5/20/25, 11:36 PM HESI
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Practice Test Assessment Performance
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A medication that is classified as a beta-1 agonist is most commonly prescribed for a
client with which condition?
Glaucoma.
Hypertension.
Heart failure.
Asthma.
Rationale
Beta-1 agonists improve cardiac output by increasing the heart rate and blood pressure and are indicated in heart failure,
shock, atrioventricular block dysrhythmias, and cardiac arrest. In contrast, glaucoma is managed using adrenergic agents and
beta-adrenergic blocking agents. Beta-1 blocking agents are used in the management of hypertension. Medications that
stimulate beta-2 receptors in the bronchi are effective for bronchoconstriction in respiratory disorders, such as asthma.
A female client with rheumatoid arthritis take ibuprofen (Motrin) 600 mg PO 4 times a
day. To prevent gastrointestinal bleeding, misoprostol (Cytotec) 100 mcg PO is
prescribed. Which information is most important for the nurse to include in client
teaching?
Use contraception during intercourse.
Ensure the Cytotec is taken on an empty stomach.
Encourage oral fluid intake to prevent constipation.
Take Cytotec 30 minutes prior to Motrin.
,5/20/25, 11:36 PM HESI
Rationale
Cytotec, a synthetic form of a prostaglandin, is classified as pregnancy Category X and can act as an abortifacient, so the client
should be instructed to use contraception during intercourse to prevent loss of an early pregnancy. A common side effect of
Cytotec is diarrhea, so constipation prevention strategies are usually not needed. Cytotec and Motrin should be taken together
to provide protective properties against gastrointestinal bleeding.
In evaluating the effects of lactulose (Cephulac), which outcome would indicate that the
drug is performing as intended?
An increase in urine output.
Two or three soft stools per day.
Watery, diarrhea stools.
Increased serum bilirubin.
Rationale
The medication lactulose can be administered for either chronic constipation or for portal-systemic encephalopathy in clients
with hepatic disease. Two to three stools a day indicate that lactulose is performing as intended for chronic constipation. This
would also indicate it should be effective for the clients with encephalopathy because the lactulose's action prevents
absorption of ammonia in the colon as it increases water absorption and softens the stool. The efficacy of the use for ammonia
absorption would have to be verified by a serum ammonia level and observation of clearing of the client's mental status.
Which instruction(s) should the nurse give to a female client who just received a
prescription for oral metronidazole (Flagyl) for treatment of trichomonas vaginalis?
(Select all that apply.)
Select all that apply
Increase fluid intake, especially cranberry juice.
Do not abruptly discontinue the medication; taper use.
Check blood pressure daily to detect hypertension.
Avoid drinking alcohol while taking this medication.
Use condoms until treatment is completed.
Ensure that all sexual partners are treated at the same time.
Rationale
Increased fluid intake and cranberry juice are recommended for prevention and treatment of urinary tract infections, which
frequently accompany vaginal infections. It is not necessary to taper use of this drug or to check the blood pressure daily, as
this condition is not related to hypertension. Flagyl can cause a disulfiram-like reaction if taken in conjunction with ingestion
of alcohol, so the client should be instructed to avoid alcohol. All sexual partners should be treated at the same time and
condoms should be used until after treatment is completed to avoid reinfection.
Which antidiarrheal agent should be used with caution in clients taking high dosages of
aspirin for arthritis?
Loperamide (Imodium).
Probanthine (Propantheline).
Bismuth subsalicylate (Pepto Bismol).
Diphenoxylate hydrochloride with atropine (Lomotil).
, 5/20/25, 11:36 PM HESI
Rationale
Bismuth subsalicylate (Pepto Bismol) contains a subsalicylate that increases the potential for salicylate toxicity when used
concurrently with aspirin (acetylsalicylic acid, another salicylate preparation).
A client has a continuous IV infusion of dopamine (Intropin) and an IV of normal saline
at 50 ml/hour. The nurse notes that the client's urinary output has been 20 ml/hour for
the last two hours. Which intervention should the nurse initiate?
Stop the infusion of dopamine.
Change the normal saline to a keep open rate.
Replace the urinary catheter.
Notify the healthcare provider of the urinary output.
Rationale
The main effect of dopamine is adrenergic stimulation used to increase cardiac output, which should also result in increased
urinary output. A urinary output of less than 20 ml/hour is oliguria and should be reported to the healthcare provider, so the
dose of dopamine can be adjusted. Depending on the current rate of administration, the dose may need to be increased or
decreased.
A client's dose of isosorbide dinitrate (Imdur) is increased from 40 mg to 60 mg PO
daily. When the client reports the onset of a headache prior to the next scheduled dose,
which action should the nurse implement?
Hold the next scheduled dose of Imdur 60 mg and administer a PRN dose of acetaminophen
(Tylenol).
Administer the 40 mg of Imdur and then contact the healthcare provider.
Administer the 60 mg dose of Imdur and a PRN dose of acetaminophen (Tylenol).
Do not administer the next dose of Imdur or any acetaminophen until notifying the healthcare
provider.
Rationale
Imdur is a nitrate which causes vasodilation. This vasodilation can result in headaches, which can generally be controlled with
acetaminophen until the client develops a tolerance to this adverse effect.
The nurse is reviewing the use of the patient-controlled analgesia (PCA) pump with a
client in the immediate postoperative period. The client will receive morphine 1 mg IV
per hour basal rate with 1 mg IV every 15 minutes per PCA to total 5 mg IV maximally
per hour. What assessment has the highest priority before initiating the PCA pump?
The expiration date on the morphine syringe in the pump.
The rate and depth of the client's respirations.
The type of anesthesia used during the surgical procedure.
The client's subjective and objective signs of pain.
Rationale
A life-threatening side effect of intravenous administration of morphine sulfate, an opiate narcotic, is respiratory depression.
Prior to the initiation of the PCA pump, the nurse should assess the client's respirations to obtain a baseline of their
Return to Overview
Practice Test Assessment Performance
100%
Awesome!
Correct Let's review your results from 5/20/2025 at 11:34 pm PST
Correct
A medication that is classified as a beta-1 agonist is most commonly prescribed for a
client with which condition?
Glaucoma.
Hypertension.
Heart failure.
Asthma.
Rationale
Beta-1 agonists improve cardiac output by increasing the heart rate and blood pressure and are indicated in heart failure,
shock, atrioventricular block dysrhythmias, and cardiac arrest. In contrast, glaucoma is managed using adrenergic agents and
beta-adrenergic blocking agents. Beta-1 blocking agents are used in the management of hypertension. Medications that
stimulate beta-2 receptors in the bronchi are effective for bronchoconstriction in respiratory disorders, such as asthma.
A female client with rheumatoid arthritis take ibuprofen (Motrin) 600 mg PO 4 times a
day. To prevent gastrointestinal bleeding, misoprostol (Cytotec) 100 mcg PO is
prescribed. Which information is most important for the nurse to include in client
teaching?
Use contraception during intercourse.
Ensure the Cytotec is taken on an empty stomach.
Encourage oral fluid intake to prevent constipation.
Take Cytotec 30 minutes prior to Motrin.
,5/20/25, 11:36 PM HESI
Rationale
Cytotec, a synthetic form of a prostaglandin, is classified as pregnancy Category X and can act as an abortifacient, so the client
should be instructed to use contraception during intercourse to prevent loss of an early pregnancy. A common side effect of
Cytotec is diarrhea, so constipation prevention strategies are usually not needed. Cytotec and Motrin should be taken together
to provide protective properties against gastrointestinal bleeding.
In evaluating the effects of lactulose (Cephulac), which outcome would indicate that the
drug is performing as intended?
An increase in urine output.
Two or three soft stools per day.
Watery, diarrhea stools.
Increased serum bilirubin.
Rationale
The medication lactulose can be administered for either chronic constipation or for portal-systemic encephalopathy in clients
with hepatic disease. Two to three stools a day indicate that lactulose is performing as intended for chronic constipation. This
would also indicate it should be effective for the clients with encephalopathy because the lactulose's action prevents
absorption of ammonia in the colon as it increases water absorption and softens the stool. The efficacy of the use for ammonia
absorption would have to be verified by a serum ammonia level and observation of clearing of the client's mental status.
Which instruction(s) should the nurse give to a female client who just received a
prescription for oral metronidazole (Flagyl) for treatment of trichomonas vaginalis?
(Select all that apply.)
Select all that apply
Increase fluid intake, especially cranberry juice.
Do not abruptly discontinue the medication; taper use.
Check blood pressure daily to detect hypertension.
Avoid drinking alcohol while taking this medication.
Use condoms until treatment is completed.
Ensure that all sexual partners are treated at the same time.
Rationale
Increased fluid intake and cranberry juice are recommended for prevention and treatment of urinary tract infections, which
frequently accompany vaginal infections. It is not necessary to taper use of this drug or to check the blood pressure daily, as
this condition is not related to hypertension. Flagyl can cause a disulfiram-like reaction if taken in conjunction with ingestion
of alcohol, so the client should be instructed to avoid alcohol. All sexual partners should be treated at the same time and
condoms should be used until after treatment is completed to avoid reinfection.
Which antidiarrheal agent should be used with caution in clients taking high dosages of
aspirin for arthritis?
Loperamide (Imodium).
Probanthine (Propantheline).
Bismuth subsalicylate (Pepto Bismol).
Diphenoxylate hydrochloride with atropine (Lomotil).
, 5/20/25, 11:36 PM HESI
Rationale
Bismuth subsalicylate (Pepto Bismol) contains a subsalicylate that increases the potential for salicylate toxicity when used
concurrently with aspirin (acetylsalicylic acid, another salicylate preparation).
A client has a continuous IV infusion of dopamine (Intropin) and an IV of normal saline
at 50 ml/hour. The nurse notes that the client's urinary output has been 20 ml/hour for
the last two hours. Which intervention should the nurse initiate?
Stop the infusion of dopamine.
Change the normal saline to a keep open rate.
Replace the urinary catheter.
Notify the healthcare provider of the urinary output.
Rationale
The main effect of dopamine is adrenergic stimulation used to increase cardiac output, which should also result in increased
urinary output. A urinary output of less than 20 ml/hour is oliguria and should be reported to the healthcare provider, so the
dose of dopamine can be adjusted. Depending on the current rate of administration, the dose may need to be increased or
decreased.
A client's dose of isosorbide dinitrate (Imdur) is increased from 40 mg to 60 mg PO
daily. When the client reports the onset of a headache prior to the next scheduled dose,
which action should the nurse implement?
Hold the next scheduled dose of Imdur 60 mg and administer a PRN dose of acetaminophen
(Tylenol).
Administer the 40 mg of Imdur and then contact the healthcare provider.
Administer the 60 mg dose of Imdur and a PRN dose of acetaminophen (Tylenol).
Do not administer the next dose of Imdur or any acetaminophen until notifying the healthcare
provider.
Rationale
Imdur is a nitrate which causes vasodilation. This vasodilation can result in headaches, which can generally be controlled with
acetaminophen until the client develops a tolerance to this adverse effect.
The nurse is reviewing the use of the patient-controlled analgesia (PCA) pump with a
client in the immediate postoperative period. The client will receive morphine 1 mg IV
per hour basal rate with 1 mg IV every 15 minutes per PCA to total 5 mg IV maximally
per hour. What assessment has the highest priority before initiating the PCA pump?
The expiration date on the morphine syringe in the pump.
The rate and depth of the client's respirations.
The type of anesthesia used during the surgical procedure.
The client's subjective and objective signs of pain.
Rationale
A life-threatening side effect of intravenous administration of morphine sulfate, an opiate narcotic, is respiratory depression.
Prior to the initiation of the PCA pump, the nurse should assess the client's respirations to obtain a baseline of their
