HESI EXIT EXAM NEXT GENERATION (NGN) TEST BANK-ACTUAL EXAM 200 QUESTIONS AND CORRECT DETAILED ANSWERS (100% VERIFIED ANSWERS) ALREADY GRADED A+

2023 HESI EXIT EXAM NEXT GENERATION (NGN) TEST BANK LATEST ACTUAL EXAM 200 QUESTIONS AND CORRECT DETAILED ANSWERS (100% VERIFIED ANSWERS) ALREADY GRADED A+ While assessing a radial artery catheter, the client complains of numbness and pain distal to the insertion site. What interventions should the nurse implement? - ANSWER>>Promptly remove the arterial catheter from the radial artery. A client is admitted with an epidural hematoma that resulted from a skateboarding accident. To differentiate the vascular source of the intracranial bleeding, which finding should the nurse monitor? - ANSWER>>Rapid onset of decreased level of consciousness. When preparing a client for discharge from the hospital following a cystectomy and a urinary diversion to treat bladder cancer, which instruction is most important for the nurse to include in the client's discharge teaching plan? - ANSWER>>Report any signs of cloudy urine output. After repositioning an immobile client, the nurse observes an area of hyperemia. To assess for blanching, what action should the nurse take? - ANSWER>>Apply light pressure over the area. The nurse enters a client's room and observes the client's wrist restraint secured as seen in the picture. What action should the nurse take? - ANSWER>>Reposition the restraint tie onto the bedframe. A female client with acute respiratory distress syndrome (ARDS) is chemically paralyzed and sedated while she is on as assist-control ventilator using 50% FIO2. Which assessment finding warrants immediate intervention by the nurse? - ANSWER>>Diminished left lower lobe sounds Rationale: Diminished lobe sounds indicate collapsed alveoli or tension pneumothorax, which required immediate chest tube insertion to re-inflate the lung. The development of atherosclerosis is a process of sequential events. Arrange the pathophysiological events in orders of occurrence. (Place the first event on top and the last on the bottom) - ANSWER>>Arterial endothelium injury causes inflammation Macrophages consume low density lipoprotein (LDL), creating foam cellsFoam cells release growth factors for smooth muscle cells Smooth muscle grows over fatty streaks creating fibrous plaques Vessel narrowing results in ischemia Following a motor vehicle collision, an adult female with a ruptured spleen and a blood pressure of 70/44, had an emergency splenectomy. Twelve hours after the surgery, her urine output is 25 ml/hour for the last two hours. What pathophysiological reason supports the nurse's decision to report this finding to the healthcare provider? - ANSWER>>Oliguria signals tubular necrosis related to hypoperfusion A nurse-manager is preparing the curricula for a class for charge nurses. A staffing formula based on what data ensures quality client care and is most cost-effective? - ANSWER>>SKills of staff and client acuity When performing postural drainage on a client with Chronic Obstructive Pulmonary Disease (COPD), which approach should the nurse use? - ANSWER>>Explain that the client may be placed in five positions A client presents in the emergency room with right-sided facial asymmetry. The nurse asks the client to perform a series of movements that require use of the facial muscles. What symptoms suggest that the client has most likely experience a Bell's palsy rather than a stroke? - ANSWER>>|nability to close the affected eye, raise brow, or smile The nurse is teaching a client how to perform colostomy irrigations. When observing the client's return demonstration, which action indicated that the client understood the teaching? - ANSWER>>Keeps the irrigating container less than 18 inches above the stoma The nurse should teach the client to observe which precaution while taking dronedarone? - ANSWER>>Avoid grapefruits and its juice A client who sustained a head injury following an automobile collision is admitted to the hospital. The nurse include the client's risk for developing increased intracranial pressure (ICP) in the plan of care. Which signs indicate to the nurse that ICP has increased? - ANSWER>>Increased Glasgow coma scale score. Nuchal rigidity and papilledema. Confusion and papilledema Periorbital ecchymosis. Rationale: papilledema is always an indicator of increased ICP, and confusion is usually the first sign of increased ICP. Other options do not necessarily reflect increased ICP.The nurse is caring for a client receiving continuous IV fluids through a single lumen central venous catheter (CVC). Based on the CVC care bundle, which action should be completed daily to reduce the risk for infection? - ANSWER>>Confirm the necessity for continued use of the CVC. During an annual physical examination, an older woman's fasting blood sugar (FBS) is determined to be 140 mg/dl or 7.8 mmol/L (Sl). Which additional finding obtained during a follow-up visit 2 weeks later is most indicative that the client has diabetes mellitus (DM)? - ANSWER>>Repeated fasting blood sugar (FBS) is 132 mg/dl or 7.4 mmol/L (Sh). A client who was admitted yesterday with severe dehydration is complaining of pain a 24 gauge IV with normal saline is infusing at a rate of 150 ml/hour. Which intervention should the nurse implement first? - ANSWER>>Stop the normal saline infusion. An elderly female is admitted because of a change in her level of sensorium. During the evening shift, the client attempts to get out bed and falls, breaking her left hip. Buck's skin traction is applied to the left leg while waiting for surgery. Which intervention is most important for the nurse to include in this client's plan care? - ANSWER>>Ensure proper alignment of the leg in traction. A client who had a right hip replacement 3 day ago is pale has diminished breath sound over the left lower lung fields, a temperature of 100.2 F, and an oxygen saturation rate of 90%. The client is scheduled to be transferred to a skilled nursing facility (SNF) tomorrow for rehabilitative critical pathway. Based on the client's symptoms, what recommendation should the nurse give the healthcare provider? - ANSWER>>Reassess readiness for SNF transfer. A client who is newly diagnosed with type 2 diabetes mellitus (DM) receives a prescription for metformin (Glucophage) 500 mg PO twice daily. What information should the nurse include in this client's teaching plan? (Select all that apply.) - ANSWER>>Recognize signs and symptoms of hypoglycemia. Report persist polyuria to the healthcare provider. Take Glucophage with the morning and evening meal. The nurse is developing an educational program for older clients who are being discharged with new antihypertensive medications. The nurse should ensure that the educational materials include which characteristics? Select all that apply - ANSWER>>Written at a twelfth grade reading level Contains a list with definitions of unfamiliar terms Uses common words with few Syllables Printed using a 12 point type fontUses pictures to help illustrate complex ideas Rationale: During the aging process older clients often experience sensory or cognitive changes, such as decreased visual or hearing acuity, slower thought or reasoning processes, and shorter attention span. Materials for this age group should include at least of terms, such as a medical terminology that incline may not know and use common words that expresses information clearly and simply. Simple, attractive pictures help hold the learner's attention. The reading level of material should be at the 4th to 5th grade level. Materials should be printed using large font (18-point or higher), not the standard 12-point font. During the admission assessment, the nurse auscultates heart sounds for a client with no history of cardiovascular disease. Where should the nurse listen when assessing the client's point of maximal impulse (PMI) (Click the chosen location. To change, click on a new location) - ANSWER>>Left Fourth Intercostal Space An older male adult resident of long-term care facility is hospitalized for a cardiac catheterization that occurred yesterday. Since the procedure was conducted, the client has become increasingly disoriented. The night shift nurse reports that he attempted to remove the sandbag from his femoral artery multiple times during the night. What actions should the nurse take? (Select all that apply.) - ANSWER>>Notify the healthcare provider of the client's change in mental status. Include g2 hour's reorientation in the client's plan of care. An older male comes to the clinic with a family member. When the nurse attempts to take the client's health history, he does not respond to questions in a clear manner. What action should the nurse implement first? - ANSWER>>Assess the surroundings for noise and distractions. The nurse caring for a client with acute renal fluid (ARF) has noted that the client has voided 800 ml of urine in 4 hours. Based on this assessment, what should the nurse anticipate that client will need? - ANSWER>>Large amounts of fluid and electrolyte replacement. Which intervention should the nurse include in the plan of care for a child with tetanus? - ANSWER>>Minimize the amount of stimuli in the room Suicide precautions are initiated for a child admitted to the mental health unit following an intentional narcotic overdose. After a visitor leaves, the nurse finds a package of cigarettes in the client's room.2023 HESI EXIT EXAM NEXT GENERATION (NGN) TEST BANK LATEST ACTUAL EXAM 200 QUESTIONS AND CORRECT DETAILED ANSWERS Which intervention is most important for the nurse to implement? - ANSWER>>Remove cigarettes for the client's room A family member of a frail elderly adult asks the nurse about eligibility requirements for hospice care. What information should the nurse provide? (Select all that apply.) - ANSWER>>A client must be willing to accept palliative care, not curative care. The healthcare provider must project that the client has 6 months or less to live. A client with atrial fibrillation receives a new prescription for dabigatran. What instruction should the nurse include in this client's teaching plan? - ANSWER>>Avoid use of nonsteroidal ant-inflammatory drugs (NSAID). A nurse with 10 years experience working in the emergency room is reassigned to the perinatal unit to work an 8 hour shift. Which client is best to assign to this nurse? - ANSWER>>A mother with an infected episiotomy An infant who is admitted for surgical repair of a ventricular septal defect (VSD) is irritable and diaphoretic with jugular vein distention. Which prescription should the nurse administer first? - ANSWER>>Digoxin. The nursing staff on a medical unit includes a registered nurse (RN), practical nurse (PN), and an unlicensed assistive personnel (UAP). Which task should the charge nurse assign to the RN? - ANSWER>>Supervise a newly hired graduate nurse during an admission assessment. While teaching a young male adult to use an inhaler for his newly diagnosed asthma, the client stares into the distance and appears to be concentrating on something other than the lesson the nurse is presenting. What action should the nurse take? - ANSWER>>Ask the client what he is thinking about at his time. After several hours of non-productive coughing, a client presents to the emergency room complaining of chest tightness and shortness of breath. History includes end stage chronic obstructive pulmonary disease (COPD) and diabetes mellitus. While completing the pulmonary assessment, the nurse hears wheezing and poor air movement bilaterally. Which actions should the nurse implement? (Select all that apply.) - ANSWER>>Administer PRN nebulizer treatment. Obtain 12 lead electrocardiogram. Monitor continuous oxygen saturation. The nurse caring for a 3-month-old boy one day after a pylorotomy notices that the infant is restless, is exhibiting facial grimaces, and is drawing his knees to his chest.2023 HESI EXIT EXAM NEXT GENERATION (NGN) TEST BANK LATEST ACTUAL EXAM 200 QUESTIONS AND CORRECT DETAILED ANSWERS What action should the nurse take? - ANSWER>>Administer a prescribed analgesia for pain. A 4-year-old with acute lymphocytic leukemia (ALL) is receiving a chemotherapy (CT) protocol that includes methotrexate (Mexate, Trexal, MIX), an antimetabolite. Which information should the nurse provide the parents about caring for their child? - ANSWER>>Use sunblock or protective clothing when outdoors. Two days after admission a male client remembers that he is allergic to eggs, and informs the nurse of the allergy. Which actions should the nurse implement? (Select all that apply) - ANSWER>>Notify the food services department of the allergy. Enter the allergy information in the client's record. Add egg allergy to the client's allergy arm band. The rapid response team's detects return of spontaneous circulation (ROSC) after 2 min of continuous chest compressions. The client has a weak, fast pulse and no respiratory effort, so the healthcare provider performs a successful oral, intubation. What action should the nurse implement? - ANSWER>>Perform bilateral chest auscultation. After administering an antipyretic medication. Which intervention should the nurse implement? - ANSWER>>Encouraging liberal fluid intake A client with hyperthyroidism is being treated with radioactive iodine (1-131). Which explanation should be included in preparing this client for this treatment? - ANSWER>>Describe radioactive iodine as a tasteless, colorless medication administered by the healthcare provider After a colon resection for colon cancer, a male client is moaning while being transferred to the Postanesthesia Care Unit (PACU). Which intervention should the nurse implement first? - ANSWER>>Determine client's pulse, blood pressure, and respirations The nurse is caring for a group of clients with the help of a licensed practical nurse (LPN) and an experienced unlicensed assistive personnel (UAP). Which procedures can the nurse delegate to the UAP? (Select all that apply) - ANSWER>>Take postoperative vital signs for a client who has an epidual following knee arthroplasty Collect a sputum specimen for a client with a fever of unknown origin Ambulate a client who had a femoral-popliteal bypass graft yesterday A male client with cirrhosis has ascites and reports feeling short of breath. The client is in semi Fowler position with his arms at his side. What action should the nurse implement? - ANSWER>>Raise the head of the bed to a Fowler's position and support his arms with a pillowA client with a history of chronic pain requests a nonopioid analgesic. The client is alert but has difficulty describing the exact nature and location of the pain to the nurse. Which action should the nurse implement next? - ANSWER>>Administer the analgesic as requested Rationale: Chronic pain may be difficult to describe but should be treated with analgesics as indicated. A client with a chronic health problem has difficulty ambulating short distance due to generalized weakness, but is able to bear weight on both legs. To assist with ambulation and provide the greatest stability, what assistive device is best for this client? - ANSWER>>Crutches with 2 point gait. Crutches with 3 point gait. Crutches with 4 point gait. A quad cane The nurse uses the parkland formula (4ml x kg x total body surface area = 24 hours fluid replacement) to calculate the 24-hours |V fluid replacement for a client with 40% burns who weighs 76kg. How many ml should the client receive? (Enter numeric value only.) - ANSWER>>Answer: 12160 Rationale: 4ml x 67kg x 40 (bsa) =12,160 ml A client with leukemia undergoes a bone marrow biopsy. The client's laboratory values indicate the client has thrombocytopenia. Based on this data, which nursing assessment is most important following the procedure? - ANSWER>>QObserve aspiration site. Assess body temperature Monitor skin elasticity Measure urinary output An 18-year-old female client is seen at the health department for treatment of condylomata acuminate (perineal warts) caused by the human papillomavirus (HPV). Which intervention should the nurse implement? - ANSWER>>Reinforce the importance of annual papanicolaou (Pap) smears. A client admitted to the psychiatric unit diagnosed with major depression wants to sleep during the day, refuses to take a bath, and refuses to eat. Which nursing intervention should the nurse implement first? - ANSWER>>Establish a structured routine for the client to follow. A client with history of bilateral adrenalectomy is admitted with a week, irregular pulse, and hypotension. Which assessment finding warrants immediate intervention by thenurse? - ANSWER>>Ventricular arrhythmias. Rationale: adrenal crisis, a potential complication of bilateral adrenalectomy, results in the loss of mineralocorticoids and sodium excretions that is characterized by hyponatremia, hyperkalemia, dehydration, and hypotension. Ventricular arrhythmias are life threatening and required immediate intervention to correct critical potassium levels. A resident of a long-term care facility, who has moderate dementia, is having difficulty eating in the dining room. The client becomes frustrated when dropping utensils on the floor and then refuses to eat. What action should the nurse implement? - ANSWER>>Encourage the client to eat finger foods. A client is receiving mesalamine 800 mg PO TID. Which assessment is most important for the nurse to perform to assess the effectiveness of the medication? - ANSWER>>Bowel patterns Rationale: the client should be assessed for a change in bowel patterns to evaluate the effectiveness of this medication because Mesalamine is used to treat ulcerative colitis (a condition which causes swelling and sores in the lining of the colon [large intestine] and rectum) and also to maintain improvement of ulcerative colitis symptoms. Mesalamine is in a class of medications called antiinflammatory agents. It works by stopping the body from producing a certain substance that may cause inflammation. While in the medical records department, the nurse observes several old medical records with names visible in waste container. What action should the nurse implement? - ANSWER>>Contact the medical records department supervisor. A 16-year-old adolescent with meningococcal meningitis is receiving a continuous IV infusion of penicillin G, which is prescribed as 20 million units in a total volume of 2 liters of normal saline every 24 hr. The pharmacy delivers 10 million units/ liters of normal saline. How many ml/hr should the nurse program the infusion pump? (Enter numeric value only. If rounding is required, round to the nearest whole number.) - ANSWER>>Answer 83 Rationale: 1000 ml-----12hr. 1000/12 = 83.33 = 83.While visiting a female client who has heart failure (HF) and osteoarthritis, the home health nurse determines that the client is having more difficulty getting in and out of the bed than she did previously. Which action should the nurse implement first? - ANSWER>>Submit a referral for an evaluation by a physical therapist. A client has an intravenous fluid infusing in the right forearm. To determine the client's distal pulse ratemost accurately, which action should the nurse implement? - ANSWER>>Palpate at the radial pulse site with the pads of two or three fingers. A child is admitted to the pediatric unit diagnosed with sickle cell crisis. When the nurse walks into the room, the unlicensed assistive personnel (UAP) is encouraging the child to stay in bed in the supine position. Which action should the nurse implement? - ANSWER>>Reposition the client with the head of the bed elevated. A preschool-aged boy is admitted to the pediatric unit following successful resuscitation from a near- drowning incident. While providing care to child, the nurse begins talking with his preadolescent brother who rescued the child from the swimming pool and initiated resuscitation. The nurse notices the older boy becomes withdrawn when asked about what happened. What action should the nurse take? - ANSWER>>Ask the older brother how he felt during the incident. After six days on a mechanical ventilator, a male client is extubated and place on 40% oxygen via face mask. He is awake and cooperative, but complaining of a severe sore throat. While sipping water to swallow a medication, the client begins coughing, as i strangled. What intervention is most important for the nurse to implement? - ANSWER>>Hold oral intake until swallow evaluation is done. The nurse is interacting with a female client who is diagnosed with postpartum depression. Which finding should the nurse document as an objective signs of depression? (Select all that apply) - ANSWER>>Interacts with a flat affect. Avoids eye contact. Has a disheveled appearance. A client in the postanesthesia care unit (PACU) has an eight (8) on the Aldrete postanesthesia scoring system. What intervention should nurse implement? - ANSWER>>Transfer the client to the surgical floor. In caring for the body of a client who just died, which tasks can be delegate to the unlicensed assistive personnel (UAP)? (Select all that apply.) - ANSWER>>Place personal religious artifacts on the body. Attach identifying name tags to the body. Follow cultural beliefs in preparing the body.An adult male reports the last time he received penicillin he developed a severe maculopapular rash all over his chest. What information should the nurse provide the client about future antibiotic prescriptions? - ANSWER>>Be alert for possible crosssensitivity to cephalosporin agents. A client with a prescription for "do not resuscitate” (DNR) begins to manifest signs of impending death. After notifying the family of the client's status, what priority action should the nurse implement? - ANSWER>>The client's need for pain medication should be determined. A client with cirrhosis of the liver is admitted with complications related to end stage liver disease. Which intervention should the nurse implement? (Select all that apply.) - ANSWER>>Monitor abdominal girth. Increase oral fluid intake to 1500 ml daily. Report serum albumin and globulin levels. Provide diet low in phosphorous. Note signs of swelling and edema. Rational: monitoring for increasing abdominal girth and generalized tissue edema and swelling are focused assessments that provide data about the progression of disease related complications. In advanced cirrhosis, liver function failure results in low serum albumin and serum protein levels, which caused third spacing that results in generalized fluid retention and ascites. Other options are not indicated in end stage liver disease. During discharge teaching, the nurse discusses the parameters for weight monitoring with a client who was recently diagnosed with heart failure (HF). Which information is most important for the client to acknowledge? - ANSWER>>Report weight gain of 2 pounds (0.9kg) in 24 hours Which problem, noted in the client's history, is important for the nurse to be aware of prior to administration of a newly prescribed selective serotonin reuptake inhibitor (SSRI)? - ANSWER>>Aural migraine headaches. When implementing a disaster intervention plan, which intervention should the nurse implement first? - ANSWER>>|nitiate the discharge of stable clients from hospital units Ildentify a command center where activities are coordinated Assess community safety needs impacted by the disaster Instruct all essential off-duty personnel to report to the facilityThe nurse is evaluating a client's symptoms, and formulates the nursing diagnosis, "high risk for injury due to possible urinary tract infection." Which symptoms indicate the need for this diagnosis? - ANSWER>>Fever and dysuria. A client is admitted with metastatic carcinoma of the liver, ascites, and bilateral 4+ pitting edema of both lower extremities. When the client complains that the antiembolic stocking are too constricting, which intervention should the nurse implement? - ANSWER>>Maintain both lower extremities elevated on pillows. A client with muscular dystrophy is concerned about becoming totally dependent and is reluctant to call the nurse to assist with activities of daily living (ADLs). To achieve maximum mobility and independence, which intervention is most important for the nurse to include in the client's plan of care? - ANSWER>>Teach family proper range of motion exercises. The nurse is teaching a postmenopausal client about osteoporosis prevention. The client reports that she smokes 2 packs of cigarettes a day and takes 750 mg calcium supplements daily. What information should the nurse include when teaching this client about osteoporosis prevention? - ANSWER>>Postmenopausal women need an intake of at least 1,500 mg of calcium daily. When evaluating a client's rectal bleeding, which findings should the nurse document? - ANSWER>>Color characteristics of each stool. The nurse is auscultating a client’s lung sounds. Which description should the nurse use to document this sound? - ANSWER>>High pitched or fine crackles. Rhonchi High pitched wheeze Stridor An adult male is admitted to the emergency department after falling from a ladder. While waiting to have a computed tomography (CT) scan, he requests something for a severe headache. When the nurse offers him a prescribed does of acetaminophen, he asks for something stronger. Which intervention should the nurse implement? - ANSWER>>Explain the reason for using only non-narcotics. The nurse is managing the care of a client with Cushing's syndrome. Which interventions should the nurse delegate to the unlicensed assistive personnel (UAP)? (Select all that apply) - ANSWER>>Weigh the client and report any weight gain. Report any client complaint of pain or discomfort. Note and report the client's food and liquid intake during meals and snacks.2023 HESI EXIT EXAM NEXT GENERATION (NGN) TEST BANK LATEST ACTUAL EXAM 200 QUESTIONS AND CORRECT DETAILED ANSWERS Ten years after a female client was diagnosed with multiple sclerosis (MS), she is admitted to a community palliative care unit. Which intervention is most important for the nurse to include in the client's plan of care? - ANSWER>>Medicate as needed for pain and anxiety. An increased number of elderly persons are electing to undergo a new surgical procedure which cures glaucoma. What effect is the nurse likely to note as a result of this increases in glaucoma surgeries? - ANSWER>>Decrease prevalence of glaucoma in the population. The nurse is caring for a client who is entering the second stage of labor. Which action should the nurse implement first? - ANSWER>>Convey to the client that birth is imminent. To evaluate the effectiveness of male client's new prescription for ezetimibe, which action should the clinic nurse implement? - ANSWER>>Remind the client to keep his appointments to have his cholesterol level checked. Diagnostic studies indicate that the elderly client has decreased bone density. In providing client teaching, which area of instruction is most important for the nurse to include? - ANSWER>>Fall prevention measures. A young adult client is admitted to the emergency room following a motor vehicle collision. The client's head hit the dashboard. Admission assessment include: Blood pressure 85/45 mm Hg, temperature 98.6 F, pulse 124 beat/minute and respirations 22 breath/minute. Based on these data, the nurse formulates the first portion of nursing diagnosis as " Risk of injury" What term best expresses the "related to" portion of nursing diagnosis? - ANSWER>>Infection Increase intracranial pressure Shock Head Injury. A male client who was diagnosed with viral hepatitis A 4 weeks ago returns to the clinic complaining of weakness and fatigue. Which finding is most important for the nurse to report to the healthcare provider? - ANSWER>>New onset of purple skin lesions. In assessing a client twelve hours following transurethral resection of the prostate (TURP), the nurse observes that the urinary drainage tubing contains a large amount of clear pale pink urine and the continuous bladder irrigation is infusing slowly. What action should the nurse implement? - ANSWER>>Ensure that no dependent loops are present in the tubing.