HESI EVOLVE COMPREHENSIVE EXAM 1
QUESTIONS AND ANSWERS 2024 (VERIFIED)
• 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?
• Pindolol (Visken).
• Carteolol (Ocupress).
• Metoprolol tartrate (Lopressor).
• Propranolol hydrochloride (Inderal) ANS 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.
• 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 ANS 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 ANS 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.
• 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 ANS 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 po-tential
development of urniary retention in this geriatric client.
ANS 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).
• 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 Admister the dose
asprescribed
QUESTIONS AND ANSWERS 2024 (VERIFIED)
• 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?
• Pindolol (Visken).
• Carteolol (Ocupress).
• Metoprolol tartrate (Lopressor).
• Propranolol hydrochloride (Inderal) ANS 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.
• 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 ANS 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 ANS 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.
• 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 ANS 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 po-tential
development of urniary retention in this geriatric client.
ANS 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).
• 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 Admister the dose
asprescribed
