EVOLVE COMPREHENSIVE EXAM (HESI)
QUESTIONS AND EXPLAINED ANSWERS
HIGHLY STUDIED
GRADED A+
QUESTIONS AND ANSWERS
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?. 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 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?. 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 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?. ANSWER - 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?.
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 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. ?. 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
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 confusion and weight loss of more
than 30 pounds over the last 6 months. " which short-term goal is best for this
client?. ANSWER - 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?. ANSWER - 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?. ANSWER - 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?. ANSWER - 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?. ANSWER - 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?. ANSWER - Graves disease
QUESTIONS AND EXPLAINED ANSWERS
HIGHLY STUDIED
GRADED A+
QUESTIONS AND ANSWERS
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?. 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 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?. 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 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?. ANSWER - 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?.
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 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. ?. 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
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 confusion and weight loss of more
than 30 pounds over the last 6 months. " which short-term goal is best for this
client?. ANSWER - 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?. ANSWER - 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?. ANSWER - 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?. ANSWER - 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?. ANSWER - 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?. ANSWER - Graves disease
