HESI Comprehensive A

The antigout medication allopurinol (Zyloprim) is prescribed for a client newly diagnosed with gout. Which comment by the client warrants intervention by the nurse?

A. "I take aspirin for my pain."

The charge nurse working in the surgical department is making shift assignments. The shift personnel include an RN with 12 years of nursing experience, an RN with 2 years of nursing experience, and an RN with 3 months of nursing experience. Which client should the charge nurse assign to the RN with 3 months of experience?

A. A client who is 2 days postoperative with a right total knee replacement

The nurse performs an assessment on a client with heart failure. Which finding(s) is(are) consistent with the diagnosis of left-sided heart failure? (Select all that apply.)

A. Confusion C. Crackles in the lungs D. Dyspnea

A very busy hospital unit has had several discharges and the census is unusually low. What is the best way for the charge nurse to use the time of the nursing staff?

A. Encourage staff to participate in online in-service education.

The nurse administers levothyroxine (Synthroid) to a client with hypothyroidism. Which data indicate(s) that the drug is effective? (Select all that apply.)

A. Increase in T3 and T4 E. Decrease in periorbital edema

The nurse plans to evaluate the effectiveness of a bronchodilator. Which assessment datum indicates that the desired effect of a bronchodilator has been achieved?

A. Increased oxygen saturation

The nurse assists the health care provider with an amniocentesis during the third trimester of pregnancy. Which intervention(s) would the nurse expect to implement after the procedure? (Select all that apply.)

A. Monitor maternal vital signs for hemorrhage. B. Instruct the woman to report any contractions. D. Monitor fetal heart rate for 1 hour after the procedure

Which intervention(s) is(are) most helpful in evaluating the effectiveness of nursing and medical treatments for dehydration in a 36-month-old child? (Select all that apply.)

A. Record wet diapers. C. Examine skin turgor. D. Observe mucous membranes.

Which nursing intervention(s) should be implemented when caring for a client with bipolar disorder in the manic phase? (Select all that apply.)

A. Report lithium level of 2.0 mEq/L to the primary health care provider. D. Maintain consistent salt levels in the diet when client is taking lithium. E. Assess the client's nutritional and hydration statu

A client reports experiencing dysuria and urinary frequency. Which client teaching should the nurse provide?

A. Save the next urine sample.

A client with acute renal failure (ARF) starts to void 4 L/day 2 weeks after treatment is initiated. Which complication is important for the nurse to monitor the client for at this time?

B. Hypotension

The health care provider performs a bone marrow aspiration from the posterior iliac crest for a client with pancytopenia. Which action should the nurse implement first?

B. Take the vital signs to determine the client's response for a potential blood loss.

The nurse performs tracheostomy suctioning on a comatose client. Place the interventions in order from first to last. A. Gently insert the catheter without suction using sterile technique. B. Hyperoxygenate using a manual reservoir-equipped resuscitation bag (MRB). C. Check the suction regulator and adjust suction pressure to 120 to 150 mm Hg. D. Apply suction intermittently while withdrawing the catheter.

C. C, B, A, D

Which instruction should the nurse provide to a client whose vision is being tested with a Snellen chart?

C. Cover one eye while reading the chart with the other.

Two days after swallowing 30 tablets of alprazolam (Xanax), a client with a history of depression is hemodynamically stable but wants to leave the hospital against medical advice. Which nursing action(s) is(are) most likely to maintain client safety? (Select all that apply.

C. Explain the benefits of remaining in the hospital. D. Instruct the client to take medications as prescribed. F. Notify the health care provider of the client's intention.

Which assessment is most important for the nurse to implement when seeing a client with multiple myeloma?

C. Pain scale measurement

The nurse formulates a nursing diagnosis of pain related to muscle spasms for a client with extreme lower back pain associated with acute lumbosacral strain. Which is the best intervention for the nurse to implement?

C. Rest in bed with the head of the bed elevated 20 degrees and flex the knees.

The nurse is monitoring a client who is receiving bedside conscious sedation with midazolam hydrochloride (Versed). In assessing the client, the nurse determines that the client has slurred speech with diplopia. Based on this finding, what action should the nurse take?

D. Continue to monitor the client