HESI Evolve Comprehensive Exam 1 Questions and Ans
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wers 2023 (Verified Answers)m m m
1. A client with asthma receives a prescription for high blood pressure during
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a clinic visit. Which prescription should the nurse anticipate the client to rec
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eive that is at least likely to exacerbate asthma?
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A. Pindolol (Visken). m
B. Carteolol (Ocupress). m
C. Metoprolol tartrate (Lopressor). m m
D. Propranolol hydrochloride (Inderal).: Metoprolol Tartrate( Lopressor)
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The best antihypertensive agent for clients with asthma is metoprolol (Lopressor)
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(C), a beta2 blocking agent which is also cardioselective and less likely to cause
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bronchoconstriction.
-
Pindolol (A) is a beta2 blocker that can cause bronchoconstriction and increasea
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1m/m33
,sthmatic symptoms. m
-
Although carteolol (B) is a beta blocking agent and an effective antihypertensive a
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gent used in managing angina, it can increase a client's risk for bronchoconstrictiond
m m m m m m m m m m m m m
ue to its nonselective beta blocker action.
m m m m m m
-Propranolol (D) also blocks the beta2 receptors in the lungs, causing bronchocon-
m m m m m m m m m m m
striction, and is not indicated in clients with asthma and other obstructive pulmonary
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disorders.
2. A male client who has been taking propranolol ( inderal) for 18 months tells
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the nurse the healthcare provider discontinued the medication because his
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blood pressure has been normal for the past three months. Which instruction
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should the use provide?: Ask the health care provider about tapering the drug d
m m m m m m m m m m m m m
ose over the next week.
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Although the healthcare provider discontinued the propranolol, measures to prevent
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rebound cardiac excitation, such as progressively reducing the dose over one to two
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weeks (C), should be recommended to prevent rebound tachycardia, hypertension,
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and ventricular dysrhythmias. Abrupt cessation (A and B) of the beta-
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2m/m33
,blocking agentmay precipitate tachycardia and rebound hypertension, so gradual w
m m m m m m m m m m
eaning shouldbe recommended.
m m m
3. A client who is taking clonidine ( Catapres, Duraclon) reports drowsiness.
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Which additional assessment should the nurse make?: How long has the client
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been taking the medication
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Drowsiness can occur in the early weeks of treatment with clonidine and with conti
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nued use becomes less intense, so the length of time the client has been on
m m m m m m m m m m m m m m
3m/m33
, the medication (A) provides information to direct additional instruction. (B, C, and D)
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are not relevant.
m m
4. The nurse is preparing to admister atropine, an anticholinergic, to a client
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who is scheduled for a cholecystectomy. The client asks the nurse to explain
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th reason for the prescribed medication. What response is best for the nurse
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to provide?: Decrease the risk of bradycardia during surgery
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Atropine may be prescribed preoperatively to increase the automaticity of the sino
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atrial node and prevent a dangerous reduction in heart rate (B) during surgicalane
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sthesia. (A, C and D) do not address the therapeutic action of atropine use periope
m m m m m m m m m m m m m m
ratively.
5. An 80 year old client is given morphine sulphate for postoperative pain.
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Which concomitant medication should the nurse question that poses a po-
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tential development of urniary retention in this geriatric client. ?: Tricyclic a
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ntidepressants
Drugs with anticholinergic properties, such as tricyclic antidepressants (C), can ex
m m m m m m m m m m
acerbate urinary retention associated with opioids in the older client. Although tricy
m m m m m m m m m m m
clic antidepressants and antihistamines with opioids can exacerbate urinary retenti
m m m m m m m m m
4m/m33
m m m m m m m
wers 2023 (Verified Answers)m m m
1. A client with asthma receives a prescription for high blood pressure during
m m m m m m m m m m m
a clinic visit. Which prescription should the nurse anticipate the client to rec
m m m m m m m m m m m m
eive that is at least likely to exacerbate asthma?
m m m m m m m m
A. Pindolol (Visken). m
B. Carteolol (Ocupress). m
C. Metoprolol tartrate (Lopressor). m m
D. Propranolol hydrochloride (Inderal).: Metoprolol Tartrate( Lopressor)
m m m m m
The best antihypertensive agent for clients with asthma is metoprolol (Lopressor)
m m m m m m m m m m m
(C), a beta2 blocking agent which is also cardioselective and less likely to cause
m m m m m m m m m m m m m m
bronchoconstriction.
-
Pindolol (A) is a beta2 blocker that can cause bronchoconstriction and increasea
m m m m m m m m m m m m
1m/m33
,sthmatic symptoms. m
-
Although carteolol (B) is a beta blocking agent and an effective antihypertensive a
m m m m m m m m m m m m
gent used in managing angina, it can increase a client's risk for bronchoconstrictiond
m m m m m m m m m m m m m
ue to its nonselective beta blocker action.
m m m m m m
-Propranolol (D) also blocks the beta2 receptors in the lungs, causing bronchocon-
m m m m m m m m m m m
striction, and is not indicated in clients with asthma and other obstructive pulmonary
m m m m m m m m m m m m m m
disorders.
2. A male client who has been taking propranolol ( inderal) for 18 months tells
m m m m m m m m m m m m m
the nurse the healthcare provider discontinued the medication because his
m m m m m m m m m m
blood pressure has been normal for the past three months. Which instruction
m m m m m m m m m m m
should the use provide?: Ask the health care provider about tapering the drug d
m m m m m m m m m m m m m
ose over the next week.
m m m m
Although the healthcare provider discontinued the propranolol, measures to prevent
m m m m m m m m m m
rebound cardiac excitation, such as progressively reducing the dose over one to two
m m m m m m m m m m m m m
weeks (C), should be recommended to prevent rebound tachycardia, hypertension,
m m m m m m m m m m
and ventricular dysrhythmias. Abrupt cessation (A and B) of the beta-
m m m m m m m m m m
2m/m33
,blocking agentmay precipitate tachycardia and rebound hypertension, so gradual w
m m m m m m m m m m
eaning shouldbe recommended.
m m m
3. A client who is taking clonidine ( Catapres, Duraclon) reports drowsiness.
m m m m m m m m m m m
Which additional assessment should the nurse make?: How long has the client
m m m m m m m m m m m
been taking the medication
m m m
Drowsiness can occur in the early weeks of treatment with clonidine and with conti
m m m m m m m m m m m m m
nued use becomes less intense, so the length of time the client has been on
m m m m m m m m m m m m m m
3m/m33
, the medication (A) provides information to direct additional instruction. (B, C, and D)
m m m m m m m m m m m m m
are not relevant.
m m
4. The nurse is preparing to admister atropine, an anticholinergic, to a client
m m m m m m m m m m m m
who is scheduled for a cholecystectomy. The client asks the nurse to explain
m m m m m m m m m m m m
th reason for the prescribed medication. What response is best for the nurse
m m m m m m m m m m m m m
to provide?: Decrease the risk of bradycardia during surgery
m m m m m m m m
Atropine may be prescribed preoperatively to increase the automaticity of the sino
m m m m m m m m m m m
atrial node and prevent a dangerous reduction in heart rate (B) during surgicalane
m m m m m m m m m m m m m
sthesia. (A, C and D) do not address the therapeutic action of atropine use periope
m m m m m m m m m m m m m m
ratively.
5. An 80 year old client is given morphine sulphate for postoperative pain.
m m m m m m m m m m m m
Which concomitant medication should the nurse question that poses a po-
m m m m m m m m m m
tential development of urniary retention in this geriatric client. ?: Tricyclic a
m m m m m m m m m m m m
ntidepressants
Drugs with anticholinergic properties, such as tricyclic antidepressants (C), can ex
m m m m m m m m m m
acerbate urinary retention associated with opioids in the older client. Although tricy
m m m m m m m m m m m
clic antidepressants and antihistamines with opioids can exacerbate urinary retenti
m m m m m m m m m
4m/m33
