EVOLVE HESI CERTIFICATION PREP EXAM
QUESTIONS RATIONALE SOLVED 2026
◉ 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?
A. Obtain another antihypertensive prescription to avoid withdrawal
symptoms.
B. Stop the medication and keep an accurate record of blood pressure.
C. Ask the healthcare provider about tapering the drug dose over the
next week.
D. Report any uncomfortable symptoms after stopping the medication.
Answer: C. 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?
A. How long has the client been taking the medication?
B. Has the client experienced constipation recently?
C. Did the client miss any doses of the medication?
D. Does the client use any tobacco products? Answer: A. 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?
A. Provide a more rapid induction of anesthesia.
B. Decrease the risk of bradycardia during surgery.
C. Induce relaxation before induction of anesthesia.
D. Minimize the amount of analgesia needed postoperatively. Answer:
B. 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 urinary retention in this geriatric
client?
A. Antacids.
B. Insulin.
C. Tricyclic antidepressants.
D. Non-steroidal anti-inflammatory agents. Answer: C. 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? Answer:
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? Answer: 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
QUESTIONS RATIONALE SOLVED 2026
◉ 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?
A. Obtain another antihypertensive prescription to avoid withdrawal
symptoms.
B. Stop the medication and keep an accurate record of blood pressure.
C. Ask the healthcare provider about tapering the drug dose over the
next week.
D. Report any uncomfortable symptoms after stopping the medication.
Answer: C. 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?
A. How long has the client been taking the medication?
B. Has the client experienced constipation recently?
C. Did the client miss any doses of the medication?
D. Does the client use any tobacco products? Answer: A. 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?
A. Provide a more rapid induction of anesthesia.
B. Decrease the risk of bradycardia during surgery.
C. Induce relaxation before induction of anesthesia.
D. Minimize the amount of analgesia needed postoperatively. Answer:
B. 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 urinary retention in this geriatric
client?
A. Antacids.
B. Insulin.
C. Tricyclic antidepressants.
D. Non-steroidal anti-inflammatory agents. Answer: C. 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? Answer:
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? Answer: 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
