HESI Final Exam
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1. An older client is admitted with a diagno- D.
sis of bacterial pneumonia. Which symptom The onset of Pneumonia in the older
should the nurse report to the HCP after as- client may be signaled by general deteri-
sessing the client? oration, confusion, increased HR, and/or
increased respirations. A, B, and C are
A)Leukocytosis and febrile. often absent in the older client with bac-
B) Polycythemia and crackles. terial pneumonia.
C) Pharyngitis and sputum production.
D) Confusion and tachycardia.
2. The nurse is reviewing routine medications B.
taken by a client with chronic angle clo- Clients with angle-closure glaucoma
sure glaucoma. Which medication prescrip- should not take medications that dilate
tion should the nurse question? the pupil because they can precipitate
acute and severely increased IOP. A, C,
A) Antianginal with a therapeutic effect of and D do not cause increased IOP, which
vasodilation. is the primary concern with angle-closure
B) Anticholinergic with a side effect of pupil- glaucoma.
lary dilation.
C) Antihistamine with a side effect of seda-
tion.
D) Corticosteroid with a side effect of hyper-
glycemia.
3. The nurse is caring for a critically ill client with C.
cirrhosis of the liver who has a NG tube drain- The breakdown of glutamine in the intes-
ing bright red blood. The nurse notes that tine and the increased activity of colonic
the client's serum hemoglobin and hemat- bacteria from the digestion of proteins
ocrit levels are decreased. Which additional increase ammonia levels in clients with
change in laboratory data should the nurse advanced liver disease, so removal of
expect? blood, a protein source, from the intes-
tine results in a reduced level of ammo-
, HESI Final Exam
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A) Increased serum albumin level. nia. A, B, and D will not be significantly
B) Decreased serum creatinine. affected by the removal of blood.
C) Decreased serum ammonia level.
D) Increased liver function test results.
4. A resident in a long-term care facility is diag-
A.
nosed with Hep B. Which intervention should Hep B vaccine should be administered to
the nurse implement with the staff caring for all health care providers. Hep A (not Hep
this client? B) can be transmitted by fecal-oral con-
tamination. There is a chance that staff
A) Determine if all employees have had the could contract Hep B if exposed to the
Hep B vaccine series. client's blood and/or body fluids, there-
B) Explain that this type of hepatitis can be fore C is incorrect. There is no need to
transmitted when feeding the client. wear gloves and gowns except with blood
C) Assure the employees that they cannot or body fluid contact.
contract Hep B when providing direct care.
D) Tell the employees that wearing gloves
and a gown are required when providing
care.
5. A client with HTN has been receiving ramipril A.
(altace), 5mg, PO, daily for 2 weeks and is The client's BP is within normal limits,
scheduled to receive a dose at 0900. At 0830, indicating that the ramipril, an antihy-
the client's blood pressure is 120/70. Which pertensive, is having the desired effect
action should the nurse take? and should be administered. B and C
would be appropriate if the client's BP
A) Administer the prescribed dose at the was excessively low (<100 systolic) or if
scheduled time. the client were exhibiting signs of hy-
B) Hold the dose and contact the HCP. potension such as dizziness.
C) Hold the dose and recheck the BP in 1
hour.
, HESI Final Exam
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D) Check with the HCP's prescription to clarify
dose.
6. The nurse assesses a client who has been D.
prescribed furosemide (Lasix) for cardiac dis- A U wave is a positive deflection follow-
ease. Which ECG change would be a concern ing the T wave and is often present with
for a client taking a diuretic? hypokalemia. A, B and C are all signs of
hyperkalemia.
A) Tall, spiked T waves.
B) A prolonged QT interval.
C) A widening QRS complex.
D) Presence of a U wave.
7. A client diagnosed with chronic kidney dis- B.
ease (CKD) 2 years ago is regularly treated Hypocalcemia develops in CKD be-
at a community hemodialysis facility. Before cause of chronic hyperphosphatemia. In-
his scheduled dialysis treatment, which elec- creased phosphate levels cause the pe-
trolyte imbalance should the nurse antici- ripheral deposition of calcium and resis-
pate? tance to vitamin D absorption needed for
calcium absorption. Prior to dialysis, the
A) Hypophosphatemia. nurse would expect to find the client hy-
B) Hypocalcemia. pernatremic and hyperkalemic, not with
C) Hyponatremia. C or D.
D) Hypokalemia
8. The home health nurse is assessing a male C.
client being treated for Parkinson's disease A masklike expression and infrequent
with Sinemet. The nurse observes that he blinking are common clinical features of
does not demonstrate any apparent emotion parkinsonism. The nurse should docu-
when speaking and rarely blinks. Which in- ment these expected findings. Signs of
tervention should the nurse implement? toxicity of Sinemet include dyskinesia,
hallucinations, and psychosis.
A) Perform a complete cranial nerve assess-
, HESI Final Exam
Study online at https://quizlet.com/_4tvzlk
ment.
B) Instruct the client that he may be experi-
encing medication toxicity.
C) Document the presence of these assess-
ment findings.
D) Advise the client to seek immediate med-
ical evaluation.
9. A client with CHF and Afib develops ven- B.
tricular ectopy with a pattern of 8 ectopic The client should have the oxygen flow
beats/min. Which action should the nurse immediately increased to promote oxy-
take based on this observation? genation of the myocardium. Ventricular
ectopy, characterized by multiple PVCs,
A) Assess for bilateral jugular vein disten- is often caused by myocardial ischemia
tion. exacerbated by hypokalemia.
B) Increase oxygen flow via nasal cannula.
C) Administer PRN Lasix.
D) Auscultate for a pleural friction rub.
10. During the change of shift report, the charge C.
nurse reviews the infusions being received All four of these clients have a potential to
by clients on the oncology unit. The client have significant complications. The client
receiving which infusion should be assessed with the morphine epidural infusion is
first? at highest risk for respiratory depression
and should be assessed first.
A) Continuous IV infusion of magnesium.
B) One-time infusion of albumin.
C) Continuous epidural infusion of mor-
phine.
D) Intermittent infusion of IV vancomycin.
11. A 25-year-old client was admitted yester- B.
day after a motor vehicle collision. Neuro- Clients with basilar skull fractures are at
Study online at https://quizlet.com/_4tvzlk
1. An older client is admitted with a diagno- D.
sis of bacterial pneumonia. Which symptom The onset of Pneumonia in the older
should the nurse report to the HCP after as- client may be signaled by general deteri-
sessing the client? oration, confusion, increased HR, and/or
increased respirations. A, B, and C are
A)Leukocytosis and febrile. often absent in the older client with bac-
B) Polycythemia and crackles. terial pneumonia.
C) Pharyngitis and sputum production.
D) Confusion and tachycardia.
2. The nurse is reviewing routine medications B.
taken by a client with chronic angle clo- Clients with angle-closure glaucoma
sure glaucoma. Which medication prescrip- should not take medications that dilate
tion should the nurse question? the pupil because they can precipitate
acute and severely increased IOP. A, C,
A) Antianginal with a therapeutic effect of and D do not cause increased IOP, which
vasodilation. is the primary concern with angle-closure
B) Anticholinergic with a side effect of pupil- glaucoma.
lary dilation.
C) Antihistamine with a side effect of seda-
tion.
D) Corticosteroid with a side effect of hyper-
glycemia.
3. The nurse is caring for a critically ill client with C.
cirrhosis of the liver who has a NG tube drain- The breakdown of glutamine in the intes-
ing bright red blood. The nurse notes that tine and the increased activity of colonic
the client's serum hemoglobin and hemat- bacteria from the digestion of proteins
ocrit levels are decreased. Which additional increase ammonia levels in clients with
change in laboratory data should the nurse advanced liver disease, so removal of
expect? blood, a protein source, from the intes-
tine results in a reduced level of ammo-
, HESI Final Exam
Study online at https://quizlet.com/_4tvzlk
A) Increased serum albumin level. nia. A, B, and D will not be significantly
B) Decreased serum creatinine. affected by the removal of blood.
C) Decreased serum ammonia level.
D) Increased liver function test results.
4. A resident in a long-term care facility is diag-
A.
nosed with Hep B. Which intervention should Hep B vaccine should be administered to
the nurse implement with the staff caring for all health care providers. Hep A (not Hep
this client? B) can be transmitted by fecal-oral con-
tamination. There is a chance that staff
A) Determine if all employees have had the could contract Hep B if exposed to the
Hep B vaccine series. client's blood and/or body fluids, there-
B) Explain that this type of hepatitis can be fore C is incorrect. There is no need to
transmitted when feeding the client. wear gloves and gowns except with blood
C) Assure the employees that they cannot or body fluid contact.
contract Hep B when providing direct care.
D) Tell the employees that wearing gloves
and a gown are required when providing
care.
5. A client with HTN has been receiving ramipril A.
(altace), 5mg, PO, daily for 2 weeks and is The client's BP is within normal limits,
scheduled to receive a dose at 0900. At 0830, indicating that the ramipril, an antihy-
the client's blood pressure is 120/70. Which pertensive, is having the desired effect
action should the nurse take? and should be administered. B and C
would be appropriate if the client's BP
A) Administer the prescribed dose at the was excessively low (<100 systolic) or if
scheduled time. the client were exhibiting signs of hy-
B) Hold the dose and contact the HCP. potension such as dizziness.
C) Hold the dose and recheck the BP in 1
hour.
, HESI Final Exam
Study online at https://quizlet.com/_4tvzlk
D) Check with the HCP's prescription to clarify
dose.
6. The nurse assesses a client who has been D.
prescribed furosemide (Lasix) for cardiac dis- A U wave is a positive deflection follow-
ease. Which ECG change would be a concern ing the T wave and is often present with
for a client taking a diuretic? hypokalemia. A, B and C are all signs of
hyperkalemia.
A) Tall, spiked T waves.
B) A prolonged QT interval.
C) A widening QRS complex.
D) Presence of a U wave.
7. A client diagnosed with chronic kidney dis- B.
ease (CKD) 2 years ago is regularly treated Hypocalcemia develops in CKD be-
at a community hemodialysis facility. Before cause of chronic hyperphosphatemia. In-
his scheduled dialysis treatment, which elec- creased phosphate levels cause the pe-
trolyte imbalance should the nurse antici- ripheral deposition of calcium and resis-
pate? tance to vitamin D absorption needed for
calcium absorption. Prior to dialysis, the
A) Hypophosphatemia. nurse would expect to find the client hy-
B) Hypocalcemia. pernatremic and hyperkalemic, not with
C) Hyponatremia. C or D.
D) Hypokalemia
8. The home health nurse is assessing a male C.
client being treated for Parkinson's disease A masklike expression and infrequent
with Sinemet. The nurse observes that he blinking are common clinical features of
does not demonstrate any apparent emotion parkinsonism. The nurse should docu-
when speaking and rarely blinks. Which in- ment these expected findings. Signs of
tervention should the nurse implement? toxicity of Sinemet include dyskinesia,
hallucinations, and psychosis.
A) Perform a complete cranial nerve assess-
, HESI Final Exam
Study online at https://quizlet.com/_4tvzlk
ment.
B) Instruct the client that he may be experi-
encing medication toxicity.
C) Document the presence of these assess-
ment findings.
D) Advise the client to seek immediate med-
ical evaluation.
9. A client with CHF and Afib develops ven- B.
tricular ectopy with a pattern of 8 ectopic The client should have the oxygen flow
beats/min. Which action should the nurse immediately increased to promote oxy-
take based on this observation? genation of the myocardium. Ventricular
ectopy, characterized by multiple PVCs,
A) Assess for bilateral jugular vein disten- is often caused by myocardial ischemia
tion. exacerbated by hypokalemia.
B) Increase oxygen flow via nasal cannula.
C) Administer PRN Lasix.
D) Auscultate for a pleural friction rub.
10. During the change of shift report, the charge C.
nurse reviews the infusions being received All four of these clients have a potential to
by clients on the oncology unit. The client have significant complications. The client
receiving which infusion should be assessed with the morphine epidural infusion is
first? at highest risk for respiratory depression
and should be assessed first.
A) Continuous IV infusion of magnesium.
B) One-time infusion of albumin.
C) Continuous epidural infusion of mor-
phine.
D) Intermittent infusion of IV vancomycin.
11. A 25-year-old client was admitted yester- B.
day after a motor vehicle collision. Neuro- Clients with basilar skull fractures are at
