HESI comprehensive practice exam 1
Questions and 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 least likely to exacerbate asthma? - ANSWER-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 that the healthcare provider discontinued the medication because his blood
pressure has been normal for the past three months. Which instruction should
the nurse provide? - ANSWER-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. (D) is not indicated.
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 administer 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.
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-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).
A client with osteoarthritis is given a new prescription for a nonsteroidal
antiinflammatory drug (NSAID). The client asks the nurse, "How is this
medication different from the acetaminophen I have been taking?" Which
information about the therapeutic action of NSAIDs should the nurse provide? -
ANSWER-Provide antiinflammatory response.
A client with cancer has a history of alcohol abuse and is taking acetaminophen
(Tylenol) for pain. Which organ function is most important for the nurse to
monitor? - ANSWER-Acetaminophen and alcohol are both metabolized in the
liver. This places the client at risk for hepatotoxicity, so monitoring liver (A)
function is the most important assessment because the combination of
acetaminophen and alcohol, even in moderate amounts, can cause potentially
fatal liver damage. Other non-narcotic analgesics, such as n onsteroidal
anti-inflammatory drugs (NSAIDs), are more likely to promote adverse renal
effects (B). Acetaminophen does not place the client at risk for toxic reactions
related to (C or 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? - ANSWER-Administer 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.
A client is admitted to the hospital with a diagnosis of Type 2 diabetes mellitus
and influenza. Which categories of illness should the nurse develop goals for the
client's plan of care? - ANSWER-One chronic and one acute illness.
Following an emergency Cesarean delivery, the nurse encourages the new
mother to breastfeed her newborn. The client asks why she should breastfeed
now. Which information should the nurse provide? - ANSWER-Stimulate
contraction of the uterus.
Which intervention should the nurse include in the plan of care for a female client
with severe postpartum depression who is admitted to the inpatient psychiatric
unit? - ANSWER-Supervised and guided visits with infant.
A 16-year-old male client is admitted to the hospital after falling off a bike and
sustaining a fractured bone. The healthcare provider explains the surgery
needed to immobilize the fracture. Which action should be implemented to obtain
a valid informed consent? - ANSWER-The client is a minor and cannot legally
sign his own consent unless he is an emancipated minor, so the consent should
be obtained from the guardian for this client, which is the custodial parent (B). (A)
is not a legal option. A stepparent is not a legal guardian for a minor unless the
child has been adopted by the stepparent (C). The non-custodial parent does not
need to co-sign this form (D).
During a client assessment, the client says, "I can't walk very well." Which action
should the nurse implement first? - ANSWER-Identify the problem.
, The nurse identifies a client's needs and formulates the nursing problem of,
"Imbalanced nutrition: less than body requirements, related to mental impairment
and decreased intake, as evidenced 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? - ANSWER-Eat 50% of six small meals each day by the end of one
week.
A male client is angry and is leaving the hospital against medical advice (AMA).
The client demands to take his chart with him and states the chart is "his" and he
doesn' t want any more contact with the hospital. How should the nurse respond?
- ANSWER-The chart is the property of the facility, but the client has a legal right
to the information in it, even if he is leaving AMA, so a copy of the record (D)
should be provided. The client does not lose his legal rights to his medical record
if he leaves AMA (A). The medical record is confidential, but the hospital protects
the client's privacy by not allowing unauthorized access to the record, so the
hospital may provide the client with a copy (B). The hospital must maintain
records of the care provided and should not release the original record (C).
The nurse manager is assisting a nurse with improving organizational skills and
time management. Which nursing activity is the priority in pre-planning a
schedule for selected nursing activities in the daily assignment? - ANSWER-In
developing organizational skills, medication administration is based on a
prescribed schedule that is time-sensitive in the delivery of nursing care and
should be the priority in scheduling nursing activities in a daily assignment.
Although suctioning a client's tracheostomy takes precedence in providing care,
the client's PRN need is less amenable to a preselected schedule. (B and C) can
be scheduled around time-sensitive delivery of care.
What nursing delivery of care provides the nurse to plan and direct care of a
group of clients over a 24-hour period? - ANSWER-Primary nursing (B) is a
model of delivery of care where a nurse is accountable for planning care for
clients around the clock. Functional nursing (D) is a care delivery model that
provides client care by assignment of functions or tasks. Team nursing (A) is a
care delivery model where assignments to a group of clients are provided by a
mixed-staff team. Case management (C) is the delivery of care that uses a
collaborative process of assessment, planning, facilitation, and advocacy for
Questions and 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 least likely to exacerbate asthma? - ANSWER-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 that the healthcare provider discontinued the medication because his blood
pressure has been normal for the past three months. Which instruction should
the nurse provide? - ANSWER-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. (D) is not indicated.
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 administer 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.
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-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).
A client with osteoarthritis is given a new prescription for a nonsteroidal
antiinflammatory drug (NSAID). The client asks the nurse, "How is this
medication different from the acetaminophen I have been taking?" Which
information about the therapeutic action of NSAIDs should the nurse provide? -
ANSWER-Provide antiinflammatory response.
A client with cancer has a history of alcohol abuse and is taking acetaminophen
(Tylenol) for pain. Which organ function is most important for the nurse to
monitor? - ANSWER-Acetaminophen and alcohol are both metabolized in the
liver. This places the client at risk for hepatotoxicity, so monitoring liver (A)
function is the most important assessment because the combination of
acetaminophen and alcohol, even in moderate amounts, can cause potentially
fatal liver damage. Other non-narcotic analgesics, such as n onsteroidal
anti-inflammatory drugs (NSAIDs), are more likely to promote adverse renal
effects (B). Acetaminophen does not place the client at risk for toxic reactions
related to (C or 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? - ANSWER-Administer 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.
A client is admitted to the hospital with a diagnosis of Type 2 diabetes mellitus
and influenza. Which categories of illness should the nurse develop goals for the
client's plan of care? - ANSWER-One chronic and one acute illness.
Following an emergency Cesarean delivery, the nurse encourages the new
mother to breastfeed her newborn. The client asks why she should breastfeed
now. Which information should the nurse provide? - ANSWER-Stimulate
contraction of the uterus.
Which intervention should the nurse include in the plan of care for a female client
with severe postpartum depression who is admitted to the inpatient psychiatric
unit? - ANSWER-Supervised and guided visits with infant.
A 16-year-old male client is admitted to the hospital after falling off a bike and
sustaining a fractured bone. The healthcare provider explains the surgery
needed to immobilize the fracture. Which action should be implemented to obtain
a valid informed consent? - ANSWER-The client is a minor and cannot legally
sign his own consent unless he is an emancipated minor, so the consent should
be obtained from the guardian for this client, which is the custodial parent (B). (A)
is not a legal option. A stepparent is not a legal guardian for a minor unless the
child has been adopted by the stepparent (C). The non-custodial parent does not
need to co-sign this form (D).
During a client assessment, the client says, "I can't walk very well." Which action
should the nurse implement first? - ANSWER-Identify the problem.
, The nurse identifies a client's needs and formulates the nursing problem of,
"Imbalanced nutrition: less than body requirements, related to mental impairment
and decreased intake, as evidenced 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? - ANSWER-Eat 50% of six small meals each day by the end of one
week.
A male client is angry and is leaving the hospital against medical advice (AMA).
The client demands to take his chart with him and states the chart is "his" and he
doesn' t want any more contact with the hospital. How should the nurse respond?
- ANSWER-The chart is the property of the facility, but the client has a legal right
to the information in it, even if he is leaving AMA, so a copy of the record (D)
should be provided. The client does not lose his legal rights to his medical record
if he leaves AMA (A). The medical record is confidential, but the hospital protects
the client's privacy by not allowing unauthorized access to the record, so the
hospital may provide the client with a copy (B). The hospital must maintain
records of the care provided and should not release the original record (C).
The nurse manager is assisting a nurse with improving organizational skills and
time management. Which nursing activity is the priority in pre-planning a
schedule for selected nursing activities in the daily assignment? - ANSWER-In
developing organizational skills, medication administration is based on a
prescribed schedule that is time-sensitive in the delivery of nursing care and
should be the priority in scheduling nursing activities in a daily assignment.
Although suctioning a client's tracheostomy takes precedence in providing care,
the client's PRN need is less amenable to a preselected schedule. (B and C) can
be scheduled around time-sensitive delivery of care.
What nursing delivery of care provides the nurse to plan and direct care of a
group of clients over a 24-hour period? - ANSWER-Primary nursing (B) is a
model of delivery of care where a nurse is accountable for planning care for
clients around the clock. Functional nursing (D) is a care delivery model that
provides client care by assignment of functions or tasks. Team nursing (A) is a
care delivery model where assignments to a group of clients are provided by a
mixed-staff team. Case management (C) is the delivery of care that uses a
collaborative process of assessment, planning, facilitation, and advocacy for
