HESI Study Materials

How does the nurse arrange the events of the positive feedback mechanism of estradiol chronologically?

1) The level of estradiol is increased during the menstrual cycle 2) Follicle-Stimulating Hormone production and release is increased 3) Estradiol levels are increased further due to FSH 4) Death of the follicle occurs 5) FSH levels in serum drop

A burn victim has waxy white areas interspersed with pink and red areas on the anterior trunk and all of both arms . The nurse calculates the percentage of TBSA. Which percentage will the nurse report?

36%. 18 from the anterior trunk, 4.5 respectively for front and back of R and L arm.

The nurse is teaching a client newly diagnosed with diabetes about the importance of glucose monitoring. Which blood glucose levels should the nurse identify as hypoglycemic?

68 mg/dL or 3.8 mmol/L

A client is suspected to have hyperpitiuitarism and is sent by the primary healthcare provider to undergo a suppression test. Which lab value would indicate a positive result?

6ng/mL (GH level in a suppression test above 5ng/mL indicates a positive result, where the client is suffering from hyperpituitarism)

The nurse is caring for the client posttranssphenoidal hypophysectomy. When assessing the client, the nurse observes clear drainage from the nares. What could be the cause of this drainage?

A cerebral spinal fluid leak from an opening to the brain. This procedure is the removal of the pituitary gland, which is very close to the brain. This should be reported to a HCP IMMEDIATELY and a sample should be sent to the lab for glucose evaluation. If the glucose is higher than 30mg/dL, it would indicate a CSF leak.

Which statement does the nurse know is true regarding a grade 2 goiter?

A goiter is usually asymmetrical

A client is admitted with a diagnosis of chronic adrenal insufficiency. Which roommate should be avoided when assigning a room for this client?

A young adult with pneumonia: circulatory collapse can be caused by exposure to an infection, cold, or overexertion of a client with chronic adrenocortical insufficiency (addison's disease)

A client is admitted for hypertension and serum electrolyte studies have yielded abnormal results. The scheduled workup includes a scan for an aldosteronoma. What gland is affected in aldosteronoma?

Adrenal Cortex

What is the most probable cause of Conn's Syndrome in an adult client?

Adrenal adenoma Conn's syndrome is primary hyperaldosteronism.

What assessment is the nurse's main priority during the early postoperative period after a subtotal thyroidectomy?

Airway obstruction

Which hormonal deficiency reduces the growth of axillae and pubic hair in female clients?

An adrenocorticotropic hormone deficiency.

What factors put a client at risk for bacterial infections?

Atopic Dermatitis Diabetes Mellitus Systemic Antibiotics

The nurse is caring for a client with burns and reviews the client's lab results: BUN: 30mg/dL or 10.2mmol/L Cr: 2.4 mg/dL or 184 mcmol/L K: 6.3 mEq/L pH: 7.1 Po2: 90mmHg Hgb: 7.4g/dL or 74 mmol/L What condition does the nurse suspect based upon these findings?

Azotemia. This is a condition where there is an accumulation of excessive nitrogenous compounds such as BUN and Cr in the blood.

While obtaining the client's health history, which factor does the nurse identify that predisopses the client to type 2 diabetes?

Being 20lbs overweight

A nurse is instructing a client with peptic ulcer disease (PUD) about the diet that should be followed during the acute phase. Which type of diet should the nurse stress?

Bland foods

A nurse explains to a client with diabetes that self-monitoring of blood glucose is preferred to urine glucose testing. Why is blood glucose monitoring preferred?

Blood glucose monitoring is more accurate

A nurse assesses a client with the diagnosis of an intestinal obstruction in the descending colon. When auscultating the midabdomen, what should the nurse expect to hear?

Borborygmi. These are rapid, high-pitched bowel sounds that indicate hyperperistalsis that occurs behind an intestinal obstruction.

A male client with ascites is to have a paracentesis and has signed the consent. While the nurse is caring for him, he says that he has changed his mind and no longer wants the procedure. Which initial response by the nurse is best?

Can you tell me why you decided to refuse the procedure?

What intervention should the nurse implement when caring for a client 24-hours post thyroidectomy?

Check the sites of the operative site dressing and the back of the neck. Bleeding tends to occur within the first 24 hours, and will pool to the back of the neck d/t gravity.

A client who is receiving combination chemotherapy for stage II Hodgkin disease is at risk for stomatitis. Which information should the nurse include in the teaching plan?

Clean the mouth with a soft toothbrush or gentle spray.

Which hormone does the nurse state is formed from cholesterol?

Cortisol

Which clinical manifestation is seen in a male client d/t deficiency of gonadotropin?

Decreased fertility

Which medical condition could most probably result in clients developing primary DI?

Defect in hypothalamus - hypothalamus is thirst and hunger center. Will result in primary DI. Meningitis or brain tumor would be central cause of DI.

Which disease is caused by the deficiency of antidiuretic hormone?

Diabetes insipidus

A client is diagnosed with hyperthyroidism, and surgery is scheduled because the client refuses ablation therapy. While awaiting the surgical date, what instruction should the nurse teach the client?

Eliminate coffee, tea and cola from diet. (Caffeine may increase thyroid activity)

When assessing a client's abdomen, the nurse palpates the area directly above the umbilicus. By what term is this area known?

Epigastric area

Which hormone secretion does the nurse state is an example of a positive feedback mechanism?

Estradiol

After surgery for creation of an ileostomy, a client is to be discharged. Before discharge, what is the primary nursing intervention?

Evaluating the client's ability to care for the ileostomy.

A PHCP prescribes a low-sodium, high potassium diet for a client with Cushing Syndrome. Which explanation should the nurse provide to the client about the need to follow this diet?

Excessive aldosterone and cortisone cause retention of Na and loss of K

A client reports their lips feel thicker, as well as joint pain and coarse facial features. What should the nurse suspect as the cause of the anterior pituitary hyperfunction?

Excessive secretion of GH. These are s/sxs of acromegaly, which is caused by pituitary gland hyperfunction leading to excessive secretion of GH.

A nurse is caring for a client with Addison's disease. Which information should the nurse include in a teaching plan to encourage this client to modify dietary intake?

Extra salt is needed to replace the amount being lost caused by lack of sufficient aldosterone to conserve sodium.

Which secondary skin lesion may include athlete's foot as an example?

Fissure

Four hours after surgery, the blood glucose of a client who has DM1 is elevated. What intervention should the nurse implement?

Give supplemental Regular Insulin

Which hormone overproduction is associated with carpal tunnel syndrome in clients?

Growth Hormone

A nurse is reviewing several charts. Which condition is Autoimmune?

Hashimoto's Disease (immune system attacks thyroid gland) NOT Addison's disease: caused by adrenal insufficiency NOT Cushing's Syndrome: caused by increased body levels of cortisol NOT Sheehan's Syndrome: hemorrhage-associated hypopituitarism after delivery of child

Which organ has only beta1 receptors?

Heart

What are the primary causes of adrenal insufficiency?

Hemorrhage Tuberculosis Acquired immune deficiency syndrome

During the first 48 hours after a client has sustained a thermal injury, which conditions should the nurse assess for?

Hyperkalemia and hyponatremia. Injured cells release potassium in the blood, sodium is lost in large amounts of edema.

A nurse is caring for a client with Addison's Disease. Upon assessment, which classic sign will the nurse find?

Hyperpigmentation

A client has a tentative diagnosis of Cushing Syndrome. What physical symptoms will the client exhibit?

Hypertension and moon face

The client's pituitary gland must be removed. Which surgery will the client undergo?

Hypophysectomy

A nurse is providing post op care for a client one hour after an adrenalectomy. Maintenance steroid therapy has not begun yet. The nurse should monitor the client for what complication?

Hypotension

When preparing a client for discharge after a thyroidectomy, the nurse teaches the signs of hypothyroidism. When teaching when to call the primary healthcare provider, what statement made by the client shows that teaching was effective?

I should call the primary healthcare provider for dry hair and an intolerance to cold.

A client is admitted with a head injury. The nurse identifies that the client's urinary catheter is draining large amounts of clear, colorless urine. What does the nurse identify as the most likely cause?

Inadequate antidiuretic hormone

Which skin color alteration may be observed in a client diagnosed with methemoglobinemia?

Indicates an increase in deoxygenated blood which is associated with methemoglobinemia.

Which is the target tissue for the parathyroid hormone?

Intestines

Which metabolic manifestations are likely to be observed in a client with hypothyroidism?

Intolerance to cold Decreased body temp

Which drug is prescribed for the client to treat severe nodulocystic acne?

Isotretinoin

An older client with diarrhea is admitted to the hospital from a nursing home. A stool specimen confirms a diagnosis of MRSA infection. The nurse is making room assignments asks if it is possible to place the new client with another client that also has MRSE in the same isolation room. How should the nurse respond?

It is safe to place people with the same infection in one room.

A nurse is caring for a client who just had surgery for a parotid tumor. Which nursing intervention is the priority in the immediate postoperative period?

Keeping the client's respiratory passages patent.

A client undergoes removal of a pituitary tumor through a transsphenoidal approach. What should the nurse implement postoperatively?

Maintain the head of bed at 30degree angle continuously: Decreases pressure on the sella turcica and promotes venous return, which limits cerebral edema.

Which hormones does the nurse state are released by the hypothatlamus?

Melanocyte Inhibiting hormone Corticotropin releasing hormone Growth hormone releasing hormone

A client with malignant hot nodules of the thyroid gland has a thyroidectomy. What is the nurse's priority action immediately postop?

Monitor the trachea for deviation to the right or left. This is an imminent sign of airway compromise requiring immediate intervention.

Which procedure is preferred to find out the composition of a thyroid nodule and ascertain the need for further surgical intervention in a client?

Needle Biopsy.

Which assessment finding in a client signifies a mild form of hypocalcemia?

Numbness around the mouth

Which client has a primary lesion?

One with erosions.

Which hormone is released form the posterior pituitary gland?

Oxytocin

Which hormones are secreted by the posterior pituitary gland?

Oxytocin ADH

A nurse is performing a health history and physical assessment of a client with cholelithiasis and obstructive jaundice. Which clinical finding should the nurse expect this client to exhibit?

Pain in the RUQ

Which cells does the nurse identify as producing thyrocalcitonin hormone?

Parafollicular cells

Which gland secretes melatonin?

Pineal Gland

Which condition results in elevated serum adrenocorticotropic hormone (ACTH) and urine cortisol levels?

Pituitary Cushing's Syndrome

Which does the nurse state is a secondary cause of adrenal insufficiency?

Pituitary Tumors. Primary cuases would be hemorrhage, TB, metastatic cancer

A nurse is caring for a client with severe burns. The nurse determines that this client is at risk for hypovolemic shock. Which physiologic finding supports the nurse's conclusion?

Plasma proteins moving out of the intravascular compartment. This causes the fluid to shift from the intravascular areas to interstitial areas, the result is decreased blood volume and hypovolemic shock. BLOOD IS NOT LOST IN A BURN, EXTRACELLULAR FLUID IS LOST!

What are the most common hormones produced in excess with hyperpituitarism?

Prolactin Growth Hormone

Which benign condition shows silver scaly plaques on the skin?

Psoriasis

Which skin lesion is found in clients with acne?

Pustule

Things NOT to do 24 hours post thyroidectomy

ROM exercises (increases pain and puts tension on suture line) Talking (only for pitch tone assessment, this indicates laryngeal nerve damage)

What is a clinical manifestation in a client with hyposecretion of growth hormone?

Reduced bone density

A client with DM1 is admitted to the hospital for major surgery. Before surgery, the client's insulin requirements are elevated but well controlled. What insulin requirements will the nurse anticipate for this client postop?

Remain elevated: Emotional and physical stress may cause insulin requirements to remain elevated in the post op period.

What is a mechanism of action for wet-to-damp saline-moistened gauze for wound debridement?

Removing the necrotic tissue mechanically.

A client is admitted to the hospital with suspected liver disease, and a needle biopsy of the liver is performed. After the procedure, the nurse should maintain the client in which position?

Right side-lying. This is because the liver is on the right side of the body, and lying on this side allows pressure against the needle insertion site and promotes hemostasis

A nurse is providing dietary teaching for a client with celiac disease. Which foods should the nurse teach the client to avoid when following a gluten-free diet?

Rye Oats Wheat

A nurse instructs a client with viral hepatitis about the type of diet that should be ingested. Which lunch selected by the patient indicates understanding about dietary principles associated with the diagnosis?

Salad, Slide Chicken Sandwich, Gelatin Dessert The diet should be high in carbs, with moderate protein and fat content. Lactose containing foods should be avoiding, for the virus interferes with the ability to break metabolize lactose. High fat diets should be avoided.

A nurse observes that a client's urine has a sweet fruity odor. Which information is most important to evaluate when performing a further client assessment?

Serum Glucose Level. This is a sign of ketoacidosis that results from uncontrolled diabetes often.

Which condition is characterized by hemorrhage after a pregnant female delivers?

Sheehan's Sydrome

A nurse in the postanesthesia unit is caring for a client who had a thyroidectomy. Which client response is most important for the nurse to monitor?

Signs of respiratory distress

Which hormone is released from the pancreas?

Somatostatin (inhibits release of insulin and glucagon)

A 24-hours urine test is prescribed for a client who has a tentative diagnosis of pheochromocytoma. What should then nurse do first?

Start the time of the test after discarding the first voiding

A client who is suspected of having salmonellosis asks the nurse how the diagnosis is confirmed. The nurse responds that the medical diagnosis is established with what laboratory value?

Stool culture

A client with hyperthyroidism asks the nurse about the tests that will be prescribed. Which diagnostic tests should the nurse include in a discussion with this client?

TSH assay and T3 (Decreased TSH and increased T2)

The nurse teaches the client about endocrine functioning of the anterior pituitary. Which information from the client indicates successful learning?

The anterior pituitary promotes growth

The RN instructs a new nurse in orientation regarding the physiologic processes of the endocrine system prior to client assessment. Which statement made by the new nurse indicates effective learning?

The hormones of the endocrine system exert their action by "lock and key" mechanism

A client is being prepared for surgery to have placement of a percutaneous endoscopic gastrostomy (PEG) tube. The client asks why the PEG tube is preferred over the existing nasogastric tube that is being used for feedings. What explanation does the nurse give for why a PEG tube is preferred for administering feedings?

There is less chance of aspiration for PEG tubes bypass the upper GI tract (oropharynx, esophagus, cardiac sphincter) which reduces the risk of tracheal aspiration.

Which adverse effect can be seen in a female client with gonadotropin deficiency and undergoing homrone replacement therapy?

Thrombosis

A client newly diagnosed with DM1 is taught to exercise on a regular basis. What is the primary reason for instruction on exercise?

To improve the cellular uptake of glucose. Exercise increases the metabolic rate, and glucose is needed for cellular metabolism, so excess glucose is consumed during exercise.

Which neurologic manifestation in a client is associated with hyperthyroidism?

Tremors

After reviewing the client's lab reports, the provider concludes that the client has primary hypofunction of the adrenal gland. Which clinical manifestation is likely to be observed in that client?

Uneven patches of pigment loss (vitiligo)

When assessing the laboratory values of a client with DM2, what would the nurse expect the results to reveal?

Urine negative for ketones and positive glucose in the blood

A nurse is caring for a client who has just returned from the postanesthesia care unit after having a thyroidectomy. Which action has priority during the first 24 hours after surgery when the nurse is concerned about thyroid storm?

Vital Signs.

A nurse is caring for a client with cholelithiasis. Which clinical manifestation does the nurse expect if the client develops obstructive jaundice?

Yellow Sclera

What will the nurse expect diagnostic studies of a client with Cushing Syndrome to indicate?

high levels of 17-ketosteroids in a 24 hours urine test Hyperaldosteronism Sodium Retention Potassium Excretion Decreased Eosinophil count High ACTH (adrenocorticotropic hormone) results