HESI EXIT - COMPREHENSIVE EXAM 2024 VERIFIED & CERTIFIED QUESTIONS WITH ANSWERS
1. A nurse who has recently complet- ed orientation is beginning work in
... [Show More] the labor and delivery unit for the first time. When making assignments, which client should the charge nurse assign to this new nurse?
A.A primigravida who is 8 cm dilated after 14 hours of labor
B.A client scheduled for a repeat ce- sarean birth at 38 weeks' gestation
C.A client being induced for fetal demise at 20 weeks' gestation
D.A multiparous client who is dilated 5 cm and 50% effaced
D
The new nurse should be assigned the least complicated client to gain experience and confidence, as well as protect client safety. Of the clients available for assignment,
(D) is progressing well and is the least complicated. (A, B and C) have actual or potential complica- tions and should be assigned to a more experienced nurse.
2. A client with human immunodeficien- cy virus (HIV) infection has white le- sions in the oral cavity that resem- ble milk curds. Nystatin (Mycostatin) preparation is prescribed as a swish and swallow. Which information is most important for the nurse to pro- vide the client?
A. Oral hygiene should be performed before the medication. B.Antifungal medications are available in tablet, suppository, and liquid forms.
C. Candida albicans is the organism that causes the white lesions in the mouth.
D. The dietary intake of dairy and spicy foods should be limited.
A
HIV infection causes depression of cell-mediated immunity that allows an overgrowth of Candida albicans (oral moniliasis), which appears as white, cheesy plaque or lesions that resemble milk curds. To ensure effective contact of the medication with the oral lesions, oral liquids should be consumed and oral hy- giene performed before swishing the liquid Mycostatin (A). (B and C) provide the client with additional information about the pathogenesis and treatment of opportunistic in- fections, but (A) allows the client to participate in self-care of the oral infection. Dietary restriction of spicy foods reduces discomfort associat- ed with stomatitis, but restriction of dairy products is not indicated (D).
3.A client who is admitted with emphy- sema is having difficulty breathing. In which position should the nurse place the client?
A. High Fowler's position without a pil- low behind the head
B. Semi-Fowler's position with a single pillow behind the head
C. Right side-lying position with the head of the bed elevated 45 degrees D.Sitting upright and forward with both arms supported on an over the bed table
D
Adequate lung expansion is depen- dent on deep breaths that allow the respiratory muscles to increase the longitudinal and anterior-posterior size of the thoracic cage. Sitting up- right and leaning forward with the arms supported on an over the bed table (D) allows the thoracic cage to expand in all four directions and reduces dyspnea. A high Fowler's position does not allow maximum expansion of the posterior lobes of the lungs (A). A semi-Fowler's po- sition restricts expansion of the an- terior-posterior diameter of the tho- racic cage (B). Positioning a client on the right side with the head of the bed elevated (C) does not facil- itate lung expansion.
4. A client with chronic renal insuffi- ciency (CRI) is taking 25 mg of hy- drochlorothiazide (HCTZ) PO and 40 mg of furosemide (Lasix) PO daily. To- day, at a routine clinic visit, the client's serum potassium level is 4 mEq/L. What is the most likely cause of this client's potassium level?
A. The client is noncompliant with his medications.
B. The client recently consumed large quantities of pears or nuts.
C. The client's renal function has af- fected his potassium level.
D. The client needs to be started on a potassium supplement.
C
The client has a normalized potas- sium level despite diuretic use (C). The kidney automatically secretes 90% of potassium consumed, but in chronic renal insufficiency (CRI), less potassium is excreted than normal. Therefore, the two potas- sium-wasting drugs, a thiazide di- uretic and loop diuretic, are not like- ly to affect potassium levels. The normal potassium level is 3.5 to 5 mEq/L, and with a potassium level of 4 mEq/L, there is no reason to believe that the client is noncom- pliant with his treatment (A). Pears and nuts do not affect the serum potassium level (B). There is no [Show Less]