hesi study

A client diagnosed with thyroid cancer signed a living will that states he doesn't want ventilatory support if his condition deteriorates. As his condition worsens, the client states, "I changed my mind. I want everything done for me." Which response by the nurse is best?

"What exactly do you mean by wanting 'everything' done for you?"

Before undergoing a subtotal thyroidectomy, a client receives potassium iodide (Lugol's solution) and propylthiouracil (PTU). The nurse should expect the client's symptoms to subside:

1-2 weeks

A Nitrazine test strip that turns deep blue indicates that the fluid being tested has a pH of:

7.5

A client with diabetic ketoacidosis (DKA) has asked the unlicensed nursing assistant for another pitcher of water. It is the third such request over the past 4 hours. The nurse would recognize this request as which of the following manifestations?

An occurrence of the excess loss of fluid associated with osmotic diuresis

After extensive cardiac bypass surgery, a client returns to the intensive care unit on dobutamine, 5 mcg/kg/minute I.V. Which classification best describes dobutamine?

B. DoButamine = Direct-acting Beta-activ

Cholinergic Crisis

Caused by excessive medication ---stop giving Tensilon...will make it worse.

A nurse observing a patient receiving treatment with edrophonium (Tensilon) for myasthenia gravis notices the patient clenching his/her jaw, salivating excessively, experiencing and muscle weakness, rigidity, and spasm. These are all symptoms of which of the following?

Cholinergic crisis

addison's crisis

LIFE THREATENING triggered by surgey, acute systemic illness trauma, or abrupt withdrawl of long therm corticosteroids therapy

elevated ST

MI

HypoKalemia

Prominent U waves, Depressed ST segment, Flat T waves

The client has had hypertension for 20 years. The nurse should assess the client for?

Renal insufficiency and failure.

hyperkalemia

Tall T-Waves, Prolonged PR interval, wide QRS

autonomy

The client is exhibiting the freedom to make a personal decision, and this reflects the concept of autonomy. Justice refers to fairness. Veracity refers to truthfulness. Beneficence refers to implementing actions that benefit others.

nitroprusside

Treatment for malignant hypertension.

Myesthenic Crisis

Weakness with change in vitals (give more meds)

dont take this with insulin

aspirin--causes hypoglycemia

The nurse is caring for a client diagnosed with chronic obstructive pulmonary disease (COPD) and experiencing respiratory acidosis. The decrease in pH exists because the client's lungs:

cant blow off carbon dioxide

Specific Gravity

diluted 1.005-1.030 concentrated

A nurse is caring for a client with frequent episodes of ventricular tachycardia. The lab calls with a critically high magnesium level of 11 mg/dL on this client. What is the nurse's priority action?

give calcium gluconate.. increasing fluids will decrease levels as well

A client who has been experiencing angina has a new prescription for nitroglycerin. The nurse should instruct the client to report having which potential side effect of nitroglycerin?

headache

pericarditis

inflammation of the membrane surrounding the heart

Which outcome is a priority for the client with Addison's disease?

med compliance

Which signs and symptoms accompany a diagnosis of pericarditis?

Fever, chest discomfort, and elevated erythrocyte sedimentation rate (ESR) The classic signs and symptoms of pericarditis include fever, positional chest discomfort, nonspecific ST-segment elevation, elevated ESR, and pericardial friction rub. Low urine output secondary to left ventricular dysfunction lethargy, anorexia, heart failure and pitting edema, result from acute renal failure.

Myesthenia Gravis

Myasthenia gravis is a chronic autoimmune neuromuscular disease characterized by varying degrees of weakness of the skeletal (voluntary) muscles of the body. The name myasthenia gravis, which is Latin and Greek in origin, literally means "grave muscle weakness." With current therapies, however, most cases of myasthenia gravis are not as "grave" as the name implies. In fact, most individuals with myasthenia gravis have a normal life expectancy. The hallmark of myasthenia gravis is muscle weakness that increases during periods of activity and improves after periods of rest. Certain muscles such as those that control eye and eyelid movement, facial expression, chewing, talking, and swallowing are often, but not always, involved in the disorder. The muscles that control breathing and neck and limb movements may also be affected.

At what age is an individual most at risk for acquiring acute lymphocytic leukemia (ALL)?

4-12

Every morning, a client with type 1 diabetes receives 15 units of Humulin 70/30. What does this type of insulin contain?

70% NPH insulin and 30% regular insulin

A client is admitted to the hospital with severe back and abdominal pain, nausea and occasional vomiting, and an oral temperature of 101°F. The client reports drinking six to eight beers a day. A diagnosis of acute pancreatitis is made. Based on the data presented, the primary nursing concern for this client is

acute pain

electroencephalogram

an amplified recording of the waves of electrical activity that sweep across the brain's surface. These waves are measured by electrodes placed on the scalp.

buerger's disease

associated with heavy cigarette smoking, men <40 years of age, rest pain and ischemic ulcers occur early in disease

A client with chronic sinusitis comes to the outpatient department complaining of headache, malaise, and a nonproductive cough. When examining the client's paranasal sinuses, the nurse detects tenderness. To evaluate this finding further, the nurse should transilluminate the:

frontal and maxillary sinuses.

A client with a history of coronary artery disease (CAD) has been diagnosed with peripheral arterial disease. The health care provider (HCP) started the client on pentoxifylline once daily. Approximately 1 hour after receiving the initial dose of pentoxifylline, the client reports having chest pain. The nurse should first:

inform the doctor. angina is a reverse reaction to pentoxifylline

Which insulin should the nurse prepare for the emergency treatment of ketoacidosis?

insulin aspart because it is rapid acting

A 23-year-old woman arrives at the prenatal clinic because she thinks that she is pregnant. Her last menstrual period began on March 31, and her pregnancy test reveals a positive result. According to Nägele's rule, what is this client's expected date of birth (EDB)?

january 7th the date is January 7 of the following year. To use Nägele's rule, subtract 3 months from the first day of the last menstrual period and add 7 days and one year. Three months were added rather than subtracted, to yield a date of July 8. December 7 is too early, and 7 days were subtracted, rather than added, for the December 24 date.

addison's disease

low secretion of adrenal cortex hormones (gluco and mineralsteroids also, it is disorder resulting from distruction or disfunction of the adrenal cortex resulting in a defeciency in cortisol, aldosterone, adrenal androgens and skin pigmentation

An intravenous solution of lactated Ringers is prescribed to replace the T-tube output of a client who had a cholecystectomy and common bile duct exploration. The nurse recalls that the condition that will improve if the administration of lactated Ringers solution is effective is: -Urinary stasis -Paralytic ileus -Metabolic acidosis -Increased potassium level

metabolic acidosis Lactated Ringers is an alkaline solution that replaces bicarbonate ions lost from T-tube bile drainage, thus preventing or treating acidosis. Urinary stasis is unrelated to the effectiveness of the administration of intravenous lactated Ringers solution. Paralytic ileus is unrelated to the effectiveness of the administration of intravenous lactated Ringers solution. An increased potassium level is unrelated to the effectiveness of the administration of intravenous lactated Ringers solution.

hypocalcemia

muscle spasms, convulsions, cramps/tetany, + Trousseau's, + Chvostek's, prolonged ST interval, prolonged QT segment

The client with Raynaud's phenomenon has coldness and numbness in the fingers. Which is an early sign of vasoconstriction?

pallor

A nurse is caring for a client with acute pulmonary edema. To immediately promote oxygenation and relieve dyspnea, the nurse should:

place in high fowlers then oxygenate

paracentesis

semi fowler's or upright on edge of bed. Empty bladder. post VS--report elevated temp. watch for hypovolemia surgical puncture to remove fluid from the abdomen