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HESI 266 CONSOLIDATED QUESTIONS AND CORRECT ANSWERS

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HESI 266 CONSOLIDATED QUESTIONS AND CORRECT ANSWERS

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The nurse assesses a client with cirrhosis and finds 4+ pitting edema of the feet and
legs, and massive ascites. Which mechanism contributes to edema and ascites in
clients with cirrhosis?


A. Decreased portocaval pressure with greater collateral circulation.
B. Hyperaldosteronism causing an increased sodium reabsorption in renal tubules.
C. Decreased renin-angiotensin response related to an increase in renal blood flow.
D. Hypoalbuminemia that results in a decreased colloidal oncotic pressure.


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D. Hypoalbuminemia that results in a decreased colloidal oncotic pressure




A client with stage IV bone cancer is admitted to the hospital for pain control. The
client verbalizes continuous, severe pain of 8 on a 1 to 10 scale. Which intervention
should the nurse implement?
a. Give maximum dosage when score reaches 10

,b. Alternate IV and IM analgesic medications.
c. Educate client on signs and symptoms of narcotic dependency
d. Administer opioids and nonopioid medications simultaneously


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d. Administer opioids and nonopioid medications simultaneously


Pharmacologic guidelines for the treatment of pain at the end of life fall
into 3 broad categories of analgesic: opioids, nonopioid analgesics and the
adjuvant analgesics which comprise numerous agents in diverse classes.
With regard to opioid selection, studies show that pain can be treated
adequately even with advanced cancer pain at end of life with only 3%
patients experiencing severe pain and 52% experiencing no pain at all if
guidelines are followed. Acetaminophen was chosen for a nonopioid
analgesic. According to The World Health Organization analgesic ladder
for cancer pain suggests that the administration of acetaminophen or
nonsteroidal anti-inflammatory drugs (NSAIDs) may be additive to that of
opioids leading to the possibility of lessening the opioid dosage and
reducing the adverse effects.




While assessing a client with degenerative joint disease, the nurse observes
Heberden's nodes, large prominences on the client's fingers that are reddened. The
client reports that the nodes are painful. Which action should the nurse take?
A. Review the client's dietary intake of high-protein foods
B. Notify the healthcare provider of the finding immediately
C. Discuss approaches to the chronic pain control with the client
D. Assess the client's radial pulses and capillary refill time


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C. Discuss approaches to the chronic pain control with the client

, The nurse is caring for a client who reports a sudden, severe headache, and facial
numbness. The nurse asks the client to smile observes an uneven smile with facial
droop to the right side and a hand grasp strength that is weaker on the right than the
left. The client denies a recent history of headaches or trauma. Which intervention
should the nurse perform in the immediate management of the client?


- A Maintain elevated positioning of the dependent joints on affected side.
- B Verify prescribed laboratory tests include prothrombin time and platelet count.
- C Start two large bore IV catheters and review inclusion criteria for IV fibrinolytic
therapy.
- D Administer aspirin to prevent further clot formation and platelet clumping.


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C Start two large bore IV catheters and review inclusion criteria for IV
fibrinolytic therapy.

Thrombolytic treatment, also known as fibrinolytic therapy, dissolves
dangerous intravascular clots to prevent ischemic damage by improving
blood flow.




The nurse is caring for a client with human immunodeficiency virus (HIV) who has
developed oral thrush and is experiencing burning and soreness in the mouth. Which
intervention should the nurse implement first?


A. Cleanse the mouth with swabs
B. Encourage frequent mouth care
C. Obtain a soft diet for the client
D. Administer a topical analgesic


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