HESI RN EXIT EXAM 2024 REAL QUESTIONS WITH RATIONALES

Enalapril maleate (Vasotec) is prescribed for a hospitalized client. Which assessment does the nurse perform as a priority before administering the medication? • Checking the client's blood pressure • checking the client's peripheral pulses • checking the most recent potassium level • checking the client's intake and output record for the last 24 hours A) Checking theclient's blood pressure Rationale--enalapril maleate is an angiotensin-converting enzyme (ACE) inhibitor used to treat hypertension. One common side effect is postural hypotension. Therefore the nurse would checkthe client's blood pressure immediately before administering each dose. A client is scheduled to undergo an upper gastrointestinal (GI) series, and the nurse provides instructions to the client about the test. Which statement by the client indicates a need for further instruction? • "The test will take about 30 minutes" • "I need to fast for 8 hours before the test" • "I need to drink citrate of magnesia the night before the test and give myself a Fleet enema onthe morning of the test." • "I need to take a laxative after the test is completed, because the liquid that I'll have to drink for the test can be constipating." C) "I need to drink citrate of magnesia the night before the test and give myself a Fleet enema on the morning of the test." Rationale An upper GI series involves visualization of the esophagus, duodenum, and upper jejunum by means of the use of a contrast medium. It involves swallowing a contrast medium (usually barium), which is administered in a flavored milkshake. Films are takenat intervals during the test, which takes about 30 minutes. No special preparation is necessary before a GI series, except that NPO status must be maintained for 8 hours before the test. After an upper GI series, the client is prescribed a laxative to hasten elimination of the barium. Barium that remains in the colon may become hard and difficult to expel, leading to fecal impaction. A nurse on the evening shift checks a physician's prescriptions and notes that the dose of a prescribed medication is higher than the normal dose. The nurse calls the physician's answering service and is told that the physician if off for the night and will be available the next morning. The nurse should: • call the nursing supervisor • Ask the answering service to contact the on-call physician • Withhold the medication until the physician can be reached in the morning • Administer the medication but consult the physician when he becomes available B) Ask the answering service to contact the on-call physician An emergency department (ED) nurse is monitoring a client with suspected acute myocardial infarction (MI) who is awaiting transfer to the coronary intensive care unit. The nurse notes the sudden onset of premature ventricular contractions (PVCs) on the monitor, checks the client's carotid pulse, and determines that the PVCs are not resulting in perfusion. The appropriate action by the nurse is: • Documenting the findings • Asking the ED physician to check the client • Continuing to monitor the client's cardiac status • Informing the client that PVCs are expected after an MI B. Asking the ED physician to check the client