Exam 3 Office Hours and HESI Questions

A nursing instructor is teaching nursing students about mixing insulins. Which point would the nursing instructor want to include in their teaching? A. "I can mix short-acting insulin (regular) and intermediate-acting (NPH) in the same syringe." B. "I can mix short-acting insulin (regular) and insulin glargine (Lantus) in the same syringe." C. "I can mix intermediate-acting insulin (NPH) and insulin degludec (Tresiba) in the same syringe." D. "I cannot mix any type of insulins together."

A. "I can mix short-acting insulin (regular) and intermediate-acting (NPH) in the same syringe."

A nurse is teaching a client newly diagnosed with type 1 diabetes about the adverse effects of insulin. What would the nurse include in their teaching? A. "I need to be aware that becoming cool, shaky, and clammy could be signs that my sugar has gotten too low." B. "I need to be aware to rotate insulin injection sites so scar tissue does not develop." C. "I could gain weight while on insulin." D. "I could experience an allergic reaction to insulin." E. "Insulin can be taken in tablet form."

A. "I need to be aware that becoming cool, shaky, and clammy could be signs that my sugar has gotten too low." B. "I need to be aware to rotate insulin injection sites so scar tissue does not develop." C. "I could gain weight while on insulin." D. "I could experience an allergic reaction to insulin."

A nurse is teaching a client about the difference between type 1 and type 2 diabetes. Which points would the nurse include in their teaching? Select all that apply A. "Type 1 diabetes can only be treated with insulin because of the immune destruction of beta cells, which then leads to little or no insulin production." B. "Type 1 diabetes has a rapid onset where type 2 diabetes has a slow, insidious onset." C. "Type 1 and type 2 are not metabolic disorders." D. "Type 1 and type 2 are characterized by hypoglycemia." E. "Type 1 diabetes is more common than type 2 diabetes."

A. "Type 1 diabetes can only be treated with insulin because of the immune destruction of beta cells, which then leads to little or no insulin production." B. "Type 1 diabetes has a rapid onset where type 2 diabetes has a slow, insidious onset."

The nurse is teaching the patient about chronic complications of diabetes. Which chronic complications would the nurse include? Select all that apply A. Retinopathy B. Diabetic nephropathy C. Diabetic ketoacidosis D. Stroke E. Gingivitis F. Peripheral artery disease G. Hyperglycemic hyperosmolar syndrome (HHS)

A. Retinopathy B. Diabetic nephropathy D. Stroke E. Gingivitis F. Peripheral artery disease

A nurse is providing care to a client diagnosed with diabetic ketoacidosis (DKA). Which client findings does the nurse recognize that supports the diagnosis of DKA? Select all that apply A. A pH of 7.2 B. Rapid, deep breaths C. A serum blood sugar of 499 mg/dL D. Blurred vision E. Headache F. Bicarbonate (HCO3) of 14 mEq/L G. A pH of 7.5 H. Bicarbonate (HCO3) of 30 mEq/L

A. A pH of 7.2 B. Rapid, deep breaths C. A serum blood sugar of 499 mg/dL D. Blurred vision E. Headache F. Bicarbonate (HCO3) of 14 mEq/L

Which assessment would the nurse perform before administering a dose of vancomycin to a client? Select all that apply A. Creatinine B. Trough level C. Hearing ability D. Intravenous site E. Blood urea nitrogen

A. Creatinine B. Trough level C. Hearing ability D. Intravenous site E. Blood urea nitrogen

Which manifestation may indicate that the client with type 1 diabetes has insulin-induced hypoglycemia? Select all that apply A. Excessive hunger B. Weakness C. Diaphoresis D. Excessive thirst E. Deep respirations

A. Excessive hunger B. Weakness C. Diaphoresis

Which manifestation would lead a nurse to suspect that a client with uncontrolled diabetes is experiencing hypoglycemia in response to insulin administration? Select all that apply A. Headache B. Confusion C. Extreme thirst D. Produse sweating E. Increased urination

A. Headache B. Confusion D. Produse sweating

Which assessment finding during the administration of intravenous penicillin would prompt the nurse to stop the infusion? Select all that apply A. Hives B. Itching C. Nausea D. Skin rash E. Shortness of breath

A. Hives B. Itching D. Skin rash E. Shortness of breath

Which action would the nurse take to avoid red man syndrome when preparing to administer a vancomycin infusion? A. Infuse slowly B. Change the intravenous (IV) site C. Reduce the dosage D. Administer vitamin K

A. Infuse slowly

Which information would the nurse include in the teaching plan of an adolescent who is found to have type 1 diabetes? Select all that apply A. Insulin therapy B. Prophylactic antibiotics C. Blood glucose monitoring D. Oral hypoglycemic agents E. Adherence to the treatment regimen

A. Insulin therapy C. Blood glucose monitoring E. Adherence to the treatment regimen

Which clinical finding is commonly associated with hyperglycemia? Select all that apply A. Polyuria B. Polydipsia C. Polyphagia D. Polyphrasia E. Polydysplasia

A. Polyuria B. Polydipsia C. Polyphagia

The nurse understands which interventions can inhibit reservoirs for microorganisms from developing? A. Wiping away excess water around the sink in the client's room B. Utilize aseptic technique when inserting an indwelling catheter C. Identifying high-risk clients D. Rapid identification of a microorganism

A. Wiping away excess water around the sink in the client's room

Which symptoms would the nurse observe in a client with hyperglycemia and ketoacidosis? A. Irritability B. Dry skin C. Diaphoresis D. Increased thirst E. Deep, rapid breathing

B. Dry skin D. Increased thirst E. Deep, rapid breathing

A client has been admitted to the hospital for osteomyelitis. The client labs: BUN 38, Cr 2.1. Which medication should the nurse question administering? A. Ciprofloxacin 500 mg by mouth every 12 hours B. Gentamicin 80 mg IV every day C. Cefepime 1 g IV every 12 hours D. Ceftaroline 200 mg IV every 12 hours

B. Gentamicin 80 mg IV every day

The nurse is in the ED caring for a 72-year-old female client. 11:00: The client presents to the ED reporting nausea, stomach pains, and severe diarrhea that started 24 hours ago. Skin warm, dry, tenting, and flushed Alert and oriented x4. PERRLA 3/2 bilaterally. Breath sounds clear throughout all lobes anteriorly and posteriorly. Heart rate regular. Bowel sounds normoactive x4 quadrants. +2 pedal pulses. Capillary refill less than 2 seconds. Vital signs ED Day 1 Temp- 101.1 F (37.9 C) HR- 104 RR- 22 BP- 92/58 O2 Sat- 98% on RA Labs ED Day 1 White blood cell ((4,500-11,000)- 11,000 BUN (10-20)- 35 Cr (.7-1.4)- 1.1 Select the 6 client findings A. Client orientation B. Nauseas C. Stomach pain D. Severe diarrhea E. Lung sounds F. Skin G. PERRLA H. Capillary refill I. Heart sounds J. Vital signs K. Lab findings

B. Nauseas C. Stomach pain D. Severe diarrhea F. Skin J. Vital signs K. Lab findings

The nurse is preparing discharge instruction for a client who acquired a nosocomial Clostridium difficile infection. Which would the nurse include in the instructions? A. Anticipate that nausea and vomiting will continue until the infection is no longer present B. The infection cause diarrhea accompanied by flatus and abdominal discomfort C. consume a diet that is high in fiber and low in fat D. Other than routine hand washing, it is not necessary to perform special disinfection procedures

B. The infection cause diarrhea accompanied by flatus and abdominal discomfort

When determining the main difference between type 1 and type 2 diabetes, the nurse recognize which clinical presentation about type 1? A. Onset of the disease is slow B. Excessive weight is a contributing factor C. Complications are not present at the time of diagnosis D. Treatment involves diet, exercise, and oral medications

C. Complications are not present at the time of diagnosis

A nursing student asks their nursing instructor which immunoglobulin is the first produced in response to a viral or bacterial infection? A. IgA B. IgG C. IgM D. IgE

C. IgM

Which prescribed intervention would the nurse question for a client who has just been diagnosed with influenza after having symptoms for 4 days? A. Loradine B. Ibuprofen C. Oseltamivir D. Acetaminophen

C. Oseltamivir

The nurse is caring for a client diagnosed with methicillin-resistant staphylococcus aureus (MRSA) in the urine. The health care provider orders an indwelling catheter to be inserted. Which safeguard would the nurse take during this procedure? A> Droplet precautions B. Reverse isolation C. Surgical asepsis D. Medical asepsis

C. Surgical asepsis

Which should the nurse include when teaching a client with Clostridium difficile about decreasing the risk of transmission to family members? A. Increase fluid intake B. Eat a high-fiber diet C. Use soap and water for hand washing D. Wash hands with an alcohol-based hand sanitizer

C. Use soap and water for hand washing

Which client would the nurse suspect as having a Candida albicans infection after reviewing the morning laboratory reports? Client A- Otomycosis Client B- Lyme disease Client C- Oral thrush Client D- Roseola infantum

Client C- Oral thrush

Which laboratory blood test result would the nurse report in a client with an infection who is receiving vancomycin? A. Hematocrit: 45% B. Calcium: 9.0 mg/dL (2.25 mmol/L) C. White blood cells (WBC): 10,000 mm3 D. Blood urea nitrogen (BUN): 30 mg/dL (10.2 mmol/L)

D. Blood urea nitrogen (BUN): 30 mg/dL (10.2 mmol/L)

When teaching a group of older adults about differences between the common cold and influenza, the nurse would educate the client that it is most important to communicate with the health care provider about which symptoms? A. Earache B. Sneezing C. Nasal stuffiness D. Elevated temperature

D. Elevated temperature

The nurse understands the patient's meal tray has to be in front of the client before administering which type of insulin? A. Insulin glargine (Lantus) B. Insulin degludec (Tresiba) C. Isophane insulin neutral promtamine hagedorn (NPH) D. Insulin aspart (Humalog)

D. Insulin aspart (Humalog)

The nurse understands which injection sites are appropriate for insulin injections?

Outer thigh (lateral upper thighs), stomach (abdomen), buttocks (above the gluteal area), back of upper arms. Most common sites are the abdomen and backs of upper arms. Must rotate injection sites.

The nurse is in the ED caring for a 72-year-old female client. 11:00: The client presents to the ED reporting nausea, stomach pains, and severe diarrhea that started 24 hours ago. Skin warm, dry, tenting, and flushed Alert and oriented x4. PERRLA 3/2 bilaterally. Breath sounds clear throughout all lobes anteriorly and posteriorly. Heart rate regular. Bowel sounds normoactive x4 quadrants. +2 pedal pulses. Capillary refill less than 2 seconds. Vital signs ED Day 1 Temp- 101.1 F (37.9 C) HR- 104 RR- 22 BP- 92/58 O2 Sat- 98% on RA Labs ED Day 1 White blood cell ((4,500-11,000)- 11,000 BUN (10-20)- 35 Cr (.7-1.4)- 1.1 Which of the following issues is the client at risk of developing? Select all that apply A. Dehydration B. Respiratory failure C. Renal insufficiency D. Left-sided HF

A. Dehydration

The nurse is in the ED caring for a 72-year-old female client. 11:00: The client presents to the ED reporting nausea, stomach pains, and severe diarrhea that started 24 hours ago. Skin warm, dry, tenting, and flushed Alert and oriented x4. PERRLA 3/2 bilaterally. Breath sounds clear throughout all lobes anteriorly and posteriorly. Heart rate regular. Bowel sounds normoactive x4 quadrants. +2 pedal pulses. Capillary refill less than 2 seconds. Vital signs ED Day 1 Temp- 101.1 F (37.9 C) HR- 104 RR- 22 BP- 92/58 O2 Sat- 98% on RA Labs ED Day 1 White blood cell ((4,500-11,000)- 11,000 BUN (10-20)- 35 Cr (.7-1.4)- 1.1 12:00: Client reports to the nurse that they forgot to tell them they had a UTI 5 days ago and were prescribed trimethoprim-sulfamethoxazole (Bactrim). Reported to the HCP who suspected clostidiodes difficile and new orders given The nurse has reviewed the orders for 12:15. Click to highlight the order that the nurse should consider a priority. A. Initiate enteric precautions B. Computed tomography (CT) scan of abdomen C. Obtain a stool specimen D. Start normal saline at 50 mL/hour

A. Initiate enteric precautions

A nurse is teaching a client recently prescribed phenazopyridine hydrochloride (Pyridium) for pain relief related to a UTI. What should the nurse include in their teaching? Select all that apply A. This medication can turn the urine a red/orange color B. Drink plenty of fluids to decrease the risk of crystalluria C. Take with food to decrease GI distress D. This medication can turn the urine brown E. Do not take with food to avoid GI distress

A. This medication can turn the urine a red/orange color C. Take with food to decrease GI distress

The nurse is in the ED caring for a 72-year-old female client. 11:00: The client presents to the ED reporting nausea, stomach pains, and severe diarrhea that started 24 hours ago. Skin warm, dry, tenting, and flushed Alert and oriented x4. PERRLA 3/2 bilaterally. Breath sounds clear throughout all lobes anteriorly and posteriorly. Heart rate regular. Bowel sounds normoactive x4 quadrants. +2 pedal pulses. Capillary refill less than 2 seconds. Vital signs ED Day 1 Temp- 101.1 F (37.9 C) HR- 104 RR- 22 BP- 92/58 O2 Sat- 98% on RA Labs ED Day 1 White blood cell ((4,500-11,000)- 11,000 BUN (10-20)- 35 Cr (.7-1.4)- 1.1 12:00: Client reports to the nurse that they forgot to tell them they had a UTI 5 days ago and were prescribed trimethoprim-sulfamethoxazole (Bactrim). Reported to the HCP who suspected clostidiodes difficile and new orders given The nurse understands which client risk factors are indicated/are not indicated for the development of clostridiodes difficile. Risk factors. Indicated. Not indicated Age Gender Antibiotic High BUN

Age- indicated Gender- not indicated Antibiotic- indicated High BUN- not indicated

The client is brought to the emergency department by family because he is very drowsy and they are having difficulty waking them. The family tells the nurse the client is a type 2 diabetic. The client's blood sugar is 990 mg/dL and the health care provider diagnoses him with hyperglycemic hyperosmolar syndrome (HHS). Which other client findings support the diagnosis of HHS? Select all that apply A. A pH of 7.2 B. A heart rate of 130 C. Acetone breath D. A pH of 7.41 E. Bicarbonate (HCO3) of 18 mEq/L F. Absent ketones in the urine G. Kussmaul respirations H. Bicarbonate (HCO3) of 24 mEq/L

B. A heart rate of 130 D. A pH of 7.41 F. Absent ketones in the urine H. Bicarbonate (HCO3) of 24 mEq/L

Which advice will the nurse provide to a client who is taking an oral hypoglycemic daily for type 2 diabetes who develops an infection with anorexia? Select all that apply A. Avoid solid food B. Continue to take the oral medication C. Drink fluids throughout the day D. Monitor capillary glucose levels E. Do not take medication until tolerating food

B. Continue to take the oral medication C. Drink fluids throughout the day D. Monitor capillary glucose levels

A client is being treated for influenza A(H1N1). The nurse has provided instructions to the client about how to decrease the risk of transmission to others. Which statements by the client indicates for a need for further instruction? A. "I should practice respiratory hygiene/cough etiquette." B. "I should avoid contact with older adults or children." C. "I should obtain a pneumococcal vaccination each year." D. "I should allow visitors for short periods of time only."

C. "I should obtain a pneumococcal vaccination each year."

A client has reported to urgent care 72-hours after flu-like symptoms started. A test confirms the client has influenza. Which statements by the client indicated the need for further teaching? A. "I will need to rest over the next few days." B. "I will need to stay hydrated over the next several days." C. "I will need to take oseltamivir phosphate (Tamiflu) twice a day for 5 days." D. "I need to stay at home while I recover over the next several days."

C. "I will need to take oseltamivir phosphate (Tamiflu) twice a day for 5 days."

The nurse is teaching a client newly diagnosed with type 2 diabetes about their new oral antidiabetic metformin (glucophage). Which statement by the client indicates a need for further teaching? A. "I need to take this medication with food." B. "I may experience taste changes." C. "The longer I am on metformin I may have Vitamin C deficiency."

C. "The longer I am on metformin I may have Vitamin C deficiency."

Which cause of tremors, pallor, and diaphoresis would be suspected in a client with type 1 diabetes? A. Overeating B. Viral infection C. Aerobic exercise D. Missed insulin dose

C. Aerobic exercise

Which category of isolation would the nurse implement for a client who is positive for Clostridium difficile? A. Airborne precautions B. Droplet precautions C. Contact precautions D. Protective environment

C. Contact precautions

Which criteria would the nurse consider when determining if an infection is a health care-associated infection? A. Originated primarily from an exogenous source B. Is associated with a medication-resistant microorganism C. Occurred in conjunction with treatment for an illness D. Still has the infection despite completing the prescribed therapy

C. Occurred in conjunction with treatment for an illness

The nurse is teaching older adults over the age of 65 in a community clinic about the vaccinations needed. Which vaccinations should the nurse include? Select all that apply A. Polio B. MMR C. Pneumococcal D. Influenza

C. Pneumococcal D. Influenza

When a client in the clinic is offered the influenza vaccine and states, "I had the vaccination already last year, so I won't need it now," which response will the nurse give? A. "The flu vaccine is recommended for everyone." B. "You only need 1 flu shot in your lifetime to achieve immunity." C. "As long as you are younger than 50 years old, you will not really need vaccination." D. "The immunization changes, so you need to get vaccine annually to stay protected."

D. "The immunization changes, so you need to get vaccine annually to stay protected."

A 15-year-old is adolescent is found to have type 1 diabetes. Which would the nurse include when teaching the adolescent about type 1 diabetes? A. It does not always require insulin B. It involves early vascular changes C. It occurs more often in obese adolescents D. It has a more rapid onset than type 2 diabetes

D. It has a more rapid onset than type 2 diabetes

The nurse is caring for a surgical client who develops a wound infection during hospitalization. Which classification would this infection belong to? A. Primary B. Secondary C. Superinfection D. Nosocomial

D. Nosocomial

A child is prescribed an intravenous (IV) antibiotic. With 10 minutes of the initial infusion, the child's face and neck are flushed but the remainder of the body is unchanged. The nurse reviews the child's record. Which action would the nurse take next? A. Administer acetaminophen B. Place the child in protective isolation C. Increase the rate of the vancomycin infusion D. Notify the primary health care provider after stopping the infusion

D. Notify the primary health care provider after stopping the infusion

Match the signs and symptoms to either reflect hypoglycemia or hyperglycemia. Dry skin → Diaphoretic → Shaky → Dizzy → Drowsy → Headache → Tachycardia →

Dry skin → hyper Diaphoretic → hypo Shaky → hypo Dizzy → hypo Drowsy → hyper Headache → hypo Tachycardia → hypo