with opioids do not. Nonsteroidal anti-
inflammatory 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- ANS : 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- ANS : 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 client’s needs and formulates the nursing problem of "
Imbalances nutrition: Less than body requirements, related to mental impairment
and decreased intake, as evidence by increasing confusion and
SPECIALISTS EXAM
