Bundle
HESI EXAM WITH VERIFIED SOLUTIONS
9 Items
Hesi Entrance Exam A&P Practice Test Latest Update 2022 Rated A
What mineral is responsible for muscle contractions? Correct Answer-Calcium Which of the the following locations would the urinary bladder and internal re... [Show More] productive organs be found? Correct Answer-Pelvic cavity What separates the thoracic cavity from the abdominal cavity? Correct Answer-Diaphragm A tissue examined under the microscope exhibits the following characteristics: cells found on internal surface of stomach, no extracellular matrix, cells tall and thin, no blood vessels in the tissue. What type of tissue is this? Correct Answer-Epithelial Nerve tissue is composed of neuron and connective tissue cells that are referred to as which of the following? Correct Answer-Neuroglia Which tissue serves as the framework of the body by providing support and structure for the organs? Correct Answer-Connective What is the basic unit of life and the building block of tissues and organs? Correct Answer-Cell Which type of cell division takes place in the gonads? Correct Answer-Meiosis In what area of the body would you expect to find and especially thick stratum corneum? Correct Answer-Heel of the foot What are the glands of the skin that produce a thin, watery secretion? Correct Answer-Eccrine glands [Show Less]
- Exam
- $5.45
- 0
- 130
Pharmacology Hesi Exam Latest 2021 with complete solutions
Which nursing action is the priority when administering chelation therapy for a toddler-age client? 1 Assessing vital signs 2 Monitoring urine output 3 ... [Show More] Conducting a behavioral assessment 4 Providing education to reduce lead exposure Correct Answer- 2 A 67-year-old client has tested positive for influenza A. The client also has asthma. Which drug would the nurse recommend be avoided in this client? 1 Ribavirin 2 Zanamivir 3 Oseltamivir 4 Amantadine Correct Answer- 2 Which first line medication would the nurse state is used to treat anaphylactic reactions? 1 Epinephrine 2 Norepinephrine 3 Dexamethasone 4 Diphenhydramine Correct Answer- 1 A mother complains that her child's teeth have become yellow in color. With prolonged use, which medication may be responsible for the child's condition? 1 Tetracycline 2 Promethazine 3 Chloramphenicol 4 Fluoroquinolones Correct Answer- 1 What are the desired outcomes that the nurse expects when administering a nonsteroidal antiinflammatory drug (NSAID)? Select all that apply 1 Diuresis 2 Pain relief 3 Antipyresis 4 Bronchodilation 5 Anticoagulation 6 Reduced inflammation Correct Answer- 2,3,6 A client with tuberculosis is started on a chemotherapy protocol that includes rifampin. The nurse evaluates that the teaching about rifampin is effective when the client makes which statement? 1 "I need to drink a lot of fluid while I take this medication." 2 "I can expect my urine to turn orange from this medication." 3 "I should have my hearing tested while I take this medication." 4 "I might get a skin rash because it is an expected side effect of this medication. Correct Answer- 2 Which statement regarding treatment with interferon indicates that the client understands the nurse's teaching? 1 "I will drink 2 to 3 quarts (2 to 3 liters) of fluid a day." 2 "Any reconstituted solution must be discarded in 1 week." 3 "I can continue driving my car as long as I have the stamina." 4 "While taking this medicine I should be able to continue my usual activity." Correct Answer- 1 A nurse administers the drug desmopressin acetate (DDAVP) to a client with diabetes insipidus. What should the nurse monitor to evaluate the effectiveness of the drug? 1 Arterial blood pH 2 Intake and output 3 Fasting serum glucose 4 Pulse and respiratory rates Correct Answer- 2 A client will be taking nitrofurantoin 50 mg orally every evening at home to manage recurrent urinary tract infections. What instructions should the nurse give to the client? 1 Increase the intake of fluids. 2 Strain the urine for crystals and stones. 3 Stop the drug if urinary output increases. 4 Maintain the exact time schedule for taking the drug Correct Answer- 1 A client admitted to the hospital with a diagnosis of chronic obstructive pulmonary disease has received a prescription for a medication that is delivered via a nebulizer. When teaching about use of the nebulizer, the nurse should teach the client to do what? 1 Hold the breath while spraying the medication into the mouth. 2 Position the lips loosely around the mouthpiece and take rapid, shallow breaths. 3 Seal the lips around the mouthpiece and breathe in and out, taking slow, deep breaths. 4 Inhale the medication from the nebulizer, remove the mouthpiece from the mouth, and then exhale. Correct Answer- 3 [Show Less]
- Exam
- $11.45
- 0
- 126
Hesi Entrance Exam A&P Practice Test. Latest 2022. Graded A+
What mineral is responsible for muscle contractions? - Calcium Which of the the following locations would the urinary bladder and internal reproductive or... [Show More] gans be found? - Pelvic cavity What separates the thoracic cavity from the abdominal cavity? - Diaphragm [Show Less]
- Exam
- $6.95
- 0
- 111
HESi Extra Credit Module 9.Q&A Marked and extensive rationale
1.Questions 1.1.ID: 9477047208 A client who has undergone abdominal surgery calls the nurse and reports that she just felt “something give way” in ... [Show More] the abdominal incision. The nurse checks the incision and notes the presence of wound dehiscence. The nurse should take which immediate action? A.Document the findings B.Contact the health care provider C.Place the client in a supine position with the legs flat D.Cover the abdominal wound with a sterile dressing moistened with sterile saline Solution Correct Rationale:Wound dehiscence is the disruption of a surgical incision or wound. When dehiscence occurs, the nurse immediately places the client in a low Fowler’s position or supine with the knees bent and instructs the client to lie quietly. These actions will minimize protrusion of the underlying tissues. The nurse then covers the wound with a sterile dressing moistened with sterile saline. The health care provider s notified, and the nurse documents the occurrence and the nursing actions that were implemented in response. Test-Taking Strategy:Note the strategic word “immediate.” Visualize this occurrence and recall that the primary concern when wound dehiscence occurs is the protrusion of underlying tissues. This will direct you to the correct option. Review the nursing actions to be taken immediately in the event of wound dehiscence Level of Cognitive Ability:Applying Client Needs:Physiological Integrity Integrated Process:Nursing Process/Implementation Content Area:Perioperatve Care Giddens Concepts: Caregiving, Tissue Integrity HESI Concepts: Caregiving, Tissue Integrity Reference:Lewis, S., Dirksen, S., Heitkemper, M., & Bucher, L. (2014).Medical-surgical nursing: Assessment and management of clinical problems(9thed., p. 180). St. Louis: Mosby. Awarded 1.0 points out of 1.0 possible points. 2.2.ID: 9477054249 A client who just returned from the recovery room after a tonsillectomy and adenoidectomy is restless and the pulse rate is increased. As the nurse continues the assessment, the client begins to vomit a copious amount of bright-red blood. The nurse should take which immediate action? A.Notify the Surgeon Correct B.Continue the assessmentC.Check the client’s blood pressure D.Obtain a flashlight, gauze, and a curved hemostat Rationale:Hemorrhage is a potential complication after tonsillectomy and adenoidectomy. If the client vomits a large amount of bright-red blood or the pulse rate increases and the patient is restless, the nurse must notify the surgeon immediately. The nurse should obtain a light, mirror, gauze, curved hemostat, and waste basin to facilitate examination of the surgical site. The nurse should also gather additional assessment data, but the surgeon must be contacted immediately. Test-Taking Strategy:Note the strategic word, immediate. Noting the words “bright-red blood” wil assist in directing you to the correct option. Remember that the presence of bright-red blood indicates active bleeding. Review the nursing actions to be taken immediately when bleeding occurs after a tonsillectomy and adenoidectomy Level of Cognitive Ability:Applying Client Needs:Physiological Integrity Integrated Process:Nursing Process/Implementation Content Area:Critical Care: Emergency Situation/Management Giddens Concepts: Collaboration, Clotting HESI Concepts:Collaboration/Managing Care, Perfusion-Clotting Reference:Ignatavcius, D., & Workman, M. (2013).Medical-surgical nursing: Patient-centered collaborative care.(7thed., p. 644). St. Louis: Saunders. Awarded 1.0 points out of 1.0 possible points. 3.3.ID: 9477051455 A client who has just undergone surgery suddenly experiences chest pain, dyspnea, and tachypnea. The nurse suspects that the client has a pulmonary embolism and immediately sets about to take which action? A.Preparing the client for a perfusion scan B.Attaching the client to a cardiac monitor C.Administering oxygen by way of nasal Cannula Correct D.Ensuring that the intravenous (IV) line is patent Rationale:Pulmonary embolism is a life-threatening emergency. Oxygen s immediately administered nasally to relieve hypoxemia, respiratory distress, and central cyanosis, and the health care providers notified. IV infusion lines are needed to administer medications or fluids. A perfusion scan, among other tests, may be performed. The electrocardiogram is monitored for the presence of dysrhythmias. Additionally, a urinary catheter may be inserted and blood for arterial blood gas determinations drawn. The immediate priority, however, s the administration of oxygen. Test-Taking Strategy:Focus on the client’s diagnosis and use the skills of prioritizing. Use the ABCs (airway, breathing, and circulation) to find the correct option. Review the nursing actions to be taken immediately in the event of pulmonary embolism Level of Cognitive Ability:Applying Client Needs:Physiological Integrity Integrated Process:Nursing Process/Implementation Content Area:Critical Care: Emergency Situation/Management Giddens Concepts: Perfusion, Clotting HESI Concepts:Oxygenation/Gas Exchange, Perfusion Clotting Reference:Lewis, S., Dirksen, S., Heitkemper, M., & Bucher, L. (2014).Medicalsurgical nursing: Assessment and management of clinical problems(9thed., p. 552). St. Louis: Mosby. Awarded 1.0 points out of 1.0 possible points. 4.4.ID: 9477051498 A nurse is assessing a client who has a closed chest tube drainage system. The nurse notes constant bubbling in the water seal chamber. What actions should the nurse take?(Select all that apply). A.Clamp the chest tube B.Chang the drainage system C.Assess the system for an external air Leak Correct D.Reduce the degree of suction being applied E.Document assessment findings, actions taken, and client Response Correct Rationale:Constant bubbling n the water sea chamber of a closed chest tube drainage system may indicate the presence of an air leak. The nurse would assess the chest tube system for the presence of an external air leak if constant bubbling were noted in this chamber. If an external air leak is not present and the ar leak is a new occurrence, the heath care provider is notified immediately, because an ar leak may be present in the pleural space. Leakage and trapping of air in the pleural space can result in a tension pneumothorax. Clamping the chest tube is incorrect. Additionally, a chest tube is not clamped unless this has been specifically prescribed n the agency’s policies and procedures. Changing the drainage system will not alleviate the problem. Reducing the degree of suction being applied will not affect the bubbling in the water seal chamber and could be harmful. The nurse would document the assessment findings and interventions taken in the client’s medical record. Test-Taking Strategy:Focus on the data in the question, noting that there is bubbling in the water seal chamber. Use knowledge regarding the priority actions in the care of a closed chest tube drainage system. Recalling that this may indicate an air leak will direct you to the correct optons. Review the nursing actions to be taken immediately in the event that complications of a closed chest tube drainage system occur Level of Cognitive Ability:Applying Client Needs:Physiological Integrity Integrated Process:Nursing Process/Implementation Content Area: Critical Care: Emergency Situation/Management Glidden's Concepts: Care Coordination, Gas Exchange HESI Concepts: Nursing Interventions,Oxygenation/Gas Exchange Reference:Lewis, S., Dirksen, S., Heitkemper, M., & Bucher, L. (2014).Medicalsurgical nursing: Assessment and management of clinical problems(9thed., p. 546). St. Louis: Mosby. Awarded 2.0 points out of 2.0 possible points. 5.5.ID: 9477055619 A nurse is helping a client with a closed chest tube drainage system get out of bed and into a chair. During the transfer, the chest tube is caught on the leg of the chair and dislodged from the insertion site. What is theimmediatenursing action? A.Reinsert the chest tube B.Contact the health care provider C.Transfer the client back to bed D.Cover the insertion site with a sterile occlusive Dressing Correct Rationale:If a chest tube is dislodged from the insertion site, the nurse immediately covers the site with sterile occlusive dressing. The nurse then performs a respiratory assessment, helps the client back into bed, and contacts the health care provider.The nurse does not reinsert the chest tube. The health care provider will reinsert the chest tube as necessary. Test-Taking Strategy:Note the strategic word “immediate.” Eliminate the option that involves reinsertion of the chest tube first, because a nurse is not trained to insert a chest tube. To select from the remaining options, focus on the subject, dislodgement of a chest tube from its insertion site, and recall the complications associated wth this occurrence; this will direct you to the correct option. Review the nursing actions to be taken immediately in the event of complications associated with a closed chest tube drainage system Level of Cognitive Ability:Applying Client Needs:Physiological Integrity Integrated Process:Nursing Process/Implementation Content Area: Critical Care: Emergency Situation/Management Glidden's Concepts: Care Coordination, Gas Exchange HESI Concepts: Nursing Interventions,Oxygenation/Gas Exchange Reference:Lewis, S., Dirksen, S., Heitkemper, M., & Bucher, L. (2014).Medicalsurgical nursing: Assessment and management of clinical problems(9thed., p. 546). St. Louis: Mosby. Awarded 1.0 points out of 1.0 possible points. 6.6.ID: 9477047967 A nurse performing nasopharyngeal suctioning and suddenly notes the presence of bloody secretions. Which action should the nurse takefirst? A.Continue suctioning to remove the bood B.Check the degree of suction being appledCorrect C.Encourage the client to cough out the bloody secretions D.Remove the suction catheter from the client’s nose and begin vigorous suctioning through the mouth Rationale:The return of bloody secretions s an unexpected outcome of suctioning. If it occurs, the nurse should first assess the client and then determine the degree of suction being applied. The degree of suction pressure may need to be decreased. The nurse must also remember to apply intermittent suction and perform catheter rotation during suctioning. Continuing the suctonng or performing vigorous suctioning through the mouth will result in increased trauma and therefore increased bleeding. Suctioning is normaly performed on clients who are unable to expectorate secretions. It is therefore unlikely that the client will be able to cough out the bloody secretions. Test-Taking Strategy:Note the strategic word, first. Eliminate the options of continuing the suctioning to remove the blood and removing the suction catheter from the nose to begin vigorous suctioning through the mouth, because they are comparable or alike. Next eliminate the option that involves encouragng the client to cough out the bloody secretions, because t is unlikely that the client will be able to do so. Review the nursing actions to be taken immediately in the event of a complication during suctioning Level of Cognitive Ability:Applying Client Needs:Physiological Integrity Integrated Process:Nursing Process/Implementation Content Area:Adult Health/Respiratory Giddens Concepts: Clinical Judgment, Gas Exchange HESI Concepts:Clinical Decision-Making/Clinical Judgment,Oxygenation/Gas Exchange Reference:Perry, A., Potter, P., & Ostendorf, W. (2014).Clinical nursing skills & techniques(8thed., pp. 629, 635). St. Louis: Mosby. [Show Less]
- Exam
- $40.45
- 0
- 119
HESi Extra Credit Module 10.Q&A Marked and extensive rationale
1.1.ID: 18630147534 A nurse s assigned to care four clients on the medical-surgical unit. Which client should the nurse see first on the shift assessmen... [Show More] t? A.A client admitted with pneumonia with a fever of 100°F and some diaphoresis B.A client with congestive heart failure with clear lung sounds on the previous shift C.A client with new-onset of shortness of breath (SOB) and a history of pulmonary Edema Correct Rationale:Theclient who should be seen first is the one with SOB and a history of pulmonary edema.In light of such a history, SOB could indicate that fluid volume overload has once again developed. The client with a fever and who is diaphoretic is at risk for insufficient fluid volume as a result of loss of fluid through the skin, but this client is not the priority. Test-Taking Strategy:Usethe process of elimination and focus on the subject of the question, the client who should be seen first. Recall the rule of assessment of the ABCs—airway, breathing, and circulation—which means that the client experiencing shortness of breath should take precedence over the other clients on the unit. This client’s condition could progress to respiratory arrest if the client were not assessed immediately on the basis of the signs and symptoms. Read each option and think about the client in most critical condition and review the disorders to determine which clients have the most critical needs. If you had difficulty with this question, review the various disease processes presented in this question. Level of Cognitive Ability:Analyzing Client Needs:Physiological Integrity Integrated Process:Nursng Process/Data Collection Content Area:Delegating/Proritizing D.A client undergoing long-term corticosteroid therapy with mild bruising on the anterior surfaces of the arms Awarded 1.0 points out of 1.0 possible points. 2.2.ID: 18630146839 A client with gastroenterits who has been vomiting and has diarrhea is admitted to the hospital with a diagnosis of dehydration. For which clinical manifestations that correlate with this flud imbalance would the nurse assess the client?Select all that apply. A.Decreased pulse B.Decreased urine Output Correct C.Increased blood pressure D.Increased respiratory Rate Correct E.Decreased respiratory depth Rationale:A client with dehydration has an increased depth and rate of respirations. The diminished fluid volume is perceived by the body as a decreased oxygen leve (hypoxia), and increased respiration is an attempt to maintain oxygen delivery. Other assessment findings in insufficient fluid volume are decreased urine volume, increased pulse, weight loss, poor skin turgor, dry mucous membranes, concentrated urine with increased specific gravity, increased hematocrit, and altered level of consciousness. Increased blood pressure, decreased pulse, and increased urine output occur with fluid-volume overload. Test-Taking Strategy:Usethe process of elimination and focus on the subject, dehydration (deficient fluid volume). Think about the pathophysiology of deficient fluid volume. Remember that the body wil increase the respiratory rate in an attempt to maintain the oxygen level. If you had difficulty with this question, review the signs of insufficient fluid volume. Level of Cognitive Ability:Analyzing Client Needs:Physiological Integrity Integrated Process:Nursing Process/Data Collection Content Area:Fluid and Electrolytes Awarded 2.0 points out of 2.0 possible points. 3.3.ID: 18630147505 A nurse s reviewing the medical records of the clients for the assigned 7 a.m.–7 p.m. shift. Which client will the nurse monitor most closely for excessive fluid volume? A.A 48-year-old client receiving diuretics to treat hypertension B.A 35-year old client who is vomiting undigested food after eating C.An 85-year-old client receiving intravenous (IV) therapy at a rate of 100 mL/hr Correct Rationale:The older adult client receiving IV therapy at 100 mL/hr is at the greatest risk for excessive fluid volume because of the diminished cardiovascular and renal function that occur with aging. Other causes of excessive flud volume include rena failure, heart failure, liver disorders, excessive use of hypotonic IV fluids to replace isotonic losses, excessive irrigation of body fluids, and excessive ingestion of table salt. A client who is receiving diuretics, vomiting, or has a nasogastric tube attached to suction is at risk for deficient fluid voume.Test-Taking Strategy:Readthe question carefully, noting that t asks for the client at risk for excessive fluid volume. Look for comparable or alike options that indicate fluid volume deficits. Read each option and think about the fluid imbalance that could occur in each situation; in the case of the incorrect options, it s flud-volume deficiency; the only option reflecting conditions that could result in an excess is the correct option. If you had difficulty with this question, review the causes of excessive fluid volume. Level of Cognitive Ability:Analyzing Client Needs:Physiological Integrity Integrated Process:Nursng Process/Data Collection Content Area:Fluid and Electrolytes D.A 65-year-old client with a nasogastric tube attached to ow suction following partial gastrectomy Awarded 1.0 points out of 1.0 possible points. 4.4.ID: 18630146876 A nurse s caring for a client who is being treated for congestive heart failure and has been assigned a nursing diagnosis of excessive fluid volume. Which finding causes the nurse to determine that the client’s condition has improved? A.Dyspnea B.1+ edema in the legs C.Moist crackles in the lower lobes of the lungs D.Weight loss of 4 lb in 24 hours correct Rationale:One sign that excessive fluid volume is resolving is loss of body weight. It is important to recall that 1 L of fluid weighs 1 kg, which equals 2.2 lb (1 liter = 2.2 lb = 1 kg). The other options listed indicate that the client is retaining fluid. Assessment findings associated with excessive fluid volume include cough, dyspnea, rales or crackles, tachypnea, tachycardia, increased blood pressure and bounding pulse, increased central venous pressure, weight gain, edema, neck and hand vein distention, altered level of consciousness, and decreased hematocrit. These symptoms must be reversed if the fluid volume excess is to be resolved. Test-Taking Strategy:Usethe process of elimination and focus on the subject, a sign that the client’s condition is improving. The only such finding is decreasing body weight. If you had difficulty with this question, review the assessment findings noted in excessive fluid volume and the signs that the condition is resolving.Level of Cognitive Ability:Evaluating Client Needs:Physiological Integrity Integrated Process:Nursng Process/Evaluation Content Area:Fluid and Electrolytes Awarded 1.0 points out of 1.0 possible points. 5.5.ID: 18630146862 A nurse notes that a client has ST-segment depression on the electrocardiogram (ECG) monitor. With which potassium reading does the nurse associate this finding? A.3.1 mEq/LCorrect Rationale:Aserum potassium level below 3.5 mEq/L is indicative of hypokalemia, the most common electrolyte imbalance, which is potentially life threatening. ECG changes in hypokalemia include peaked P waves, flat T waves, a depressed ST segment, and prominent U waves. Readings of 4.5 mEq/L and 4.2 mEq/L are normal potassium evels; 5.4 mEq/L indicates hyperkalemia. Test-Taking Strategy:Beginto answer this question by recalling the normal range of values for serum potassium. Next it is necessary to know that ST segment depression occurs in hypokalemia. Look for comparable or alike options that indicate a normal potassium reading. If you had difficulty with this question, review the ECG changes that occur in hypokalemia. Level of Cognitive Ability:Analyzing Client Needs:Physiological Integrity Integrated Process:Nursng Process/Analysis Content Area:Fluid and Electrolytes B.4.2 mEq/L C.4.5 mEq/L D.5.4 mEq/L Awarded 1.0 points out of 1.0 possible points. 6.6.ID: 18630146885 A health care provider writes a prescription for the administration of intravenous (IV) potassium chloride to a client with hypokalemia. The nurse should reinforce which client instructions? A.A catheter will be inserted to drain your bladder. B.A large intravenous line will be inserted into your chest vein.C.This infusion requires use of a large caliber IV tubing. D.This medication is diluted in a large bag of IV fluid and infused slowly into your vein.Correct Rationale:Potassium chloride administered IV must always be diluted in IV fluid. Undiluted potassium chloride given IV can cause cardiac arrest. Potassium chloride is never administered as a bolus (IV push) injection; an IV push would result in sudden severe hyperkalemia, which could precipitate cardiac arrest. Although urine output is monitored carefully during administration, it s not necessary to insert a Foley catheter unless this is specifically prescribed. Potassium chloride should be administered with the use of a controlled IV infusion device to avoid bolus infusion and increased risk of cardiac arrest. A central IV line is not necessary; potassium chloride may be administered through a peripheral IV line. Test-Taking Strategy:Usethe process of elimination and note the strategic words “intravenous potassium chloride.” Recalling that the medication must be diluted will direct you to the correct option. If you had difficulty with this question, review the guidelines for the administration of potassium chloride. Level of Cognitive Ability:Analyzing Client Needs:Physiological Integrity Integrated Process:Teaching and Learning Content Area:Pharmacology Awarded 1.0 points out of 1.0 possible points. 7.7.ID: 18630146897 A nurse notes that a client’s serum potassium level is 5.8 mEq/L. The nurse interprets this as an expected finding in the client with? A.Diarrhea B.Wound drainage C.Addison Disease Correct Rationale:Aserum potassium level greater than 5.1 mEq/L indicates hyperkalemia, and the nurse would report the finding to the heath care provider. Adrena insufficiency (Addison disease) is a cause of hyperkalemia. Other common causes of hyperkalemia include tissue damage, such as that in burn injuries, renal failure, and the use of potassium-sparing diuretics. The client with diarrhea or wound drainage or the client being treated with diuretics is at risk for hypokalemia. Test-Taking Strategy:Usethe process of elimination. Eliminate the comparable or alike options that indicate that the cient is experencing body fluid losses and therefore a loss of potassium. If you had difficulty with this question, review the risk factors associated with hyperkalemia. Level of Cognitive Ability:Analyzing Client Needs:Physiological Integrity Integrated Process:Nursng Process/Analysis Content Area:Fluid and Electrolytes D.Heart failure being treated with loop diuretics Awarded 1.0 points out of 1.0 possible points. 8.8.ID: 18630146883 A nurse s caring for a client experiencing hyponatremia who was admitted to the medica-surgical unit with fluid-volume overload. For which clinical manifestatons of this electrolyte imbaance does the nurse monitor this cient?Select all that apply. A.Slow pulse B.Decreased urine output C.Skeletal musce weaknessCorrect D.Hyperactive bowel soundsCorrect E.Hyperactive deep tendon reflexes Rationale:Signs ofhyponatremia include a rapid, thready pulse; skeletal muscle weakness; diminished deep tendon reflexes; abdominal cramping and hyperactive bowel sounds; increased urine output; headache; and personality changes. The nurse must assess these changes from baseline. If muscle weakness is detected, the nurse should immediately check respiratory effectiveness because ventilation depends on strength of the respiratory muscles. Test-Taking Strategy:Specificknowledge of the subject, the manifestations of hyponatremia, is needed to answer this question. Remember that muscle weakness and hyperactive bowel sounds are characteristics of hyponatrema. If you had difficuty with this question, review the clinical manifestations of hyponatremia. Level of Cognitive Ability:Analyzing Client Needs:Physiological Integrity Integrated Process:Nursing Process/Data Collection Content Area:Fluid and Electroytes [Show Less]
- Exam
- $42.45
- 0
- 108
HESI EXIT RN 2022 V3 160 Questions WITH VERIFIED ANSWERS
1. A male client with stomach cancer returns to the unit following a total gastrectomy. He has a nasogastric tube to suction and is receiving Lactated Rin... [Show More] ger’s solution at 75 mL/hour IV. One hour after admission to the unit, the nurse notes 300 mL of blood in the suction canister, the client’s heart rate is 155 beats/minute, and his blood pressure is 78/48 mmHg. In addition to reporting the finding to the surgeon. Which action should the nurse implement first? a. Measure and document the client’s urinary output. b. Request the client’s reserved unit if packed red blood cells. c. Prepare the placement of a central venous catheter. d. Increase the infusion rate of Lactated Ringer’s solution. 2. an adult male who fell 20 feet from the roof of this home has multiple injuries, including a right pneumothorax. Chest tubes were inserted in the emergency department prior to his transfer to the intensive care unit (ICU). the nurse notes that the suction control chamber is bubbling at the - 10 cm H2O mark, with fluctuation in the water seal, and over the past hour 75 ml of bright red blood is measured in the collection chamber. Which intervention should the nurse implement? a. Add sterile water to the suction control chamber. b. Give blood from the collection chamber as autotransfusion c. Manipulate blood in tubing to drain into chamber. d. Increase wall suction to eliminate fluctuation in water seal. 3. A client who received hemodialysis yesterday is experiencing a blood pressure of 200/100 mmHg, heart rate 110 beats/minute, and respiratory rate 36 breaths/minute. The client is manifesting shortness of breath, bilateral 2+ pedal edema, and an oxygen saturation on room air of 89%. Which action should the nurse take first? a. Elevate the foot of the bed. b. Restrict the client’s fluid. c. Begin supplemental oxygen. d. Prepare the client for hemodialysis. 4. A client with Addison’s crisis is admitted for treatment with adrenal cortical supplementation. Based on the client’s admitting diagnosis, which findings require immediate action by the nurse? (Select all that apply) a. Headache and tremors b. Irregular heart rate c. Skin hyperpigmentation d. Postural hypotension e. Pallor and diaphoresis 5. An older client is admitted with fluid volume deficit and dehydration. Which assessment finding is the best indicator of hydration that the nurse should report to the healthcare provider? a. Urine specific gravity is 1.040 b. Systolic blood pressure decreases 10 points when standing. c. The client denies being thirsty. d. Skin tenting occurs when the client’s forearm is pinched. 6. After an inservice about electronic health record (EHR) security and safeguarding client information, the nurse observes a colleague going home with printed copies of client information in a uniform pocket. Which action should the nurse take? a. File a detailed incident report with the specific hiring facility. b. Warn the colleague that their actions are unprofessional. c. Comment anonymously about the action of a staff discussion board. d. Communicate the colleague’s actions to the unit charge nurse. 7. The nurse is evaluating a tertiary prevention program for clients with cardiovascular disease implemented in a rural health clinic. Which outcome indicate the program is effective? a. At-risk clients received an increased number of routine health screenings. b. Clients reported having new confidence in making healthy food choices. c. Clients who incurred disease complications promptly received rehabilitation. d. Client relapse rate of 30% in a 5-year community-wide anti-smoking campaign. 8. The nurse is caring for a client with chronic obstructive pulmonary disease (COPD) who uses oxygen at 2 L/minute per nasal cannula continuously. The nurse observes that the client is having increased shortness of breath with respirations at 23 breaths/minute. Which action should the nurse implement first? a. Determine if the client is experiencing any anxiety. b. Auscultate the client’s bilateral lung sounds and oxygen saturation. c. Notify the healthcare provider about the client’s distress. d. Assess the delivery mechanism of the oxygen tank, tubing, and cannula. 9. Which statement by a client who is 24 hours post-subtotal thyroidectomy requires an immediate investigation by the nurse? a. “When I get out of bed quickly, I feel a little dizzy.” b. “The dressing over my incision feels like it is too tight.” c. “I’m most comfortable when the head of the bed is raised.” d. “This IV infusion makes me urinate more often than usual.” 10. An older adult male who is in his early 70’s is admitted to the emergency department because of a COPD exacerbation. This client is struggling to breathe and the healthcare team is preparing for endotracheal intubation. The spouse’s wife, who is 30 years younger than the client, asks the nurse to stop the procedure and provide the nurse a copy of the client’s living will. Which action should the nurse take? a. Facilitate a family meeting with the palliative care team. b. Notify the healthcare provider of the client’s wishes. c. Place a certified copy of the living will in the client’s record. d. Alert the nursing staff of the client’s don’t resuscitate status. 11. An unlicensed assistive personnel (UAP) is assigned to provide personal care for a client whose prescribed activity is bedrest with bedside commode use. The UAP reports to the nurse that the client is so obese that the UAP feels unable to safely assist the client in transferring from the bed to the bedside commode. How should the nurse respond? a. Determine the client’s level of mobility and need for assistance. b. Instruct the UAP that all clients deserve equal care. c. Advice the client to maintain bedrest so that safety can be ensured. d. Assign another UAP to care for the client. 12. A nurse determines that more than 25% of the students at a middle school are overweight. The nurse presents the information at the parent-teacher meeting. What action is most important for the nurse to include in the meeting? a. Provide information on ways to increase activity for the family. b. Have several teachers talk about health risks associated with obesity. c. Distribute a shopping list of suggested healthy snack items. d. Determine the parents’ degree of concern about their children’s weight. 13. After several months of chronic fatigue, morning stiffness, and join pain, a young adult is diagnosed with rheumatoid arthritis, and the healthcare provider prescribes prednisone. Which education should the nurse provide the client with regard to taking prednisone? a. Take prednisone doses before meals on an empty stomach. b. Wear sunglasses when exposed to bright sunlight. c. If sequential doses are missed, notify the healthcare provider. d. Schedule a monthly laboratory visit for a complete blood count. [Show Less]
- Exam
- $32.45
- 0
- 224
HESI EXIT RN EXAM-756 QA, HESI EXIT RN Exam (Version 1 to Version 7) TEST BANK
1. Following discharge teaching, a male client with duodenal ulcer tells the nurse the he will drink plenty of dairy products, suchas milk, to help coat a... [Show More] nd protect his ulcer. What is the best follow-up action by the nurse? a- Remind the client that it is also important to switch to decaffeinated coffee and tea. b- Suggest that the client also plan to eat frequent small meals to reduce discomfort c- Review with the client the need to avoid foods that are rich in milk and cream. d- Reinforce this teaching by asking the client to list a dairy food that he might select. 2. A male client with hypertension, who received new antihypertensive prescriptions at his last visit returns to the clinic two weeks later to evaluate his blood pressure (BP). His BP is 158/106 and he admits that he has not been taking the prescribed medication because the drugs make him “feel bad”. In explaining the need for hypertension control, the nurse should stress that an elevated BP places the client at risk for which pathophysiological condition? a- Blindness secondary to cataracts b- Acute kidney injury due to glomerular damage c- Stroke secondary to hemorrhage d- Heart block due to myocardial damage 3.The nurse observes an unlicensed assistive personnel (UAP) positioning a newly admitted client who has a seizure disorder.The client is supine and the UAP is placing soft pillows along the side rails. What action should the nurse implement? a- Ensure that the UAP has placed the pillows effectively to protect the client. b- Instruct the UAP to obtain soft blankets to secure to the side rails instead of pillows.a- Assume responsibility for placing the pillows while the UAP completes another task. b- Ask the UAP to use some of the pillows to prop the client in a side lying position. 4. An adolescent with major depressive disorder has been taking duloxetine (Cymbalta) for the past 12 days. Which assessmentfinding requires immediate follow-up? a- Describes life without purpose b- Complains of nausea and loss of appetite c- States is often fatigued and drowsy d- Exhibits an increase in sweating. 5. A 60-year-old female client with a positive family history of ovarian cancer has developed an abdominal mass and is being evaluated for possible ovarian cancer. Her Papanicolau (Pap) smear results are negative. What information should the nurse include in the client’s teaching plan? a- Further evaluation involving surgery may be needed b- A pelvic exam is also needed before cancer is ruled out c- Pap smear evaluation should be continued every six month d- One additional negative pap smear in six months is needed. 6. A client who recently underwear a tracheostomy is being prepared for discharge to home. Which instructions is mostimportant for the nurse to include in the discharge plan? a- Explain how to use communication tools. b- Teach tracheal suctioning techniques c- Encourage self-care and independence. d- Demonstrate how to clean tracheostomy site. 2 7.In assessing an adult client with a partial rebreather mask, the nurse notes that the oxygen reservoir bag does not deflate completely during inspiration and the client’s respiratory rate is 14 breaths / minute. What action should the nurse implement?a- Encourage the client to take deep breaths b- Remove the mask to deflate the bag c- Increase the liter flow of oxygen d- Document the assessment data 8. During a home visit, the nurse observed an elderly client with diabetes slip and fall. What action should the nurse take first? a- Give the client 4 ounces of orange juice b- Call 911 to summon emergency assistance c- Check the client for lacerations or fractures d- Asses clients blood sugar level 9. At 0600 while admitting a woman for a schedule repeat cesarean section (C-Section), the client tells the nurse that she dranka cup a coffee at 0400 because she wanted to avoid getting a headache. Which action should the nurse take first? a- Ensure preoperative lab results are available b- Start prescribed IV with lactated Ringer’s c- Inform the anesthesia care provider d- Contact the client’s obstetrician. 10.After placing a stethoscope as seen in the picture, the nurse auscultates S1 and S2 heart sounds. To determine if an S3 heartsound is present, what action should the nurse take first? a- Side the stethoscope across the sternum. b- Move the stethoscope to the mitral site c- Listen with the bell at the same location d- Observe the cardiac telemetry monitor 11.A 66-year-old woman is retiring and will no longer have a health insurance through her place of employment. Which agencyshould the client be referred to by the employee health nurse for health insurance needs? a- Woman, Infant, and Children program b- Medicaid c- Medicare d- Consolidated Omnibus Budget Reconciliation Act provision. 12.A client who is taking an oral dose of a tetracycline complains of gastrointestinal upset. What snack should the nurseinstruct the client to take with the tetracycline? a- Fruit-flavored yogurt. b- Cheese and crackers. c- Cold cereal with skim milk. d- Toasted wheat bread and jelly 13.Following a lumbar puncture, a client voices several complaints. What complaint indicated to the nurse that the clientis experiencing a complication? a- “I am having pain in my lower back when I move my legs” b- “My throat hurts when I swallow” c- “I feel sick to my stomach and am going to throw up” d- I have a headache that gets worse when I sit up” 14.An elderly client seems confused and reports the onset of nausea, dysuria, and urgency with incontinence. 3 Which actionshould the nurse implement? a- Auscultate for renal bruits b- Obtain a clean catch mid-stream specimen c- Use a dipstick to measure for urinary ketone d- Begin to strain the client’s urine. 15.The nurse is assisting the mother of a child with phenylketonuria (PKU) to select foods that are in keeping withthe child’s dietary restrictions. Which foods are contraindicated for this child? a- Wheat products b- Foods sweetened with aspartame. c- High fat foods d- High calories foods. 16.Before preparing a client for the first surgical case of the day, a part-time scrub nurse asks the circulating nurse if a 3-minutesurgical hand scrub is adequate preparation for this client. Which response should the circulating nurse provide? a- Ask a more experience nurse to perform that scrub since it is the first time of the day b- Validate the nurse is implementing the OR policy for surgical hand scrub c- Inform the nurse that hand scrubs should be 3 minutes between cases. d- Direct the nurse to continue the surgical hand scrub for a 5-minute duration. 17.Which breakfast selection indicates that the client understands the nurse’s instructions about the dietary management ofosteoporosis? a- Egg whites, toast and coffee. b- Bran muffin, mixed fruits, and orange juice. c- Granola and grapefruit juice d- Bagel with jelly and skim milk. 18.The charge nurse of a critical care unit is informed at the beginning of the shift that less than the optimal number of registered nurses will be working that shift. In planning assignments, which client should receive the most care hours by aregistered nurse (RN)? a- A 34-year -old admitted today after an emergency appendendectomy who has a peripheral intravenous catheter and a Foleycatheter. b- A 48-year-old marathon runner with a central venous catheter who is experiencing nausea and vomiting due to electrolytedisturbance following a race. c- A 63-year-old chain smoker admitted with chronic bronchitis who receiving oxygen via nasal cannula and has a saline-lockedperipheral intravenous catheter. d- An 82-year-old client with Alzheimer’s disease newly-fractures femur who has a Foley catheter and soft wrist restrainsapplied 19.Z a- Cleanse the foot with soap and water and apply an antibiotic ointment b- Provide teaching about the need for a tetanus booster within the next 72 hours. c- have the mother check the child's temperature q4h for the next 24 hours d- transfer the child to the emergency department to receive a gamma globulin injection 20.The mother of an adolescent tells the clinic nurse, “My son has athlete’s foot, I have been applying triple antibioticointment for two days, but there has been no improvement.” What instruction should the nurse provide? a- Antibiotics take two weeks to become effective against infections such as athlete’s foot. b- Continue using the ointment for a full week, even after the symptoms disappear. c- Applying too much ointment can deter its effectiveness. Apply a thin layer to prevent maceration. d- Stop using the ointment and encourage complete drying of the feet and wearing clean socks. 4 21.A 26-year-old female client is admitted to the hospital for treatment of a simple goiter, and levothyroxine sodium (Synthroid) is prescribed. Which symptoms indicate to the nurse that the prescribed dosage is too high for this client? The clientexperiences a- Palpitations and shortness of breath b- Bradycardia and constipation c- Lethargy and lack of appetite d- Muscle cramping and dry, flushed skin 22.A client with a history of heart failure presents to the clinic with a nausea, vomiting, yellow vision and palpitations. Whichfinding is most important for the nurse to assess to the client? a- Determine the client’s level of orientation and cognition b- Assess distal pulses and signs of peripheral edema c- Obtain a list of medications taken for cardiac history. d- Ask the client about exposure to environmental heat. 23.The healthcare provider prescribes an IV solution of isoproterenol (Isuprel) 1 mg in 250 ml of D5W at 300 mcg/hour.The nurse should program the infusion pump to deliver how many ml/hour? (Enter numeric value only.) a- 75 24.The pathophysiological mechanisms are responsible for ascites related to liver failure? (Select all that apply)a- Bleeding that results from a decreased production of the body’s clotting factors b- Fluid shifts from intravascular to interstitial area due to decreased serum protein c- Increased hydrostatic pressure in portal circulation increases fluid shifts into abdomen d- Increased circulating aldosterone levels that increase sodium and water retention e- Decreased absorption of fatty acids in the duodenum leading to abdominal distention. 25.The nurse is auscultating a client’s heart sounds. Which description should the nurse use to document this sound? (Pleaselisten to the audio first to select the option that applies) a- S1 S2 b- S1 S2 S3 c- Murmur d- Pericardial friction rub. 26.The healthcare provider prescribes celtazidime (Fortax) 35 mg every 8 hours IM for an infant. The 500 mg vial is labeledwith the instruction to add 5.3 ml diluent to provide a concentration of 100 mg/ml. How many ml should the nurse administered for each dose? (Enter numeric value only. If rounding is required, round to the nearest tenth) a- 0.4 27.The nurse notes that a client has been receiving hydromorphone (Dilaudid) every six hours for four days. Whatassessment is most important for the nurse to complete? a- Auscultate the client's bowel sounds b- Observe for edema around the ankles c- Measure the client’s capillary glucose level d- Count the apical and radial pulses simultaneously 28.A female client is admitted with end stage pulmonary disease is alert, oriented, and complaining of shortness of breath. The client tells the nurse that she wants “no heroic measures” taken if she stops breathing, and she asks the nurse to document thisin her medical record. What action should the nurse implement? a- Ask the client to discuss “do not resuscitate” with her healthcare provider 5 29.A client is receiving a full strength continuous enteral tube feeding at 50 ml/hour and has developed diarrhea. The clienthas a new prescription to change the feeding to half strength. What intervention should the nurse implement? a- Add equal amounts of water and feeding to a feeding bag and infuse at 50ml/hour b- Continue the full strength feeding after decreasing the rate of infusion to 25 ml/hr. c- Maintain the present feeding until diarrhea subsides and the begin the next new prescription. d- Withhold any further feeding until clarifying the prescription with healthcare provides. 30.A female client reports that her hair is becoming coarse and breaking off, that the outer part of her eyebrows havedisappeared, and that her eyes are all puffy. Which follow-up question is best for the nurse to ask? a- “Is there a history of female baldness in your family?” b- “Are you under any unusual stress at home or work?” c- “Do you work with hazardous chemicals?” d- “Have you noticed any changes in your fingernails?” 31.After a third hospitalization 6 months ago, a client is admitted to the hospital with ascites and malnutrition. The client is drowsy but responding to verbal stimuli and reports recently spitting up blood. What assessment finding warrants immediateintervention by the nurse? a- Bruises on arms and legs b- Round and tight abdomen c- Pitting edema in lower legs d- Capillary refill of 8 seconds 32.After the nurse witnesses a preoperative client sign the surgical consent form, the nurse signs the form as a witness. Whatare the legal implications of the nurse’s signature on the client’s surgical consent form? (Select all that apply) a- The client voluntarily grants permission for the procedure to be done b- The surgeon has explained to the client why the surgery is necessary. c- The client is competent to sign the consent without impairment of judgement d- The client understands the risks and benefits associated with the procedure e- After considering alternatives to surgery, the client elects to have the procedure. 33.Following surgery, a male client with antisocial personality disorder frequently requests that a specific nurse be assigned tohis care and is belligerent when another nurse is assigned. What action should the charge nurse implement? a- Ask the client to explain why he constantly request the nurse b- Encourage the client to verbalize his feelings about the nurse c- Reassure the client that his request will be met whenever possible. d- Advise the client that assignments are not based on client requests 34.A client with cervical cancer is hospitalized for insertion of a sealed internal cervical radiation implant. While providing care,the nurse finds the radiation implant in the bed. What action should the nurse take? a- Call the radiology department b- Reinsert the implant into the vagina c- Apply double gloves to retrieve the implant for disposal. d- Place the implant in a lead container using long-handled forceps 35.The client with which type of wound is most likely to need immediate intervention by the nurse?a- Laceration b- Abrasion 6 c- Contusion d- Ulceration 36.The nurse is planning care for a client admitted with a diagnosis of pheochromocytoma. Which intervention has thehighest priority for inclusion in this client’s plan of care? a- Record urine output every hour b- Monitor blood pressure frequently c- Evaluate neurological status d- Maintain seizure precautions 37.When caring for a client who has acute respiratory distress syndrome (ARDS), the nurse elevates the head of the bed 30degrees. What is the reason for this intervention? a- To reduce abdominal pressure on the diaphragm b- to promote retraction of the intercostal accessory muscle of respiration c- to promote bronchodilation and effective airway clearance d- to decrease pressure on the medullary center which stimulates breathing 38.When assessing a mildly obese 35-year-old female client, the nurse is unable to locate the gallbladder when palpating below the liver margin at the lateral border of the rectus abdominal muscle. What is the most likely explanation for failure tolocate the gallbladder by palpation? a- The client is too obese b- Palpating in the wrong abdominal quadrant c- The gallbladder is normal d- Deeper palpation technique is needed 39.A woman with an anxiety disorder calls her obstetrician’s office and tells the nurse of increased anxiety since the normalvaginal delivery of her son three weeks ago. Since she is breastfeeding, she stopped taking her antianxiety medications, but thinks she may need to start taking them again because of her increased anxiety. What response is best for the nurse toprovide this woman? a- Describe the transmission of drugs to the infant through breast milk b- Encourage her to use stress relieving alternatives, such as deep breathing exercises c- Inform her that some antianxiety medications are safe to take while breastfeeding d- Explain that anxiety is a normal response for the mother of a 3-weekold. 40.An older male client with a history of type 1 diabetes has not felt well the past few days and arrives at the clinic with abdominal cramping and vomiting. He is lethargic, moderately, confused, and cannot remember when he took his last dose ofinsulin or ate last. What action should the nurse implement first? a- obtain a serum potassium level b- administer the client's usual dose of insulin c- assess pupillary response to light d- Start an intravenous (IV) infusion of normal saline 41.A client who received multiple antihypertensive medications experiences syncope due to a drop-in blood pressure to 70/40.What is the rationale for the nurse’s decision to hold the client’s scheduled antihypertensive medication? a- Increased urinary clearance of the multiple medications has produced diuresis and lowered the blood pressure b- The antagonistic interaction among the various blood pressure medications has reduced their effectiveness c- The additive effect of multiple medications has caused the blood pressure to drop too low. d- The synergistic effect of the multiple medications has resulted in drug toxicity and resulting hypotension. 42.Which client is at the greatest risk for developing delirium?a- An adult client who cannot sleep due to constant pain. 7 b- an older client who attempted 1 month ago c- a young adult who takes antipsychotic medications twice a day d- a middle-aged woman who uses a tank for supplemental oxygen 43.Which intervention should the nurse include in a long-term plan of care for a client with Chronic Obstructive PulmonaryDisease (COPD)? a- Reduce risks factors for infection b- Administer high flow oxygen during sleep c- Limit fluid intake to reduce secretions d- Use diaphragmatic breathing to achieve better exhalation 44.Which location should the nurse choose as the best for beginning a screening program for hypothyroidism?a- A business and professional women's group. b- An African-American senior citizens center c- A daycare center in a Hispanic neighborhood d- An after-school center for Native-American teens 45.A female client has been taking a high dose of prednisone, a corticosteroid, for several months. After stopping the medication abruptly, the client reports feeling “very tired”. Which nursing intervention is most important for the nurse toimplement? a- Measure vital signs b- Auscultate breath sounds c- Palpate the abdomen d- Observe the skin for bruising 46.A male client reports the onset of numbness and tingling in his fingers and around his mouth. Which lab is important for thenurse to review before contacting the health care provider? a- capillary glucose b- urine specific gravity c- Serum calcium d- white blood cell count 47.What explanation is best for the nurse to provide a client who asks the purpose of using the log-rolling technique forturning? a- working together can decrease the risk for back injury b- The technique is intended to maintain straight spinal alignment. c- Using two or three people increases client safety. d- turning instead of pulling reduces the likelihood of skin damage 48.A client receiving chemotherapy has severe neutropenia. Which snack is best for the nurse to recommend to the client?a- Plain yogurt with sweetened with raw honey b- Peanuts in the shell, roasted or un-roasted. c- Aged farmer’s cheese with celery sticks d- Baked apples topped with dried raisins 49.Which action should the school nurse take first when conducting a screening for scoliosis?a- Compare dorsal measurement of trunk b- Extend arms over head for visualization c- Inspect for symmetrical shoulder height. d- Observe weight-bearing on each leg. 50.An unlicensed assistive personnel (UAP) assigned to obtain client vital signs reports to the charge nurse that a client has aweak pulse with a rate of 44 beat/ minutes. What action should the charge nurse implement? 8 a- Instruct the UAP to count the client apical pulse rate for sixty seconds b- Determine if the UAP also measured the client’s capillary refill time. c- Assign a practical nurse (LPN) to determine if an apical radial deficit is present. d- Notify the health care provider of the abnormal pulse rate and pulse volume. [Show Less]
- Exam
- $60.45
- 0
- 128
HESI EXIT V 2 EXAM WITH VERIFIED SOLUTIONS
1. The nurse is caring for a pre-adolescent client in skeletal Dunlop traction. Which nursing intervention is appropriate for this child? A) Make certai... [Show More] n the child is maintained in correct body alignment. B) Be sure the traction weights touch the end of the bed. C) Adjust the head and foot of the bed for the child's comfort D) Release the traction for 15-20 minutes every 6 hours PRN. 2. The nurse is assessing a healthy child at the 2 year check up. Which of the following should the nurse report immediately to the health care provider? A) Height and weight percentiles vary widely B) Growth pattern appears to have slowed C) Recumbent and standing height are different D) Short term weight changes are uneven 3. The parents of a 2 year-old child report that he has been holding his breath whenever he has temper tantrums. What is the best action by the nurse? A) Teach the parents how to perform cardiopulmonary resuscitation B) Recommend that the parents give in when he holds his breath to prevent anoxia C) Advise the parents to ignore breath holding because breathing will begin as a reflex D) Instruct the parents on how to reason with the child about possible harmful effects 4. The nurse is assessing a client in the emergency room. Which statement suggests that the problem is acute angina? A) "My pain is deep in my chest behind my sternum." B) "When I sit up the pain gets worse." C) "As I take a deep breath the pain gets worse." D) "The pain is right here in my stomach area." . 5. The nurse is assessing the mental status of a client admitted with possible organic brain disorder. Which of these questions will best assess the function of the client's recent memory? A) "Name the year." "What season is this?" (pause for answer after each question) B) "Subtract 7 from 100 and then subtract 7 from that." (pause for answer) "Now continue to subtract 7 from the new number." C) "I am going to say the names of three things and I want you to repeat them after me: blue, ball, pen." D) "What is this on my wrist?" (point to your watch) Then ask, "What is the purpose of it?" 6. In planning care for a 6 month-old infant, what must the nurse provide to assist in the development of trust? A) Food B) Warmth C) Security D) Comfort 7. A nurse has just received a medication order which is not legible. Which statement best reflects assertive communication? A) "I cannot give this medication as it is written. I have no idea of what you mean." B) "Would you please clarify what you have written so I am sure I am reading it correctly?" C) "I am having difficulty reading your handwriting. It would save me time if you would be more careful." D) "Please print in the future so I do not have to spend extra time attempting to read your writing." 8. What is the most important consideration when teaching parents how to reduce risks in the home? A) Age and knowledge level of the parents B) Proximity to emergency services C) Number of children in the home D) Age of children in the home 9. A 35 year-old client with sickle cell crisis is talking on the telephone but stops as the nurse enters the room to request something for pain. The nurse should A) Administer a placebo B) Encourage increased fluid intake C) Administer the prescribed analgesia D) Recommend relaxation exercises for pain control 10. While caring for a toddler with croup, which initial sign of croup requires the nurse's immediate attention? A) Respiratory rate of 42 B) Lethargy for the past hour C) Apical pulse of 54 D) Coughing up copious secretions 11. A client is admitted with low T3 and T4 levels and an elevated TSH level. On initial assessment, the nurse would anticipate which of the following assessment findings? A) Lethargy B) Heat intolerance C) Diarrhea D) Skin eruptions 12. The emergency room nurse admits a child who experienced a seizure at school. The father comments that this is the first occurrence, and denies any family history of epilepsy. What is the best response by the nurse? A) "Do not worry. Epilepsy can be treated with medications." B) "The seizure may or may not mean your child has epilepsy." C) "Since this was the first convulsion, it may not happen again." D) "Long term treatment will prevent future seizures." 13. Alcohol and drug abuse impairs judgment and increases risk taking behavior. What nursing diagnosis best applies? A) Risk for injury B) Risk for knowledge deficit C) Altered thought process D) Disturbance in self-esteem 14. The nurse is caring for a 10 month-old infant who is has oxygen via mask. It is important for the nurse to maintain patency of which of these areas? A) Mouth B) Nasal passages C) Back of throat D) Bronchials 15. The nurse is providing instructions for a client with pneumonia. What is the most important information to convey to the client? A) "Take at least 2 weeks off from work." B) "You will need another chest x-ray in 6 weeks." C) "Take your temperature every day." D) "Complete all of the antibiotic even if your findings decrease." 16. When counseling a 6 year old who is experiencing enuresis, what must the nurse understand about the pathophysiological basis of this disorder? A) Has no clear etiology B) May be associated with sleep phobia C) Has a definite genetic link D) Is a sign of willful misbehavior 17. The nurse is discussing negativism with the parents of a 30 month-old child. How should the nurse tell the parents to best respond to this behavior? A) Reprimand the child and give a 15 minute "time out" B) Maintain a permissive attitude for this behavior C) Use patience and a sense of humor to deal with this behavior D) Assert authority over the child through limit setting 18. The nurse is talking by telephone with a parent of a 4 year-old child who has chickenpox. Which of the following demonstrates appropriate teaching by the nurse? A) Chewable aspirin is the preferred analgesic B) Topical cortisone ointment relieves itching C) Papules, vesicles, and crusts will be present at one time D) The illness is only contagious prior to lesion eruption 19. The nurse is assigned to a client who has heart failure. During the morning rounds the nurse sees the client develop sudden anxiety, diaphoresis and dyspnea. The nurse auscultates, crackles bilaterally. Which nursing intervention should be performed first? A) Take the client's vital signs B) Place the client in a sitting position with legs dangling C) Contact the health care provider D) Administer the PRN anti-anxiety agent 20. The nurse is caring for a toddler with atopic dermatitis. The nurse should instruct the parents to A) Dress the child warmly to avoid chilling B) Keep the child away from other children for the duration of the rash C) Clean the affected areas with tepid water and detergent D) Wrap the child's hand in mittens or socks to prevent scratching [Show Less]
- Exam
- $22.45
- 0
- 106
HESI Exit V2 (Nurse Hero Review)Brandis HESI Review
1.The LPN/LVN is preparing to ambulate a postoperative client after cardiac surgery. The nurse plans to do which to enable the client to best tolerate t... [Show More] he ambulation? 1. Provide the client with a walker. 2. Remove the telemetry equipment. 3. Encourage the client to cough and deep breathe. 4. Premedicate the client with an analgesic before ambulating. 2. A client is wearing a continuous cardiac monitor, which begins to alarm at the nurse's station. The nurse sees no electrocardiographic complexes on the screen. The nurse should do which first? a. Call a code blue. b. Call the health care provider. c. Check the client status and lead placement. d. Press the recorder button on the ECG console. 3. 3) The LPN/LVN in a medical unit is caring for a client with heart failure. The client suddenly develops extreme dyspnea, tachycardia, and lung crackles, and the nurse suspects pulmonary edema. The nurse immediately notifies the registered nurse and expects which interventions to be prescribed? Select all that apply. a. Administering oxygen b. Inserting a Foley catheter c. Administering furosemide (Lasix) d. Administering morphine sulfate intravenously e. Transporting the client to the coronary care unit f. Placing the client in a low-Fowler's side-lying position 4. The nurse is monitoring a client following cardioversion. Which observations should be of highest priority to the nurse? a. Blood pressure b. Status of airway c. Oxygen flow rate d. Level of consciousness 5. The nurse is assisting in caring for the client immediately after insertion of a permanent demand pacemaker via the right pg. 1 FINAL “EXIT” HESI! Last day of Concorde LVN School – 04/16/2021 subclavian vein. The nurse prevents dislodgement of the pacing catheter by implementing which intervention? a. Limiting movement and abduction of the left arm b. Limiting movement and abduction of the right arm c. Assisting the client to get out of bed and ambulate with a walker 4. Having the physical therapist do active range of motion to the right arm 6. A client diagnosed with thrombophlebitis 1 day ago suddenly complains of chest pain and shortness of breath, and the client is visibly anxious. The LPN/LVN understands that a life-threatening complication of this condition is which? a. Pneumonia b. Pulmonary edema c. Pulmonary embolism d. Myocardial infarction 7. A 24-year-old man seeks medical attention for complaints of claudication in the arch of the foot. The nurse also notes superficial thrombophlebitis of the lower leg. The nurse should check the client for which next? a. Smoking history b. Recent exposure to allergens c. History of recent insect bites d. Familial tendency toward peripheral vascular disease 8. The nurse has reinforced instructions to the client with Raynaud's disease about self-management of the disease process. The nurse determines that the client needs further teaching if the client states which? a. "Smoking cessation is very important." b. "Moving to a warmer climate should help." c. "Sources of caffeine should be eliminated from the diet." 4. "Taking nifedipine (Procardia) as prescribed will decrease vessel spasm." 9. A client with myocardial infarction suddenly becomes tachycardic, shows signs of air hunger, and begins coughing frothy, pinktinged sputum. The nurse listens to breath sounds, expecting to hear which breath sounds bilaterally? a. Rhonchi b. Crackles c. Wheezes pg. 2 FINAL “EXIT” HESI! Last day of Concorde LVN School – 04/16/2021 d. Diminished breath sounds 10. The LPN/LVN is collecting data on a client with a diagnosis of right sided heart failure. The nurse should expect to note which specific characteristic of this condition? a. Dyspnea b. Hacking cough c. Dependent edema d. Crackles on lung auscultation 11. The LPN/LVN is checking the neurovascular status of a client who returned to the surgical nursing unit 4 hours ago after undergoing an aortoiliac bypass graft. The affected leg is warm, and the nurse notes redness and edema. The pedal pulse is palpable and unchanged from admission. The nurse interprets that the neurovascular status is which? a. Moderately impaired, and the surgeon should be called b. Normal, caused by increased blood flow through the leg c. Slightly deteriorating, and should be monitored for another hour d. Adequate from an arterial approach, but venous complications are arising 12. A client with a diagnosis of rapid rate atrial fibrillation asks the nurse why the health care provider is going to perform carotid massage. The LPN/LVN responds that this procedure may stimulate which? a. Vagus nerve to slow the heart rate b. Vagus nerve to increase the heart rate c. Diaphragmatic nerve to slow the heart rate d. Diaphragmatic nerve to increase the heart rate 13. A client is admitted to the hospital with possible rheumatic endocarditis. The LPN/LVN should check for a history of which type of infection? a. Viral infection b. Yeast infection c. Streptococcal infection d. Staphylococcal infection 14. A client has an Unna boot applied for treatment of a venous stasis leg ulcer. The LPN/LVN notes that the client's toes are mottled, pg. 3 FINAL “EXIT” HESI! Last day of Concorde LVN School – 04/16/2021 and cool and the client verbalizes some numbness and tingling of the foot. Which interpretation should the nurse make of these findings? a. The boot has not yet dried. b. The boot is controlling leg edema. c. The boot is impairing venous return. d. The boot has been applied too tightly. 15. A client with angina complains that the anginal pain is prolonged and severe and occurs at the same time each day, most often in the morning. On further data collection, the nurse notes that the pain occurs in the absence of precipitating factors. How should the LPN/LVN best describe this type of anginal pain? a. Stable angina b. Variant angina c. Unstable angina d. Nonanginal pain [Show Less]
- Exam
- $17.95
- 0
- 142
Purchase the bundle to get the full access instantly
- 3 Million+ Study Documents
- 100% Money Back Guarantee
- Immediate Download Access
Add To Cart
Reviews 0
Bundle Details
$27.45
- Trusted by 800,000+ Students
- 24/7 Money Back Guarantee
- Download is directly available
160
0
Seller Details
Beginner
Reviews received
