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HESI PN EXIT
EXAM
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HESI PN EXIT EXAM
1.Which information is most concerning to the nurse when caring for an older
client with bilateral cataracts?
A. States having difficulty with color perception
B. Presents with opacity of the lens upon assessment
C. Complains of seeing a cobweb-type structure
in the visual field
D. Reports the need to use a magnifying glass to
see small print Rationale:
Visualization of a cobweb- or hairnet-type structure is a sign of a retinal
detachment, which constitutes a medical emergency. Clients with cataracts are
at increased risk for retinal detachment. Distorted color perception, opacity of
the lens, and gradual vision loss are expected signs and symptom of cataracts
but do not need immediate attention.
2.When caring for a client hospitalized with Guillain-Barré syndrome, which
information is most important for the nurse to report to the primary health
care provider?
A. Ascending numbness from the feet to the knees
B. Decrease in cognitive status of the client
C. Blurred vision and sensation changes
D. Persistent unilateral headache Rationale:
A decline in cognitive status in a client is indicative of symptoms of hypoxia and
a possible need to assist the client with mechanical ventilation. A primary
health care provider will need to be contacted immediately. Options A, C, and
D are findings associated with Guillain-Barré syndrome that should also be
reported but are not as critical as the client's hypoxic status.
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HESI PN EXIT
EXAM
Downloaded by: Ariah |
Distribution of this document is illegal
, Stuvia.com - The Marketplace to Buy and Sell your Study Material
HESI PN EXIT EXAM
1.Which information is most concerning to the nurse when caring for an older
client with bilateral cataracts?
A. States having difficulty with color perception
B. Presents with opacity of the lens upon assessment
C. Complains of seeing a cobweb-type structure
in the visual field
D. Reports the need to use a magnifying glass to
see small print Rationale:
Visualization of a cobweb- or hairnet-type structure is a sign of a retinal
detachment, which constitutes a medical emergency. Clients with cataracts are
at increased risk for retinal detachment. Distorted color perception, opacity of
the lens, and gradual vision loss are expected signs and symptom of cataracts
but do not need immediate attention.
2.When caring for a client hospitalized with Guillain-Barré syndrome, which
information is most important for the nurse to report to the primary health
care provider?
A. Ascending numbness from the feet to the knees
B. Decrease in cognitive status of the client
C. Blurred vision and sensation changes
D. Persistent unilateral headache Rationale:
A decline in cognitive status in a client is indicative of symptoms of hypoxia and
a possible need to assist the client with mechanical ventilation. A primary
health care provider will need to be contacted immediately. Options A, C, and
D are findings associated with Guillain-Barré syndrome that should also be
reported but are not as critical as the client's hypoxic status.
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