HESI comprehensive practice exam 1
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 least likely to
exacerbate asthma? - ANS 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
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?
- ANS 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.
A client who is taking clonidine (Catapres, Duraclon) reports drowsiness. Which
additional assessment should the nurse make? - ANS 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 administer 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? - ANS
Decrease the risk of bradycardia during surgery.
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? - ANS 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).
A client with osteoarthritis is given a new prescription for a nonsteroidal
antiinflammatory drug (NSAID). The client asks the nurse, "How is this medication
different from the acetaminophen I have been taking?" Which information about the
therapeutic action of NSAIDs should the nurse provide? - ANS Provide
antiinflammatory response.
A client with cancer has a history of alcohol abuse and is taking acetaminophen
(Tylenol) for pain. Which organ function is most important for the nurse to monitor? -
ANS Acetaminophen and alcohol are both metabolized in the liver. This places the client
at risk for hepatotoxicity, so monitoring liver (A) function is the most important
assessment because the combination of acetaminophen and alcohol, even in moderate
amounts, can cause potentially fatal liver damage. Other non-narcotic analgesics, such
as n onsteroidal anti-inflammatory drugs (NSAIDs), are more likely to promote adverse
renal effects (B). Acetaminophen does not place the client at risk for toxic reactions
related to (C or 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? - ANS Administer 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.
A client is admitted to the hospital with a diagnosis of Type 2 diabetes mellitus and
influenza. Which categories of illness should the nurse develop goals for the client's
plan of care? - ANS One chronic and one acute illness.
Following an emergency Cesarean delivery, the nurse encourages the new mother to
breastfeed her newborn. The client asks why she should breastfeed now. Which
information should the nurse provide? - ANS Stimulate contraction of the uterus.
Which intervention should the nurse include in the plan of care for a female client with
severe postpartum depression who is admitted to the inpatient psychiatric unit? - ANS
Supervised and guided visits with infant.
A 16-year-old male client is admitted to the hospital after falling off a bike and sustaining
a fractured bone. The healthcare provider explains the surgery needed to immobilize
the fracture. Which action should be implemented to obtain a valid informed consent? -
ANS The client is a minor and cannot legally sign his own consent unless he is an
emancipated minor, so the consent should be obtained from the guardian for this client,
which is the custodial parent (B). (A) is not a legal option. A stepparent is not a legal
guardian for a minor unless the child has been adopted by the stepparent (C). The
non-custodial parent does not need to co-sign this form (D).
During a client assessment, the client says, "I can't walk very well." Which action should
the nurse implement first? - ANS Identify the problem.
The nurse identifies a client's needs and formulates the nursing problem of,
"Imbalanced nutrition: less than body requirements, related to mental impairment and
decreased intake, as evidenced 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? - ANS
Eat 50% of six small meals each day by the end of one week.
A male client is angry and is leaving the hospital against medical advice (AMA). The
client demands to take his chart with him and states the chart is "his" and he doesn' t
want any more contact with the hospital. How should the nurse respond? - ANS The
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 least likely to
exacerbate asthma? - ANS 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
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?
- ANS 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.
A client who is taking clonidine (Catapres, Duraclon) reports drowsiness. Which
additional assessment should the nurse make? - ANS 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 administer 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? - ANS
Decrease the risk of bradycardia during surgery.
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? - ANS 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).
A client with osteoarthritis is given a new prescription for a nonsteroidal
antiinflammatory drug (NSAID). The client asks the nurse, "How is this medication
different from the acetaminophen I have been taking?" Which information about the
therapeutic action of NSAIDs should the nurse provide? - ANS Provide
antiinflammatory response.
A client with cancer has a history of alcohol abuse and is taking acetaminophen
(Tylenol) for pain. Which organ function is most important for the nurse to monitor? -
ANS Acetaminophen and alcohol are both metabolized in the liver. This places the client
at risk for hepatotoxicity, so monitoring liver (A) function is the most important
assessment because the combination of acetaminophen and alcohol, even in moderate
amounts, can cause potentially fatal liver damage. Other non-narcotic analgesics, such
as n onsteroidal anti-inflammatory drugs (NSAIDs), are more likely to promote adverse
renal effects (B). Acetaminophen does not place the client at risk for toxic reactions
related to (C or 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? - ANS Administer 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.
A client is admitted to the hospital with a diagnosis of Type 2 diabetes mellitus and
influenza. Which categories of illness should the nurse develop goals for the client's
plan of care? - ANS One chronic and one acute illness.
Following an emergency Cesarean delivery, the nurse encourages the new mother to
breastfeed her newborn. The client asks why she should breastfeed now. Which
information should the nurse provide? - ANS Stimulate contraction of the uterus.
Which intervention should the nurse include in the plan of care for a female client with
severe postpartum depression who is admitted to the inpatient psychiatric unit? - ANS
Supervised and guided visits with infant.
A 16-year-old male client is admitted to the hospital after falling off a bike and sustaining
a fractured bone. The healthcare provider explains the surgery needed to immobilize
the fracture. Which action should be implemented to obtain a valid informed consent? -
ANS The client is a minor and cannot legally sign his own consent unless he is an
emancipated minor, so the consent should be obtained from the guardian for this client,
which is the custodial parent (B). (A) is not a legal option. A stepparent is not a legal
guardian for a minor unless the child has been adopted by the stepparent (C). The
non-custodial parent does not need to co-sign this form (D).
During a client assessment, the client says, "I can't walk very well." Which action should
the nurse implement first? - ANS Identify the problem.
The nurse identifies a client's needs and formulates the nursing problem of,
"Imbalanced nutrition: less than body requirements, related to mental impairment and
decreased intake, as evidenced 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? - ANS
Eat 50% of six small meals each day by the end of one week.
A male client is angry and is leaving the hospital against medical advice (AMA). The
client demands to take his chart with him and states the chart is "his" and he doesn' t
want any more contact with the hospital. How should the nurse respond? - ANS The
