Page 1 of 96
EVOLVE COMPREHENSIVE EXAM (HESI) 1 EXAM
QUESTIONS AND CORRECT ANSWERS WITH WELL-
ELABORATED RATIONALES / EVOLVE MED SURG HESI
LATEST EXAM 2025(BRAND NEW!!)
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
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
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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
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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?
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......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
EVOLVE COMPREHENSIVE EXAM (HESI) 1 EXAM
QUESTIONS AND CORRECT ANSWERS WITH WELL-
ELABORATED RATIONALES / EVOLVE MED SURG HESI
LATEST EXAM 2025(BRAND NEW!!)
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
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
,Page 2 of 96
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
,Page 3 of 96
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?
, Page 4 of 96
......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
