HESI EXIT Evolve Comprehensive V1 Exam
1. A client with asthma receives a prescription for high blood pressure duringa 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)
Answer: 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 increaseasthmatic 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 bronchoconstrictiondue 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 pulmonarydisorders.
2. A male client who has been taking propranolol ( inderal) for 18 months tellsthe nurse the
healthcare provider discontinued the medication because his blood pressure has been normal for
the past three months.Which instructionshould the use provide
Answer: 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 twoweeks (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
shouldbe recommended.
3. A client who is taking clonidine ( Catapres, Duraclon) reports drowsiness. Which additional
assessment should the nurse make
Answer: 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
,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 clientwho is scheduled
for a cholecystectomy. The client asks the nurse to explainth reason for the prescribed medication.
What response is best for the nurseto provide
Answer: 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 surgicalanesthesia. (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.
Answer: 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 urinaryretention with opioids (D).
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
Answer: Admister the dose asprescribed
Verapamil slows sinoatrial (SA) nodal automaticity, delays atrioventricular (AV) nodalconduction, 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 andC) 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 breastfeednow. 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 pituitaryto 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
1. A client with asthma receives a prescription for high blood pressure duringa 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)
Answer: 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 increaseasthmatic 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 bronchoconstrictiondue 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 pulmonarydisorders.
2. A male client who has been taking propranolol ( inderal) for 18 months tellsthe nurse the
healthcare provider discontinued the medication because his blood pressure has been normal for
the past three months.Which instructionshould the use provide
Answer: 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 twoweeks (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
shouldbe recommended.
3. A client who is taking clonidine ( Catapres, Duraclon) reports drowsiness. Which additional
assessment should the nurse make
Answer: 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
,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 clientwho is scheduled
for a cholecystectomy. The client asks the nurse to explainth reason for the prescribed medication.
What response is best for the nurseto provide
Answer: 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 surgicalanesthesia. (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.
Answer: 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 urinaryretention with opioids (D).
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
Answer: Admister the dose asprescribed
Verapamil slows sinoatrial (SA) nodal automaticity, delays atrioventricular (AV) nodalconduction, 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 andC) 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 breastfeednow. 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 pituitaryto 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
