1
EVOLVE HESI PHARM PN EXAM NEWEST
COMPLETE QUESTIONS AND CORRECT VERIFIED
ANSWERS(DETAILED ANSWERS)|ALREADY GRADED
A+
•
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? - (answers)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? - (answers)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.
, 2
A client who is taking clonidine ( Catapres, Duraclon) reports drowsiness.
Which additional assessment should the nurse make? - (answers)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? - (answers)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. ? - (answers)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).
, 3
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? - (answers)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? - (answers)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? - (answers)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.
, 4
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? - (answers)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? - (answers)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? - (answers)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
EVOLVE HESI PHARM PN EXAM NEWEST
COMPLETE QUESTIONS AND CORRECT VERIFIED
ANSWERS(DETAILED ANSWERS)|ALREADY GRADED
A+
•
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? - (answers)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? - (answers)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.
, 2
A client who is taking clonidine ( Catapres, Duraclon) reports drowsiness.
Which additional assessment should the nurse make? - (answers)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? - (answers)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. ? - (answers)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).
, 3
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? - (answers)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? - (answers)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? - (answers)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.
, 4
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? - (answers)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? - (answers)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? - (answers)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
