Evolve Comprehensive Exam (Hesi) Questions
With Correct Answers
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? |- |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
Atenolol, |a |beta-blocker, |blocks |the |beta |receptors |of |the |sinoatrial |node |to |reduce |the |heart |
rate, |so |the |medication |should |be |administered |(C) |because |the |client's |apical |pulse |is |greater |
than |60. |(A, |B, |and |D) |are |not |indicated |at |this |time.
A |6 |year |old |child |is |alert |but |quiet |when |brought |to |the |emergency |center |with |periobital |
ecchymosis |and |ecchymosis |behind |the |ears. |The |nurse |suspects |potential |child |abuse |and |
continues |to |assess |the |child |for |additional |manifestations |of |a |basilar |skull |fracture. |What |
assessment |finding |would |be |consistent |with |the |basilar |skull |fracture? |- |CORRECT |
ANSWER✔✔-Rhinorrhoea |or |otorrhoea |with |halo |sign
Raccoon |eyes |(periorbital |ecchymosis) |and |Battle's |sign |(ecchymosis |behind |the |ear |over |the |
mastoid |process) |are |both |signs |of |a |basilar |skull |fracture, |so |the |nurse |should |assess |for |
possible |meningeal |tears |that |manifest |as |a |Halo |sign |with |CSF |leakage |from |the |ears |or |nose |
(D). |(A) |is |consistent |with |orbital |fractures. |(B) |occurs |with |wrenching |traumas |of |the |shoulder |
or |arm |fractures. |(C) |occurs |with |blunt |abdominal |injuries.
With Correct Answers
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? |- |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
Atenolol, |a |beta-blocker, |blocks |the |beta |receptors |of |the |sinoatrial |node |to |reduce |the |heart |
rate, |so |the |medication |should |be |administered |(C) |because |the |client's |apical |pulse |is |greater |
than |60. |(A, |B, |and |D) |are |not |indicated |at |this |time.
A |6 |year |old |child |is |alert |but |quiet |when |brought |to |the |emergency |center |with |periobital |
ecchymosis |and |ecchymosis |behind |the |ears. |The |nurse |suspects |potential |child |abuse |and |
continues |to |assess |the |child |for |additional |manifestations |of |a |basilar |skull |fracture. |What |
assessment |finding |would |be |consistent |with |the |basilar |skull |fracture? |- |CORRECT |
ANSWER✔✔-Rhinorrhoea |or |otorrhoea |with |halo |sign
Raccoon |eyes |(periorbital |ecchymosis) |and |Battle's |sign |(ecchymosis |behind |the |ear |over |the |
mastoid |process) |are |both |signs |of |a |basilar |skull |fracture, |so |the |nurse |should |assess |for |
possible |meningeal |tears |that |manifest |as |a |Halo |sign |with |CSF |leakage |from |the |ears |or |nose |
(D). |(A) |is |consistent |with |orbital |fractures. |(B) |occurs |with |wrenching |traumas |of |the |shoulder |
or |arm |fractures. |(C) |occurs |with |blunt |abdominal |injuries.
