EVOLVE COMPREHENSIVE EXAM (HESI) QUESTIONS
| TESTED AND PROVEN ANSWERS | LATEST UPDATE
2024/2025 100% (GRADE A+)
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?
Ans>> 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?
Ans>> Ask the health care provider about tapering the drug dose over the next week.
1
,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?
Ans>> 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?
Ans>> Decrease the risk of bradycardia during surgery
2
,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. ?
Ans>> 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?
Ans>> Admister the dose as prescribed
3
, 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?
Ans>> 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?
4
| TESTED AND PROVEN ANSWERS | LATEST UPDATE
2024/2025 100% (GRADE A+)
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?
Ans>> 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?
Ans>> Ask the health care provider about tapering the drug dose over the next week.
1
,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?
Ans>> 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?
Ans>> Decrease the risk of bradycardia during surgery
2
,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. ?
Ans>> 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?
Ans>> Admister the dose as prescribed
3
, 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?
Ans>> 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?
4
