366 Hesi Study Guide Hesi 366 Study guide Questions With
Complete Solutions
A 6 -week-old infant with pyloric stenosis is scheduled for a
pylonmyectomy. Which pre-operative nursing action has highest
priority? Correct Answers Initiate a continuous infusion of IV
fluids per prescription.
A child with heart failure (HF) is taking digitalis. Which signs
indicates to the nurse that the child may be experiencing digitalis
toxicity? Correct Answers Vomiting
A client is admitted to a mental health unit after attempting
suicide by taking a handful of medications. In developing a plan
of care for the client, which goal has the highest priority?
Correct Answers Signs a no self-harm contract.
A client is admitted to the hospital after experiencing a stroke or
cerebral vascular accident (CVA). The nurse should request a
referral speech therapy if the client exhibits which finding?
Correct Answers Persistent coughing while drinking.
A client is admitted to the intensive care unit with diabetes
insipidus due to a pituitary gland tumor. Which potential
complication should the nurse monitor closely? Correct
Answers Hypokalemia
A client is admitted with the diagnosis of Wernicke's syndrome.
What assessment finding should the nurse use in planning the
client's care? Correct Answers Confusion
,A client is being discharged home after being treated for heart
failure (HF). What instructions should the nurse include in this
client's discharge teaching plan? Correct Answers Weigh every
morning
A client is receiving continuous ambulatory peritoneal dialysis
since the arteriovenous (AV) graft in the right arm is no longer
available to use for hemodialysis. The client has lost weight, has
increasing peripheral edema, and has a serum albumin level of
1.5 g/dL (15g/L). Which intervention is the priority for the nurse
to implement? Correct Answers Ensure the client receives
frequent small meals containing complete proteins.
A client is receiving lactulose (Portalac) for signs of hepatic
encephalopathy. to evaluate the client's therapeutic response to
this medication, which assessment should the nurse obtain?
Correct Answers Level of consciousness (LOC)
A client is unable to void following a procedure, so the nurse
obtains a prescription to perform a straight catheterization. After
inserting the catheter, the nurse observes that the client has an
immense output of 500 mL of clear yellow urine. Which action
should the nurse implement next? Correct Answers Allow the
bladder to empty completely or up to 1,000 mL of urine.
A client morning assessment incudes bounding peripheral
pulses, weight gain of 2 pounds, pitting ankle edema, and moist
crackles bilaterally. Which intervention is most important for the
nurse to include in this client's plan of care? Correct Answers
Administer prescribed diuretic
, A client receives a prescription for norepinephrine 3 mcg/min
intravenously (IV). The IV bag contains norepinephrine 4mg in
dextrose 5% in water (DW) 1000 ml. How many mL/hr should
the nurse program the infusion pump? Correct Answers 45ml
A client who had a small bowel resection acquired methicillin-
resistant staphylococcus aureus (MRSA) while hospitalized. He
treated and released but is readmitted today because of diarrhea
and dehydration. It si important for the nurse to implement
which intervention? Correct Answers Maintain contact
transmission precautions
A client who is hypotensive is receiving dopamine, an
adrenergic agonist IV at eh rate of 8mcg/kg. Which intervention
should the nurse implement with assessing the medication?
Correct Answers Initiate seizure precaution.
A client who is newly diagnosed with type 2 diabetes mellitus
(DM) receives a prescription for metformin 500mg PO twice
daily. Which information should the nurse include in the client's
teaching plan? Correct Answers -Recognizing signs and
symptoms of hypoglycemia.
-Take metformin with the morning and evening meal
-Report persistent polyuria to the healthcare provider.
A client who weighs 176 pounds receives a prescription for
enoxaparin sodium 1.5 mg/kg/day subcutaneously. The
medication is available in 120 mg. How many ml should the
nurse administer? Correct Answers 8 mL
Complete Solutions
A 6 -week-old infant with pyloric stenosis is scheduled for a
pylonmyectomy. Which pre-operative nursing action has highest
priority? Correct Answers Initiate a continuous infusion of IV
fluids per prescription.
A child with heart failure (HF) is taking digitalis. Which signs
indicates to the nurse that the child may be experiencing digitalis
toxicity? Correct Answers Vomiting
A client is admitted to a mental health unit after attempting
suicide by taking a handful of medications. In developing a plan
of care for the client, which goal has the highest priority?
Correct Answers Signs a no self-harm contract.
A client is admitted to the hospital after experiencing a stroke or
cerebral vascular accident (CVA). The nurse should request a
referral speech therapy if the client exhibits which finding?
Correct Answers Persistent coughing while drinking.
A client is admitted to the intensive care unit with diabetes
insipidus due to a pituitary gland tumor. Which potential
complication should the nurse monitor closely? Correct
Answers Hypokalemia
A client is admitted with the diagnosis of Wernicke's syndrome.
What assessment finding should the nurse use in planning the
client's care? Correct Answers Confusion
,A client is being discharged home after being treated for heart
failure (HF). What instructions should the nurse include in this
client's discharge teaching plan? Correct Answers Weigh every
morning
A client is receiving continuous ambulatory peritoneal dialysis
since the arteriovenous (AV) graft in the right arm is no longer
available to use for hemodialysis. The client has lost weight, has
increasing peripheral edema, and has a serum albumin level of
1.5 g/dL (15g/L). Which intervention is the priority for the nurse
to implement? Correct Answers Ensure the client receives
frequent small meals containing complete proteins.
A client is receiving lactulose (Portalac) for signs of hepatic
encephalopathy. to evaluate the client's therapeutic response to
this medication, which assessment should the nurse obtain?
Correct Answers Level of consciousness (LOC)
A client is unable to void following a procedure, so the nurse
obtains a prescription to perform a straight catheterization. After
inserting the catheter, the nurse observes that the client has an
immense output of 500 mL of clear yellow urine. Which action
should the nurse implement next? Correct Answers Allow the
bladder to empty completely or up to 1,000 mL of urine.
A client morning assessment incudes bounding peripheral
pulses, weight gain of 2 pounds, pitting ankle edema, and moist
crackles bilaterally. Which intervention is most important for the
nurse to include in this client's plan of care? Correct Answers
Administer prescribed diuretic
, A client receives a prescription for norepinephrine 3 mcg/min
intravenously (IV). The IV bag contains norepinephrine 4mg in
dextrose 5% in water (DW) 1000 ml. How many mL/hr should
the nurse program the infusion pump? Correct Answers 45ml
A client who had a small bowel resection acquired methicillin-
resistant staphylococcus aureus (MRSA) while hospitalized. He
treated and released but is readmitted today because of diarrhea
and dehydration. It si important for the nurse to implement
which intervention? Correct Answers Maintain contact
transmission precautions
A client who is hypotensive is receiving dopamine, an
adrenergic agonist IV at eh rate of 8mcg/kg. Which intervention
should the nurse implement with assessing the medication?
Correct Answers Initiate seizure precaution.
A client who is newly diagnosed with type 2 diabetes mellitus
(DM) receives a prescription for metformin 500mg PO twice
daily. Which information should the nurse include in the client's
teaching plan? Correct Answers -Recognizing signs and
symptoms of hypoglycemia.
-Take metformin with the morning and evening meal
-Report persistent polyuria to the healthcare provider.
A client who weighs 176 pounds receives a prescription for
enoxaparin sodium 1.5 mg/kg/day subcutaneously. The
medication is available in 120 mg. How many ml should the
nurse administer? Correct Answers 8 mL
