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HESI Evolve Comprehensive Exam 1 Questionsand Answers 2023 (Verified Answers)
- 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?
A. Pindolol (Visken).
B. Carteolol (Ocupress).
C. Metoprolol tartrate (Lopressor).
D. 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
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.
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-Propranolol (D) also blocks the beta2 receptors in the lungs, causingbronchocon- striction, and is not indicated in clients with asthma andother obstructive pulmonary disorders.
2.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 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 progressivelyreducing the dose over one to two weeks (C), should be recommendedto prevent rebound tachycardia, hypertension, and ventriculardysrhythmias. Abrupt cessation (A and B) of the beta-blocking agentmay precipitate tachycardia and rebound hypertension, so graduaweaning should be recommended.
3.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
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the medication (A) provides information to direct additional instruction.
(B, C, and D) are not relevant.
4.The nurse is preparing to admister atropine, an anticholinergic, to a client
who is scheduled for a cholecystectomy. The client asks the nurse to explainth reason for the prescribed medication. What response is best for the
nurse to 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.
5.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 urinary retention with
opioids (D).
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6.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 as prescribed
Verapamil slows sinoatrial (SA) nodal automaticity, delaysatrioventricular (AV) nodal conduction, which slows the ventricular rate,and is used to treat atrial flutter, so (A) should be implemented, basedon the client’s heart rate and blood pressure. (B and C) are notindicated. (D) delays the administration of the scheduled dose.
7.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 ANS 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
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HESI Evolve Comprehensive Exam 2 Questions
and Answers 2023 (Verified Answers)
- 1. A parent whose 12-year-old child has been inhaling paint fumes asksthe nurse, “Can he become addicted to paint fumes?” What is the bestresponse for the nurse to provide?
A. Any time you use an illegal substance, you are abusing drugs.
B.Tell me what you think may have caused him to start inhaling paint fumes.C. Only hard drugs like cocaine and heroin can cause problems with
addiction.
D. Abuse of any of the inhalants can eventually lead to addiction ANS D.
Abuse of any of the inhalants can eventually lead to addiction.
Any inhalant can become addictive. Any substance that is used to alter
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perception can be addictive and is not limited to the common street
drugs.
- 2. A young adult female is brought to the emergency room by family
mem- bers who report that she ingested a large quantity of acetaminophen
(Tylenol). The nurse should prepare for which treatment to be implemented?A. Gastric lavage with normal saline.
B. IV administration of Narcan.
C. Syrup of ipecac per nasogastric tube.
D. Acetylcysteine (Mucomyst) 140 mg/kg ANS – Acetylcysteine
(Mucomyst) 140 mg/kg.
Mucomyst (D) is the antidote for acute acetaminophen (Tylenol)
poisoning and is the treatment of choice for an overdose. (B) is used for
an overdose of narcotics. (C) is used for ingestion of non-corrosive
products such as iron tablets. (A) might also be implemented,
depending on the amount of drugs ingested and the time elapsed since ingestion. - 3. An 8-year-old male client with nephrotic syndrome is in remission
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follow- ing treatment with prednisone (Deltasone). The nurse should teach
the child to check his urine for which finding?
A. Ketones.
B. Protein.
C.White blood cells.
D. Glucose ANS B. Protein.
Children should be taught to check for protein (albumin) (B) in the
urine daily, because a positive reading for protein in the urine is often
the only indicator of a relapse of nephrotic syndrome. (C) is an
indication of infection. (A and D) should
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be assessed while the child is receiving corticosteroid therapy, since
corticosteroids increase blood glucose.
- 4. When making a home visit to a family with a teething 4-month-old,
what information is most important for the nurse to provide the parents?
A. No action is required for the common symptoms associated with
teething, which include drooling, irritability, and poor sleeping.
B. A slight fever is often associated with teething, but a fever lasting more
than three days requires medical attention.
C.Though child development is characterized by individual differences,
first teeth usually erupt during the seventh month.
D. Providing cooled teething toys can help decrease the discomfort
associat- ed with tooth eruption ANS B. A slight fever is often associated
with teething, but a fever lasting more than three days requires medicalattention.
A slight fever that persists longer than three days is likely to be
associated with a pathological process, not teething, and the parents
should seek the attention of their healthcare provider if it occurs (B). (A,