HESI EVOLVE COMPREHENSIVE EXAM 1 QUESTIONS AND ANSWERS (GRADED A+)
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Course
HESI
Institution
HESI
HESI EVOLVE COMPREHENSIVE EXAM 1
QUESTIONS AND ANSWERS
(GRADED A+)
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 (...
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) 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
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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 ANS 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 ANS How long has the
clientbeen 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
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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 ANS 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. 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 antiin-
flammatory agents (D) can increase the risk for bleeding, but do not increase urinary
retention with opioids (D).
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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 ANS Admister the
dose asprescribed
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 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
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