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NURS 102 Evolve Comprehensive Exam: HESI Well Explained Questions And Answers 2022/2023 Study Guide (NURS102)

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NURS 102 Evolve Comprehensive Exam: HESI Well Explained Questions And Answers 2022/2023 Study Guide (NURS102) Evolve Comprehensive Exam (Hesi) A client with asthma receives a prescription for high blood pressure during a clinic visit. Which prescription should the nurse anticipate the client to r...

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  • March 21, 2022
  • 46
  • 2021/2022
  • Exam (elaborations)
  • Questions & answers

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  • nurs 102
  • evolve comprehensive exam
  • hesi
  • evolve comprehensive exam hesi
  • a client with asthma receives a prescription for high blood pressure during a clinic visit which prescription should the nurse

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  • NURS 102 (NURS102)
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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 least likely to
exacerbate asthma?

Pindolol (Visken).

Carteolol (Ocupress).

Metoprolol tartrate (Lopressor). Correct

Propranolol hydrochloride (Inderal).

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.

2. 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?

Report any uncomfortable symptoms after stopping the medication.

Stop the medication and keep an accurate record of blood pressure.

Ask the healthcare provider about tapering the drug dose over the next week. Correct

Obtain another antihypertensive prescription to avoid withdrawal symptoms.

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.

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? Correct

Does the client use any tobacco products?

Has the client experienced constipation recently?

Did the client miss any doses of 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.

4. 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?

Provide a more rapid induction of anesthesia.

Decrease the risk of bradycardia during surgery. Correct

Induce relaxation before induction of anesthesia.

Minimize the amount of analgesia needed postoperatively.

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 potential development of
urinary retention in this geriatric client?

Insulin.

Antacids.

Tricyclic antidepressants. Correct

Nonsteroidal antiinflammatory agents.

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).

6. 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?

Are less expensive.

Provide antiinflammatory response. Correct

Cause gastrointestinal bleeding.

Increase hepatotoxic side effects.

,Nonsteroidal antiinflammatory drugs (NSAIDs) have antiinflammatory properties (B), which
relieves pain associated with osteoarthritis and differs from acetaminophen, a non-narcotic
analgesic and antipyretic. (A) does not teach the client about the medication's actions. Although
NSAIDs are irritating to the gastrointestinal (GI) system and can cause GI bleeding (C),
instructions to take with food in the stomach to manage this as an expected side effect should
be included, but this does not answer the client's question. Acetaminophen is potentially
hepatotoxic (D), not NSAIDs.

7. 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?

Liver. Correct

Kidney.

Sensory.

Cardiorespiratory.

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).

8. 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?

Administer the dose as prescribed. Correct

Withhold the drug and notify the healthcare provider.

Give intravenous (IV) calcium gluconate.

Recheck the vital signs in 30 minutes and then administer the dose.

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.

9. 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?

Two acute illnesses.

, Two chronic illnesses.

One chronic and one acute illness. Correct

One acute and one infectious illness.

The plan of care should include goals that are specific for chronic and acute illnesses. Adult-
onset diabetes is a life-long chronic disease, whereas influenza is an acute illness with a short
term duration (C). (A, B, and D) do not include the correct duration categories for this situation.

Awarded 1.0 points out of 1.0 possible points.

10. 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?

Initiate the lactation process.

Prevent neonatal hypoglycemia.

Stimulate contraction of the uterus. Correct

Facilitate maternal-infant bonding.

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.

11. 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?

Full rooming-in for the infant and mother.

Restrict visitors who irritate the client.

Supervised and guided visits with infant. Correct

Daily visits with her significant other.

Structured visits (C) provide an opportunity for the mother and infant to bond and should be
facilitated and encouraged according to the client's pace of progress. (A) is unrealistic and may
not be safe for the baby or the client. (B) is an unrealistic expectation. Although daily visits may
provide support, the significant other may not be able to be there every day (D) based on other
family responsibilities.

12. 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?

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