BSN 366 EXIT HESI FULL ACTUAL EXAM | ALL VERIFIED QUESTIONS ACCURATELY
ANSWERED
A male client with heart failure become short of breath, anxious, and has audible wheezing
with sputum pink and frothy. The nurse sits the client upright and provides oxygen per nasal
cannula. The nurse receives a prescription to administer a one time dose of morphine
sulfate IV. What action should the nurse take?
A) Consult with the charge nurse regarding the morphine prescription.
B) Administer the dose of morphine sulfate as prescribed.
C) Withhold the morphine until the clients dyspnea resolves.
D) Review the need for the prescription with the healthcare provider.
D) Review the need for the prescription with the healthcare provider.
A mother calls the nurse to report that aa 0900 she administered an oral dose of digoxin to
her four-month-old infant, but at 0920 the baby vomited the medicine. Which instruction
should the nurse provide to this mother?
A) Withhold this dose.
B) Mix the next dose with food.
C) Give another dose.
D) Administer a half dose now.
A) Withhold this dose.
,Bryant is receiving continuous ambulatory peritoneal dialysis since the AV graft in the right
arm is no longer available to use for hemodialysis. The client has lost weight, has
increasing peripheral edema, and has a serum albumin level of 1.5. Which intervention is a
priority for the nurse to implement?
A) Evaluate patency of the AV graft for resumption of hemodialysis.
B) Ensure the client receives frequent small meals containing complete proteins.
C) Instruct the client to continue to follow the prescribed rigid fluid regimen amounts.
D) Recommend the use of support stockings to enhance venous return.
B) Ensure the client receives frequent small meals containing complete proteins.
The nurse is assigning care of the client with prostatitis to a practical nurse. Which
instruction should the nurse provide the p.m. regarding care of this client?
A) Restrict oral fluid intake.
B) Strain all urine.
C) Maintain contact isolation.
D) Avoid urinary catheterization.
D) Avoid urinary catheterization.
The nurse observes an unlicensed assistive personnel who is preparing to provide personal
care for a client who requires contact precautions. The UAP has applied a gown and gloves
and secured the tops of the gloves over the gown sleeves. Which action should the nurse
take?
,A) Help the UAP reposition the gown sleeve over the glove edges.
B) Remind the UP to wash hands frequently while in the room.
C) Confirm that the gown is tied securely at the neck and waist.
D) Assist the UAP with application of a facemask or face shield.
C) Confirm that the gown is tied securely at the neck and waist.
A mother brings her four month old son to the clinic with a quarter taped over his
umbilicus, and tells the nurse that the quarter is supposed to fix her child's hernia. Which
explanation should the nurse provide?
A) Restrictive clothing will be adequate to help the hernia go away.
B) This hernia is a normal variation that resolves without treatment.
C) The quarter should be secured with an elastic bandage wrap.
D) An abdominal binder can be worn daily to reduce the protrusion.
B) This hernia is a normal variation that resolves without treatment.
At the end of a pre-operative teaching session on pain management techniques, a client
starts to cry and states, I just know I can't handle all the pain. Which is the priority nursing
problem for this client?
A) Knowledge deficit.
B) Pain (acute).
C) Anticipatory grieving.
D) Anxiety.
, D) Anxiety.
Adult male client reports that he recently experienced an episode of chest pressure and
breathlessness when he was jogging. The client expresses concern because both of his
deceased parents have heart disease and his father had diabetes. He lives with his male
partner, is a vegetarian, and takes atenolol which maintains his blood pressure at 130/74.
Which risk factors should the nurse explore further with the client? SATA.
A) History of hypertension.
B) Homosexual lifestyle.
C) Vegetarian diet.
D) Excessive aerobic exercise.
E) Family health history.
A) History of hypertension.
E) Family health history.
Nurse is educating a client about essential hypertension prevention. Which information
should the nurse provide? SATA.
A) Sodium intake can be regulated by limiting canned foods in the diet.
B) Salt substitutes can help with maintaining a healthy diet.
C) Alcohol consumption will not produce vascular changes.
D) Uncontrolled hypertension can lead to renal damage.
E) Blood pressure readings should be taken at noon time.
F) Weight management is promoted by taking daily walks for 30 minutes.
ANSWERED
A male client with heart failure become short of breath, anxious, and has audible wheezing
with sputum pink and frothy. The nurse sits the client upright and provides oxygen per nasal
cannula. The nurse receives a prescription to administer a one time dose of morphine
sulfate IV. What action should the nurse take?
A) Consult with the charge nurse regarding the morphine prescription.
B) Administer the dose of morphine sulfate as prescribed.
C) Withhold the morphine until the clients dyspnea resolves.
D) Review the need for the prescription with the healthcare provider.
D) Review the need for the prescription with the healthcare provider.
A mother calls the nurse to report that aa 0900 she administered an oral dose of digoxin to
her four-month-old infant, but at 0920 the baby vomited the medicine. Which instruction
should the nurse provide to this mother?
A) Withhold this dose.
B) Mix the next dose with food.
C) Give another dose.
D) Administer a half dose now.
A) Withhold this dose.
,Bryant is receiving continuous ambulatory peritoneal dialysis since the AV graft in the right
arm is no longer available to use for hemodialysis. The client has lost weight, has
increasing peripheral edema, and has a serum albumin level of 1.5. Which intervention is a
priority for the nurse to implement?
A) Evaluate patency of the AV graft for resumption of hemodialysis.
B) Ensure the client receives frequent small meals containing complete proteins.
C) Instruct the client to continue to follow the prescribed rigid fluid regimen amounts.
D) Recommend the use of support stockings to enhance venous return.
B) Ensure the client receives frequent small meals containing complete proteins.
The nurse is assigning care of the client with prostatitis to a practical nurse. Which
instruction should the nurse provide the p.m. regarding care of this client?
A) Restrict oral fluid intake.
B) Strain all urine.
C) Maintain contact isolation.
D) Avoid urinary catheterization.
D) Avoid urinary catheterization.
The nurse observes an unlicensed assistive personnel who is preparing to provide personal
care for a client who requires contact precautions. The UAP has applied a gown and gloves
and secured the tops of the gloves over the gown sleeves. Which action should the nurse
take?
,A) Help the UAP reposition the gown sleeve over the glove edges.
B) Remind the UP to wash hands frequently while in the room.
C) Confirm that the gown is tied securely at the neck and waist.
D) Assist the UAP with application of a facemask or face shield.
C) Confirm that the gown is tied securely at the neck and waist.
A mother brings her four month old son to the clinic with a quarter taped over his
umbilicus, and tells the nurse that the quarter is supposed to fix her child's hernia. Which
explanation should the nurse provide?
A) Restrictive clothing will be adequate to help the hernia go away.
B) This hernia is a normal variation that resolves without treatment.
C) The quarter should be secured with an elastic bandage wrap.
D) An abdominal binder can be worn daily to reduce the protrusion.
B) This hernia is a normal variation that resolves without treatment.
At the end of a pre-operative teaching session on pain management techniques, a client
starts to cry and states, I just know I can't handle all the pain. Which is the priority nursing
problem for this client?
A) Knowledge deficit.
B) Pain (acute).
C) Anticipatory grieving.
D) Anxiety.
, D) Anxiety.
Adult male client reports that he recently experienced an episode of chest pressure and
breathlessness when he was jogging. The client expresses concern because both of his
deceased parents have heart disease and his father had diabetes. He lives with his male
partner, is a vegetarian, and takes atenolol which maintains his blood pressure at 130/74.
Which risk factors should the nurse explore further with the client? SATA.
A) History of hypertension.
B) Homosexual lifestyle.
C) Vegetarian diet.
D) Excessive aerobic exercise.
E) Family health history.
A) History of hypertension.
E) Family health history.
Nurse is educating a client about essential hypertension prevention. Which information
should the nurse provide? SATA.
A) Sodium intake can be regulated by limiting canned foods in the diet.
B) Salt substitutes can help with maintaining a healthy diet.
C) Alcohol consumption will not produce vascular changes.
D) Uncontrolled hypertension can lead to renal damage.
E) Blood pressure readings should be taken at noon time.
F) Weight management is promoted by taking daily walks for 30 minutes.
