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HESI RN MEDICAL SURGICAL EXAM Questions Answers & Rationales The nurse assesses a postoperative client whose skin is cool, pale, and moist. The client is very restless and has scant urine output. Oxygen is being administered at 2 L/min, and a saline lock is in place. Which intervention should the nurse implement first? A. Measure the urine specific gravity. B. Obtain IV fluids for infusion per protocol. C. Prepare for insertion of a central venous catheter. D. Auscultate the client's b...

HESI RN Med Surg II A nurse is caring for a client who is learning how to take care of a newly created colostomy. When observing a return demonstration of the colostomy irrigation, the nurse evaluates that more teaching is required when the client: Hangs the irrigation bag on the door clothes hook during fluid insertion Following surgery, a client asks the nurse if he or she can help measure intake and output. What is the best nursing response? Assess the client's ability to measure t...

Fundamental HESI Which assessment data would provide the most accurate determination of proper placement of a nasogastric tube? A) Aspirating gastric contents to assure a pH value of 4 or less. B) Hearing air pass in the stomach after injecting air into the tubing. C) Examining a chest x-ray obtained after the tubing was inserted. D) Checking the remaining length of tubing to ensure that the correct length was inserted. C) Examining a chest x-ray obtained after the tubing was inserted B...

HESI RN Fundamentals B 1.What is the rationale for using the nursing process in planning care for clients? A. As a scientific process to identify nursing diagnoses of a clients' healthcare problems. B. To establish nursing theory that incorporates the biopsychosocial nature of humans. C. As a tool to organize thinking and clinical decision making about clients' healthcare needs. D. To promote the management of client care in collaboration with other healthcare professionals. C (The nursi...

HESI RN Medical Surgical EXAM The nurse is assessing a clients laboratory values following the administration of chemotherapy. Which lab value leads the nurse to suspect that the client is experiencing tumor lysis syndrome? A. Hemoglobin of 10 g/dl B. Serum calcium of 5mg/dl C. Serum PTT of 10 seconds D. Oxygen saturation of 90% Answer: B TLS results in hyperkalemia, hypocalcemia, hyperuricemia, and hyperphosphatemia. A serum calcium level of 5 is low and so is an indicator of possibl...

HESI RN MEDICAL SURGICAL EXAM Questions Answers & Rationales The nurse assesses a postoperative client whose skin is cool, pale, and moist. The client is very restless and has scant urine output. Oxygen is being administered at 2 L/min, and a saline lock is in place. Which intervention should the nurse implement first? A. Measure the urine specific gravity. B. Obtain IV fluids for infusion per protocol. C. Prepare for insertion of a central venous catheter. D. Auscultate the client's b...

HESI RN EXIT V2 1. The nurse knows that which statement by the mother indicates that the mother understands safety precautions with her four month-old infant and her 4 year-old child? A) "I strap the infant car seat on the front seat to face backwards." B) "I place my infant in the middle of the living room floor on a blanket to play with my 4 year old while I make supper in the kitchen." C) "My sleeping baby lies so cute in the crib with the little buttocks stuck up in the air while...

Chris jay HESI RN adaptive quiz A 20-year-old woman comes into the clinic after missing her menstrual period 2 weeks ago and states that she suspects that she is pregnant. As the nurse is reviewing her medications, the client says that she is taking isotretinoin. What should the nurse consider regarding isotretinoin? it is a teratogen A nurse is teaching skin and basic care to the mother of a 6-month-old infant with eczema. Which statement indicates that the mother needs further teachi...

HESI Med-Surg Respiratory What is a common adverse effect of the tetracycline antibiotics? Photosensitivity Why should tetracyclines be avoided in pregnant clients and children under 8 years? It can cause yellow-brown discoloration of teeth and growth retardation Antibiotics ending in -mycin are usually? nephrotoxic and ototoxic What is the patho behind chronic bronchitis? Chronic sputum with cough production on a daily basis for a minimum of 3 months in each of 2 consecutive years ch...

HESI Med-Surg (Respiratory) List four common symptoms of pneumonia that the nurse might note on a physical examination. Fever and chills, diminished breath sounds, productive cough and tachypnea State 4 nursing interventions for assisting the client to cough productively Encourage deep breathing, staying hydrated, humidify to loosen secretions, and suction airway to stimulate coughing. What symptoms of pneumonia might the nurse expect to see in an older client? Confusion, lethargy, rapid...