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Evolve Comprehensive Exam: HESI (Answered+ Rationale) Updated Spring 2022/2023.

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Course
Science/ Medicine/ Surgery (HES207)

Institution
Colorado State University - Fort Collins

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Hesi Comprehensive Review for the NCLEX-RN Examination - Pageburst E-Book on Kno (Retail Access Card)

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hes 207
evolve comprehensive exam hesi
evolve comprehensive exam hesi
hesi evolve comprehensive exam
a client with asthma receives a prescription for high blood pressure during a clinic visit which

Book Title:Hesi Comprehensive Review for the NCLEX-RN Examination - Pageburst E-Book on Kno (Retail Access Card)

Author(s):HESI

Edition:2013
ISBN:9781455774746
Edition:Unknown

Exam (elaborations)
HESI Fundamental of Nursing Questions and answers 2024 Reviewed
Exam (elaborations)
2021 HESI EXIT EXAM WITH ANSWERS.
Exam (elaborations)
Pharm_HESI

Institution
Colorado State University - Fort Collins
Course
Science/ Medicine/ Surgery (HES207)

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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 receive that is at least likely to exacerbate
asthma?
✅- 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?
✅- 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.

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 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?
✅- 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.

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. ?
✅- 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?
✅- 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.

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 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?
✅- 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.

the nursie is caring for a client who is unable to void. The plan of care establishes 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 performance 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.

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.

A client is receiving atonal (tenormin) 25 mg PO after a myocardial infraction. 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 the heart rate,
so the medication should be administered (C) because the client's apical pulse is greater than 60.
(A, B, and D) are not indicated at this time.

A 6 year old child is alert but quiet when brought to the emergency center with periobital
ecchymosis and ecchymosis behind the ears. The nurse suspects potential child abuse and
continues to assess the child for additional manifestations of a basilar skull fracture. What
assessment finding would be consistent with the basilar skull fracture?
✅- Rhinorrhoea or otorrhoea with halo sign

, Raccoon eyes (periorbital ecchymosis) and Battle's sign (ecchymosis behind the ear over the
mastoid process) are both signs of a basilar skull fracture, so the nurse should assess for possible
meningeal tears that manifest as a Halo sign with CSF leakage from the ears or nose (D). (A) is
consistent with orbital fractures. (B) occurs with wrenching traumas of the shoulder or arm
fractures. (C) occurs with blunt abdominal injuries.

The nurse is assessing a client who complains of weight loss, racing heart rate and difficulty
sleeping. The nurse determines the client has moist skin with fine hair, prominent eyes, lid
retrace, and a staring expression. These findings are consistent with which disorder? ✅- Graves
disease

This client is exhibiting symptoms associated with hyperthyroidism or Grave's disease (A),
which is an autoimmune condition affecting the thyroid. (B, C, and D) are not associated with
these symptoms.

The nurse is assessing an older adult client and determines that the client's left upper eyelid
droops, covering more of the iris than the right eyelid. Which description should the nurse use to
document this finding? ✅- Ptosis on the left eyelid

Ptosis is the term to describe an eyelid droop that covers a large portion of the iris (A), which
may result from oculomotor nerve or eyelid muscle disorder. (B) is characterized by rapid,
rhythmic movement of both eyes. (C) is a distortion of the lens of the eye, causing decreased
visual acuity. (D) is a term used to describe a protrusion of the eyeballs that occurs with
hyperthyroidism.

The nurse obtains the pluse rate of 89 beats/min for an infant before administering digoxin
(Lanoxin) which action should the nurse take? ✅- Withhold the medication and contact the
healthcare provider

Bradycardia is an early sign of digoxin toxicity, so if the infant's pulse rate is less than 100
beats/minute, digoxin should be withheld and the healthcare provider should be notified (D).
Assessing the respiratory rate (A) is not indicated before administering Lanoxin. (B and C) place
the infant at further risk for digoxin toxicity.

The nurse is developing a teaching plan for an adolescent with a milwaukee brace. Which
instruction should the nurse include? ✅- Wear the brace over a T-shirt 23 hours a day.

Idiopathic scoliosis is an abnormal lateral curvature of the spine in adolescent females. Early
treatment uses a Milwaukee brace that places pressure against the lateral spinal curvature, under
the neck, and against the iliac crest, so it should be worn for 23 hours per day over a T-shirt (D)

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