EXIT HESI COMPREHENSIVE B EVOLVE
COMPREHENSIVE REVIEW PAPER WITH
SOLVED QUESTIONS
◉ A client who is recuperating from a spinal cord injury at the T4
level wants to use a wheelchair. What should the nurse teach the
client to do in preparation for this activity?
1
Push-ups to strengthen arm muscles
2
Leg lifts to prevent hip contractures
3
Balancing exercises to promote equilibrium
4
Quadriceps-setting exercises to maintain muscle tone
Answer: 1 -Arm strength is necessary for transfers and activities
of daily living and for use of crutches or a wheelchair, so the nurse
should teach the client how to do wheelchair push-ups safely.
Equilibrium is not a problem. The client does not have neurologic
control of the other activities.
◉ A nurse administers leucovorin calcium to a client before the
prescribed methotrexate. The client asks the reason for this. What
effect of leucovorin calcium should the nurse consider when
formulating a response?
,1
Supplies levels of folic acid required by blood-forming organs
2
Potentiates metabolite required for destruction of cancer cells
3
Acts synergistically with antineoplastic drugs to destroy cancer
cells
4
Increases production of phagocytes to help remove debris from
destroyed cancer cells
Answer: 1- Methotrexate is a folic acid antagonist that can depress
the bone marrow; this serious toxic effect sometimes is prevented
by administration of folic acid. Some healthcare providers
advocate its administration after a course of methotrexate therapy
to avoid interfering with methotrexate activity.
◉ The nurse is providing discharge teaching to the parents of a 3-
day-old infant. The mother expresses concern regarding sudden
infant death syndrome (SIDS). To reduce the risk of SIDS during
sleep, how does the nurse instruct the parents to position the
infant?
1
Prone
2
Supine
3
, Side-lying
4
Next to an adult in bed for closer monitoring
Answer: Supine - 2 - provides for maximal air movement
◉ A client will be discharged with a peripherally inserted central
venous catheter (PICC) for administration of peripheral
parenteral nutrition (PPN). What would be appropriate for the
nurse to include in the client's discharge teaching?
1
Learning how to change the percutaneous catheter
2
Determining which days to self-administer the PPN solution
3
Arranging for professional help to monitor the alternative
nutrition
4
Scheduling administration of the PPN solution around mealtimes
Answer: 3- Professional assistance will ensure correct
administration, which may limit complications such as
intravascular overload and sepsis; eventually, the client may self-
administer the PPN with supervision. Learning how to change the
percutaneous catheter usually is done by an appropriate health
care provider. PPN usually is administered every day. The PPN
solution usually is administered as an intermittent infusion while
the client is sleeping at night, not at mealtimes; this allows for
independent movement during the day.
COMPREHENSIVE REVIEW PAPER WITH
SOLVED QUESTIONS
◉ A client who is recuperating from a spinal cord injury at the T4
level wants to use a wheelchair. What should the nurse teach the
client to do in preparation for this activity?
1
Push-ups to strengthen arm muscles
2
Leg lifts to prevent hip contractures
3
Balancing exercises to promote equilibrium
4
Quadriceps-setting exercises to maintain muscle tone
Answer: 1 -Arm strength is necessary for transfers and activities
of daily living and for use of crutches or a wheelchair, so the nurse
should teach the client how to do wheelchair push-ups safely.
Equilibrium is not a problem. The client does not have neurologic
control of the other activities.
◉ A nurse administers leucovorin calcium to a client before the
prescribed methotrexate. The client asks the reason for this. What
effect of leucovorin calcium should the nurse consider when
formulating a response?
,1
Supplies levels of folic acid required by blood-forming organs
2
Potentiates metabolite required for destruction of cancer cells
3
Acts synergistically with antineoplastic drugs to destroy cancer
cells
4
Increases production of phagocytes to help remove debris from
destroyed cancer cells
Answer: 1- Methotrexate is a folic acid antagonist that can depress
the bone marrow; this serious toxic effect sometimes is prevented
by administration of folic acid. Some healthcare providers
advocate its administration after a course of methotrexate therapy
to avoid interfering with methotrexate activity.
◉ The nurse is providing discharge teaching to the parents of a 3-
day-old infant. The mother expresses concern regarding sudden
infant death syndrome (SIDS). To reduce the risk of SIDS during
sleep, how does the nurse instruct the parents to position the
infant?
1
Prone
2
Supine
3
, Side-lying
4
Next to an adult in bed for closer monitoring
Answer: Supine - 2 - provides for maximal air movement
◉ A client will be discharged with a peripherally inserted central
venous catheter (PICC) for administration of peripheral
parenteral nutrition (PPN). What would be appropriate for the
nurse to include in the client's discharge teaching?
1
Learning how to change the percutaneous catheter
2
Determining which days to self-administer the PPN solution
3
Arranging for professional help to monitor the alternative
nutrition
4
Scheduling administration of the PPN solution around mealtimes
Answer: 3- Professional assistance will ensure correct
administration, which may limit complications such as
intravascular overload and sepsis; eventually, the client may self-
administer the PPN with supervision. Learning how to change the
percutaneous catheter usually is done by an appropriate health
care provider. PPN usually is administered every day. The PPN
solution usually is administered as an intermittent infusion while
the client is sleeping at night, not at mealtimes; this allows for
independent movement during the day.
