Evolve Comprehensive Exam (Hesi) 2022-2023 with
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, Evolve Comprehensive Exam (Hesi) 1
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1. 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).: 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. 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?: 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.
3. A client who is taking clonidine ( Catapres, Duraclon) reports drowsiness.
Which additional assessment should the nurse make?: 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
, Evolve Comprehensive Exam (Hesi) 1
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the medication (A) provides information to direct additional instruction. (B, C, and D)
are not relevant.
4. 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?: 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.
5. An 80 year old client is given morphine sulphate for postoperative pain.
Which concomitant medication should the nurse question that poses a po-
tential development of urniary retention in this geriatric client. ?: 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 antiin-
flammatory agents (D) can increase the risk for bleeding, but do not increase urinary
retention with opioids (D).
6. 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?: 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.
7. 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?: 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
, Evolve Comprehensive Exam (Hesi) 1
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maternal-newborn bonding (D) is facilitated by early breastfeeding, the priority is
uterine contraction stimulation.
8. 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?: 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.
9. the nursie is caring for a client who is unable to void. The plan of care es-
tablishes 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?: Drinks 240 mL of fluid five times during the
shift.
The nurse should evaluate the client's outcome by observing the client's perfor-
mance 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.
10. a client who has active tuberculosis ( TB) is admitted to the medical unit.
What action is most important for the nurse to implement?: 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.
11. A client is receiving atonal (tenormin) 25 mg PO after a myocardial infrac-
tion. The nurse determines the clinents apical pulse is 65 beats per minute.
What action should the nurse implement next?: Administer the medication
Atenolol, a beta-blocker, blocks the beta receptors of the sinoatrial node to reduce
well explained answers verified by experts
, Evolve Comprehensive Exam (Hesi) 1
Study online at https://quizlet.com/_5hkgmx
1. 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).: 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. 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?: 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.
3. A client who is taking clonidine ( Catapres, Duraclon) reports drowsiness.
Which additional assessment should the nurse make?: 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
, Evolve Comprehensive Exam (Hesi) 1
Study online at https://quizlet.com/_5hkgmx
the medication (A) provides information to direct additional instruction. (B, C, and D)
are not relevant.
4. 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?: 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.
5. An 80 year old client is given morphine sulphate for postoperative pain.
Which concomitant medication should the nurse question that poses a po-
tential development of urniary retention in this geriatric client. ?: 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 antiin-
flammatory agents (D) can increase the risk for bleeding, but do not increase urinary
retention with opioids (D).
6. 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?: 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.
7. 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?: 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
, Evolve Comprehensive Exam (Hesi) 1
Study online at https://quizlet.com/_5hkgmx
maternal-newborn bonding (D) is facilitated by early breastfeeding, the priority is
uterine contraction stimulation.
8. 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?: 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.
9. the nursie is caring for a client who is unable to void. The plan of care es-
tablishes 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?: Drinks 240 mL of fluid five times during the
shift.
The nurse should evaluate the client's outcome by observing the client's perfor-
mance 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.
10. a client who has active tuberculosis ( TB) is admitted to the medical unit.
What action is most important for the nurse to implement?: 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.
11. A client is receiving atonal (tenormin) 25 mg PO after a myocardial infrac-
tion. The nurse determines the clinents apical pulse is 65 beats per minute.
What action should the nurse implement next?: Administer the medication
Atenolol, a beta-blocker, blocks the beta receptors of the sinoatrial node to reduce
