HESI COMPREHENSIVE exam 1 100%
VERIFIED OLUTIONS
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)
Best antihypertensive med for asthmatics. Beta2 blocking agent -- also a cardioselective
and less likely to cause bronchoconstriction.
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 3 months. Which instruction should the nurse provide? -
ANSWER Ask the healthcare provider about tapering the drug dose over the next week.
HCP discontinued drug BUT measures to prevent rebound cardiac excitation, such as
progressively reducing the dose over 1 or 2 weeks, should be recommended to prevent
rebound tachycardia, hypertension, and ventricular dysrhythmias.
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
provides information to direct additional instruction.
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? - 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 during surgical anesthesia.
An 80-year old client is given morphine sulfate for post-op pain. Which concomitant med
should the nurse question that poses a potential development of urinary retention in this
geriatric client? - ANSWER Tricyclic antidepressants
,Drugs with anticholinergic properties can exacerbate urinary retention associated with
opioids in the older client.
A client with osteoarthritis is given a new script for a NSAID. The client asks the nurse,
"How is this med different from the acetaminophen I have been taking?" Which
information about the therapeutic action of NSAIDs should the nurse provide? -
ANSWER Provide anti-inflammatory response
NSAIDs relieve pain associated with osteoarthritis and differs from acetaminophen(a
non-narcotic & antipyretic). Also potentially hepatotoxic.
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? -
ANSWER Liver
Acetaminophen & alcohol both metabolized in the liver. Pt at risk of hepatotoxicity &
potentially fatal liver damage.
The nurse obtains a heart rate of 92 and a BP of 110/76 prior to administering a
scheduled does of verapamil (Calan) for a client with atrial flutter. Which action should
the nurse implement? - ANSWER Administer the dose as prescribed.
Verapamil slows SA nodal automaticity, delays AV nodal conduction, slowing ventricular
rate & treats atrial flutter. HR is above 60 and BP is WNL.
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? - ANSWER One chronic and one acute illness
Adult onset DM is life-long chronic disease. Influenza is acute illness with short term
duration.
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
Infant suckling breast releases oxytocin by the posterior pituitary and stimulates the
"letdown" reflex. Causing release of colostrum & contracts the uterus to prevent uterine
hemorrhage.
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? -
ANSWER Supervised and guided visits with infant.
Structured visits provide an opportunity for the mother and infant to bond and should be
facilitated and encouraged according to the client's pace of progress.
, A 16-year-old male client is admitted to the hospital after falling off a bike and sustaining
a fractured bone. The HCP explains the surgery needed to immobilize the fracture.
Which action should be implemented to obtain a valid informed consent? - ANSWER
Obtain the permission of the custodial parent for the surgery.
Pt is a minor and cannot legally sign his own consent unless he is an emancipated
minor. Consent should be obtained from the guardian, custodial parent.
During a client assessment, the client says, "I can't walk very well." Which action should
the nurse implement first? - ANSWER Identify the problem
Sequential problem solving steps: 1) Identify the problem, 2) consider alternatives, 3)
consider outcomes of the alternatives, 4) predict the likelihood of the outcomes
occurring and choose best chance of success.
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 lbs over the last 6 months." Which short term goal is best for this pt? - ANSWER Eat
50% of six small meals each day by the end of one week
Short term goals: realistic & attainable, time frame 7-10 days before discharge
A male client is angry and is leaving the hospital AMA. The client demands to take his
chart with him and states it's "his" and doesn't want contact with the hospital anymore.
How should the nurse respond? - ANSWER The chart is the property of the hospital but
I will see that a cope is made for you.
Pt has legal right to the information in it even if leaving AMA
The nurse manager is assisting a nurse with improving organizational skills and time
management. Which nursing activity is the priority in pre-planning a schedule for
selected nursing activities in the daily assignment? - ANSWER Medication
administration
Med admin is based on a prescribed schedule that is time-sensitive in the delivery of
nursing care and should be priority in scheduling nursing activities in a daily
assignment.
What nursing delivery of care provides the nurse to plan and direct care of a group of
clients over a 24-hour period? - ANSWER Primary nursing
is a model of delivery of care where a nurse us accountable for planning care for clients
around the clock.
VERIFIED OLUTIONS
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)
Best antihypertensive med for asthmatics. Beta2 blocking agent -- also a cardioselective
and less likely to cause bronchoconstriction.
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 3 months. Which instruction should the nurse provide? -
ANSWER Ask the healthcare provider about tapering the drug dose over the next week.
HCP discontinued drug BUT measures to prevent rebound cardiac excitation, such as
progressively reducing the dose over 1 or 2 weeks, should be recommended to prevent
rebound tachycardia, hypertension, and ventricular dysrhythmias.
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
provides information to direct additional instruction.
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? - 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 during surgical anesthesia.
An 80-year old client is given morphine sulfate for post-op pain. Which concomitant med
should the nurse question that poses a potential development of urinary retention in this
geriatric client? - ANSWER Tricyclic antidepressants
,Drugs with anticholinergic properties can exacerbate urinary retention associated with
opioids in the older client.
A client with osteoarthritis is given a new script for a NSAID. The client asks the nurse,
"How is this med different from the acetaminophen I have been taking?" Which
information about the therapeutic action of NSAIDs should the nurse provide? -
ANSWER Provide anti-inflammatory response
NSAIDs relieve pain associated with osteoarthritis and differs from acetaminophen(a
non-narcotic & antipyretic). Also potentially hepatotoxic.
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? -
ANSWER Liver
Acetaminophen & alcohol both metabolized in the liver. Pt at risk of hepatotoxicity &
potentially fatal liver damage.
The nurse obtains a heart rate of 92 and a BP of 110/76 prior to administering a
scheduled does of verapamil (Calan) for a client with atrial flutter. Which action should
the nurse implement? - ANSWER Administer the dose as prescribed.
Verapamil slows SA nodal automaticity, delays AV nodal conduction, slowing ventricular
rate & treats atrial flutter. HR is above 60 and BP is WNL.
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? - ANSWER One chronic and one acute illness
Adult onset DM is life-long chronic disease. Influenza is acute illness with short term
duration.
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
Infant suckling breast releases oxytocin by the posterior pituitary and stimulates the
"letdown" reflex. Causing release of colostrum & contracts the uterus to prevent uterine
hemorrhage.
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? -
ANSWER Supervised and guided visits with infant.
Structured visits provide an opportunity for the mother and infant to bond and should be
facilitated and encouraged according to the client's pace of progress.
, A 16-year-old male client is admitted to the hospital after falling off a bike and sustaining
a fractured bone. The HCP explains the surgery needed to immobilize the fracture.
Which action should be implemented to obtain a valid informed consent? - ANSWER
Obtain the permission of the custodial parent for the surgery.
Pt is a minor and cannot legally sign his own consent unless he is an emancipated
minor. Consent should be obtained from the guardian, custodial parent.
During a client assessment, the client says, "I can't walk very well." Which action should
the nurse implement first? - ANSWER Identify the problem
Sequential problem solving steps: 1) Identify the problem, 2) consider alternatives, 3)
consider outcomes of the alternatives, 4) predict the likelihood of the outcomes
occurring and choose best chance of success.
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 lbs over the last 6 months." Which short term goal is best for this pt? - ANSWER Eat
50% of six small meals each day by the end of one week
Short term goals: realistic & attainable, time frame 7-10 days before discharge
A male client is angry and is leaving the hospital AMA. The client demands to take his
chart with him and states it's "his" and doesn't want contact with the hospital anymore.
How should the nurse respond? - ANSWER The chart is the property of the hospital but
I will see that a cope is made for you.
Pt has legal right to the information in it even if leaving AMA
The nurse manager is assisting a nurse with improving organizational skills and time
management. Which nursing activity is the priority in pre-planning a schedule for
selected nursing activities in the daily assignment? - ANSWER Medication
administration
Med admin is based on a prescribed schedule that is time-sensitive in the delivery of
nursing care and should be priority in scheduling nursing activities in a daily
assignment.
What nursing delivery of care provides the nurse to plan and direct care of a group of
clients over a 24-hour period? - ANSWER Primary nursing
is a model of delivery of care where a nurse us accountable for planning care for clients
around the clock.
