HESI 2 - practical of hesi questions with solutions Rn Capstone Course (Chamberlain University)

HESI 2 - practical of hesi questions with solutions Rn Capstone Course (Chamberlain University) Practice Test Assessment Performance Correct Which client is at highest risk for chronic kidney disease (CKD) secondary to diabetes mellitus (DM)? Type 1 DM and a serum hemoglobin-A1c of 3.5%. Type 1 DM and retinopathy and mild vision loss. Type 2 DM and hypertension controlled by metoprolol. Type 2 DM and a history of morbid obesity for 5 years. Rationale Diabetic retinopathy and nephropathy are related to prolonged hyperglycemia and hypertension which damage the microvasculature of the eyes and kidneys, so a client with Type 1 DM and retinopathy is most likely to develop nephropathy and CKD. The client with hemoglobin A1C of 3.5% is demonstrating compliance with therapy (H-A1c target level is no greater than 7%), which indicates tight glucose control and reduces the risk for microvascular complications. The client with controlled hypertension is less likely to develop CKD, although metoprolol, a beta adrenergic receptor antagonist, can mask the signs of hypoglycemia. A client with Type 2 DM is more likely at risk for complications associated with chronic obesity. Which clinical finding should the nurse identify in a client who is admitted with cardiac cirrhosis? Jaundice. Vomiting. Peripheral edema. Left upper quadrant pain. Rationale Four types of cirrhosis include alcoholic, post-necrotic, biliary, and cardiac cirrhosis, which are associated with severe right-sided heart failure (HF), so peripheral edema is most consistent with right-sided HF. Although jaundice and vomiting can occur in all types of cirrhosis, the most defining characteristic of cardiac cirrhosis is related to HF. Hepatic engorgement can occur in a client with HF or cirrhosis and cause right upper quadrant pain, not left sided quadrant pain.