Adult Health 2 HESI
A patron arrives to the scientific surgical unit four hours after a transurethral resection of the
prostate. A triple-lumen catheter for continuous bladder irrigation with normal saline is infusing
and the nurse observes dark, pink- tinged outflow with blood clots inside the tubing and
collection bag. Which motion should the nurse take?
A. Monitoring catheter drainage
b. Reducing the flow charge
c. Irrigating the catheter manually
d. Discontinuing infusing solution - ANS-a. Monitoring catheter drainage
A customer hospitalized with heart failure (HF). Which intervention need to the nurse implement
to enhance air flow and reduce venous return?
A. Perform passive range of movement sporting events
b. Place the customer in excessive fowler role
c. Administer oxygen per nasal canula
d. Increase the client's interest degree - ANS-b. Place the customer in high fowler function
A consumer in the working room obtained succinylcholine. The customer is experiencing muscle
pressure and has an extremely high temperature. Which motion should the nurse put in force?
A. Hold a prescription for dantrolene until fever is decreased
b. Put together ice packs for placement inside the consumer's axillary area
c. Call the PACU nurse to put together for prolonged ventilatory guide
d. Determine if prescribed antibiotics have been administered preoperative - ANS-b. Put
together ice packs for placement inside the purchaser's axillary region
A patron receives a prescription for 1 liter of lactated ringer's intravenously to be infused over 6
hours. How many mL/hr should the nurse application the infusion pump to deliver? - ANS-167
A patron receives prescriptions for a multi drug regimen for the treatment of tuberculosis. Which
information should the nurse prioritize?
A. Adherence to the regimen is vital
b. Medicinal drugs should be interested by meals
c. Serum liver panels are accrued frequently
d. More desirable sun protection measures will be wanted - ANS-a. Adherence to the routine is
vital
A patron tells the medical institution nurse about experiencing burning on urination, and
evaluation famous that the consumer had sexual sex four days in the past with someone who
became casually met. Which movement should the nurse put into effect?
A. Observe perineal place fora. Chancroid-like lesion
, b. Obtain a specimen of urethral drainage for subculture
c. Assess for perineal itching, erythema, and excoriation
d. Identify all sexual companions within the final four days. - ANS-b. Obtain a specimen of
urethral drainage for way of life
A patron who had a C-5 spinal cord harm 2 years ago is admitted to the emergency branch with
the prognosis of autonomic dysreflexia secondary to a full bladder. Which assessment finding
have to the nurse count on this patron to show off?
A. Complaints of chest pain and shortness of breath
b. Hypotension and venous pooling within the extremities
c. Profuse diaphoresis and intense, pounding headache
d. Pain and burning sensation upon urination and hematuria - ANS-d. Pain and burning
sensation upon urination and hematuria
A customer who turned into worried in a motor vehicle collision is admitted with a fractured left
femur that is immobilized the use of a fracture traction splint in preparation for an open reduction
internal fixation (ORIF). The nurse determines that the consumer's distal pulses are faded inside
the left foot. Which interventions must the nurse put in force? (choose all)
a. Verify pedal pulses the use of a doppler pulse tool
b. Evaluate the utility of the splint to the left leg.
C. Offer ice chips and oral clear beverages.
D. Monitor left leg for ache, pallor, paresthesia, paralysis, strain
three. Administer oral antispasmodics and narcotic analgesics - ANS-a. Verify pedal pulses the
usage of a doppler pulse tool
b. Evaluate the utility of the splint to the left leg
d. Monitor left leg for pain, pallor, paresthesia, paralysis, stress
A patron with a history of asthma and bronchitis arrives a the health facility with shortness of
breath, productive cough with thickened, tenacious mucous, and the incapacity to stroll up a
flight of stairs without experiencing breathlessness. Which is most essential for the nurses to
train the patron approximately self-care?
A. Call the sanatorium if undesirable aspect effects of medicines occur
b. Avoid crowded enclosed areas to reduce pathogen exposure
c. Increase the each day intake of oral fluids to liquefy secretions
d. Teach tension discount methods for emotions of suffocation - ANS-c. Increase the each day
consumption of oral fluids to liquefy secretions
A client with a history of peptic ulcer disorder is admitted after vomiting shiny pink blood several
times over the course of 2 hours. In reviewing the laboratory consequences, the nurse reveals
the client's hemoglobin is 12 and the hematocrit is 35%. Which motion ought to the nurse put
together to take?
A. Continue to screen for blood loss
b. Administer 1,000 mL (1L) normal saline
c. Transfuse 2 devices of platelets
A patron arrives to the scientific surgical unit four hours after a transurethral resection of the
prostate. A triple-lumen catheter for continuous bladder irrigation with normal saline is infusing
and the nurse observes dark, pink- tinged outflow with blood clots inside the tubing and
collection bag. Which motion should the nurse take?
A. Monitoring catheter drainage
b. Reducing the flow charge
c. Irrigating the catheter manually
d. Discontinuing infusing solution - ANS-a. Monitoring catheter drainage
A customer hospitalized with heart failure (HF). Which intervention need to the nurse implement
to enhance air flow and reduce venous return?
A. Perform passive range of movement sporting events
b. Place the customer in excessive fowler role
c. Administer oxygen per nasal canula
d. Increase the client's interest degree - ANS-b. Place the customer in high fowler function
A consumer in the working room obtained succinylcholine. The customer is experiencing muscle
pressure and has an extremely high temperature. Which motion should the nurse put in force?
A. Hold a prescription for dantrolene until fever is decreased
b. Put together ice packs for placement inside the consumer's axillary area
c. Call the PACU nurse to put together for prolonged ventilatory guide
d. Determine if prescribed antibiotics have been administered preoperative - ANS-b. Put
together ice packs for placement inside the purchaser's axillary region
A patron receives a prescription for 1 liter of lactated ringer's intravenously to be infused over 6
hours. How many mL/hr should the nurse application the infusion pump to deliver? - ANS-167
A patron receives prescriptions for a multi drug regimen for the treatment of tuberculosis. Which
information should the nurse prioritize?
A. Adherence to the regimen is vital
b. Medicinal drugs should be interested by meals
c. Serum liver panels are accrued frequently
d. More desirable sun protection measures will be wanted - ANS-a. Adherence to the routine is
vital
A patron tells the medical institution nurse about experiencing burning on urination, and
evaluation famous that the consumer had sexual sex four days in the past with someone who
became casually met. Which movement should the nurse put into effect?
A. Observe perineal place fora. Chancroid-like lesion
, b. Obtain a specimen of urethral drainage for subculture
c. Assess for perineal itching, erythema, and excoriation
d. Identify all sexual companions within the final four days. - ANS-b. Obtain a specimen of
urethral drainage for way of life
A patron who had a C-5 spinal cord harm 2 years ago is admitted to the emergency branch with
the prognosis of autonomic dysreflexia secondary to a full bladder. Which assessment finding
have to the nurse count on this patron to show off?
A. Complaints of chest pain and shortness of breath
b. Hypotension and venous pooling within the extremities
c. Profuse diaphoresis and intense, pounding headache
d. Pain and burning sensation upon urination and hematuria - ANS-d. Pain and burning
sensation upon urination and hematuria
A customer who turned into worried in a motor vehicle collision is admitted with a fractured left
femur that is immobilized the use of a fracture traction splint in preparation for an open reduction
internal fixation (ORIF). The nurse determines that the consumer's distal pulses are faded inside
the left foot. Which interventions must the nurse put in force? (choose all)
a. Verify pedal pulses the use of a doppler pulse tool
b. Evaluate the utility of the splint to the left leg.
C. Offer ice chips and oral clear beverages.
D. Monitor left leg for ache, pallor, paresthesia, paralysis, strain
three. Administer oral antispasmodics and narcotic analgesics - ANS-a. Verify pedal pulses the
usage of a doppler pulse tool
b. Evaluate the utility of the splint to the left leg
d. Monitor left leg for pain, pallor, paresthesia, paralysis, stress
A patron with a history of asthma and bronchitis arrives a the health facility with shortness of
breath, productive cough with thickened, tenacious mucous, and the incapacity to stroll up a
flight of stairs without experiencing breathlessness. Which is most essential for the nurses to
train the patron approximately self-care?
A. Call the sanatorium if undesirable aspect effects of medicines occur
b. Avoid crowded enclosed areas to reduce pathogen exposure
c. Increase the each day intake of oral fluids to liquefy secretions
d. Teach tension discount methods for emotions of suffocation - ANS-c. Increase the each day
consumption of oral fluids to liquefy secretions
A client with a history of peptic ulcer disorder is admitted after vomiting shiny pink blood several
times over the course of 2 hours. In reviewing the laboratory consequences, the nurse reveals
the client's hemoglobin is 12 and the hematocrit is 35%. Which motion ought to the nurse put
together to take?
A. Continue to screen for blood loss
b. Administer 1,000 mL (1L) normal saline
c. Transfuse 2 devices of platelets
