Exam (elaborations) MDA 224 HESI EXIT V6 2018

1. A parent tells the nurse that their 6 year-old child who normally enjoys school, has not been doing well since the grandmother died 2 months ago. Which statement most accurately describes thoughts on death and dying at this age? A) Death is personified as the bogeyman or devil B) Death is perceived as being irreversible C) The child feels guilty for the grandmother's death D) The child is worried that he, too, might die The correct answer is A: Death is personified as the bogeyman or devil 2. A 67 year-old client with non-insulin dependent diabetes should be instructed to contact the out-patient clinic immediately if the following findings are present A) Temperature of 37.5 degrees Celsius with painful urination B) An open wound on their heel C) Insomnia and daytime fatigue D) Nausea with 2 episodes of vomiting The correct answer is B: An open wound on their heel 3. The nurse admits an elderly Mexican-American migrant worker after an accident that occurred during work. To facilitate communication the nurse should initially A) Request a Spanish interpreter B) Speak through the family or co-workers C) Use pictures, letter boards, or monitoring D) Assess the client's ability to speak English The correct answer is D: Assess the client''s ability to speak English 4. In assessing a post partum client, the nurse palpates a firm fundus and observes a constant trickle of bright red blood from the vagina. What is the most likely cause of these findings? A) Uterine atony B) Genital lacerations C) Retained placenta D) Clotting disorder The correct answer is B: Genital lacerations 5. The nurse notes an abrupt onset of confusion in an elderly patient. Which of the following recently-ordered medications would most likely contribute to this change? MDA 224 HESI EXIT V6 2018 A) Anticoagulant B) Liquid antacid C) Antihistamine D) Cardiac glycoside The correct answer is C: Antihistamine 6. The nurse is caring for a client with active tuberculosis who has a history of noncompliance. Which of the following actions by the nurse would represent appropriate care for this client? A) Instruct the client to wear a high efficiency particulate air mask in public places. B) Ask a family member to supervise daily compliance C) Schedule weekly clinic visits for the client D) Ask the health care provider to change the regimen to fewer medications The correct answer is B: Ask a family member to supervise daily compliance 7. The nurse manager identifies that time spent by staff in charting is excessive, requiring overtime for completion. The nurse manager states that "staff will form a task force to investigate and develop potential solutions to the problem, and report on this at the next staff meeting." The nurse manager's leadership style is best described as A) Laissez-faire B) Autocratic C) Participative D) Group The correct answer is C: Participative 8. A nursing student asks the nurse manager to explain the forces that drive health care reform. The appropriate response by the nurse manager should include A) The escalation of fees with a decreased reimbursement percentage B) High costs of diagnostic and end-of-life treatment procedures C) Increased numbers of elderly and of the chronically ill of all ages D) A steep rise in health care provider fees and in insurance premiums The correct answer is A: The escalation of fees with a decreased reimbursement percentage 9. A client with hepatitis A (HAV) is newly admitted to the unit. Which action would be the priority to include in the plan of care within the initial 24 hours for this client? A) Wear masks with shields if potential splash B) Use disposable utensils and plates for meals C) Wear gown and gloves during client contact D) Provide soft easily digested food with frequent snacks The correct answer is C: Wear gown and gloves during client contact 10. A client has been taking alprazolam (Xanax) for 3 days. Nursing assessment should reveal which expected effect of the drug? A) Tranquilization, numbing of emotions B) Sedation, analgesia C) Relief of insomnia and phobias D) Diminished tachycardia and tremors associated with anxiety The correct answer is A: Tranquilization, numbing of emotions 11. The nurse observes a staff member caring for a client with a left unilateral mastectomy. The nurse would intervene if she notices the staff member is A) Advising client to restrict sodium intake B) Taking the blood pressure in the left arm C) Elevating her left arm above heart level D) Compressing the drainage device The correct answer is B: Taking the blood pressure in the left arm 12. A 70 year-old post-operative client has elevated serum BUN, Hct, Cl, and Na+. Creatinine and K+ are within normal limits. The nurse should perform additional assessments to confirm that an actual problem is: A) Impaired gas exchange B) Metabolic acidosis C) Renal insufficiency D) Fluid volume deficit The correct answer is D: Fluid volume deficit 13. The nurse is providing foot care instructions to a client with arterial insufficiency. The nurse would identify the need for additional teaching if the client stated A) "I can only wear cotton socks." B) "I cannot go barefoot around my house." C) "I will trim corns and calluses regularly." D) "I should ask a family member to inspect my feet daily." The correct answer is C: "I will trim corns and calluses regularly." 14. A woman who delivered 5 days ago and had been diagnosed with preeclampsia calls