WGU D455 EVOLVE COMPREHENSIVE EXAM 1 HESI
124 QUSTIONS WITH VERIFIED ANSWERS
Metoprolol Tartrate( Lopressor)
The best antihypertensive agent for clients with asthma is metoprolol (Lopressor)
(C), a beta2 blocking agent which is also cardio selective and less likely to cause
bronchoconstriction.
-Pindolol (A) is a beta2 blocker that can cause bronchoconstriction and increase
asthmatic symptoms.
-Although caretook (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. - CORRECT ANSWER 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?
A. Pindolol (Vasken).
B. Castello (Compress).
C. Metoprolol tartrate (Lopressor).
D. Propranolol hydrochloride (Inderal).
,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. - CORRECT ANSWER 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?
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. - CORRECT ANSWER A client who is taking clonidine
( Catapres, Dracon) reports drowsiness. Which additional assessment should the
nurse make?
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. - CORRECT ANSWER The nurse is preparing to ad mister atropine,
an anticholinergic, to a client who is scheduled for a cholecystectomy. The client
,asks the nurse to explain the reason for the prescribed medication. What
response is best for the nurse to provide?
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 anti-
inflammatory agents (D) can increase the risk for bleeding, but do not increase
urinary retention with opioids (D). - CORRECT ANSWER 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. ?
Ad mister 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. - CORRECT ANSWER 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?
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. - CORRECT ANSWER
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?
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. -
CORRECT ANSWER The nurse identifies a client’s needs and formulates the
nursing problem of " Imbalance nutrition: Less than body requirements, related to
mental impairment and decreased intake, 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?
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 mile (C) is not an evaluation of the specific fluid intake. -
124 QUSTIONS WITH VERIFIED ANSWERS
Metoprolol Tartrate( Lopressor)
The best antihypertensive agent for clients with asthma is metoprolol (Lopressor)
(C), a beta2 blocking agent which is also cardio selective and less likely to cause
bronchoconstriction.
-Pindolol (A) is a beta2 blocker that can cause bronchoconstriction and increase
asthmatic symptoms.
-Although caretook (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. - CORRECT ANSWER 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?
A. Pindolol (Vasken).
B. Castello (Compress).
C. Metoprolol tartrate (Lopressor).
D. Propranolol hydrochloride (Inderal).
,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. - CORRECT ANSWER 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?
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. - CORRECT ANSWER A client who is taking clonidine
( Catapres, Dracon) reports drowsiness. Which additional assessment should the
nurse make?
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. - CORRECT ANSWER The nurse is preparing to ad mister atropine,
an anticholinergic, to a client who is scheduled for a cholecystectomy. The client
,asks the nurse to explain the reason for the prescribed medication. What
response is best for the nurse to provide?
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 anti-
inflammatory agents (D) can increase the risk for bleeding, but do not increase
urinary retention with opioids (D). - CORRECT ANSWER 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. ?
Ad mister 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. - CORRECT ANSWER 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?
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. - CORRECT ANSWER
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?
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. -
CORRECT ANSWER The nurse identifies a client’s needs and formulates the
nursing problem of " Imbalance nutrition: Less than body requirements, related to
mental impairment and decreased intake, 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?
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 mile (C) is not an evaluation of the specific fluid intake. -
