Practice HESI Exam for Adult Health with 100% correct answers(verified for accuracy)

The healthcare provider prescribes aluminum and magnesium hydroxide (Maalox), 1 tablet PO PRN, for a client with chronic kidney disease (CKD) who is complaining of indigestion. What intervention should the nurse implement? a. Administer 30 minutes before eating. b. Evaluate the effectiveness 1 hour after administration. c. Instruct the client to swallow the tablet whole. d. Question the healthcare provider's prescription. d. Question the healthcare provider's prescription. Rationale Magnesium agents are not usually used for clients with CKD due to the risk of hypermagnesemia, so this prescription should be questioned by the nurse. In assessing a client diagnosed with primary hyperaldosteronism, the nurse expects the laboratory test results to indicate a decreased serum level of which substance? Sodium. Antidiuretic hormone. Potassium. Glucose. Potassium Rationale Clients with primary hyperaldosteronism exhibit a profound decline in the serum levels of potassium (hypokalemia). Hypertension, along with the hypokalemia are the most prominent and universal signs for this condition. If both of these findings are present, there is 50% likelihood the client to be diagnosed with hyperaldosteronism. Previous Play Next Rewind 10 seconds Move forward 10 seconds Unmute 0:00 / 0:15 Full screen Brainpower Read More A client with gastroesophageal reflux disease (GERD) has been experiencing severe reflux during sleep. Which recommendation by the nurse is most effective to assist the client? Losing weight. Decreasing caffeine intake. Avoiding large meals. Raising the head of the bed on blocks. Raising the head of the bed on blocks. Rationale Raising the head of the bed on blocks (reverse Trendelenburg position) to reduce reflux and subsequent aspiration is the most non-pharmacological effective recommendation for a client experiencing severe gastroesophageal reflux during sleep. A client with diabetes mellitus is experiencing polyphagia. Which outcome statement is the priority for this client? Fluid and electrolyte balance. Prevention of water toxicity. Reduced glucose in the urine. Adequate cellular nourishment. Adequate cellular nourishment. Rationale Diabetes mellitus Type 1 is characterized by hyperglycemia that precipitates glucosuria and polyuria (frequent urination), polydipsia (excessive thirst), and polyphagia (excessive hunger). Polyphagia is a consequence of cellular malnourishment when insulin deficiency prevents utilization of glucose into the cell for energy, so the outcome statement should include stabilization of adequate cellular nutrition which is done by providing the insulin supplement the client needs. An elderly client is admitted with a diagnosis of bacterial pneumonia. The nurse's assessment of the client will most likely reveal which sign/symptom? Leukocytosis and febrile. Polycythemia and crackles. Pharyngitis and sputum production. Confusion and tachycardia. Confusion and tachycardia. Rationale The onset of pneumonia in the elderly may be signaled by general deterioration, confusion, increased heart rate or increased respiratory rate due to the decreased oxygen- carbon dioxide exchange at the alveoli, known as the V-Q mismatch. A client with a 16-year history of diabetes mellitus is having renal function tests because of recent fatigue, weakness, elevated blood urea nitrogen, and serum creatinine levels. Which finding should the nurse conclude as an early symptom of renal insufficiency? Dyspnea. Nocturia. Confusion. Stomatitis. Nocturia Rationale As the glomerular filtration rate decreases in early renal insufficiency, metabolic waste products, including urea, creatinine, and other substances, such phenols, hormones, electrolytes, accumulate in the blood. In the early stage of renal insufficiency, polyuria results from the inability of the kidneys to concentrate urine and contribute to nocturia. When teaching diaphragmatic breathing to a client with chronic obstructive pulmonary disease (COPD), which information should the nurse provide? Place a small book or magazine on the abdomen and make it rise while inhaling deeply. Purse the lips while inhaling as deeply as possible and then exhale through the nose. Wrap a towel around the abdomen and push against the towel while forcefully exhaling. Place one hand on the chest, one hand the abdomen and make both hands move outward. Place a small book or magazine on the abdomen and make it rise while inhaling deeply. Rationale Diaphragmatic or abdominal breathing uses the diaphragm instead of accessory muscles to achieve maximum inhalation and to slow the respiratory rate. The client should protrude the abdomen on inhalation and contract it with exhalation, so placing a book or magazine, helps the client visualize the rise and fall of the abdomen. While working in the emergency room, the nurse is exposed to a client with active tuberculosis. When should the nurse plan to obtain a tuberculin skin test? Immediately after the exposure. Within one week of the exposure. Four to six weeks after the exposure. Three months after the exposure. Four to six weeks after the exposure Rationale A tuberculin skin test is effective 4 to 6 weeks after an exposure, so the individual with a known exposure should wait 4 to 6 weeks before having a tuberculin skin test. During assessment of a client with amyotrophic lateral sclerosis (ALS), which finding should the nurse identify when planning care for this client? Muscle weakness. Urinary frequency. Abnormal involuntary movements. A decline in cognitive function. Muscle weakness Rationale Amyotrophic lateral sclerosis (ALS) is characterized by a degeneration of motor neurons in the brainstem and spinal cord and are manifested by muscle weakness and wasting. The nurse assesses a client with advanced cirrhosis of the liver for signs of hepatic encephalopathy. Which finding would the nurse consider an indication of progressive hepatic encephalopathy? An increase in abdominal girth. Hypertension and a bounding pulse. Decreased bowel sounds. Difficulty in handwriting. Difficulty in handwriting Rationale A daily record in handwriting may provide evidence of progression or reversal of hepatic encephalopathy leading to coma (D). (A) is a sign of ascites. (B) are not seen with hepatic encephalopathy. (C) does not indicate an increase in serum ammonia level which is the primary cause of hepatic encephalopathy. Which intervention should the nurse plan to implement when caring for a client who has just undergone a right above-the-knee amputation? Maintain the residual limb on three pillows at all times. Place a large tourniquet at the client's bedside. Apply constant, direct pressure to the residual limb. Do not allow the client to lie in the prone position. Place a large tourniquet at the client's bedside Rationale A large tourniquet should be placed in plain sight at the client's bedside, in the event severe bleeding occurs. The purpose is to have the tourniquet available to applied to the residual limb to control bleeding if hemorrhaging was to occur. The residual limb should not be placed on a pillow because a flexion contracture of the hip may result and the client should be encouraged to lie in the prone position to prevent flexion contracture of the hip. A client with heart disease is on a continuous telemetry monitor and has developed sinus bradycardia. In determining the possible cause of the bradycardia, the nurse assesses the client's medication record. Which medication is most likely the cause of the bradycardia? Propanolol (Inderal). Captopril (Capoten). Furosemide (Lasix). Dobutamine (Dobutrex). Propranolol (Inderal) Rationale Inderal is a beta adrenergic blocking agent, which causes decreased heart rate and decreased contractility.