Final Exam HESI Questions

While reviewing the client's lab reports, the nurse finds that there is an elevation in the client's growth hormone levels. Which key physical changes would the nurse expect to find if acromegaly is suspected? SATA. a. facial shape b. body weight c. chest shape d. lip thickness e. length of hands

a. facial shape c. chest shape d. lip thickness e. length of hands

Which clinical manifestations support the nurse's suspicions that a client with AIDS is infected with Cryptococcus neoformans? SATA. a. fever b. seizures c. diarrhea d. confusion e. persistent dry cough

a. fever b. seizures d. confusion

Which clinical manifestation would the nurse expect to find in a client who has acute HIV infection? SATA. a. malaise b. confusion c. constipation d. swollen lymph glands e. oropharyngeal candidiasis

a. malaise d. swollen lymph glands Acute HIV is Stage 1.

Which clinical finding would the nurse expect when assessing a client with MG? a. partial improvement in muscle strength after mild exercise b. fluctuating weakness of muscles innervated by cranial nerves c. dramatic worsening of muscle strength with anticholinesterase inhibitors d. minimal changes in muscle strength regardless of the therapy initiated

b. fluctuating weakness of muscles innervated by cranial nerves

Which phrase describes why a lumbar puncture is performed when meningitis is suspected? a. to identify the presence of blood b. to determine the causative agent c. to reduce the ICP d. to measure the spinal fluid glucose level

b. to determine the causative agent viral or bacterial

The nurse is caring for a variety of clients. In which client is it most essential for the nurse to implement measures to prevent pulmonary embolism? a. 59 yr old with knee replacement b. 60 yr old with pneumonia c. 68 yr old with emergency dental surgery d. 76 yr old with thrombocytopenia

a. 59 yr old with knee replacement

In which order do the events of heat production using the endocrine system occur? 1. Stimulation of the anterior pituitary gland 2. Release of thyroxine from the thyroid gland 3. Hypothalamus secretes thyrotropin-releasing hormone 4. Release of TSH 5. Release of epinephrine from activated adrenal medulla 6. Increase in metabolic rate, simulation of glycolysis, and vasoconstriction

3. Hypothalamus secretes thyrotropin-releasing hormone 1. Stimulation of the anterior pituitary gland 4. Release of TSH 2. Release of thyroxine from the thyroid gland 5. Release of epinephrine from activated adrenal medulla 6. Increase in metabolic rate, simulation of glycolysis, and vasoconstriction

A client has developed hepatic encephalopathy secondary to cirrhosis. The client's current medication regimen includes lactulose 4 times daily. Which of the following indicates the therapeutic response of this med? SATA. Improvement in indigestion 2-3 soft BMs daily Decrease in confusion Decreased AST and ALT Absence of blood or mucous in stool

Improvement in indigestion 2-3 soft BMs daily Decrease in confusion Decreased AST and ALT

When a client develops bacterial meningitis, which action is the nurse's priority? a. monitoring for signs of increased ICP b. adding pads to the sides of the bed c. administering prescribed antibiotics d. administering glucocorticoids

c. administering prescribed antibiotics

The assessment of a newly diagnosed client reveals malnourishment, nausea, distension, and a firm abdomen with ascites. The client has tachycardia and is hypotensive. Which physiological change occurred that resulted in the client's development of ascites? a. an increase in vitamins to maintain cell coenzyme function b. an increase in iron to maintain adequate hemoglobin synthesis c. a decrease in Na to maintain its concentration in tissue fluid d. a decrease in plasma protein to maintain adequate capillary-tissue circulation

d. a decrease in plasma protein to maintain adequate capillary-tissue circulation malnourishment and liver damage lead to decrease in albumin (the plasma protein)

The nurse reviews a client's medical record, specifically the client's skull radiograph results. An abnormality in the endocrine gland situated in a depression of the sphenoid bone is noted on the report. The nurse recalls that which hormone release is most probably affected? a. glucagon b. cortisol c. aldosterone d. corticotropin

d. corticotropin secreted by the pituitary gland

The nurse observes abnormal rigidity with pronation of the arms and plantar flexion while assessing a client. Which condition would the nurse record in the assessment findings? a. decortication b. pronator drift c. babinski reflex d. decerebration

d. decerebration

The nurse is performing a physical assessment of a client admitted to the hospital with a diagnosis of cirrhosis. The nurse expects to observed which skin conditions? SATA. a. vitiligo b. hirsutism c. melanosis d. ecchymoses e. telangiectasia

d. ecchymoses e. telangiectasia bleeding signs are indicative of decreased synthesis of prothrombin

Which precaution would the nurse identify as a prevention for transmission of HIV and other bloodborne illnesses? a. barrier b. droplet c. contact d. standard

d. standard

For a client admitted to the hospital after an accident, the nurse uses the Glasgow coma scale. The client is alert and opens his eyes when there is a sound or someone talks. When asked questions, the pt answers in a confused manner. The client obeys commands, such as being asked to move his leg. Which total score would the nurse document?

13

Which clinical manifestation indicates a possible pulmonary embolism in a client after a total hip replacement? SATA. a. sudden chest pain b. flushing of the face c. elevation of temp. d. abrupt onset of SOB e. hip pain increase from 2 to 8

a. sudden chest pain d. abrupt onset of SOB

Which statement by a client with RA prescribed ibuprofen 800 by mouth q3daily indicates that the nurse's teaching was effective? SATA. a. "I need to report any dark tarry stools." b. "I will need to stop taking this med before any scheduled surgeries." c. "I should change positions slowly." d. "I will take the med on an empty stomach." e. "I need to stop taking low-dose aspirin while I take this med."

a. "I need to report any dark tarry stools." b. "I will need to stop taking this med before any scheduled surgeries."

Which preventable childhood communicable disease may lead to encephalitis? a. varicella b. scarlet fever c. poliomyelitis d. whooping cough

a. varicella

Which statement indicates that a female client who is receiving Rifampin for TB understands the teaching? SATA. a. "This med may be hard on the liver, so I must avoid alcoholic drinks while taking it." b. "This med may reduce the effectiveness of oral contraceptives I am taking." c. "I cannot take an antacid within 2 hours before taking this med." d. "My HCP must be called immediately if my eyes and skin turn yellow."

a. "This med may be hard on the liver, so I must avoid alcoholic drinks while taking it." b. "This med may reduce the effectiveness of oral contraceptives I am taking." d. "My HCP must be called immediately if my eyes and skin turn yellow."

Which instruction about Phenytoin will the nurse provide during discharge teaching to a client with epilepsy who is prescribed phenytoin for seizure control? a. Antiseizure meds will probably be continued for life. b. Phenytoin prevents any further occurrence of seizures. c. This med needs to be taken during times of emotional stress d. Your antiseizure med can usually be stopped after a year's absence of seizures.

a. Antiseizure meds will probably be continued for life.

Which info will the nurse consider when planning care for a client with HIV who has been diagnosed with Class 3 TB? SATA. a. Class 3 TB is a clinically active disease, which is contagious. b. TB is the leading cause of mortality in clients infected with HIV. c. HIV+ pts are more likely to have multidrug resistant TB. d. Individuals with HIV usually have high fevers with active TB infection. e. Persons with active TB are usually treated on an outpatient basis.

a. Class 3 TB is a clinically active disease, which is contagious. b. TB is the leading cause of mortality in clients infected with HIV. e. Persons with active TB are usually treated on an outpatient basis.

Which info would the nurse include when counselling a client with ALS? SATA. a. Space planned activities throughout the day b. Engage in social interactions with large groups c. Request an opioid if leg pain becomes excessive d. Anticipate the use of alternative ways to communicate e. Use leg restraints to decrease the risk for physical injury

a. Space planned activities throughout the day d. Anticipate the use of alternative ways to communicate

Which instruction would the nurse prescribe a client prescribed rifampin for TB? SATA. a. You should report any yellow tinge to your skin. b. Your soft contact lenses will be stained permanently. c. You should report any reddish-orange tinge to your secretions. d. You need to drink at least 8 oz of water with this med. e. You should report any increased tendency to bruising or bleeding.

a. You should report any yellow tinge to your skin. b. Your soft contact lenses will be stained permanently. e. You should report any increased tendency to bruising or bleeding.

The nurse is caring for a client with cirrhosis of the liver. The nurse anticipates a prescription for neomycin based on which abnormal laboratory test? a. ammonia level b. culture and sensitivity c. WBC count d. ALT level

a. ammonia level

Which medications increase the risk for an upper GI bleed? SATA. a. aspirin b. ibuprofen c. ciprofloxacin d. acetaminophen e. methylprednisolone

a. aspirin b. ibuprofen e. methylprednisolone

Which diagnosis increases the risk for developing pulmonary embolism? a. atrial fibrillation b. forearm laceration c. migraine d. respiratory infection

a. atrial fibrillation

Which finding would be expected in a pt with a hx of hypothyroidism? SATA. a. cold intolerance b. lethargy and fatigue c. hemoglobin 11.2 d. 15 lb weight gain e. HR 59

a. cold intolerance b. lethargy and fatigue c. hemoglobin 11.2 d. 15 lb weight gain e. HR 59

Which clinical finding would the nurse expect when completing a health history and physical assessment for a client who has MG? SATA. a. double vision b. problems with cognition c. difficulty swallowing saliva d. intention tremors of the hands e. drooping of the upper eyelids f. nonintention tremors of the extremities

a. double vision c. difficulty swallowing saliva e. drooping of the upper eyelids

When assessing a client with diabetes insipidus, which sign would the nurse anticipate finding? SATA. a. excessive thirst b. elevated BG c. dry mucous membranes d. increased BP e. decreased serum osmalility f. decreased urine specific gravity

a. excessive thirst c. dry mucous membranes f. decreased urine specific gravity

Which s/s would the nurse associate with hyperthyroidism? a. fatigue b. dry skin c. anorexia d. bradycardia

a. fatigue

For which signs of hepatic encephalopathy would the nurse assess a client with cirrhosis of the liver? SATA. a. mental confusion b. increased cholesterol c. brown-colored stools d. flapping hand tremors e. musty, sweet breath odor

a. mental confusion d. flapping hand tremors e. musty, sweet breath odor

Which intervention is necessary before a blood transfusion is administered? SATA. a. obtain the client's VS b. monitor H&H levels c. allow the blood to reach room temp d. determine typing and crossmatching of blood e. use a y-type infusion set to initiate 0.9% NS

a. obtain the client's VS d. determine typing and crossmatching of blood e. use a y-type infusion set to initiate 0.9% NS

Which sign would the nurse expect to observe in a client with SIADH? SATA. a. oliguria b. seizures c. vomiting d. polydipsia e. polyphasia

a. oliguria b. seizures c. vomiting vomiting d/t hyponatremia

Which hormones are secreted by the posterior pituitary gland? SATA. a. oxytocin b. prolactin c. corticotropin d. antidiuretic hormone e. melanocyte-stimulating hormone

a. oxytocin d. antidiuretic hormone The other 3 are secreted by anterior pituitary gland

Which outcome is likely if the nurse palpates a pt's joints during an acute episode of RA? a. pain b. swelling c. nodule formation d. tophaceous deposits

a. pain

The nurse teaches the pt about endocrine functioning of the pituitary gland. Which info from the client indicates successful learning? a. promotes growth b. promotes stress response c. increases serum Ca levels d. increases intestinal Ca absorption

a. promotes growth

Which description would the nurse expect the client to use to characterize the pain when admitted to the coronary care unit with a STEMI? a. severe, intense chest pain b. burning sensation of short duration c. sharp, stabbing chest pain with breathing d. squeezing chest pain relieved by nitroglycerin

a. severe, intense chest pain

Which important suggestion would the nurse take when counseling a client with ALS about mx of this disorder? a. Eye surgery may improve your vision b. Activities should be spaced throughout the day c. Opioids may be necessary for the pain in your legs d. Leg restraints will decrease the chance of physical injury

b. Activities should be spaced throughout the day

Which findings would the nurse expect when caring for a client with cor pulmonale? SATA. a. weight loss b. JVD c. lower extremity edema d. RUQ abdominal tenderness e. lower than normal H&H f. Elevated BNP levels

b. JVD c. lower extremity edema d. RUQ abdominal tenderness f. Elevated BNP levels

A child who has recently been diagnosed with a brain tumor vomits during breakfast. Which nursing intervention is priority? a. Refeeding breakfast b. Notifying the HCP c. Requesting a reevaluation d. Administering the prescribed antiemetic e. Increasing the IV infusion rate

b. Notifying the HCP c. Requesting a reevaluation

Which diagnostic test will a nurse anticipate being prescribed to a female client suspected by the HCP of having pituitary gland dysfunction? a. estradiol test b. prolactin test c. PCT d. Pap test

b. prolactin test

The nurse is assessing client with a moon shaped face and thin arms and legs. The nurse expects which other assessment findings? SATA. a. weight loss b. gastric ulcer c. pain in bones d. poor appetite e. muscle weakness

b. gastric ulcer c. pain in bones e. muscle weakness

Which problem in a client presenting to the clinic for a follow-up after starting pyridostigmine for mx of MG is an adverse effect of this med? SATA. a. respiratory depression b. increased urinary frequency c. diploplia d. muscle twitching e. diarrhea

b. increased urinary frequency d. muscle twitching e. diarrhea

The nurse is caring for a client with hepatic encephalopathy and ascites. Which elements are important to include in the client's diet? SATA. a. high fat b. low Na c. high vitamins d. moderate proteins e. low carbs

b. low Na c. high vitamins d. moderate proteins

Which area would a nurse suspect is injured when a client brought to the ER after a MVH pulls his arms upwards and inwards in response to pain? a. pons b. midbrain c. brainstem d. frontal lobe

b. midbrain

Which finding would the nurse expect when assessing a client who is in an early stage of MS? SATA. a. headache b. nystagmus c. skin infection d. scanning speech e. intentional tremors

b. nystagmus d. scanning speech e. intentional tremors

Which findings would the nurse expect when assessing a client with MS? SATA. a. headache b. nystagmus c. skin infection d. scanning speech e. intentional tremors

b. nystagmus d. scanning speech e. intentional tremors

Which action would the nurse take after a TST on a nurse working in the ED revealed an 11-mm induration? a. plan for a repeat TST in one year b. schedule the nurse for a chest xray c. ask the nurse to provide sputum specimens d. teach about the multiple drug treatment regimen

b. schedule the nurse for a chest xray

Which diagnostic test results indicates if a client will develop AIDS from HIV? a. level of IgM in their blood b. the number of CD4 + T cells c. presence of antigen-antibody complexes d. speed with which the virus invades the RNA

b. the number of CD4 + T cells

Which response would a nurse give when a client asks what to expect when beginning treatment for TB? a. therapy will last a few weeks b. therapy will occur over 2 phases c. therapy will involve one medication d. therapy will involve monitoring kidney function

b. therapy will occur over 2 phases

Which statement would a nurse make when a client had sudden loss of muscle tone that lasted for a few seconds followed by confusion during a seizure? SATA. a. these seizures are associated with amnesia. b. these seizures increase the risk of injury from a fall c. these seizures are most resistant to med therapy d. these seizures are proceeded by an offensive smell e. these seizures cause one-sided movement of extremities in the client

b. these seizures increase the risk of injury from a fall c. these seizures are most resistant to med therapy

Which response would the nurse make to a client who has MS and asks the nurse, "Will I experience unbearable pain?" a. "Tell me about your fears regarding pain." b. "Analgesics would be prescribed to control the pain." c. "Some clients report tingling or burning but not unbearable pain." d. "Let's make a list of the things you need to ask your HCP."

c. "Some clients report tingling or burning but not unbearable pain."

Which statement made by a client prescribed Isoniazid (INH) as a prophylactic measure d/t having a spouse with active TB indicates that there is a need for further teaching? SATA. a. "I plan to start taking Vit B6 with breakfast." b. "I'll still be taking this med 6 months from now." c. 'I sometimes allow our children to sleep in our bed at night." d. "I know I also have TB because the skin test was positive." e. I plan to attend a wine tasting this evening."

c. 'I sometimes allow our children to sleep in our bed at night." d. "I know I also have TB because the skin test was positive." e. I plan to attend a wine tasting this evening."

Which finding would be of most concern to the nurse when caring for a client with massive vomiting of blood? a. hematocrit of 35% b. cold hands and feet c. HR 124 d. stools positive for occult blood

c. HR 124 tachycardia is a compensatory mechanism to hypovolemic shock

Which client has a higher risk for contracting HIV? a. a client who is involved in mutual masturbation b. a client who undergoes voluntary prenatal HIV screening c. a client who shares equipment to smoke or snort drugs d. a client who engages in insertive sex with noninfective partner

c. a client who shares equipment to smoke or snort drugs more likely to engage in high-risk behaviors while under the influence

Which property would the nurse understand that the med is being used primarily for when aspirin is prescribed on a regular schedule for a client with RA? a. analgesic b. antipyretic c. anti-inflammatory d. anti-platelet

c. anti-inflammatory

The nurse reviews a medical record of a client with ascites. Which client condition is a contributing factor to the development of ascites? a. portal hypotension b. kidney malfunction c. diminished plasma protein level d. decreased production of K

c. diminished plasma protein level Albumin is the primary plasma protein.

Which MOA is responsible for the therapeutic effects of mannitol prescribed for a client with a head injury? a. decreasing the production of CSF b. limiting the metabolic requirements of the brain c. drawing fluid from brain cells into the bloodstream d. preventing uncontrolled electrical discharges in the brain

c. drawing fluid from brain cells into the bloodstream

Which test would the nurse identify as specific to the diagnosis of MG? a. ECT b. pyridostigmine test c. endrophonium chloride test d. hx of physical deterioration

c. endrophonium chloride test Tensilon test

Which action would the nurse take next after the nurse immediately stops the infusion of a client demonstrating S&S of a transfusion reaction? a. obtain BP and pulse b. send a urine specimen to the lab c. hang a bag of NS with new tubing d. monitor the i&os every 15 mins

c. hang a bag of NS with new tubing

When caring for a client with a possible pulmonary embolism, the nurse will anticipate preparing the client for which test? a. chest x-ray b. thoracic ultrasound c. helical computed tomography (CT) d. MRI

c. helical computed tomography (CT)

The nurse conducts an initial interview and would suspect the client has TB based on which clinical indicator? SATA. a. vomiting b. weight gain c. hemoptysis d. night sweats e. bilateral crackles

c. hemoptysis d. night sweats

While assessing a 5 yr old child, which clinical finding would the nurse recognize as indicative of a verbal response score of 3 on the Glawgow coma scale? a. oriented b. confused c. inappropriate words d. incomprehensible sounds

c. inappropriate words

Which client would the nurse identify as having findings consistent with RA? a. uric acid 8.5 b. CRP 800 c. Anti-DNA antibody 90 d. ESR 65

d. ESR 65 ESR is a nonspecific index of inflammation. Normal range < 30.

Which information would the nurse expect the client who has MS with hand tremors to report? a. The tremors increase when I fall asleep. b. The tremors increase when I feel fatigued. c. The tremors increase when I become nervous. d. The tremors increase when I perform an activity.

d. The tremors increase when I perform an activity.

Which additional supplement will be needed by a client with chronic liver disease who reports, "My gums have been bleeding spontaneously. and has small hemorrhagic lesions on the face? a. bile salts b. folic acid c. Vitamin A d. Vitamin K

d. Vitamin K

Which symptom would the nurse expect to decrease in response to corticosteroid therapy prescribed for a client with MS? a. emotional lability b. muscular contractions c. pain in the extremities d. visual impairment

d. visual impairment

Which virus can cause encephalitis in adults and children? a. rubella b. parvovirus c. rotaviruses d. west nile virus

d. west nile virus