HESI 799 RN EXIT EXAM (605-708)-100 QUESTIONS FULLY SOLVED & UPDATED 2024

A client with acute pancreatitis is complaining of pain and nausea. Which interventions should the nurse implement (Select all that apply) a. Monitor heart, lung, and kidney function. b. Notify healthcare provider of serum amylase and lipase levels. c. Position client on abdomen to provide organ stability d. Encourage an increased intake of clear oral fluids e. Review client's abdominal ultrasound findings. a. Monitor heart, lung, and kidney function. b. Notify healthcare provider of serum amylase and lipase levels. e. Review client's abdominal ultrasound findings. A nurse is caring for a client with Diabetes Insipidus. Which assessment finding warrants immediate intervention by the nurse? a. Hypernatremia b. Excessive thirst c. Elevated heart rate d. Poor skin turgor a. Hypernatremia Brainpower Read More In caring for a client receiving the aminoglycoside antibiotic gentamicin, it is most important for the nurse to monitor which diagnostic test? a. Urinalysis b. Serum creatinine c. Serum osmolarity d. Liver enzymes. b. Serum creatinine A client who is at 36 weeks gestation is admitted with severe preeclampsia. After a 6 gram loading dose of magnesium sulfate is administered, an intravenous infusion of magnesium sulfate at a rate of 2 grams/hour is initiated. Which assessment finding warrants immediate intervention by the nurse? A. Urine output 20 ml/hour B. Blood pressure 138/88 C. Respiratory rate 18 breaths/min D. Temperature of 99.8 A. Urine output 20 ml/hour We have an expert-written solution to this problem! The nurse weighs a 6-month-old infant during a well-baby check-up and determines that the baby's weight has tripled compared to the birth weight of 7 pounds 8 ounces. The mother asks if the baby is gaining enough weight. What response should the nurse offer? a. Your baby is gaining weight right on schedule b. What food does your baby usually eat in a normal day? c. The baby is below the normal percentile for weight gain d. What was the baby's weight at the last well-baby clinic visit b. What food does your baby usually eat in a normal day? The nurse is preparing to discharge an older adult female client who is at risk for hyPOCALCEMIA nurse include with this client's discharge teaching? (SATA) a. Report any muscle twitching or seizures b. Take vitamin D with calcium daily c. Avoid seafood, particularly shellfish d. Low fat yogurt is a good source of calcium e. Keep a diet record to monitor calcium intake a. Report any muscle twitching or seizures b. Take vitamin D with calcium daily d. Low fat yogurt is a good source of calcium e. Keep a diet record to monitor calcium intake The husband of a client with advanced ovarian cancer wants his wife to have every treatment available. When the husband leaves, the client tells the nurse that she has had enough chemotherapy and wants to stop all treatments but knows her husband will sign the consent form for more treatment. The nurse's response should include which information? a. The husband cannot sign the consent for the client, her signature is required b. The client's specific wishes should be discussed with her healthcare provider c. Counseling should be sought to resolve the husband's desire to control his wife d. The healthcare team will formulate a plan of care to keep the client comfortable e. The client should seek a second medical opinion before deciding to stop treatment. a. The husband cannot sign the consent for the client, her signature is required b. The client's specific wishes should be discussed with her healthcare provider d. The healthcare team will formulate a plan of care to keep the client comfortable The nurse is preparing a 50 ml dose of 50% dextrose IV for a client with insulin SHOCK... medication? a. Dilute the Dextrose in one liter of 0.9% Normal Saline solution. b. Mix the dextrose in a 50 ml piggyback for a total volume of 100 ml. c. Push the undiluted Dextrose slowly through the currently infusion IV. d. Ask the pharmacist to add the Dextrose to a TPN solution. c. Push the undiluted Dextrose slowly through the currently infusion IV. The daughter of an older female client tells the clinic nurse that she is no longer able to care for her mother since her mother has lost the ability to perform activities of daily living (ADLs) due to aging. Which options should the nurse discuss with the daughter? a. Home hospice agency b. Long-term care facility c. Rehabilitation facility d. Independent senior apartment e. Home health agency b. Long-term care facility e. Home health agency A male client with cancer, who is receiving antineoplastic drugs, is admitted to the... what findings is most often manifest this condition? a. Ecchymosis and hematemesis b. Weight loss and alopecia c. Weakness and activity intolerance d. Sore throat and fever a. Ecchymosis and hematemesis A 7-year-old boy is brought to the clinic because of facial edema. He reports that he has been voiding small amounts of dark, cloudy, tea-colored urine. The parents state that their son had a sore throat 2 weeks earlier, but it has resolved. After assessing the child's vital signs and weight, what intervention should the nurse implement next? a. Perform an otoscopic examination b. Measure the child's abdominal girth c. Collect a urine specimen for routine urinalysis d. Obtain a blood specimen for serum electrolytes. c. Collect a urine specimen for routine urinalysis We have an expert-written solution to this problem! The nurse observes an adolescent client prepare to administer a prescribed corticosteroid medication using a metered dose inhaler as seen in the picture. What action should the nurse take? a. Remind the client to hold his breath after inhaling the medication b. Confirm that the client has correctly shaken the inhaler c. Affirm that the client has correctly positioned the inhaler d. Ask the client if he has a spacer to use for this medication a. Remind the client to hold his breath after inhaling the medication The nurse teaches an adolescent male client how to use a metered dose inhaler. Seen in the picture. What instruction should the nurse provide? a. Secure the mouthpiece under the tongue. b. Press down on the device after breathing in fully c. Move the device one to two inches away from the mouth d. Breathe out slowly and deeply while compressing the device c. Move the device one to two inches away from the mouth Rationale: Optimal position of a metered dose inhaler includes placing the inhaler one two inches away from the mouth. A 3-year-old boy with a congenital heart defect is brought to the clinic by his mother... During the assessment, the mother asks the nurse why her child is at the 5th percent...response is best for the nurse to provide? a. Does your child seem mentally slower than his peers also? b. "His smaller size is probably due to the heart disease" c. Haven't you been feeding him according to recommended daily allowances for children? d. You should not worry about the growth tables. They are only averages for children b. "His smaller size is probably due to the heart disease" A client with hypertension receives a prescription for enalapril, an angiotensin... instruction should the nurse include in the medication teaching plan? a. Increase intake of potassium-rich foods b. Report increased bruising of bleeding c. Stop medication if a cough develops d. Limit intake of leafy green vegetables b. Report increased bruising of bleeding When administering ceftriaxone sodium (Rocephin) intravenously to a client before... most immediate intervention by the nurse? a. Stridor b. Nausea c. Headache d. Pruritus a. Stridor The nurse is assessing a client with a small bowel obstruction who was hospitalized 24 hours ago. Which assessment finding should the nurse report immediately to the healthcare provider? a. Hypoactive bowel sounds in the lower quadrant. b. Rebound tenderness in the upper quadrants. c. Tympani with percussion of the abdomen. d. Light colors gastric aspirate via the nasogastric tube. b. Rebound tenderness in the upper quadrants An adult female client is admitted to the psychiatric unit because of a complex handwashing ritual she performs daily that takes two hours or longer to complete. She worries about staying clean and refuses to sit on any of the chairs in the day area. This client's handwashing is an example of which clinical behavior? a. Addiction b. Phobia c. Compulsion d. Obsession c. Compulsion Following routine diagnostic test, a client who is symptom-free is diagnosed with Paget's disease. Client teaching should be directed toward what important goal for this client? a. Maintain adequate cardiac output b. Promote adequate tissue perfusion c. Promote rest and sleep d. Reduce the risk for injury d. Reduce the risk for injury The mother of a one-month-old boy born at home brings the infant to his first well...was born two weeks after his due date, and that he is a "good, quiet baby" who almost... hypothyroidism, what question is most important for the nurse to ask the mother? a. Has your son had any immunizations yet? b. Is your son sleepy and difficult to feed? c. Are you breastfeeding or bottle feeding your son? d. Were any relatives born with birth defects? b. Is your son sleepy and difficult to feed? In preparing assignments for the shift, which client is best for the charge nurse to assign to a practical nurse (PN)? a. An older client who fell yesterday and is now complaining of diplopia b. An adult newly diagnosed with type 1 diabetes and high cholesterol c. A client with pancreatic cancer who is experience intractable pain. d. An older client post-stroke who is aphasic with right-sided hemiplegia a. An older client who fell yesterday and is now complaining of diplopia Following a gun shot wound to the abdomen, a young adult male had an emergency bowel...Multiple blood products while in the operating room. His current blood pressure is 78/52...He is being mechanically ventilated, and his oxygen saturation is 87%. His laboratory values...Grams / dl (70 mmol / L SI), platelets 20,000 / mm 3 (20 x 10 9 / L (SI units), and white blood cells. Based on these assessments findings, which intervention, should the nurse implements first? a. Transfuse packed red blood cells b. Obtain blood and sputum cultures. c. Infuse 1000 ml normal saline d. Titrate oxygen to keep o2 saturation 90% b. Obtain blood and sputum cultures. After checking the fingerstick glucose at 1630, what action should the nurse implement? a. Notify the healthcare provider b. Administer 8 units of insulin aspart SubQ c. Gives an IV bolus of Dextrose 50% 50 ml d. Perform quality control on the glucometer. b. Administer 8 units of insulin aspart SubQ Progressive kyphoscoliosis leading to respiratory distress is evident in a client with muscul...Which finding warrants immediate intervention by the nurse? a. Extremity muscle weakness b. Bilateral eyelid drooping c. Inability to swallow pills d. Evidence of hypoventilation d. Evidence of hypoventilation An adult male who lives alone is brought to the Emergency Department by his daughter who is unresponsive. Initial assessment indicated that the client has minimal respiratory effort, and his pupils are fixed and dilated. At the daughter's request, the client is intubated and... Which nursing intervention has the highest priority? a. Offer to notify the client's minister of his condition. b. Determine if the client has an executed living will c. Provide the family with information about palliative care d. Explore the possibility of organ donation with the family. b. Determine if the client has an executed living will The nurse determines that a client's pupils constricts as they change focus from a far object. What documentation should the nurse enter about this finding? a. Pupils reactive to accommodation b. Nystagmus present with pupillary focus. c. Peripheral vision intact d. Consensual pupillary constriction present a. Pupils reactive to accommodation Which nursing intervention has the highest priority for a multigravida who delivered? a. Maintain cold packs to the perineum for 24 hrs. b. Assess the client pain level frequently c. Observe for appropriate interaction with the infants. d. Assess fundal tone and lochia flow b. Assess the client pain level frequently We have an expert-written solution to this problem! A client who had a gestational trophoblastic disease (GTD) evacuated 2 days ago is being...18 months-old child and lives in a rural area. Her husband takes the family car to work daily...transportation during the day. What intervention is most important for the nurse to implement? a. Teach a client amount the use of a home pregnancy test. b. Schedule a weekly home visit to draw hCG values. c. Make a 5 week follow- up with healthcare provider d. Begin chemotherapy administration during the first home visit b. Schedule a weekly home visit to draw hCG values. A newly graduated female staff nurse approaches the nurse manager and request reassignment to another client because a male client is asking her for a date and making suggestive comments. Which response is best for the nurse manager to provide? a. I have to call the supervisor to get someone else to transfer to this unit to care for him. b. I know you are good nurse and can handle this client in a professional manner. c. I'll talked to the client about his sexual harassment and I'll insist that he stop it immediately. d. I'll change your assignment, but let's talk about how a nurse should respond to this kind of client. d. I'll change your assignment, but let's talk about how a nurse should respond to this kind of client. After removing a left femoral arterial sheath, which assessment findings warrant immediate interventions by the nurse? (Select all that applied.) a. Tenderness over insertion b. Unrelieved back and flank pain. c. Cool and pale left leg and foot. d. Left groin egg-size hematoma. e. Quarter size red drainage at site. b. Unrelieved back and flank pain. c. Cool and pale left leg and foot. d. Left groin egg-size hematoma. Which instruction is most important for the nurse to provide a client who receives a new plan of care to treat osteoporosis? a. Begin a weight-bearing exercise plan b. Increase intake of foods rich in calcium c. Schedule a bone density tests every year. d. Remain upright after taking the medication. d. Remain upright after taking the medication. A newly hired home health care nurse is planning the initial visit to an adult client who has had multiple sclerosis (MS) for the past 20 years and is currently bed-bound and is lifted by a hoist. An unlicensed caregiver provides care 8 hours/ daily, 5 days/week. During the initial visit to this client, which intervention is most important to the nurse to implement? a. Determine how the client is cared for when caregiver is not present. b. Develop a client needs assessment and review with the caregiver c. Evaluate the caregiver's ability to care for the client's needs. d. Review with the care giver the interventions provided each day. a. Determine how the client is cared for when caregiver is not present. A client with urticaria due to an environmental allergies is taking diphenhydramine... Which complaint should the nurse identify to the client as a side effect of the OTC medication? a. Nausea and indigestion. b. Hyper salivation c. Eyelid and facial twitching d. Increased appetite a. Nausea and indigestion. In caring for a client with a PCA infusion of morphine sulfate through the right cephalic vein, The nurse assesses that the client is lethargic with a blood pressure of 90/60, pulse rate of 118 beats per minute, and respiratory rate of 8 breaths per minutes. What assessment should the nurse perform next? a. Note the appearance and patency of the client's peripheral IV site. b. Palpate the volume of the client's right radial pulse c. Auscultate the client's breath sounds bilaterally. d. Observe the amount and dose of morphine in the PCA pump syringe. d. Observe the amount and dose of morphine in the PCA pump syringe A male client is having abdominal pain after a left femoral angioplasty and stent, and is asking for additional pain medication for right lower quadrant pain (9/10), two hours ago, he received hydrocodone / acetaminophen 7.5/7.50 mg his vital signs are elevated from reading of a previous hour: temperature 97.8 F, heart rate 102 beats / minute, respiration 20 breaths/minutes. His abdomen is swollen, the groin access site is tender, peripheral pulses are present, but left is greater than right. Preoperatively, clopidrogel was prescribed for a history of previous peripheral stents. Another nurse is holding manual pressure on the femoral arterial access site which may be leaking into the abdomen. What data is needed to make this report complete? a. Client's lungs are clear bilaterally and oxygen saturation is 97% b. Surgeon needs to see client immediately to evaluate the situation c. Left peripheral pulses were present only by Doppler pre-procedure d. Client' history includes multiple back surgeries and chronic pain. b. Surgeon needs to see client immediately to evaluate the situation Which instruction is most important for the nurse to provide a client who is being discharge following treatment for Guillain-Barre syndrome? a. Avoid exposure to respiratory infections. b. Use relaxation exercise when anxious c. Continue physical therapy at home d. Plan short, frequent rest periods. a. Avoid exposure to respiratory infection