HESI Adult Health Practice Exam: Questions & Answers: With Rationales

A client with rheumatoid arthritis is prescribed piroxicam (Feldene), a nonsteroidal anti-inflammatory drug (NSAID). Which effect is characteristic of (NSAIDs) used for treating rheumatoid arthritis? A. Production of replacement cartilage is stimulated. B. Further destruction of the articular cartilage is prevented. C. Inflammation is reduced by inhibiting prostaglandin synthesis. D. Bradykinin is inhibited, thereby reducing acute and chronic pain. (Ans- C. Inflammation is reduced by inhibiting prostaglandin synthesis. Rationale Nonsteroidal anti-inflammatory drugs (NSAIDs), used for treating rheumatoid arthritis, by inhibiting the synthesis of prostaglandins and providing relief from the associated pain. When planning care for a client with right renal calculi, which nursing diagnosis has the highest priority? A. Acute pain related to movement of the stone. B. Impaired urinary elimination related to obstructed flow of urine. C. Risk for infection related to urinary stasis. D. Deficient knowledge related to need for prevention of recurrence of calculi. (Ans- A. Acute pain related to movement of the stone. Rationale The nursing diagnosis of the highest priority is "Acute pain related the renal calculi's movement". The nurse is caring for a client who is admitted with a hemorrhagic stroke. Which nursing action should be included in the plan of care? A. Perform active range of motion three times daily B. Monitor for Battle's sign every four hours C. Teach measures to avoid the Valsalva maneuver D. Maintain the head of bed in a flat position (Ans- C. Teach measures to avoid the Valsalva maneuver Rationale The Valsalva maneuver, straining with bowel movements while holding one's breath, increases intracerebral pressure (ICP) which may induce bleeding or rupture of cerebral blood vessels. Which preexisting diagnosis places a client at greatest risk of developing superior vena cava syndrome? A. Carotid stenosis. B. Steatosis hepatitis. C. Metastatic cancer. D. Clavicular fracture. (Ans- C. Metastatic cancer. Rationale Superior vena cava syndrome occurs when the superior vena cava (SVC) is compressed by outside structures, such as a growing tumor that impedes the return blood flow to the heart. Superior vena cava syndrome is likely to occur with metastatic cancer from a primary tumor in the upper lobe of the right lung that compresses the superior vena cava. What assessment finding should the nurse identify that indicates a client with an acute asthma exacerbation is beginning to improve after treatment? A. Wheezing becomes louder. B. Cough remains unproductive. C. Vesicular breath sounds decrease. D. Bronchodilators stimulate coughing. (Ans- A. Wheezing becomes louder. Rationale In an acute asthma attack, air flow may be so significantly restricted that breath sounds and wheezing is diminished. If the client is successfully responding to bronchodilators and respiratory treatments, wheezing should become louder as the air flow increases in the airways. As the airways open and mucous is mobilized in response to treatment, the cough should become more productive. Vesicular breath sounds are soft, low-pitched sounds heard throughout the lungs. These are normal. The nurse is providing postoperative instructions for a female client after a mastectomy. Which information should the nurse include in the teaching plan? (Select all that apply.) Select all that apply A. Empty surgical drains once a week using procedure gloves. B. Report inflammation of the incision site or the affected arm. C. Wear clothing with snug sleeves over the arm on the operative side. D. Avoid lifting more than 4.5 kg (10 lb) or reaching above her head. (Ans- B. Report inflammation of the incision site or the affected arm. D. Avoid lifting more than 4.5 kg (10 lb) or reaching above her head.