EVOLVE COMPREHENSIVE EXAM (HESI)
1 QUESTIONS WITH COMPLETE
ANSWERS
A bbclient bbwith bbasthma bbreceives bba bbprescription bbfor bbhigh bbblood bbpressure
bbduring bba bbclinic bbvisit. bbWhich bbprescription bbshould bbthe bbnurse bbanticipate bbthe
bbclient bbto bbreceive bbthat bbis bbat bbleast bblikely bbto bbexacerbate bbasthma?
A. bbPindolol bb(Visken). bb
B. bbCarteolol bb(Ocupress). bb
C. bbMetoprolol bbtartrate bb(Lopressor). bb
D. bbPropranolol bbhydrochloride bb(Inderal). bb- bbAnswer bbMetoprolol
bbTartrate( bbLopressor)
The bbbest bbantihypertensive bbagent bbfor bbclients bbwith bbasthma bbis bbmetoprolol
bb(Lopressor) bb(C), bba bbbeta2 bbblocking bbagent bbwhich bbis bbalso bbcardioselective
bband bbless bblikely bbto bbcause bbbronchoconstriction. bb
-Pindolol bb(A) bbis bba bbbeta2 bbblocker bbthat bbcan bbcause bbbronchoconstriction bband
bbincrease bbasthmatic bbsymptoms. bb
-Although bbcarteolol bb(B) bbis bba bbbeta bbblocking bbagent bband bban bbeffective
bbantihypertensive bbagent bbused bbin bbmanaging bbangina, bbit bbcan bbincrease bba
bbclient's bbrisk bbfor bbbronchoconstriction bbdue bbto bbits bbnonselective bbbeta bbblocker
bbaction. bb
-Propranolol bb(D) bbalso bbblocks bbthe bbbeta2 bbreceptors bbin bbthe bblungs, bbcausing
bbbronchoconstriction, bband bbis bbnot bbindicated bbin bbclients bbwith bbasthma bband
bbother bbobstructive bbpulmonary bbdisorders.
A bbmale bbclient bbwho bbhas bbbeen bbtaking bbpropranolol bb( bbinderal) bbfor bb18 bbmonths
bbtells bbthe bbnurse bbthe bbhealthcare bbprovider bbdiscontinued bbthe bbmedication
bbbecause bbhis bbblood bbpressure bbhas bbbeen bbnormal bbfor bbthe bbpast bbthree
bbmonths. bbWhich bbinstruction bbshould bbthe bbuse bbprovide? bb- bbAnswer bbAsk bbthe
bbhealth bbcare bbprovider bbabout bbtapering bbthe bbdrug bbdose bbover bbthe bbnext bbweek.
Although bbthe bbhealthcare bbprovider bbdiscontinued bbthe bbpropranolol, bbmeasures bbto
bbprevent bbrebound bbcardiac bbexcitation, bbsuch bbas bbprogressively bbreducing bbthe
bbdose bbover bbone bbto bbtwo bbweeks bb(C), bbshould bbbe bbrecommended bbto bbprevent
,bbrebound bbtachycardia, bbhypertension, bband bbventricular bbdysrhythmias. bbAbrupt
bbcessation bb(A bband bbB) bbof bbthe bbbeta-blocking bbagent bbmay bbprecipitate
bbtachycardia bband bbrebound bbhypertension, bbso bbgradual bbweaning bbshould bbbe
bbrecommended.
A bbclient bbwho bbis bbtaking bbclonidine bb( bbCatapres, bbDuraclon) bbreports bbdrowsiness.
bbWhich bbadditional bbassessment bbshould bbthe bbnurse bbmake? bb- bbAnswer bbHow
bblong bbhas bbthe bbclient bbbeen bbtaking bbthe bbmedication
Drowsiness bbcan bboccur bbin bbthe bbearly bbweeks bbof bbtreatment bbwith bbclonidine
bband bbwith bbcontinued bbuse bbbecomes bbless bbintense, bbso bbthe bblength bbof bbtime
bbthe bbclient bbhas bbbeen bbon bbthe bbmedication bb(A) bbprovides bbinformation bbto
bbdirect bbadditional bbinstruction. bb(B, bbC, bband bbD) bbare bbnot bbrelevant.
The bbnurse bbis bbpreparing bbto bbadmister bbatropine, bban bbanticholinergic, bbto bba
bbclient bbwho bbis bbscheduled bbfor bba bbcholecystectomy. bbThe bbclient bbasks bbthe
bbnurse bbto bbexplain bbth bbreason bbfor bbthe bbprescribed bbmedication. bbWhat
bbresponse bbis bbbest bbfor bbthe bbnurse bbto bbprovide? bb- bbAnswer bbDecrease bbthe
bbrisk bbof bbbradycardia bbduring bbsurgery
Atropine bbmay bbbe bbprescribed bbpreoperatively bbto bbincrease bbthe bbautomaticity bbof
bbthe bbsinoatrial bbnode bband bbprevent bba bbdangerous bbreduction bbin bbheart bbrate
bb(B) bbduring bbsurgical bbanesthesia. bb(A, bbC bband bbD) bbdo bbnot bbaddress bbthe
bbtherapeutic bbaction bbof bbatropine bbuse bbperioperatively.
An bb80 bbyear bbold bbclient bbis bbgiven bbmorphine bbsulphate bbfor bbpostoperative bbpain.
bbWhich bbconcomitant bbmedication bbshould bbthe bbnurse bbquestion bbthat bbposes bba
bbpotential bbdevelopment bbof bburniary bbretention bbin bbthis bbgeriatric bbclient. bb? bb-
bbAnswer bbTricyclic bbantidepressants
Drugs bbwith bbanticholinergic bbproperties, bbsuch bbas bbtricyclic bbantidepressants bb(C),
bbcan bbexacerbate bburinary bbretention bbassociated bbwith bbopioids bbin bbthe bbolder
bbclient. bbAlthough bbtricyclic bbantidepressants bband bbantihistamines bbwith bbopioids
bbcan bbexacerbate bburinary bbretention, bbthe bbconcurrent bbuse bbof bb(A bband bbB) bbwith
bbopioids bbdo bbnot. bbNonsteroidal bbantiinflammatory bbagents bb(D) bbcan bbincrease
bbthe bbrisk bbfor bbbleeding, bbbut bbdo bbnot bbincrease bburinary bbretention bbwith bbopioids
bb(D).
The bbnurse bbobtains bba bbheart bbrate bbof bb92 bband bba bbblood bbpressure bbof bb110/76
bbprior bbto bbadministering bba bbscheduled bbdose bbof bbverapamil bb(Calan) bbfor bba
bbclient bbwith bbatrial bbflutter bbWhich bbaction bbshould bbthe bbnurse bbimplement? bb-
bbAnswer bbAdmister bbthe bbdose bbas bbprescribed
Verapamil bbslows bbsinoatrial bb(SA) bbnodal bbautomaticity, bbdelays bbatrioventricular
bb(AV) bbnodal bbconduction, bbwhich bbslows bbthe bbventricular bbrate, bband bbis bbused bbto
bbtreat bbatrial bbflutter, bbso bb(A) bbshould bbbe bbimplemented, bbbased bbon bbthe bbclient's
,bbheart bbrate bband bbblood bbpressure. bb(B bband bbC) bbare bbnot bbindicated. bb(D)
bbdelays bbthe bbadministration bbof bbthe bbscheduled bbdose.
following bban bbemergency bbCesarean bbdelivery bbthe bbnurse bbencourages bbthe bbnew
bbmother bbto bbbreastfed bbher bbnewborn bb. bbthe bbclient bbasks bbwhy bbshe bbshould
bbbreastfeed bbnow. bbWhich bbinfo bbshould bbthe bbnurse bbprovide? bb- bbAnswer
bbStimulate bbcontraction bbof bbthe bbuterus
When bbthe bbinfant bbsuckles bbat bbthe bbbreast, bboxytocin bbis bbreleased bbby bbthe
bbposterior bbpituitary bbto bbstimulates bbthe bb"letdown" bbreflex, bbwhich bbcauses bbthe
bbrelease bbof bbcolostrum, bband bbcontracts bbthe bbuterus bb(C) bbto bbprevent bbuterine
bbhemorrhage. bb(A bband bbB) bbdo bbnot bbsupport bbthe bbclient's bbneed bbin bbthe
bbimmediate bbperiod bbafter bbthe bbemergency bbdelivery. bbAlthough bbmaternal-newborn
bbbonding bb(D) bbis bbfacilitated bbby bbearly bbbreastfeeding, bbthe bbpriority bbis bbuterine
bbcontraction bbstimulation.
The bbnurse bbidentifies bba bbclients bbneeds bband bbformulates bbth bbnursing bbproblem
bbof bb" bbImbalancee bbnutrition: bbLess bbthan bbbody bbrequirements, bbrelated bbto
bbmental bbimpairment bband bbdecreased bbintkae, bbas bbevidence bbby bbincreasing
bbconfusion bband bbweight bbloss bbof bbmore bbthan bb30 bbpounds bbover bbthe bblast bb6
bbmonths. bb" bbwhich bbshort-term bbgoal bbis bbbest bbfor bbthis bbclient? bb- bbAnswer bbEat
bb50% bbof bbsix bbsmall bbmeals bbeach bbday bbby bbthe bbend bbof bbthe bbweek
Short-term bbgoals bbshould bbbe bbrealistic bband bbattainable bband bbshould bbhave bba
bbtimeline bbof bb7 bbto bb10 bbdays bbbefore bbdischarge. bb(A) bbmeets bbthose bbcriteria.
bb(B) bbis bbnurse-oriented. bb(C) bbmay bbbe bbbeyond bbthe bbcapabilities bbof bba
bbconfused bbclient. bb(D) bbis bba bblong-term bbgoal.
the bbnursie bbis bbcaring bbfor bba bbclient bbwho bbis bbunable bbto bbvoid. bbThe bbplan bbof
bbcare bbestablishes bban bbobjective bbfor bbthe bbclient bbto bbingest bbat bbleast bb1000 bbmL
bbof bbfluid bbbetween bb7:00 bbam bband bb3:30pm. bbWhich bbclient bbresponse bbshould
bbthe bbnurse bbdocument bbthat bbindicates bba bbsuccessful bboutcome? bb- bbAnswer
bbDrinks bb240 bbmL bbof bbfluid bbfive bbtimes bbduring bbthe bbshift.
The bbnurse bbshould bbevaluate bbthe bbclient's bboutcome bbby bbobserving bbthe bbclient's
bbperformance bbof bbeach bbexpected bbbehavior, bbso bbdrinking bb240 bbmL bbof bbfluid
bbfive bbor bbsix bbtimes bbduring bbthe bbshift bb(D) bbindicates bba bbfluid bbintake bbof bb1200
bbto bb1440 bbmL, bbwhich bbmeets bbthe bbobjective bbof bbat bbleast bb1000 bbmL bbduring
bbthe bbdesignated bbperiod. bb(A) bbuses bbthe bbterm bb"adequate," bbwhich bbis bbnot
bbquantified. bb(B) bbis bbnot bbthe bbobjective, bbwhich bbestablishes bban bbintake bbof bbat
bbleast bb1000 bbmL. bb(C) bbis bbnot bban bbevaluation bbof bbthe bbspecific bbfluid bbintake.
a bbclient bbwho bbhas bbactive bbtuberculosis bb( bbTB) bbis bbadmitted bbto bbthe bbmedical
bbunit. bbWhat bbaction bbis bbmost bbimportant bbfor bbthe bbnurse bbto bbimplement? bb-
bbAnswer bbAssign bbthe bbclient bbto bba bbnegative bbair-flow bbroom
, Active bbtuberculosis bbrequires bbimplementation bbof bbairborne bbprecautions, bbso bbthe
bbclient bbshould bbbe bbassigned bbto bba bbnegative bbpressure bbair-flow bbroom bb(D).
bbAlthough bb(A bband bbC) bbshould bbbe bbimplemented bbfor bbclients bbin bbisolation bbwith
bbcontact bbprecautions, bbit bbis bbmost bbimportant bbthat bbair bbflow bbfrom bbthe bbroom
bbis bbminimized bbwhen bbthe bbclient bbhas bbTB. bb(B) bbshould bbbe bbimplemented bbwhen
bbthe bbclient bbleaves bbthe bbisolation bbenvironment.
A bbclient bbis bbreceiving bbatonal bb(tenormin) bb25 bbmg bbPO bbafter bba bbmyocardial
bbinfraction. bbThe bbnurse bbdetermines bbthe bbclinents bbapical bbpulse bbis bb65 bbbeats
bbper bbminute. bbWhat bbaction bbshould bbthe bbnurse bbimplement bbnext? bb- bbAnswer
bbAdminister bbthe bbmedication
Atenolol, bba bbbeta-blocker, bbblocks bbthe bbbeta bbreceptors bbof bbthe bbsinoatrial bbnode
bbto bbreduce bbthe bbheart bbrate, bbso bbthe bbmedication bbshould bbbe bbadministered bb(C)
bbbecause bbthe bbclient's bbapical bbpulse bbis bbgreater bbthan bb60. bb(A, bbB, bband bbD)
bbare bbnot bbindicated bbat bbthis bbtime.
A bb6 bbyear bbold bbchild bbis bbalert bbbut bbquiet bbwhen bbbrought bbto bbthe bbemergency
bbcenter bbwith bbperiobital bbecchymosis bband bbecchymosis bbbehind bbthe bbears. bbThe
bbnurse bbsuspects bbpotential bbchild bbabuse bband bbcontinues bbto bbassess bbthe bbchild
bbfor bbadditional bbmanifestations bbof bba bbbasilar bbskull bbfracture. bbWhat bbassessment
bbfinding bbwould bbbe bbconsistent bbwith bbthe bbbasilar bbskull bbfracture? bb- bbAnswer
bbRhinorrhoea bbor bbotorrhoea bbwith bbhalo bbsign
Raccoon bbeyes bb(periorbital bbecchymosis) bband bbBattle's bbsign bb(ecchymosis
bbbehind bbthe bbear bbover bbthe bbmastoid bbprocess) bbare bbboth bbsigns bbof bba bbbasilar
bbskull bbfracture, bbso bbthe bbnurse bbshould bbassess bbfor bbpossible bbmeningeal bbtears
bbthat bbmanifest bbas bba bbHalo bbsign bbwith bbCSF bbleakage bbfrom bbthe bbears bbor
bbnose bb(D). bb(A) bbis bbconsistent bbwith bborbital bbfractures. bb(B) bboccurs bbwith
bbwrenching bbtraumas bbof bbthe bbshoulder bbor bbarm bbfractures. bb(C) bboccurs bbwith
bbblunt bbabdominal bbinjuries.
The bbnurse bbis bbassessing bba bbclient bbwho bbcomplains bbof bbweight bbloss, bbracing
bbheart bbrate bband bbdifficulty bbsleeping. bbThe bbnurse bbdetermines bbthe bbclient bbhas
bbmoist bbskin bbwith bbfine bbhair, bbprominent bbeyes, bblid bbretrace, bband bba bbstaring
bbexpression. bbThese bbfindings bbare bbconsistent bbwith bbwhich bbdisorder? bb- bbAnswer
bbGraves bbdisease
This bbclient bbis bbexhibiting bbsymptoms bbassociated bbwith bbhyperthyroidism bbor
bbGrave's bbdisease bb(A), bbwhich bbis bban bbautoimmune bbcondition bbaffecting bbthe
bbthyroid. bb(B, bbC, bband bbD) bbare bbnot bbassociated bbwith bbthese bbsymptoms.
The bbnurse bbis bbassessing bban bbolder bbadult bbclient bband bbdetermines bbthat bbthe
bbclient's bbleft bbupper bbeyelid bbdroops, bbcovering bbmore bbof bbthe bbiris bbthan bbthe
bbright bbeyelid. bbWhich bbdescription bbshould bbthe bbnurse bbuse bbto bbdocument bbthis
bbfinding? bb- bbAnswer bbPtosis bbon bbthe bbleft bbeyelid