HESI EXIT EXAM 799 QUESTIONS AND
ANSWERS
Followingzdischargezteaching,zazmalezclientzwithzduodenalzulcerztellsztheznursezthezhez
willzdrinkzplentyzofzdairyzproducts,zsuchzaszmilk,ztozhelpzcoatzandzprotectzhiszulcer.zWh
atziszthezbestzfollow-upzactionzbyztheznurse?
a.zRemindzthezclientzthatzitziszalsozimportantztozswitchztozdecaffeinatedzcoffeezandztea.
b.zSuggestzthatzthezclientzalsozplanztozeatzfrequentzsmallzmealsztozreducezdiscomfort
c.zReviewzwithzthezclientzthezneedztozavoidzfoodszthatzarezrichzinzmilkzandzcream.
d.zReinforcezthiszteachingzbyzaskingzthezclientztozlistzazdairyzfoodzthatzhezmightzselect.z-
zanswer--
c.zReviewzwithzthezclientzthezneedztozavoidzfoodszthatzarezrichzinzmilkzandzcream.
Theznursezobserveszanzunlicensedzassistivezpersonnelz(UAP)zpositioningzaznewlyzad
mittedzclientzwhozhaszazseizurezdisorder.zThezclientziszsupinezandzthezUAPziszplacingzs
oftzpillowszalongzthezsidezrails.zWhatzactionzshouldztheznursezimplement?
a.zEnsurezthatzthezUAPzhaszplacedzthezpillowszeffectivelyztozprotectzthezclient.
b.zInstructzthezUAPztozobtainzsoftzblanketsztozsecureztozthezsidezrailszinsteadzofzpillows.
c.zAssumezresponsibilityzforzplacingzthezpillowszwhilezthezUAPzcompleteszanotherztask
.
d.zAskzthezUAPztozusezsomezofzthezpillowsztozpropzthezclientzinzazsidezlyingzposition.z-
zanswer--
b.zInstructzthezUAPztozobtainzsoftzblanketsztozsecureztozthezsidezrailszinsteadzofzpillows.
Azmalezclientzwithzhypertension,zwhozreceivedznewzantihypertensivezprescriptionszatzh
iszlastzvisitzreturnsztozthezclinicztwozweekszlaterztozevaluatezhiszbloodzpressurez(BP).zHi
szBPzisz158/106zandzhezadmitszthatzhezhasznotzbeenztakingzthezprescribedzmedicationz
becausezthezdrugszmakezhimz"feelzbad".zInzexplainingzthezneedzforzhypertensionzcontr
ol,ztheznursezshouldzstresszthatzanzelevatedzBPzplaceszthezclientzatzriskzforzwhichzpath
ophysiologicalzcondition?
a.zBlindnesszsecondaryztozcataracts
b.zAcutezkidneyzinjuryzdueztozglomerularzdamage
c.zStrokezsecondaryztozhemorrhage
d.zHeartzblockzdueztozmyocardialzdamagez-zanswer--
c.zStrokezsecondaryztozhemorrhage
Anzadolescentzwithzmajorzdepressivezdisorderzhaszbeenztakingzduloxetinez(Cymbalta)z
forzthezpastz12zdays.zWhichzassessmentzfindingzrequireszimmediatezfollow-up
a.zDescribeszlifezwithoutzpurpose
b.zComplainszofznauseazandzlosszofzappetite
c.zStatesziszoftenzfatiguedzandzdrowsy
d.zExhibitszanzincreasezinzsweating.z-zanswer--a.zDescribeszlifezwithoutzpurpose
,Az60-year-
oldzfemalezclientzwithzazpositivezfamilyzhistoryzofzovarianzcancerzhaszdevelopedzanzabd
ominalzmasszandziszbeingzevaluatedzforzpossiblezovarianzcancer.zHerzPapanicolauz(Pa
p)zsmearzresultszareznegative.zWhatzinformationzshouldztheznursezincludezinzthezclient'
szteachingzplan
a.zFurtherzevaluationzinvolvingzsurgeryzmayzbezneeded
b.zAzpelviczexamziszalsozneededzbeforezcancerziszruledzout
c.zPapzsmearzevaluationzshouldzbezcontinuedzeveryzsixzmonth
d.zOnezadditionalznegativezpapzsmearzinzsixzmonthsziszneeded.z-zanswer--
a.zFurtherzevaluationzinvolvingzsurgeryzmayzbezneeded
Azclientzwhozrecentlyzunderwentzaztracheostomyziszbeingzpreparedzforzdischargeztozho
me.zWhichzinstructionsziszmostzimportantzforztheznurseztozincludezinzthezdischargezplan
?
a.zExplainzhowztozusezcommunicationztools.
b.zTeachztrachealzsuctioningztechniques
c.zEncouragezself-carezandzindependence.
d.zDemonstratezhowztozcleanztracheostomyzsite.z-zanswer--
b.zTeachztrachealzsuctioningztechniques
Inzassessingzanzadultzclientzwithzazpartialzrebreatherzmask,ztheznurseznoteszthatzthezox
ygenzreservoirzbagzdoesznotzdeflatezcompletelyzduringzinspirationzandzthezclient'szresp
iratoryzratezisz14zbreathsz/zminute.zWhatzactionzshouldztheznursezimplement
a.zEncouragezthezclientztoztakezdeepzbreaths
b.zRemovezthezmaskztozdeflatezthezbag
c.zIncreasezthezliterzflowzofzoxygen
d.zDocumentzthezassessmentzdataz-zanswer--d.zDocumentzthezassessmentzdata
Duringzshiftzreport,zthezcentralzelectrocardiogramz(EKG)zmonitoringzsystemzalarms.zW
hichzclientzalarmzshouldztheznursezinvestigatezfirst?
a.zRespiratoryzapneazofz30zseconds
b.zOxygenzsaturationzratezofz88%
c.zEightzprematurezventricularzbeatszeveryzminute
d.zDisconnectedzmonitorzsignalzforzthezlastz6zminutes.z-zanswer--
a.zRespiratoryzapneazofz30zseconds
Duringzazhomezvisit,ztheznursezobservedzanzelderlyzclientzwithzdiabeteszslipzandzfall.zW
hatzactionzshouldztheznurseztakezfirst?
a.zGivezthezclientz4zounceszofzorangezjuice
b.zCallz911ztozsummonzemergencyzassistance
c.zCheckzthezclientzforzlacerationszorzfractures
d.zAsseszclientszbloodzsugarzlevelz-zanswer--
c.zCheckzthezclientzforzlacerationszorzfractures
Atz0600zwhilezadmittingzazwomanzforzazschedulezrepeatzcesareanzsectionz(C-
Section),zthezclientztellsztheznursezthatzshezdrankzazcupzazcoffeezatz0400zbecausezshez
wantedztozavoidzgettingzazheadache.zWhichzactionzshouldztheznurseztakezfirst?
a.zEnsurezpreoperativezlabzresultszarezavailable
b.zStartzprescribedzIVzwithzlactatedzRinger's
,c.zInformzthezanesthesiazcarezprovider
d.zContactzthezclient'szobstetrician.z-zanswer--c.zInformzthezanesthesiazcarezprovider
Afterzplacingzazstethoscopezaszseenzinzthezpicture,ztheznursezauscultateszS1zandzS2zh
eartzsounds.zTozdeterminezifzanzS3zheartzsoundziszpresent,zwhatzactionzshouldztheznur
seztakezfirst
a.zSidezthezstethoscopezacrosszthezsternum.
b.zMovezthezstethoscopeztozthezmitralzsite
c.zListenzwithzthezbellzatzthezsamezlocation
d.zObservezthezcardiacztelemetryzmonitorz-zanswer--
c.zListenzwithzthezbellzatzthezsamezlocation
Az66-year-
oldzwomanziszretiringzandzwillznozlongerzhavezazhealthzinsurancezthroughzherzplacezofz
employment.zWhichzagencyzshouldzthezclientzbezreferredztozbyzthezemployeezhealthzn
ursezforzhealthzinsurancezneeds?
a.zWoman,zInfant,zandzChildrenzprogram
b.zMedicaid
c.zMedicare
d.zConsolidatedzOmnibuszBudgetzReconciliationzActzprovision.z-zanswer--c.zMedicare
Azclientzwhozisztakingzanzoralzdosezofzaztetracyclinezcomplainszofzgastrointestinalzupse
t.zWhatzsnackzshouldztheznursezinstructzthezclientztoztakezwithztheztetracycline?
a.zFruit-flavoredzyogurt.
b.zCheesezandzcrackers.
c.zColdzcerealzwithzskimzmilk.
d.zToastedzwheatzbreadzandzjellyz-zanswer--d.zToastedzwheatzbreadzandzjelly
Followingzazlumbarzpuncture,zazclientzvoiceszseveralzcomplaints.zWhatzcomplaintzindic
atedztoztheznursezthatzthezclientziszexperiencingzazcomplication?
a.z"IzamzhavingzpainzinzmyzlowerzbackzwhenzIzmovezmyzlegs"
b.z"MyzthroatzhurtszwhenzIzswallow"
c.z"Izfeelzsickztozmyzstomachzandzamzgoingztozthrowzup"
d.zIzhavezazheadachezthatzgetszworsezwhenzIzsitzup"z-zanswer--
d.zIzhavezazheadachezthatzgetszworsezwhenzIzsitzup"
Anzelderlyzclientzseemszconfusedzandzreportszthezonsetzofznausea,zdysuria,zandzurgen
cyzwithzincontinence.zWhichzactionzshouldztheznursezimplement
a.zAuscultatezforzrenalzbruits
b.zObtainzazcleanzcatchzmid-streamzspecimen
c.zUsezazdipstickztozmeasurezforzurinaryzketone
d.zBeginztozstrainzthezclient'szurine.z-zanswer--b.zObtainzazcleanzcatchzmid-
streamzspecimen
Theznurseziszassistingzthezmotherzofzazchildzwithzphenylketonuriaz(PKU)ztozselectzfood
szthatzarezinzkeepingzwithzthezchild'szdietaryzrestrictions.zWhichzfoodszarezcontraindicat
edzforzthiszchild?
a.zWheatzproducts
b.zFoodszsweetenedzwithzaspartame.
c.zHighzfatzfoods
, d.zHighzcalorieszfoods.z-zanswer--b.zFoodszsweetenedzwithzaspartame.
Beforezpreparingzazclientzforzthezfirstzsurgicalzcasezofzthezday,zazpart-
timezscrubznursezaskszthezcirculatingznursezifzaz3zminutezsurgicalzhandzscrubziszadequ
atezpreparationzforzthiszclient.zWhichzresponsezshouldzthezcirculatingznursezprovide?
a.zAskzazmorezexperienceznurseztozperformzthatzscrubzsincezitziszthezfirstztimezofzthezda
y
b.zValidateztheznurseziszimplementingzthezORzpolicyzforzsurgicalzhandzscrub
c.zInformztheznursezthatzhandzscrubszshouldzbez3zminuteszbetweenzcases.
d.zDirectztheznurseztozcontinuezthezsurgicalzhandzscrubzforzaz5-minutezduration.z-
zanswer--d.zDirectztheznurseztozcontinuezthezsurgicalzhandzscrubzforzaz5-
minutezduration.
Whichzbreakfastzselectionzindicateszthatzthezclientzunderstandsztheznurse'szinstruction
szaboutzthezdietaryzmanagementzofzosteoporosis?
a.zEggzwhites,ztoastzandzcoffee.
b.zBranzmuffin,zmixedzfruits,zandzorangezjuice.
c.zGranolazandzgrapefruitzjuice
d.zBagelzwithzjellyzandzskimzmilk.z-zanswer--d.zBagelzwithzjellyzandzskimzmilk.
Thezchargeznursezofzazcriticalzcarezunitziszinformedzatzthezbeginningzofzthezshiftzthatzles
szthanzthezoptimalznumberzofzregisteredznurseszwillzbezworkingzthatzshift.zInzplanningza
ssignments,zwhichzclientzshouldzreceivezthezmostzcarezhourszbyzazregisteredznursez(R
N)
a.zAz34-yearz-
oldzadmittedztodayzafterzanzemergencyzappendendectomyzwhozhaszazperipheralzintrav
enouszcatheterzandzazFoleyzcatheter.
b.zAz48-year-
oldzmarathonzrunnerzwithzazcentralzvenouszcatheterzwhoziszexperiencingznauseazandzv
omitingzdueztozelectrolytezdisturbancezfollowingzazrace.
c.zAz63-year-
oldzchainzsmokerzadmittedzwithzchroniczbronchitiszwhoziszreceivingzoxygenzviaznasalzc
annulazandzhaszazsaline-lockedzperipheralzintravenouszcatheter.
d.zAnz82-year-oldzclientzwithzAlzheimer'szdiseaseznewly-
fractureszfemurzwhozhaszazFoleyzcatheterzandzsoftzwristzrestrainszappliedz-zanswer--
d.zAnz82-year-oldzclientzwithzAlzheimer'szdiseaseznewly-
fractureszfemurzwhozhaszazFoleyzcatheterzandzsoftzwristzrestrainszapplied
Azmotherzbringszherz6-year-
oldzchild,zwhozhaszjustzsteppedzonzazrustyznail,ztozthezpediatrician'szoffice.zUponzinspe
ction,ztheznurseznoteszthatztheznailzwentzthroughzthezshoezandzpiercedzthezbottomzofzth
ezchild'szfoot.zWhichzactionzshouldztheznursezimplementzfirst?
a.zCleansezthezfootzwithzsoapzandzwaterzandzapplyzanzantibioticzointment
b.zProvidezteachingzaboutzthezneedzforzaztetanuszboosterzwithinztheznextz72zhours.
c.zhavezthezmotherzcheckzthezchild'sztemperaturezq4hzforztheznextz24zhours
d.ztransferzthezchildztozthezemergencyzdepartmentztozreceivezazgammazglobulinzinjecti
onz-zanswer--a.zCleansezthezfootzwithzsoapzandzwaterzandzapplyzanzantibioticzointment
ANSWERS
Followingzdischargezteaching,zazmalezclientzwithzduodenalzulcerztellsztheznursezthezhez
willzdrinkzplentyzofzdairyzproducts,zsuchzaszmilk,ztozhelpzcoatzandzprotectzhiszulcer.zWh
atziszthezbestzfollow-upzactionzbyztheznurse?
a.zRemindzthezclientzthatzitziszalsozimportantztozswitchztozdecaffeinatedzcoffeezandztea.
b.zSuggestzthatzthezclientzalsozplanztozeatzfrequentzsmallzmealsztozreducezdiscomfort
c.zReviewzwithzthezclientzthezneedztozavoidzfoodszthatzarezrichzinzmilkzandzcream.
d.zReinforcezthiszteachingzbyzaskingzthezclientztozlistzazdairyzfoodzthatzhezmightzselect.z-
zanswer--
c.zReviewzwithzthezclientzthezneedztozavoidzfoodszthatzarezrichzinzmilkzandzcream.
Theznursezobserveszanzunlicensedzassistivezpersonnelz(UAP)zpositioningzaznewlyzad
mittedzclientzwhozhaszazseizurezdisorder.zThezclientziszsupinezandzthezUAPziszplacingzs
oftzpillowszalongzthezsidezrails.zWhatzactionzshouldztheznursezimplement?
a.zEnsurezthatzthezUAPzhaszplacedzthezpillowszeffectivelyztozprotectzthezclient.
b.zInstructzthezUAPztozobtainzsoftzblanketsztozsecureztozthezsidezrailszinsteadzofzpillows.
c.zAssumezresponsibilityzforzplacingzthezpillowszwhilezthezUAPzcompleteszanotherztask
.
d.zAskzthezUAPztozusezsomezofzthezpillowsztozpropzthezclientzinzazsidezlyingzposition.z-
zanswer--
b.zInstructzthezUAPztozobtainzsoftzblanketsztozsecureztozthezsidezrailszinsteadzofzpillows.
Azmalezclientzwithzhypertension,zwhozreceivedznewzantihypertensivezprescriptionszatzh
iszlastzvisitzreturnsztozthezclinicztwozweekszlaterztozevaluatezhiszbloodzpressurez(BP).zHi
szBPzisz158/106zandzhezadmitszthatzhezhasznotzbeenztakingzthezprescribedzmedicationz
becausezthezdrugszmakezhimz"feelzbad".zInzexplainingzthezneedzforzhypertensionzcontr
ol,ztheznursezshouldzstresszthatzanzelevatedzBPzplaceszthezclientzatzriskzforzwhichzpath
ophysiologicalzcondition?
a.zBlindnesszsecondaryztozcataracts
b.zAcutezkidneyzinjuryzdueztozglomerularzdamage
c.zStrokezsecondaryztozhemorrhage
d.zHeartzblockzdueztozmyocardialzdamagez-zanswer--
c.zStrokezsecondaryztozhemorrhage
Anzadolescentzwithzmajorzdepressivezdisorderzhaszbeenztakingzduloxetinez(Cymbalta)z
forzthezpastz12zdays.zWhichzassessmentzfindingzrequireszimmediatezfollow-up
a.zDescribeszlifezwithoutzpurpose
b.zComplainszofznauseazandzlosszofzappetite
c.zStatesziszoftenzfatiguedzandzdrowsy
d.zExhibitszanzincreasezinzsweating.z-zanswer--a.zDescribeszlifezwithoutzpurpose
,Az60-year-
oldzfemalezclientzwithzazpositivezfamilyzhistoryzofzovarianzcancerzhaszdevelopedzanzabd
ominalzmasszandziszbeingzevaluatedzforzpossiblezovarianzcancer.zHerzPapanicolauz(Pa
p)zsmearzresultszareznegative.zWhatzinformationzshouldztheznursezincludezinzthezclient'
szteachingzplan
a.zFurtherzevaluationzinvolvingzsurgeryzmayzbezneeded
b.zAzpelviczexamziszalsozneededzbeforezcancerziszruledzout
c.zPapzsmearzevaluationzshouldzbezcontinuedzeveryzsixzmonth
d.zOnezadditionalznegativezpapzsmearzinzsixzmonthsziszneeded.z-zanswer--
a.zFurtherzevaluationzinvolvingzsurgeryzmayzbezneeded
Azclientzwhozrecentlyzunderwentzaztracheostomyziszbeingzpreparedzforzdischargeztozho
me.zWhichzinstructionsziszmostzimportantzforztheznurseztozincludezinzthezdischargezplan
?
a.zExplainzhowztozusezcommunicationztools.
b.zTeachztrachealzsuctioningztechniques
c.zEncouragezself-carezandzindependence.
d.zDemonstratezhowztozcleanztracheostomyzsite.z-zanswer--
b.zTeachztrachealzsuctioningztechniques
Inzassessingzanzadultzclientzwithzazpartialzrebreatherzmask,ztheznurseznoteszthatzthezox
ygenzreservoirzbagzdoesznotzdeflatezcompletelyzduringzinspirationzandzthezclient'szresp
iratoryzratezisz14zbreathsz/zminute.zWhatzactionzshouldztheznursezimplement
a.zEncouragezthezclientztoztakezdeepzbreaths
b.zRemovezthezmaskztozdeflatezthezbag
c.zIncreasezthezliterzflowzofzoxygen
d.zDocumentzthezassessmentzdataz-zanswer--d.zDocumentzthezassessmentzdata
Duringzshiftzreport,zthezcentralzelectrocardiogramz(EKG)zmonitoringzsystemzalarms.zW
hichzclientzalarmzshouldztheznursezinvestigatezfirst?
a.zRespiratoryzapneazofz30zseconds
b.zOxygenzsaturationzratezofz88%
c.zEightzprematurezventricularzbeatszeveryzminute
d.zDisconnectedzmonitorzsignalzforzthezlastz6zminutes.z-zanswer--
a.zRespiratoryzapneazofz30zseconds
Duringzazhomezvisit,ztheznursezobservedzanzelderlyzclientzwithzdiabeteszslipzandzfall.zW
hatzactionzshouldztheznurseztakezfirst?
a.zGivezthezclientz4zounceszofzorangezjuice
b.zCallz911ztozsummonzemergencyzassistance
c.zCheckzthezclientzforzlacerationszorzfractures
d.zAsseszclientszbloodzsugarzlevelz-zanswer--
c.zCheckzthezclientzforzlacerationszorzfractures
Atz0600zwhilezadmittingzazwomanzforzazschedulezrepeatzcesareanzsectionz(C-
Section),zthezclientztellsztheznursezthatzshezdrankzazcupzazcoffeezatz0400zbecausezshez
wantedztozavoidzgettingzazheadache.zWhichzactionzshouldztheznurseztakezfirst?
a.zEnsurezpreoperativezlabzresultszarezavailable
b.zStartzprescribedzIVzwithzlactatedzRinger's
,c.zInformzthezanesthesiazcarezprovider
d.zContactzthezclient'szobstetrician.z-zanswer--c.zInformzthezanesthesiazcarezprovider
Afterzplacingzazstethoscopezaszseenzinzthezpicture,ztheznursezauscultateszS1zandzS2zh
eartzsounds.zTozdeterminezifzanzS3zheartzsoundziszpresent,zwhatzactionzshouldztheznur
seztakezfirst
a.zSidezthezstethoscopezacrosszthezsternum.
b.zMovezthezstethoscopeztozthezmitralzsite
c.zListenzwithzthezbellzatzthezsamezlocation
d.zObservezthezcardiacztelemetryzmonitorz-zanswer--
c.zListenzwithzthezbellzatzthezsamezlocation
Az66-year-
oldzwomanziszretiringzandzwillznozlongerzhavezazhealthzinsurancezthroughzherzplacezofz
employment.zWhichzagencyzshouldzthezclientzbezreferredztozbyzthezemployeezhealthzn
ursezforzhealthzinsurancezneeds?
a.zWoman,zInfant,zandzChildrenzprogram
b.zMedicaid
c.zMedicare
d.zConsolidatedzOmnibuszBudgetzReconciliationzActzprovision.z-zanswer--c.zMedicare
Azclientzwhozisztakingzanzoralzdosezofzaztetracyclinezcomplainszofzgastrointestinalzupse
t.zWhatzsnackzshouldztheznursezinstructzthezclientztoztakezwithztheztetracycline?
a.zFruit-flavoredzyogurt.
b.zCheesezandzcrackers.
c.zColdzcerealzwithzskimzmilk.
d.zToastedzwheatzbreadzandzjellyz-zanswer--d.zToastedzwheatzbreadzandzjelly
Followingzazlumbarzpuncture,zazclientzvoiceszseveralzcomplaints.zWhatzcomplaintzindic
atedztoztheznursezthatzthezclientziszexperiencingzazcomplication?
a.z"IzamzhavingzpainzinzmyzlowerzbackzwhenzIzmovezmyzlegs"
b.z"MyzthroatzhurtszwhenzIzswallow"
c.z"Izfeelzsickztozmyzstomachzandzamzgoingztozthrowzup"
d.zIzhavezazheadachezthatzgetszworsezwhenzIzsitzup"z-zanswer--
d.zIzhavezazheadachezthatzgetszworsezwhenzIzsitzup"
Anzelderlyzclientzseemszconfusedzandzreportszthezonsetzofznausea,zdysuria,zandzurgen
cyzwithzincontinence.zWhichzactionzshouldztheznursezimplement
a.zAuscultatezforzrenalzbruits
b.zObtainzazcleanzcatchzmid-streamzspecimen
c.zUsezazdipstickztozmeasurezforzurinaryzketone
d.zBeginztozstrainzthezclient'szurine.z-zanswer--b.zObtainzazcleanzcatchzmid-
streamzspecimen
Theznurseziszassistingzthezmotherzofzazchildzwithzphenylketonuriaz(PKU)ztozselectzfood
szthatzarezinzkeepingzwithzthezchild'szdietaryzrestrictions.zWhichzfoodszarezcontraindicat
edzforzthiszchild?
a.zWheatzproducts
b.zFoodszsweetenedzwithzaspartame.
c.zHighzfatzfoods
, d.zHighzcalorieszfoods.z-zanswer--b.zFoodszsweetenedzwithzaspartame.
Beforezpreparingzazclientzforzthezfirstzsurgicalzcasezofzthezday,zazpart-
timezscrubznursezaskszthezcirculatingznursezifzaz3zminutezsurgicalzhandzscrubziszadequ
atezpreparationzforzthiszclient.zWhichzresponsezshouldzthezcirculatingznursezprovide?
a.zAskzazmorezexperienceznurseztozperformzthatzscrubzsincezitziszthezfirstztimezofzthezda
y
b.zValidateztheznurseziszimplementingzthezORzpolicyzforzsurgicalzhandzscrub
c.zInformztheznursezthatzhandzscrubszshouldzbez3zminuteszbetweenzcases.
d.zDirectztheznurseztozcontinuezthezsurgicalzhandzscrubzforzaz5-minutezduration.z-
zanswer--d.zDirectztheznurseztozcontinuezthezsurgicalzhandzscrubzforzaz5-
minutezduration.
Whichzbreakfastzselectionzindicateszthatzthezclientzunderstandsztheznurse'szinstruction
szaboutzthezdietaryzmanagementzofzosteoporosis?
a.zEggzwhites,ztoastzandzcoffee.
b.zBranzmuffin,zmixedzfruits,zandzorangezjuice.
c.zGranolazandzgrapefruitzjuice
d.zBagelzwithzjellyzandzskimzmilk.z-zanswer--d.zBagelzwithzjellyzandzskimzmilk.
Thezchargeznursezofzazcriticalzcarezunitziszinformedzatzthezbeginningzofzthezshiftzthatzles
szthanzthezoptimalznumberzofzregisteredznurseszwillzbezworkingzthatzshift.zInzplanningza
ssignments,zwhichzclientzshouldzreceivezthezmostzcarezhourszbyzazregisteredznursez(R
N)
a.zAz34-yearz-
oldzadmittedztodayzafterzanzemergencyzappendendectomyzwhozhaszazperipheralzintrav
enouszcatheterzandzazFoleyzcatheter.
b.zAz48-year-
oldzmarathonzrunnerzwithzazcentralzvenouszcatheterzwhoziszexperiencingznauseazandzv
omitingzdueztozelectrolytezdisturbancezfollowingzazrace.
c.zAz63-year-
oldzchainzsmokerzadmittedzwithzchroniczbronchitiszwhoziszreceivingzoxygenzviaznasalzc
annulazandzhaszazsaline-lockedzperipheralzintravenouszcatheter.
d.zAnz82-year-oldzclientzwithzAlzheimer'szdiseaseznewly-
fractureszfemurzwhozhaszazFoleyzcatheterzandzsoftzwristzrestrainszappliedz-zanswer--
d.zAnz82-year-oldzclientzwithzAlzheimer'szdiseaseznewly-
fractureszfemurzwhozhaszazFoleyzcatheterzandzsoftzwristzrestrainszapplied
Azmotherzbringszherz6-year-
oldzchild,zwhozhaszjustzsteppedzonzazrustyznail,ztozthezpediatrician'szoffice.zUponzinspe
ction,ztheznurseznoteszthatztheznailzwentzthroughzthezshoezandzpiercedzthezbottomzofzth
ezchild'szfoot.zWhichzactionzshouldztheznursezimplementzfirst?
a.zCleansezthezfootzwithzsoapzandzwaterzandzapplyzanzantibioticzointment
b.zProvidezteachingzaboutzthezneedzforzaztetanuszboosterzwithinztheznextz72zhours.
c.zhavezthezmotherzcheckzthezchild'sztemperaturezq4hzforztheznextz24zhours
d.ztransferzthezchildztozthezemergencyzdepartmentztozreceivezazgammazglobulinzinjecti
onz-zanswer--a.zCleansezthezfootzwithzsoapzandzwaterzandzapplyzanzantibioticzointment