322 HESI PRACTICE TEST 1

How to reduce risk of kidney stones? (food the produces (alkaline or acidic)________kind of urine

Drink cranberry juice--promote ACIDIC URINE DON'T EAT/DRINK: Yogurt, fruits/veggies, diary--promote ALKALITIC URINE

Know where Erb's point is located (on the chest)

Third left intercostal space, close to the sternum. Murmurs of both aortic and pulmonic origin may be heard here.

How to clean urinary catheters at home?

Use aseptic technique by boiling the catheters for X amt of time just before use and allow to cool before using.

When does Alcohol withdrawal usually occur? S/S?

can being 5-7 days after the last drink. S/S can include tremors, agitation, and experiencing hallucinations.

Direct visualization of epiglottis can do _______ (what are the risk(s) ) and needs to be done by ________________

direct visualization of the epiglottis can trigger a complete airway obstruction and should only be done in a controlled environment by an anesthesiologist or a physician skilled in pediatric intubations.

What is placenta previa?

occurs when a baby's placenta partially or totally covers the mother's cervix — the outlet for the uterus. Placenta previa can cause severe bleeding during pregnancy and delivery. If you have placenta previa, you might bleed throughout your pregnancy and during your delivery.

A client experiencing alcohol withdrawal syndrome says he's itching everywhere from the bugs on his bed. Which response is appropriate? 1. Examine the client's skin 2. Ask what kind of bugs he things they are 3. Tell the client there are no bugs on his bed 4. Tell the client he's having tactile hallucinations

1. Examine the patient's skin. Make sure the client doesn't have a rash, skin allergy, or something on his skin (like crumbs) causing his discomfort. Reality should be presented to the client gently without being derogatory. The nurse shouldn't support the client's hallucinations.

3 Hallmark signs of DM?

1. Polyuria (increased urine) 2. Polydisia (increased thirst) 3. Polyphagia (Excessive hunger)

Which medication is given with pentamidine isethionate (Pentam) to clients with AIDS for Pneumocystitis carinii pneumonia? 1. Amphotericin B (amphocin) 2. Co-trimoxazole (Bactrim) 3. Fluconazole (Diflucan) 4. Sulfadizine

2. Co-trimoxazole is given orally or I.V. for P. carinii penumonia. Fluconazole and amphotericin B are used for coccidioidomycosis. Sulfadiaine is used to treat toxoplasmosis.

A client asks what DM does to the body over time. Which conditions should the nurse include in her teaching as a common chronic complication of DM?

3. Cardiovascular disease HHNS and diabetic ketoacidosis are ACUTE complications.

A 30-year old primagravida in her second trimester tells a nurse her fingers feel tight and sometimes she feels as though her heart skips a beat. She has a history of rheumatic fever. Which assessment indicates the client may be experiencing cardiovascular disease? 1. Clear lungs 2. Sinus tachycardia 3. Increased dyspnea on exertion 4. Runs of paroxysmal atrial tachycardia

3. Increasing dyspnea on exertion should alert the nursse to cardiovascular compromise. (because your heart can't beat fast enough to compensate for increased exertion). NOTES: PRIMAGRAVIDA: it means you are pregnant for the first time Paroxysmal (episode begins and ends abruptly) atrial (begins in atrium) tachycardia: heart arrhythmia Rheumatic fever: inflammatory disease that can develop when strep throat or scarlet fever isn't properly treated. Auto-immune, causes inflammation

A client tells his nurse that his TB medications are so expensive that he can't afford to take them. Which intervention by the nurse is best? 1. Refer the client to social services 2. Tell the client to apply to Medicaid 3. Refer the client to the local or county health department 4. Tell the client to follow his insurance rules and regulations

3. The local and county health departments provide treatment and follow-up free of charge for all residents to ensure proper care. Social services can help seek alternative methods of payment and reimbursement but would probably first refer the client to the local and county health departments. Medicaid or medical assistance and insurance can be alternatives but are not guaranteed.

A 2-year old child is being examined in the ER for epiglottiditis. Which assessment finding supports this diagnosis? 1. Mild fever 2. Clear speech 3. Tripod position 4. Gradual onset of symptoms

3. The tripod position (sitting up and leaning forward) facilitates breathing. Epiglottiditis present with a sudden onset of symptoms, high fever, and muffled speech. Additional symptoms are inspiratory stridor and drooling.

A neonate requires blood transfusions after birth. Which cannulation site is most preferred? 1. scalp veins 2. Intraosseous 3. Umbilical cord 4. Subclavian cutdown

3. Umbilical cord may be easily cannulated and is the preferred site. Scalp veins may also be used. Intraosseous cannulation is attempted if two attempts at other sites prove inaccessible A subclavian cutdown takes a prolonged time and is the least desired.

What is the typical length of TB treatment?

9-12 months

A 62 year old client is admitted to the hospital with pneumonia. He has a history of Parkinson's disease, which his family says is progressively worsening. Which assessment is expected? 1. Impaired speech 2. Muscle flaccidity 3. Pleasant and smiling demeanor 4. Tremors in the fingers that increase with purposeful movement

1. Impaired speech (dysarthria) is due to the disturbance in muscle control. Muscle rigidity results in resistance to passive muscle stretching. The client may have a masklike appearance. Tremors should decrease with purposeful movement and sleep.

A client with an endotracheal (ET)tube has copious brown-tinged secretions. Which intervention is a priority? 1. Use a trap to obtain a specimen 2. Instill saline to break up secretions 3. Culture the specimen with a culturette swab 4. Obtain an order for a liquefying agent for the sputum

1. Suspicious secretions should be sent for culture and sensitivity using a sterile technique like a trap. Saline would dilute the specimen. Swab culturettes are useful for wound cultures--not ET cultures. Various agents are available to help break up secretions, and respiratory therapists can usually help recommend the right agent, but this isn't a priority WHEN YOU SEE GREEN OR BROWN SECRETIONS THINK INFECTION. RED OBVIOUSLY BLEEDING

The usual treatment for TB includes the use of isoniazid (INH) and which other therapy? 1. Theophylline inhaler (Theodur) 2. I.M. penicillin 3. Three other antibacterial agents 4. Aerosol treatments with pentamidine (Pentam)

3. Because TB has become resistant to many antibacterial agenets, the initial treatment includes the use of multiple antituberculotic cor antibacterial agnets, the initial treamtent includes the use of multiple antituberculotic or antibacterial drugs (rifampin, ethambutol, hydrochloride, pyrazinamide, cycloserine, clofazimine, and streptomycin)

A client has copious secretions. X-ray results indicate TB. Which intervention should be performed first? 1. Repeat X-ray 2. Tracheostomy 3. Bronchoscopy 4. ABG analysis

3. Bronchioscopy can held diagnose TB and obtain specimens (with "pincher" arms) while clearing the bronchial tree of secretions (through using suction).

A client receiving pentamidine isethionate (Pentam) should have what parameter monitored frequently? 1. HR 2. Electrolyte levels 3. BS levels 4. CBC

3. Can cause permanent DM and requires monitoring of BS.

Which classification of medication meay be used safely in a pregnant client with cardiovascular disease? 1. Antibiotics 2. warfarin (coumadin) 3. Cardiac glycosides 4. Diuretics

3. Cardiac glycosides (treat HF and irregular heart beats, increase heart contraction e.g. digoxin) and common antiarrhythmics may be used. Prophylactic antibiotics are used for clients susceptible to endocarditis (infection of the endocardium, which is the inner lining of your heart chambers and heart valves.) If anticoagulants are needed heparin is drug of choice not warfarin (heparin works faster, . Diuretics should be used with extreme caution if at all because of the potential for causing uterine contractions.

Which method is used to diagnose epiglottiditis?? 1. Lateral neck x-rau 2. Direct visualization 3. Hx of sudden onset 4. Presenting signs and symptoms

4. Lateral neck x-ray is not necessary. Only an anesthesiologicst or physician skilled in intubation should do direct visualization. Hx of sudden onset helps support assessment but alone is not sufficient to make a dx.

A nurse teaches a client with TB that he is still considered infectious after treatment is started for which period of time? 1. 72 hours 2. 1 week 3. 2 weeks 4. 4 weeks

4. After 4 weeks the disease is no longer infections but the client must continue to take medication.

A client is experiencing mild diarrhea through his colostomy. Which instruction is correct to give this client? 1. Eat prunes 2. Drink apple juice 3. Increase lettuce intake 4. Increase intake of banans

4. Eat more bananas (help make formed stool and aren't irritating to the bowel. Apple juice and prunes can increase frequency of diarrhea. Lettuce acts as fiber and can increase the looseness of stools.

A nurse is teaching a client with glaucoma the proper technique for instilling eyedrops. She instructs the client to place the drops: 1. On the cornea 2. In the outer canthus 3. Near the opening of the lacrimal duct 4. In the lower conjuctival sac

4. Eyedrops should be placed in the lower conjunctival sac starting at the inner, not outer canthus. Placing eyedrops on the cornea causes discomfort and should be avoided. Eyedrops shouldn't be placed by the opening of the lacrimal ducts to avoid systemic absorption. IF YOU PUT IT ON THE LACRIMAL DUCT OPENING IT CAN TRAVEL TO OTHER EYE AND BRING BACTERIA/INFECTION WITH IT!

Which opportunistic disease is caused by protozoa in clinets with acquired immunodeficiency syndrome? 1. TB 2. Histoplasmosis 3. Kaposi's sarcoma 4. Pneumocystis carinii infection

4. P. carinii infection is caused by protozoa. TB is caused by bacteria. Histoplasmosis is a fungal infection. Kaposi's sarcoma is a neoplasm.

A nurse is aware that family members of a client diagnosed with TB may have been exposed to the disease. The nurse explains that a TB skin test should be performed on each family member and that this may show: 1. active disease 2. recent infection 3. extent of the infection 4. infection at some point

4. a positive skin test doesn't guarantee that an infection is currently present. Some people have false-positive results. Active diseasee may be viewed on a chest x-ray. MRI can evaluate the extent of lung damage. THEY PUT A SMALL, HARMLESS FORM OF TB INTO YOUR DERMIS TO SEE IF YOUR BODY ATTACKS IT. IF IT DOES, THAT MEANS YOUR BODY HAS 'SEEN' IT BEFORE AND YOU HAVE HAD OR CURRENTLY HAVE TB.

A mother says her 2-year old child is up to date with his immunizations. Which should be included?

DTaP, IPV, MMR, Hib, varicella, pneumococcal, hepatitis B and Rotavirus vaccines

What are early and late S/S of UTI

Early: Fever and change in clarity of urine Late: Lower back pain

What are stridorous breath sounds?

Stridor is a high-pitched, wheezing sound caused by disrupted airflow. Stridor may also be called musical breathing or extrathoracic airway obstruction. Airflow is usually disrupted by a blockage in the larynx (voice box) or trachea (windpipe).