Extra HESI 290 Practice Questions

An ABG report indicates the client's pH is 7.25, PCO2 is 35 mmHG, and HCO3 is 20 mEq/L. Which disturbance would the nurse identify based on these results? A) metabolic acidosis B) metabolic alkalosis C) respiratory acidosis D) respiratory alkalosis

A) metabolic acidosis

A client shows an increase in respiratory rate that is abnormally deep and regular. Which condition would the nurse expect? A) hypoventilation B) Biot respiration C) Kussmaul's respirations D) Cheyne-Stokes respirations

C) Kussmaul's respirations

Which action would the nurse anticipate taking when a client with anxiety begins hyperventilating and reports feeling dizzy? A) administering O2 B) offering an incentive spirometer C) having the client breathe in and out of a paper bag D) administering IV sodium bicarbonate

C) having the client breathe in and out of a paper bag

Which prescribed intervention would the nurse question for a client who has just been diagnosed with influenza after having symptoms for 4 days? A) loratadine B) ibuprofen C) oseltamivir D) acetaminophen

C) oseltamivir ***antiviral meds such as oseltamivir must be taken within 48 hours after onset of symptoms to be effective

A client with COPD has a blood pH of 7.25 and PCO2 of 60. These ABG results require nursing attention because they indicate which condition? A) metabolic acidosis B) metabolic alkalosis C) respiratory acidosis D) respiratory alkalosis

C) respiratory acidosis

Which nursing action is a priority before administering prescribed furosemide? A) weigh the client B) assess skin turgor C) review the potassium level results D) check the 24-hour I&Os

C) review the potassium level results

When assessing a client with a diagnosis of left ventricular failure, which statement by the client would the nurse expect? A) "My ankles are swollen" B) "My appetite is not very good" C) "When I eat a large meal, I feel bloated" D) "I have trouble breathing when I walk rapidly"

D) "I have trouble breathing when I walk rapidly" ***dyspnea on exertion often occurs with left ventricular heart failure because the heart is unable to pump enough oxygenated blood to meet the energy requirements for muscle contractions related to the activity

The nurse administers a parenteral preparation of potassium slowly to avoid which complication?

cardiac arrest ***too rapid an administration can cause hyperkalemia, which contributes to a long refractory period in the cardaic cycle resulting in cardiac dysrhythmias and arrest

Which change in the ABG would the nurse expect in a client with hyperventilation due to anxiety?

respiratory alkalosis

Which assessment findings are consistent with a client diagnosis of right-sided heart failure? SELECT ALL THAT APPLY. - collapsed neck veins - distended abdomen - dependent edema - decreased appetite - cool extremities

- distended abdomen - dependent edema - decreased appetite

When a client is diagnosed with left-sided congestive HF, which assessment findings would the nurse expect? SELECT ALL THAT APPLY. - dyspnea - crackles - frequent cough - peripheral edema - jugular distention

- dyspnea - crackles - frequent cough

Which signs of hypokalemia would the nurse monitor in the postoperative surgical client with a nasogastric tube attached to continuous low suction? SELECT ALL THAT APPLY. - irritability - dysrhythmias - muscle weakness - abdominal cramps - acidosis

- dysrhythmias - muscle weakness

The nurse is caring for a client with dysphagia. Which interventions would the nurse include in the plan of care? SELECT ALL THAT APPLY. - recline after meals - rinse mouth with water - keep suction equipment nearby - provide thickened liquids - sit in high Fowler position

- keep suction equipment nearby - provide thickened liquids - sit in high Fowler position

When a client is admitted with dehydration. which clinical manifestations would the nurse expect to find? SELECT ALL THAT APPLY. - oliguria - dyspnea - hypotension - pulmonary crackes - tenting skin turgor

- oliguria (low urine output) - hypotension - tenting skin turgor

When caring for a client with PAD, which assessment findings will the nurse expect? SELECT ALL THAT APPLY. - absence of hair on the toes - pink and moist ankle ulcers - pitting edema of the lower legs - reports of pain associated with exercising - increased pigmentation of the medial malleolus area

- reports of pain associated with exercising - absence of hair on the toes

Which explanation would the nurse include when teaching a client with heart failure about the reason for a low-sodium diet? A) body weight control B) decreased fluid retention C) lowering of blood pressure D) prevention of hypernatremia

B) decreased fluid retention

Which assessment finding of a client with heart failure would prompt the nurse to contact the health care provider? SELECT ALL THAT APPLY. - fatigue - orthopnea - pitting edema - dry hacking cough - 4-pound weight gain

- fatigue - orthopnea - pitting edema - dry hacking cough - 4-pound weight gain

When caring for a client with heart failure, which type of lung sounds would the nurse expect to hear? A) stridor B) crackles C) wheezes D) rhonchi

B) crackles ***left-sided heart failure caused fluid accumulation in the capillary network of the lungs; fluid eventually enters alveolar spaces and causes crackling sounds at the end of inspiration

Which findings are consistent with hypercalcemia after prolonged immobility? SELECT ALL THAT APPLY. - bone pain - convulsions - muscle spasms - tingling of extremities - depressed deep tendon reflexes

- bone pain - depressed deep tendon reflexes *** increased serum calcium comes from bone demineralization, which results in bone pain. Depressed or absent deep tendon reflexes are associated with hypercalcemia

When caring for a client with a diagnosis of right ventricular heart failure, the nurse expects which assessment findings? SELECT ALL THAT APPLY. - dependent edema - swollen hands/fingers - collapsed neck veins - right upper quadrant discomfort - oliguria

- dependent edema - swollen hands/fingers - right upper quadrant discomfort

How would anxiety affect outcomes for a client with HF?

anxiety increases the cardiac workload

Which med requires the nurse to monitor the client for signs of hyperkalemia?

spironolactone ***is a potassium-sparing diuretic

When caring for a client who has hypokalemia, which ECG change will the nurse expect to observe? A) inverted P waves B) flattened T waves C) absence of U waves D) elevated ST segment

B) flattened T waves

For which clinical manifestations will the nurse monitor when caring for a client admitted with heart failure? SELECT ALL THAT APPLY. - weight loss - unusual fatigue - dependent edema - noctural dyspnea - increased urinary output

- unusual fatigue - dependent edema - noctural dyspnea

Metroprolol is prescribed for a client with hypertension. The nurse monitors the client for which adverse effect? A) hirsutism B) bradycardia C) restlessness D) angina

B) bradycardia *** beta blockers lower heart rate and blood pressure so we need to monitor both

A client with known PAD calls the clinic and tells the nurse about experiencing several symptoms. Which symptom requires the MOST rapid action by the nurse? A) anxiety B) chest pain C) weak pulse quality D) cool/pale lower legs

B) chest pain

Which clinical sign is the MOST important indication of an accurate degree of dehydration? A) dry skin B) weight loss C) sunken fontanel D) decreased urine output

B) weight loss *** loss of fluid as a result of dehydration is most objectively assessed by weighing the patient daily

When taking the health history for a client admitted with heart failure, which assessment finding will the nurse expect the client to report? A) losing weight over the past week B) tingling in the upper extremities C) using several pillows at night to sleep D) wheezing when exposed to dust or pollen

C) using several pillows at night to sleep ***heart failure causes pulmonary congestion, leading to orthopnea and the need to elevate the head and chest with pillows when lying down

The nurse provides discharge teaching to a client who has received prescriptions for digoxin, furosemide, and a 2-g sodium diet. Which statement from the client indicates that further teaching is needed? A) "I must check my pulse every day" B) "I can gradually increase my exercise as long as I take rest periods" C) "I should call my HCP if I have difficulty breathing when I am lying flat" D) "I can use a little table salt on my food as long as I do not use it when cooking"

D) "I can use a little table salt on my food as long as I do not use it when cooking" ***table salt and foods high in sodium SHOULD BE AVOIDED

When a client with venous insufficiency has questions about the brownish discoloration of the skin on the legs, which response will the nurse make to explain the discoloration? A) "the arterial blood supply is in adequate" B) "there is delayed healing in the area after an injury" C) "the production of melanin in the area has increased" D) "there is leakage of RBCs through the vein wall"

D) "there is leakage of RBCs through the vein wall"

After a gastrectomy, a client has a NG tube set to low continuous suction. The client begins to hyperventilate. How would the nurse anticipate that this breathing pattern will alter the client's ABG? A) increase the PO2 level B) decrease the pH level C) increase the HCO3 level D) decrease the pCO2 level

D) decrease the pCO2 level

Which information about a client who has heart failure would the nurse communicate to the health care provider before administration of the prescribed digoxin? A) apical pulse rate 96 beats/minute B) bilateral foot/ankle pitting edema C) crackles heard at the base of both lungs D) potassium level of 2.3 mEq/L

D) potassium level of 2.3 mEq/L ***symptoms of digoxin toxicity, including life-threatening dysrhythmias, can occur when digoxin is administered to a client with hypokalemia

When the clinic nurse is teaching a group of clients with heart failure about dietary interventions to prevent fluid overload, which topic will be included? A) fluid intake restrictions B) low-calorie diet for weight loss C) avoidance of high-fat, high-cholesterol foods D) use of fresh/frozen veggies instead of canned ones

D) use of fresh/frozen veggies instead of canned ones ***canned foods have high sodium contents and should be avoided

What is the DASH diet?

Dietary Approaches to Stop Hypertension includes: - fruits - veggies - low-fat/fat-free foods - fish/poultry - reduced sugar

When teaching a group of older adults about differences between the common cold and influenza, the nurse would educate the clients that it is MOST important to communicate with the health care provider about which symptom?

elevated temperature