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HESI-RN Comprehensive Exam A Questions with Verified Answers

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The nurse is providing care to an 86-year-old admitted with generalized weakness. Dietary modifications and levothyroxine are prescribed. Which physiologic finding in an older adult could precipitate an adverse reaction to the medication? A. Reduced renal excretion B. Reduced gastrointestinal motility C. Increased hepatic metabolism D. Increased risk of autoimmune disorders - ANSWERSA Rationale: During the aging process, reduced renal function is common and contributes to drug accumulation that contributes to adverse reactions. Reduced hepatic function, not option C, predisposes an older adult to an increase in adverse drug reactions. Option B may occur frequently in an older client but does not impact the bioavailability of drugs. Although an older adult may have a decreased immune response, the aging client's risk for autoimmune disorders is not increased, nor does it affect drug pharmacotherapeutics The charge nurse of a 16-bed medical unit is making 0700 to 1900 shift assignments. The team consists of two RNs, two PN/VNs, and two UAP. Which assignment is the most effective use of the available team members? A. Assign the PNs to perform am care and assist with feeding the clients. B. Assign the UAPs to take vital signs and obtain daily weights. C. Assign the RNs to answer the call lights and administer all medications. D. Assign the PN/VNs to assist health care providers on rounds and perform glucometer checks. - ANSWERSB Rationale: A UAP can take vital signs and daily weights on stable clients. UAPs can perform am care and feed clients, which is a better use of personnel than assigning the task to the PN. All team members can answer call lights, and PNs can administer some of the medications, so assigning the RN these tasks is not an effective use of the available personnel. The RN is the best team member to assist on rounds, and the UAP can perform glucometer checks, so assigning the PN these tasks is not an effective use of available personnel.

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Comprehensive Exam Peds Questions
with Correct Answers
The presence of which vitamin is most effective in enhancing absorption of iron?

a. Vitamin A
b. Vitamin B
c. Vitamin C
d. Vitamin D - ANSWERSc. Vitamin C

Which of the following children with sickle cell anemia is at greatest risk for exacerbation
of the disease?

a. Anita, who lives in Pittsburgh and is visiting Denver, CO to go snow skiing
b. Jacques, who is spending a warm summer day swimming with his friends
c. Ed, who is learning how to rollerblade
d. Janessa, who is in a gymnastics class - ANSWERSa.

Takisha, age 8, has been admitted tot he hospital in sickle cell crisis. She complains of
pain all over her body. Which intervention by the new nurse requires the supervising
nurse to intervene? The new nurse:

a. allows Takisha to determine the level of activity she can tolerate
b. provides Takisha passive range of motion exercises
c. administers fluids to maintain hydration status
d. applies ice packs to specific painful areas of the body - ANSWERSd.

In a child with beta-thalassemia major, the nurse would expect to find which of the
following clinical manifestations?

a. long thin nose
b. malocclusion
c. narrow set eyes
d. concave forehead - ANSWERSb.

The first line of treatment for type I, or mild type II, von WIllebrand's diease is:

a. desmopressin
b. heparin
c. warfarin sodium
d. protamine - ANSWERSa.

,Which of hte following over-the-counter medications should not be taken by a child who
has immune thrombocytopenic purpura?

a. ibuprofen (Motrin)
b. asprin
c. acetaminophen (Tylenol)
d. ibuprofen (Advil) - ANSWERSb.

The child with disseminated intravascular coagulation is at greatest risk for the
development of which complication?

a. infection
b. airway obstruciton
c. hemorrhage
d. impaired skin integrity - ANSWERSc.

A caregiver of a child with a bleeding disorder has been taught the actions to take for
treatment of a nosebleed. Which statement by teh caregiver indicates that more
teaching is needed? If the child experiences a nosebleed I will:

a. lie the child down
b. pinch the child's nose
c. hold the nose for at least 10 minutes
d. apply ice to the bridge of the nose - ANSWERSa.

Which of the following is considered appropriate treatment for hemophilia B?

a. factor VIII concentrates
b. Desmopressin
c. aspirin
d. factor IX concentrates - ANSWERSd.

Which of the following is a side effect associated with cyclosporine therapy fo rhte
treatment of aplastic anemia?

a. decreased blood pressure
b. loss of body hair
c. gingival hyperplasia
d. decreased potassium - ANSWERSc.

Which of the following are compensatory mechanisms for anemia? Select all that apply.

a. increased erythropoiesis
b. decreased heart rate
c. retention of sodium
d. increased respiratory rate

, e. retention of water
f. leukocytosis - ANSWERSa,c,d,e

Marty, age 14, has iron deficiency anemia. When talking wtih him about which types of
foods to choose that are high in iron conent, the nurse suggests which of the following?
Select all that apply.

a. peas
b. potatoes
c. bananas
d. peaches
e. rasins
f. shrimp - ANSWERSa,b,d,e,f

Initial signs and symptoms of iron overdose include which of the following? Select all
that apply.

a. skin rash
b. vomiting
c. abdominal pain
d. bloody diarrhea
e. lethargy
f. dsypnea - ANSWERSb,c,d,e,f

Which of the following are stimuli for sickle cell crisis? Select all that apply.

a. exposure to heat
b. infection
c. fever
d. acidosis
e. diet high in carbohydrates
f. immunizations - ANSWERSb,c,d

A student nurse is obtaining a height for an 18-month old infant. Which action by the
student nurse requires the supervising nurse to intervene? The student nurse:

a. records the child's height to the nearest full inch
b. uses the supine position to measure the child's height
c. places the soles of the child's feet in a 90-degree angle to the footboard
d. measures the child when the child is barefoot - ANSWERSa

Which statement by a parent of a child receiving growth hormone replacement therapy
indicates taht more teaching is needed? I will call the primary care provider immediately
if my child experiences:

a. rapid weight gain
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