HESI Critical Care Midterm Exam () QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS)Rationales A Graded
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Course
HESI Critical Care
Institution
HESI Critical Care
HESI Critical Care Midterm Exam () QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS)Rationales A Graded
1. A patient with asthma receives a prescription for high blood pressure during a clinic visit.
Which prescription should the nurse anticipate the patient to receive that is least likely to ...
HESI Critical Care Midterm Exam (2024-
2025) QUESTIONS AND CORRECT
ANSWERS (VERIFIED
ANSWERS)Rationales A Graded
1. A patient with asthma receives a prescription for high blood pressure during a clinic visit.
Which prescription should the nurse anticipate the patient to receive that is least likely to
exacerbate asthma?
A. Carteolol (Ocupress).
B. Propranolol hydrochloride (Inderal).
C. Pindolol (Visken). Inaccurate
D. Metoprolol tartrate (Lopressor). Accurate
The best antihypertensive agent for patients 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 patient'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 patients with asthma and other obstructive
pulmonary disorders.
,2. A male patient 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?
A. Obtain another antihypertensive prescription to avoid withdrawal symptoms.
B. Stop the medication and keep an accurate record of blood pressure.
C. Report any uncomfortable symptoms after stopping the medication.
D. Ask the healthcare provider about tapering the drug dose over the next week. Accurate
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 patient who is taking clonidine (Catapres, Duraclon) reports drowsiness. Which
additional assessment should the nurse make?
A. Has the patient experienced constipation recently?
B. Did the patient miss any doses of the medication?
C. How long has the patient been taking the medication? Accurate
D. Does the patient use any tobacco products?
Drowsiness can occur in the early weeks of treatment with clonidine and with continued use
becomes less intense, so the length of time the patient has been on the medication (A) provides
information to direct additional instruction. (B, C, and D) are not relevant.
4. ID: 6974873590
The nurse is preparing to administer atropine, an anticholinergic, to a patient who is scheduled for
, a cholecystectomy. The patient asks the nurse to explain the reason for the prescribed
medication. What response is best for the nurse to provide?
A. Provide a more rapid induction of anesthesia.
B. Induce relaxation before induction of anesthesia.
C. Decrease the risk of bradycardia during surgery. Accurate
D. 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. ID: 6974876286
An 80-year-old patient 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 patient?
A. Antacids.
B. Tricyclic antidepressants. Accurate
C. Nonsteroidal antiinflammatory agents.
D. Insulin.
Drugs with anticholinergic properties, such as tricyclic antidepressants (C), can exacerbate
urinary retention associated with opioids in the older patient. 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. ID: 6974873559
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