1 NGN NURSING MED SURG HESI EXIT EXAM LATEST
2024 TEST BANK WITH RATIONALES COMPLETE
RATED A+
The mother of an adolescent tells the clinic nurse, "My son has athlete's foot, I have
f f f f f f f f f f f f f f f
been applying triple antibiotic ointment for two days, but there has been no
f f f f f f f f f f f f f
improvement." What instruction should the nurse provide?
f f f f f f f
(ANS- Stop using the ointment and encourage complete drying of the feet and
f f f f f f f f f f f f
wearing clean socks.
f f f
A 26-year-old female client is admitted to the hospital for treatment of a simple goiter,
f f f f f f f f f f f f f f
and levothyroxine sodium (Synthroid) is prescribed. Which symptoms indicate to
f f f f f f f f f f
the nurse that the prescribed dosage is too high for this client? The client experiences
f f f f f f f f f f f f f f f
Bradycardia and constipation f f
Lethargy and lack of appetite
f f f f f
Muscle cramping and dry, flushed skin
f f f f f
Palpitations and shortness of breath
f f f f f
(ANS- Palpitations and shortness of breath
f f f f f
A client with a history of heart failure presents to the clinic with nausea, vomiting,
f f f f f f f f f f f f f f
yellow vision and palpitations. Which finding is most important for the nurse to
f f f f f f f f f f f f f
assess to the client?
f f f f
(ANS- Obtain a list of medications taken for cardiac history
f f f f f f f f f
The healthcare provider prescribes an IV solution of isoproterenol (Isuprel) 1 mg in
f f f f f f f f f f f f
250 ml of D5W at 300 mcg/hour. The nurse should program the infusion pump to
f f f f f f f f f f f f f f f
deliver how many ml/hour? (Enter numeric value only.)
f f f f f f f f
(ANS- 75 f
Rationale: Convert mg to mcg and use the formula D/H x Q. 300 mcg/hour / 1,000
f f f f f f f f f f f f f f f
,2 mcg x 250 ml = 3/1 x 25 = 75 ml/hour
f f f f f f f f f f
The pathophysiological mechanisms that are responsible for ascites related to liver
f f f f f f f f f f
failure? (Select all that apply)
f f f f f
(ANS- Fluid shifts from intravascular to interstitial area due to decreased serum
f f f f f f f f f f f
protein
f
Increased hydrostatic pressure in portal circulation increases fluid shifts into abdomen
f f f f f f f f f f
Increased circulating aldosterone levels that increase sodium and water retention
f f f f f f f f f
The nurse is auscultating a client's heart sounds. Which description should the
f f f f f f f f f f f
nurse use to document this sound? (Please listen to the audio first to select the
f f f f f f f f f f f f f f f
option that applies)
f f f
(ANS- Murmur f
Rationale: A murmur is auscultated as a swishing sound that is associated with the
f f f f f f f f f f f f f
blood turbulence created by the heart or valvular defect.
f f f f f f f f f
The healthcare provider prescribes celtazidime (Fortax) 35 mg every 8 hours IM for
f f f f f f f f f f f f
an infant. The 500 mg vial is labeled with the instruction to add 5.3 ml diluent to
f f f f f f f f f f f f f f f f f
provide a concentration of 100 mg/ml. How many ml should the nurse administered
f f f f f f f f f f f f f
for each dose? (Enter numeric value only. If rounding is required, round to the
f f f f f f f f f f f f f f
nearest tenth)
f f
(ANS- 0.4 f
ationale: 35mg/100mg x 1 = 0.35 = 0.4 ml f f f f f f f f
The nurse notes that a client has been receiving hydromorphone (Dilaudid) every six
f f f f f f f f f f f f
hours for four days. What assessment is most important for the nurse to complete?
f f f f f f f f f f f f f f
Auscultate the client's bowel sounds f f f f
Observe for edema around the ankles
f f f f f f
Measure the client's capillary glucose level
f f f f f f
Count the apical and radial pulses simultaneously
f f f f f f
(ANS- Auscultate the client's bowel sounds
f f f f f f
,3 Rationale: hydromorphone is a potent opioid analgesic that slows peristalsis and
f f f f f f f f f f
frequently causes constipation, so it is most important to Auscultate the client's
f f f f f f f f f f f f
bowel sounds
f f
A female client is admitted with end stage pulmonary disease is alert, oriented, and
f f f f f f f f f f f f f
complaining of shortness of breath. The client tells the nurse that she wants "no
f f f f f f f f f f f f f f
heroic measures" taken if she stops breathing, and she asks the nurse to document
f f f f f f f f f f f f f f
this in her medical record. What action should the nurse implement?
f f f f f f f f f f f
(ANS- Ask the client to discuss "do not resuscitate" with her healthcare provider
f f f f f f f f f f f f
A client is receiving a full strength continuous enteral tube feeding at 50 ml/hour and
f f f f f f f f f f f f f f
has developed diarrhea. The client has a new prescription to change the feeding to
f f f f f f f f f f f f f f
half strength. What intervention should the nurse implement?
f f f f f f f f
(ANS- Add equal amounts of water and feeding to a feeding bag and infuse at
f f f f f f f f f f f f f f
50ml/hour
f
A female client reports that her hair is becoming coarse and breaking off, that the
f f f f f f f f f f f f f f
outer part of her eyebrows have disappeared, and that her eyes are all puffy. Which
f f f f f f f f f f f f f f f
follow-up question is best for the nurse to ask?
f f f f f f f f f
(ANS- Have you noticed any changes in your fingernails?
f f f f f f f f
Rationale: The pattern of reported manifestations is suggestive of hypothyroidism
f f f f f f f f f
Following discharge teaching, a male client with duodenal ulcer tells the nurse the he
f f f f f f f f f f f f f
will drink plenty of dairy products, such as milk, to help coat and protect his ulcer.
f f f f f f f f f f f f f f f f
What is the best follow-up action by the nurse?
f f f f f f f f f
(ANS- Review with the client the need to avoid foods that are rich in milk and cream
f f f f f f f f f f f f f f f f
A male client with hypertension, who received new antihypertensive prescriptions at
f f f f f f f f f f
his last visit returns to the clinic two weeks later to evaluate his blood pressure (BP).
f f f f f f f f f f f f f f f f
His BP is 158/106 and he admits that he has not been taking the prescribed
f f f f f f f f f f f f f f f
medication because the drugs make him "feel bad". In explaining the need for
f f f f f f f f f f f f f
hypertension control, the nurse should stress that an elevated BP places the client at
f f f f f f f f f f f f f f
risk for which pathophysiological condition?
f f f f f
(ANS- Stroke secondary to hemorrhagef f f f
, 4 The nurse observes unlicensed assistive personnel (UAP) positioning a newly
f f f f f f f f f
admitted client who has a seizure disorder. The client is supine and the UAP is
f f f f f f f f f f f f f f f
placing soft pillows along the side rails. What action should the nurse implement?
f f f f f f f f f f f f f
(ANS- Instruct the UAP to obtain soft blankets to secure to the side rails instead of
f f f f f f f f f f f f f f f f
pillows.
f
An adolescent with major depressive disorder has been taking duloxetine
f f f f f f f f f
(Cymbalta) for the past 12 days. Which assessment finding requires immediate
f f f f f f f f f f f
follow-up?
f
(ANS- Describes life without purpose
f f f f
A 60-year-old female client with a positive family history of ovarian cancer has
f f f f f f f f f f f f
developed an abdominal mass and is being evaluated for possible ovarian cancer. Her
f f f f f f f f f f f f f
Papanicolau (Pap) smear results are negative. What information should the nurse
f f f f f f f f f f f
include in the client's teaching plan?
f f f f f f
(ANS- Further evaluation involving surgery may be needed
f f f f f f f
A client who recently underwear a tracheostomy is being prepared for discharge to
f f f f f f f f f f f f
home. Which instructions is most important for the nurse to include in the discharge
f f f f f f f f f f f f f f
plan?
f
(ANS- Teach tracheal suctioning techniques
f f f f
In assessing an adult client with a partial rebreather mask, the nurse notes that the
f f f f f f f f f f f f f f
oxygen reservoir bag does not deflate completely during inspiration and the client's
f f f f f f f f f f f f
respiratory rate is 14 breaths / minute. What action should the nurse implement?
f f f f f f f f f f f f f
(ANS- Document the assessment data
f f f f f
Rationale: reservoir bag should not deflate completely during inspiration and the
f f f f f f f f f f
client's respiratory rate is within normal limits.
f f f f f f f
During shift report, the central electrocardiogram (EKG) monitoring systemalarms.
f f f f f f f f
Which client alarm should the nurse investigate firs?
f f f f f f f f
(ANS- Respiratory apnea of 30 seconds
f f f f f
2024 TEST BANK WITH RATIONALES COMPLETE
RATED A+
The mother of an adolescent tells the clinic nurse, "My son has athlete's foot, I have
f f f f f f f f f f f f f f f
been applying triple antibiotic ointment for two days, but there has been no
f f f f f f f f f f f f f
improvement." What instruction should the nurse provide?
f f f f f f f
(ANS- Stop using the ointment and encourage complete drying of the feet and
f f f f f f f f f f f f
wearing clean socks.
f f f
A 26-year-old female client is admitted to the hospital for treatment of a simple goiter,
f f f f f f f f f f f f f f
and levothyroxine sodium (Synthroid) is prescribed. Which symptoms indicate to
f f f f f f f f f f
the nurse that the prescribed dosage is too high for this client? The client experiences
f f f f f f f f f f f f f f f
Bradycardia and constipation f f
Lethargy and lack of appetite
f f f f f
Muscle cramping and dry, flushed skin
f f f f f
Palpitations and shortness of breath
f f f f f
(ANS- Palpitations and shortness of breath
f f f f f
A client with a history of heart failure presents to the clinic with nausea, vomiting,
f f f f f f f f f f f f f f
yellow vision and palpitations. Which finding is most important for the nurse to
f f f f f f f f f f f f f
assess to the client?
f f f f
(ANS- Obtain a list of medications taken for cardiac history
f f f f f f f f f
The healthcare provider prescribes an IV solution of isoproterenol (Isuprel) 1 mg in
f f f f f f f f f f f f
250 ml of D5W at 300 mcg/hour. The nurse should program the infusion pump to
f f f f f f f f f f f f f f f
deliver how many ml/hour? (Enter numeric value only.)
f f f f f f f f
(ANS- 75 f
Rationale: Convert mg to mcg and use the formula D/H x Q. 300 mcg/hour / 1,000
f f f f f f f f f f f f f f f
,2 mcg x 250 ml = 3/1 x 25 = 75 ml/hour
f f f f f f f f f f
The pathophysiological mechanisms that are responsible for ascites related to liver
f f f f f f f f f f
failure? (Select all that apply)
f f f f f
(ANS- Fluid shifts from intravascular to interstitial area due to decreased serum
f f f f f f f f f f f
protein
f
Increased hydrostatic pressure in portal circulation increases fluid shifts into abdomen
f f f f f f f f f f
Increased circulating aldosterone levels that increase sodium and water retention
f f f f f f f f f
The nurse is auscultating a client's heart sounds. Which description should the
f f f f f f f f f f f
nurse use to document this sound? (Please listen to the audio first to select the
f f f f f f f f f f f f f f f
option that applies)
f f f
(ANS- Murmur f
Rationale: A murmur is auscultated as a swishing sound that is associated with the
f f f f f f f f f f f f f
blood turbulence created by the heart or valvular defect.
f f f f f f f f f
The healthcare provider prescribes celtazidime (Fortax) 35 mg every 8 hours IM for
f f f f f f f f f f f f
an infant. The 500 mg vial is labeled with the instruction to add 5.3 ml diluent to
f f f f f f f f f f f f f f f f f
provide a concentration of 100 mg/ml. How many ml should the nurse administered
f f f f f f f f f f f f f
for each dose? (Enter numeric value only. If rounding is required, round to the
f f f f f f f f f f f f f f
nearest tenth)
f f
(ANS- 0.4 f
ationale: 35mg/100mg x 1 = 0.35 = 0.4 ml f f f f f f f f
The nurse notes that a client has been receiving hydromorphone (Dilaudid) every six
f f f f f f f f f f f f
hours for four days. What assessment is most important for the nurse to complete?
f f f f f f f f f f f f f f
Auscultate the client's bowel sounds f f f f
Observe for edema around the ankles
f f f f f f
Measure the client's capillary glucose level
f f f f f f
Count the apical and radial pulses simultaneously
f f f f f f
(ANS- Auscultate the client's bowel sounds
f f f f f f
,3 Rationale: hydromorphone is a potent opioid analgesic that slows peristalsis and
f f f f f f f f f f
frequently causes constipation, so it is most important to Auscultate the client's
f f f f f f f f f f f f
bowel sounds
f f
A female client is admitted with end stage pulmonary disease is alert, oriented, and
f f f f f f f f f f f f f
complaining of shortness of breath. The client tells the nurse that she wants "no
f f f f f f f f f f f f f f
heroic measures" taken if she stops breathing, and she asks the nurse to document
f f f f f f f f f f f f f f
this in her medical record. What action should the nurse implement?
f f f f f f f f f f f
(ANS- Ask the client to discuss "do not resuscitate" with her healthcare provider
f f f f f f f f f f f f
A client is receiving a full strength continuous enteral tube feeding at 50 ml/hour and
f f f f f f f f f f f f f f
has developed diarrhea. The client has a new prescription to change the feeding to
f f f f f f f f f f f f f f
half strength. What intervention should the nurse implement?
f f f f f f f f
(ANS- Add equal amounts of water and feeding to a feeding bag and infuse at
f f f f f f f f f f f f f f
50ml/hour
f
A female client reports that her hair is becoming coarse and breaking off, that the
f f f f f f f f f f f f f f
outer part of her eyebrows have disappeared, and that her eyes are all puffy. Which
f f f f f f f f f f f f f f f
follow-up question is best for the nurse to ask?
f f f f f f f f f
(ANS- Have you noticed any changes in your fingernails?
f f f f f f f f
Rationale: The pattern of reported manifestations is suggestive of hypothyroidism
f f f f f f f f f
Following discharge teaching, a male client with duodenal ulcer tells the nurse the he
f f f f f f f f f f f f f
will drink plenty of dairy products, such as milk, to help coat and protect his ulcer.
f f f f f f f f f f f f f f f f
What is the best follow-up action by the nurse?
f f f f f f f f f
(ANS- Review with the client the need to avoid foods that are rich in milk and cream
f f f f f f f f f f f f f f f f
A male client with hypertension, who received new antihypertensive prescriptions at
f f f f f f f f f f
his last visit returns to the clinic two weeks later to evaluate his blood pressure (BP).
f f f f f f f f f f f f f f f f
His BP is 158/106 and he admits that he has not been taking the prescribed
f f f f f f f f f f f f f f f
medication because the drugs make him "feel bad". In explaining the need for
f f f f f f f f f f f f f
hypertension control, the nurse should stress that an elevated BP places the client at
f f f f f f f f f f f f f f
risk for which pathophysiological condition?
f f f f f
(ANS- Stroke secondary to hemorrhagef f f f
, 4 The nurse observes unlicensed assistive personnel (UAP) positioning a newly
f f f f f f f f f
admitted client who has a seizure disorder. The client is supine and the UAP is
f f f f f f f f f f f f f f f
placing soft pillows along the side rails. What action should the nurse implement?
f f f f f f f f f f f f f
(ANS- Instruct the UAP to obtain soft blankets to secure to the side rails instead of
f f f f f f f f f f f f f f f f
pillows.
f
An adolescent with major depressive disorder has been taking duloxetine
f f f f f f f f f
(Cymbalta) for the past 12 days. Which assessment finding requires immediate
f f f f f f f f f f f
follow-up?
f
(ANS- Describes life without purpose
f f f f
A 60-year-old female client with a positive family history of ovarian cancer has
f f f f f f f f f f f f
developed an abdominal mass and is being evaluated for possible ovarian cancer. Her
f f f f f f f f f f f f f
Papanicolau (Pap) smear results are negative. What information should the nurse
f f f f f f f f f f f
include in the client's teaching plan?
f f f f f f
(ANS- Further evaluation involving surgery may be needed
f f f f f f f
A client who recently underwear a tracheostomy is being prepared for discharge to
f f f f f f f f f f f f
home. Which instructions is most important for the nurse to include in the discharge
f f f f f f f f f f f f f f
plan?
f
(ANS- Teach tracheal suctioning techniques
f f f f
In assessing an adult client with a partial rebreather mask, the nurse notes that the
f f f f f f f f f f f f f f
oxygen reservoir bag does not deflate completely during inspiration and the client's
f f f f f f f f f f f f
respiratory rate is 14 breaths / minute. What action should the nurse implement?
f f f f f f f f f f f f f
(ANS- Document the assessment data
f f f f f
Rationale: reservoir bag should not deflate completely during inspiration and the
f f f f f f f f f f
client's respiratory rate is within normal limits.
f f f f f f f
During shift report, the central electrocardiogram (EKG) monitoring systemalarms.
f f f f f f f f
Which client alarm should the nurse investigate firs?
f f f f f f f f
(ANS- Respiratory apnea of 30 seconds
f f f f f
