HESI Comprehensive Exam Success: Elite
Questions & Expert Solutions from World-
Renowned Scholars
A client is found to have hypoxemic respiratory failure. Which finding does the nurse expect
to note on review of the results of the client's arterial blood gas (ABG) analysis?
Pao2 of 73 mm Hg, Paco2 of 62 mm Hg
Pao2 of 58 mm Hg, Paco2 of 35 mm Hg
Pao2 of 60 mm Hg, Paco2 of 45 mm Hg
Pao2 of 49 mm Hg, Paco2 of 32 mm Hg - CORRECT ANS- -Pao2 of 49 mm Hg, Paco2 of 32
mm Hg
Rationale: Hypoxemic respiratory failure is characterized by a low Pao2 (less than 55 mm
Hg) and a normal or low Paco2. The normal Pao2 is 80 to 100 mm Hg and the normal Paco2
is 35 to 45 mm Hg. Respiratory failure may be classified, according to the underlying
pathophysiology, as hypoxemic respiratory failure or hypoxemic-hypercapnic respiratory
failure. Hypoxemic-hypercapnic respiratory failure is characterized by a low Pao2 (less than
55 mm Hg) and an increased Paco2 (greater than 50 mm Hg). A Pao2 of 49 mm Hg and
Paco2 of 32 mm Hg is the only option that characterizes hypoxemic respiratory failure.
A client with acute gouty arthritis is being started on medication therapy with
indomethacin. The nurse provides medication instructions to the client. How does the
nurse tell the client to take the medication?
At bedtime
With food
1 hour before meals
On an empty stomach - CORRECT ANS- -With food
,Rationale: The client is instructed to take the medication with food. Indomethacin is a
nonsteroidal antiinflammatory medication that produces analgesic and antiinflammatory
effects by inhibiting prostaglandin synthesis. Adverse effects include ulceration of the
esophagus, stomach, duodenum, and small intestine.
An emergency department (ED) nurse is monitoring a client who sustained a severe
inhalation burn injury during a fire in which the client was trapped in an enclosed space.
The nurse auscultates the client's trachea and notes that the previously heard wheezing
sounds have disappeared. What is the most appropriate action the nurse should take?
Continue monitoring the client
Notify the emergency department (ED) primary health care provider
Document the client's improvement in the medical record
Remove the oxygen mask and fit the client with a nasal - CORRECT ANS- -Notify the
emergency department (ED) primary health care provider
Rationale: The most appropriate action by the nurse would be to notify the ED primary
health care provider immediately. A client with a severe inhalation injury may sustain such
progressive obstruction that within a short time he/she cannot force air through the
narrowed airways. As a result, the wheezing sounds disappear. This finding indicates
impending airway obstruction and demands immediate intubation. A client with an
inhalation burn injury is at risk for respiratory complications. Upper-airway edema and
inhalation injury are most notable in the trachea and main stem bronchi. Auscultation of
these areas reveals wheezes, which are a sign/symptom of obstruction. Continuing to
monitor the client, documenting the client's improvement in the medical record, and
removing the oxygen mask and fitting the client with a nasal cannula are all incorrect and
would delay necessary interventions.
A nurse reviews arterial blood gas (ABG) values and notes a pH of 7.50 and a Pco2 of 30
mm Hg. What does the nurse interpret these values as indicative of?
, Metabolic acidosis
Metabolic alkalosis
Respiratory acidosis
Respiratory alkalosis - CORRECT ANS- -Respiratory alkalosis
Rationale: The nurse interprets these values as indicative of respiratory alkalosis. The
normal pH is 7.35 to 7.45. The normal Pco2 is 35 to 45 mm Hg. In respiratory alkalosis, the
pH will be higher than normal and the Pco2 will be low.
A nurse provides information to a client with chronic obstructive pulmonary disease
(COPD) about methods of alleviating shortness of breath while the client is eating. Which
statement by the client indicates a need for further instruction?
"I should rest before I eat."
"I should use my bronchodilator 30 minutes before I eat."
"Pursed-lip breathing will help relieve my shortness of breath."
"I should eat three meals a day, and the biggest meal should be at suppertime." - CORRECT
ANS- -"I should eat three meals a day, and the biggest meal should be at suppertime."
Rationale: There is a need for further instruction if the client states, "I should eat three
meals a day, and the biggest meal should be at suppertime." The biggest meal of the day is
planned for the time when the client is hungriest and most rested. Most clients are
increasingly tired at the end of the day. Four to six small meals per day are preferable to
three larger ones. Pursed-lip or abdominal breathing may alleviate dyspnea.Shortness of
breath is the most common problem related to eating for a client with COPD. The client can
ease dyspnea by resting before meals. A bronchodilator used 30 minutes before a meal
may be helpful if the meal-related dyspnea is a result of bronchospasm or secretions.
A postoperative client with deep-vein thrombosis is at risk for pulmonary embolism. For
which characteristic sign/symptom of this complication does the nurse monitor the client?
Questions & Expert Solutions from World-
Renowned Scholars
A client is found to have hypoxemic respiratory failure. Which finding does the nurse expect
to note on review of the results of the client's arterial blood gas (ABG) analysis?
Pao2 of 73 mm Hg, Paco2 of 62 mm Hg
Pao2 of 58 mm Hg, Paco2 of 35 mm Hg
Pao2 of 60 mm Hg, Paco2 of 45 mm Hg
Pao2 of 49 mm Hg, Paco2 of 32 mm Hg - CORRECT ANS- -Pao2 of 49 mm Hg, Paco2 of 32
mm Hg
Rationale: Hypoxemic respiratory failure is characterized by a low Pao2 (less than 55 mm
Hg) and a normal or low Paco2. The normal Pao2 is 80 to 100 mm Hg and the normal Paco2
is 35 to 45 mm Hg. Respiratory failure may be classified, according to the underlying
pathophysiology, as hypoxemic respiratory failure or hypoxemic-hypercapnic respiratory
failure. Hypoxemic-hypercapnic respiratory failure is characterized by a low Pao2 (less than
55 mm Hg) and an increased Paco2 (greater than 50 mm Hg). A Pao2 of 49 mm Hg and
Paco2 of 32 mm Hg is the only option that characterizes hypoxemic respiratory failure.
A client with acute gouty arthritis is being started on medication therapy with
indomethacin. The nurse provides medication instructions to the client. How does the
nurse tell the client to take the medication?
At bedtime
With food
1 hour before meals
On an empty stomach - CORRECT ANS- -With food
,Rationale: The client is instructed to take the medication with food. Indomethacin is a
nonsteroidal antiinflammatory medication that produces analgesic and antiinflammatory
effects by inhibiting prostaglandin synthesis. Adverse effects include ulceration of the
esophagus, stomach, duodenum, and small intestine.
An emergency department (ED) nurse is monitoring a client who sustained a severe
inhalation burn injury during a fire in which the client was trapped in an enclosed space.
The nurse auscultates the client's trachea and notes that the previously heard wheezing
sounds have disappeared. What is the most appropriate action the nurse should take?
Continue monitoring the client
Notify the emergency department (ED) primary health care provider
Document the client's improvement in the medical record
Remove the oxygen mask and fit the client with a nasal - CORRECT ANS- -Notify the
emergency department (ED) primary health care provider
Rationale: The most appropriate action by the nurse would be to notify the ED primary
health care provider immediately. A client with a severe inhalation injury may sustain such
progressive obstruction that within a short time he/she cannot force air through the
narrowed airways. As a result, the wheezing sounds disappear. This finding indicates
impending airway obstruction and demands immediate intubation. A client with an
inhalation burn injury is at risk for respiratory complications. Upper-airway edema and
inhalation injury are most notable in the trachea and main stem bronchi. Auscultation of
these areas reveals wheezes, which are a sign/symptom of obstruction. Continuing to
monitor the client, documenting the client's improvement in the medical record, and
removing the oxygen mask and fitting the client with a nasal cannula are all incorrect and
would delay necessary interventions.
A nurse reviews arterial blood gas (ABG) values and notes a pH of 7.50 and a Pco2 of 30
mm Hg. What does the nurse interpret these values as indicative of?
, Metabolic acidosis
Metabolic alkalosis
Respiratory acidosis
Respiratory alkalosis - CORRECT ANS- -Respiratory alkalosis
Rationale: The nurse interprets these values as indicative of respiratory alkalosis. The
normal pH is 7.35 to 7.45. The normal Pco2 is 35 to 45 mm Hg. In respiratory alkalosis, the
pH will be higher than normal and the Pco2 will be low.
A nurse provides information to a client with chronic obstructive pulmonary disease
(COPD) about methods of alleviating shortness of breath while the client is eating. Which
statement by the client indicates a need for further instruction?
"I should rest before I eat."
"I should use my bronchodilator 30 minutes before I eat."
"Pursed-lip breathing will help relieve my shortness of breath."
"I should eat three meals a day, and the biggest meal should be at suppertime." - CORRECT
ANS- -"I should eat three meals a day, and the biggest meal should be at suppertime."
Rationale: There is a need for further instruction if the client states, "I should eat three
meals a day, and the biggest meal should be at suppertime." The biggest meal of the day is
planned for the time when the client is hungriest and most rested. Most clients are
increasingly tired at the end of the day. Four to six small meals per day are preferable to
three larger ones. Pursed-lip or abdominal breathing may alleviate dyspnea.Shortness of
breath is the most common problem related to eating for a client with COPD. The client can
ease dyspnea by resting before meals. A bronchodilator used 30 minutes before a meal
may be helpful if the meal-related dyspnea is a result of bronchospasm or secretions.
A postoperative client with deep-vein thrombosis is at risk for pulmonary embolism. For
which characteristic sign/symptom of this complication does the nurse monitor the client?
