HESI questions
Which question would the nurse ask before administering an adrenergic agonist to a client with increased intraocular pressure? [] "Do you take antidepressants?" [] "Do you have any respiratory disorders?" [] "Do you wear glasses?" [] "Do you have allergies to sulfonamides?"
[*] "Do you take antidepressants?"
Which reason would the nurse provide to a client who asks why blood tests are necessary after a health care provider prescribes peak and trough levels after initiation of intravenous antibiotic? [] "They determine if the dosage of the medication is adequate." [] "They detect if you are having an allergic reaction to the medication." [] "The tests permit blood culture specimens to be obtained when the medication is at its lowest level." [] "These allow comparison of your fever to changes in the antibiotic level."
[*] "They determine if the dosage of the medication is adequate."
A client at 31 weeks' gestation is admitted in preterm labor. Which class of medications would the nurse anticipate providing education for? [] An oxytocic [] An analgesic [] A corticosteroid [] A beta-andrenergic
[*] A beta-andrenergic
The registered nurse teaches a student nurse regarding the management of increased potassium levels in a client. Which action performed by the student nurse indicated effective learning? [] Administering sodium polystyrene sulfonate [] Instructing a client to increase potassium and sodium intake [] Monitoring glucose levels hourly [] Providing potassium-sparing diuretics
[*] Administering sodium polystyrene sulfonate
When the nurse is reviewing a client's arterial blood gas results, which finding would the nurse identify as being consistent with respiratory alkalosis? [] A decreased pH, elevated PCO2 [] An elevated pH, decreased PCO2 [] A decreased pH, decreased PCO2 [] An elevated pH, elevated partial pressure of carbon dioxide (PCO2)
[*] An elevated pH, decreased PCO2
While assessing a client's pupils, a health care professional notices pupillary dilatation. Which drug would cause this condition? [] Heroin [] Atropine [] Morphine [] Pilocarpine
[*] Atropine
Which medication is indicated to treat bradycardia for a client whose heart rate drops to 38 bpm during a procedure? [] Digoxin [] Lidocaine [] Amiodarone [] Atropine sulfate
[*] Atropine sulfate
Which catecholamine receptor is responsible for increased heart rate? [] Beta-1 receptor [] Beta-2 receptor [] Alpha-1 receptor [] Alpha-2 receptor
[*] Beta-1 receptor
Which findings are consistent with hypercalcemia after prolonged immobility? Select all that apply. [] Bone pain [] Convulsions [] Muscle spasms [] Tingling of extremities [] Depressed deep tendon reflexes
[*] Bone pain [*] Depressed deep tendon reflexes
Which adverse effect would a nurse monitor for when caring for a client with hypertension who is prescribed metoprolol? [] Hirsutism [] Bradycardia [] Restlessness [] Angina
[*] Bradycardia
Which complication would a nurse try to avoid by slowly administering a parenteral preparation of potassium? [] Metabolic acidosis [] Cardiac arrest [] Seizure activity [] Respiratory depression
[*] Cardiac arrest
Which clinical manifestation would the nurse expect when assessing a client with hypercalcemia? Select all that apply. [] Muscle tremors [] Abdominal cramps [] Increased peristalsis [] Cardiac dysrhythmias [] Hypoactive bowel sounds
[*] Cardiac dysrhythmias [*] Hypoactive bowel sounds
After assessing four clients who have respiratory disorders, which client would the nurse suspect as having metabolic acidosis? [] Client 1 - Tachypnea [] Client 2 - Pursed lip breathing [] Client 3 - Kussmaul respiration [] Client 4 - Abdominal paradox
[*] Client 3 - Kussmaul respiration
The nurse reviews the kidney function blood studies of four clients. Which client's results indicate kidney impairment? []Client 1 - Serum creatinine (0.1 mg/dL [8.84 mmol/L]) Blood urea nitrogen (16 mg/dL [5.712 mmol/L]) [] Client 2 - Serum creatinine (0.8 mg/dL [70.72 mmol/L]) Blood urea nitrogen (18 mg/dL [6.426 mmol/L]) [] Client 3 - Serum creatinine (1.2 mg/dL [106.08 mmol/L]) Blood urea nitrogen (20 mg/dL [7.14 mmol/L]) [] Client 4 - Serum creatinine (1.9 mg/dL [167.96 mmol/L]) Blood urea nitrogen (22 mg/dL [7.85 mmol/L])
[*] Client 4 - Serum creatinine (1.9 mg/dL [167.96 mmol/L]) Blood urea nitrogen (22 mg/dL [7.85 mmol/L])
Which clinical indicator would the nurse expect a client with hyperkalemia to exhibit? Select all that apply. [] Tetany [] Seizures [] Confusion [] Weakness [] Dysrhythmias
[*] Confusion [*] Weakness [*] Dysrhythmias
Which response indicates that a beta blocker prescribed for persistent ventricular tachycardia is working effectively? [] Decreased anxiety [] Reduced chest pain [] Decreased heart rate [] Increased blood pressure
[*] Decreased heart rate
Which finding would the nurse expect when assessing a client with compensated metabolic acidosis? [] Muscle twitching [] Mental instability [] Deep and rapid respirations [] Tachycardia and cardiac dysrhythmias
[*] Deep and rapid respirations
A client at 35 weeks' gestation is admitted with preeclampsia and receives magnesium sulfate intravenously. Which is the MOST important parameter for the nurse to assess which monitoring the client for magnesium sulfate toxicity? [] Heart rate [] Daily weight [] Deep tendon reflex [] Blood pressure
[*] Deep tendon reflex
A client admitted with preeclampsia is receiving magnesium sulfate. Which assessment finding indicates to the nurse that a therapeutic level has been reached? [] Increased fetal activity [] Decreased urine output [] Deep tendon reflexes of +2 [] Respiratory rate of 10 breaths/min
[*] Deep tendon reflexes of +2
Which diagnosis would a nurse suspect in a client who has an arterial blood gas report of pH 7.25, PCO2 35 mm Hg, and HCO3 20 mEq/L (20 mmol/L)? [] Panic attack [] Persistent vomiting [] Diabetic ketoacidosis [] Advanced emphysema
[*] Diabetic ketoacidosis
Which signs of hypokalemia would the nurse monitor in the postoperative surgical client with a nasogastric tube attached to continuous low suction? Select all that apply. [] Irritability [] Dysrhythmias [] Muscle weakness [] Abdominal cramps [] Acidosis
[*] Dysrhythmias [*] Muscle weakness
The nurse is caring for a postpartum client with preeclampsia being managed with a magnesium sulfate infusion. Which is the priority nursing assessment? [] Assessing maternal temperature [] Obtaining blood pressure [] Eliciting deep tendon reflexes [] Monitoring urine output
[*] Eliciting deep tendon reflexes
When a client who has had a thoracotomy develops respiratory acidosis, which action would the nurse take? [] Administer oral fluids [] Encourage deep breathing [] Increase the oxygen flow rate [] Preform nasotracheal suctioning
[*] Encourage deep breathing
Surgery is preformed on a client with a parotid tumor. Postoperative arterial blood gas values are pH 7.32, PCO2 55 mm Hg, and HCO3 25 mEq/L (25 mmol/L). Which action would the nurse take? [] Administer a potent diuretic [] Obtain a prescription for an alkalinizing agent [] Have the client breathe into a rebreather bag at a slow rate [] Encourage the client to cough and then take deep breaths between coughs
[*] Encourage the client to cough and then take deep breaths between coughs
Which medication can be administered via the intramuscular route to treat anaphylaxis? [] Epinephrine [] Methdilazine [] Phenylephrine [] Mycophenolate mofetil
[*] Epinephrine
Which early sign of respiratory acidosis would the nurse expect the client with a restrictive airway disease to exhibit? Select all that apply. [] Headache [] Irritability [] Restlessness [] Hypertension [] Lightheadedness
[*] Headache [*] Irritability [*] Restlessness
Which action describes a therapeutic effect of atenolol? [] Heart rate decreases [] Blood pressure increases [] Bronchospasm is relieved [] Pulse oximetry improves
[*] Heart rate decreases
The nurse is caring for a child with severe dehydration and its associated acid-base imbalance. Which compensatory medication within the body is activated to counteract the effects of the child's acid-base imbalance? [] Profuse diaphoresis [] Increased temperature [] Increased respiratory rate [] Renal retention of hydrogen ions
[*] Increased respiratory rate
An arterial blood gas report indicates the clients pH is 7.25, PCO2 is 35 mm Hg, and HCO3 is 20 mEq/L. Which disturbance would the nurse identify based on these results? [] Metabolic acidosis [] Metabolic alkalosis [] Respiratory acidosis [] Respiratory alkalosis
[*] Metabolic acidosis
The nurse assesses a client who is experiencing profound (late) hypovolemic shock. When monitoring the clients arterial blood gas results, which response would the nurse expect? [] Hypokalemia [] Metabolic acidosis [] Respiratory alkalosis [] Decreased carbon dioxide level
[*] Metabolic acidosis
Which acid-base imbalance would the nurse anticipate in a client in the progressive stage of shock? [] Metabolic acidosis [] Metabolic alkalosis [] Respiratory acidosis [] Respiratory alkalosis
[*] Metabolic acidosis
Which complication will the nurse anticipate when caring for a client in later hypovolemic shock? [] Hypokalemia [] Metabolic acidosis [] Respiratory alkalosis [] Decreased PCO2 levels
[*] Metabolic acidosis
A critically ill 5-year-old child exhibits Kussmaul respirations. Which response would the nurse suspect may be causing an increasing acid-base imbalance? [] Metabolic alkalosis caused by an increase in base bicarbonate [] Respiratory alkalosis caused by excess carbon dioxide (CO2) output [] Respiratory acidosis caused by an accumulation of CO2 [] Metabolic acidosis caused by concentration of cations in body fluids
[*] Metabolic acidosis caused by concentration of cations in body fluids
A client is hospitalized after 4 days of epigastric pain, nausea, and vomiting. The nurse reviews the laboratory test results: plasma pH 7.51, PCO2 50 mm Hg, bicarbonate 58 mEq/L (58 mmol/L), chloride 55 mEq/L (55 mmol/L), sodium 132 mEq/L (132 mmol/L), and potassium 3.8 mEq/L (3.8 mmol/L). Which condition does the nurse determine the results indicate? [] Hypernatremia [] Hyperchloremia [] Metabolic alkalosis [] Respiratory acidosis
[*] Metabolic alkalosis
Which diagnosis is suspected by the nurse when the labratory data for a client with prolonged vomiting rebeal arterial blood gases of pH 7.51, PCO2 of 45 mm Hg, HCO3 of 58 mEq/L (59 mmol/L), and a serum potassium level of 3.8 mEq/L (3.8 mmol/L)? [] Hypocapnia [] Hyperkalemia [] Metabolic alkalosis [] Respiratory acidosis
[*] Metabolic alkalosis
Which nursing action is the PRIORITY for a client who has a serum potassium level of 6.7 mEq/L (6.7 mmol/L)? [] Monitor for cardiac dysrhythmias [] Inquire about changes in bowel patterns [] Assess for leg muscle twitching or weakness [] Assess for signs and symptoms of dehydration
[*] Monitor for cardiac dysrhythmias
Which clinical manifestation is indicative of the fluid and electrolyte imbalance associate with a parathyroidectomy? [] Constipation [] Muscle spasms [] Hypoactive reflexes [] Increased specific gravity
[*] Muscle spasms
Which sign of hypokalemia will the nurse monitor for in a client receiving furosemide? [] Chvostek sign [] Muscle weakness [] Anxious behavior [] Abdominal cramping
[*] Muscle weakness
Which clinical manifestation will the nurse assess for in a client with serum potassium level of 6.4 mEq/L (6.4 mmol/L). Select all that apply. [] Anorexia [] Constipation [] Muscle weakness [] Irregular heart rhythm [] Hyperactive bowel tones
[*] Muscle weakness [*] Irregular heart rhythm [*] Hyperactive bowel tones
Which arterial blood gas report is indicative of diabetic ketoacidosis? [] PCO2: 49, HCO3: 32, pH: 7.50 [] PCO2: 26, HCO3: 20, pH: 7.52 [] PCO2: 54, HCO3: 28, pH: 7.30 [] PCO2: 28, HCO3: 18, pH: 7.28
[*] PCO2: 28, HCO3: 18, pH: 7.28
Which laboratory value indicates to the nurse a client with urinary problems may be at risk for developing weakness and cardiac arrhythmias? [] Calcium of 9.5 mg/dL (2.375 mmol/L) [] Potassium of 7.02 mEq/L (7.02 mmol/L) [] Bicarbonate of 22.8 mEq/L (22.8 mmol/L) [] Phosphorus of 4.1 mg/dL (1.3243 mmol/L)
[*] Potassium of 7.02 mEq/L (7.02 mmol/L)
A client with chronic obstructive pulmonary disease (COPD) has a blood pH of 7.25 and PCO2 of 60 mm Hg. These blood gas results require nursing attention because they indicate which condition? [] Metabolic acidosis [] Metabolic alkalosis [] Respiratory acidosis [] Respiratory alkalosis
[*] Respiratory acidosis
Which type of acid-base imbalance would the nurse expect in a child admitted with a severe asthma exacerbation? [] Metabolic alkalosis caused by excessive production of acid metabolites [] Respiratory alkalosis caused by accelerated respirations and loss of carbon dioxide [] Respiratory acidosis caused by impaired respirations and increased formation of carbonic acid [] Metabolic acidosis caused by the kidney's inability to compensate for increased carbonic acid formation
[*] Respiratory acidosis caused by impaired respirations and increased formation of carbonic acid
Which change in the arterial blood gases would the nurse expect in a client with hyperventilation due to anxiety? [] Respiratory acidosis [] Respiratory alkalosis [] Respiratory compensation [] Respiratory decompensation
[*] Respiratory alkalosis
Which laboratory test provides evidence consistent with a client having renal impairment? Select all that apply. [] Serum albumin: 4.7 g/dL (6.815 umol/L) [] Serum creatinine: 2.0 mg/dL (176.8 umol/L) [] Serum potassium: 5.9 mEq/L (5.9 mmol/L) [] Serum cholesterol: 120 mg/dL (3.108 mmol/L) [] Blood urea nitrogen (BUN): 32 mg/dL (11.424 mmol/L)
[*] Serum creatinine: 2.0 mg/dL (176.8 umol/L) [*] Serum potassium: 5.9 mEq/L (5.9 mmol/L) [*] Blood urea nitrogen (BUN): 32 mg/dL (11.424 mmol/L)
The nurse determined a client's arterial blood gases reflect a compensated respiratory acidosis. The pH was 7.34; which additional laboratory value did the nurse consider? [] The partial pressure of oxygen (PO2) value is 80 mm Hg. [] The partial pressure of carbon dioxide (PCO2) value is 60 mm Hg. [] The bicarbonate (HCO3) value is 50 mEq/L (50 mmol/L). [] Serum potassium value is 4 mEq/L (4 mmol/L).
[*] The bicarbonate (HCO3) value is 50 mEq/L (50 mmol/L).
Which conclusion would be made by the nurse caring for a client with osteomyelitis receiving antibiotic therapy through a central line whose laboratory results reveal that the through level is higher than the peak level after trough blood levels were obtained immediately before prescribed dose of antibiotics was administered and peak levels were obtained 30 mins after the infusion was completed? [] The dose should be increased [] The dose is in excess of the client's needs [] There was an adequate administration of the antibiotic [] There was a problem with the obtaining of blood specimens
[*] There was a problem with the obtaining of blood specimens
Which ophthalmic preparation is indicated to manage a client who has primary open-angle glaucoma? [] Tetracaine [] Fluorescein [] Timolol maleate [] Atropine sulfate
[*] Timolol maleate
The arterial blood gases for a client with acute respiratory distress are pH 7.30, PaO2 80 mm Hg (10.64 kPa), PaCO2 55 mm Hg (7.32 kPa), and HCO3 23 mEq/L (23 mmol/L). How would the nurse interpret these findings? [] Hypoxemia [] Hypocapnia [] Compensated metabolic acidosis [] Uncompensated respiratory acidosis
[*] Uncompensated respiratory acidosis
Which assessment finding would the nurse evaluate before continuing the administration of intravenous (IV) magnesium sulfate therapy? [] Temperature [] Urinary output [] Urinary glucose [] Level of consciousness
[*] Urinary output
Which effect would the nurse anticipate after the health care provider prescribes a cholinergic medication to treat a client's urinary problem? [] Urinary frequency decreases [] Urinary retention is prevented [] Pain is controlled [] Urinary urgency decreases
[*] Urinary retention is prevented
Which pharmacokinetic condition would result in a high intensity and long duration of response? [] When both absorption and elimination are rapid [] When both absorption and elimination are delayed [] When absorption is rapid but elimination is delayed [] When absorption is delayed but elimination is rapid
[*] When absorption is rapid but elimination is delayed
Which blood gas result would the nurse expect an adolescent with diabetic ketoacidosis to exhibit? [] pH 7.30, CO2 40 mm Hg, HCO3(-) 20 mEq/L (20 mmol/L) [] pH 7.35, CO2 47 mm Hg, HCO3(-) 24 mEq/L (24 mmol/L) [] pH 7.46, CO2 30 mm Hg, HCO3(-) 24 mEq/L (24 mmol/L) [] pH 7.50, CO2 50 mm Hg, HCO3(-) 22 mEq/L (22 mmol/L)
[*] pH 7.30, CO2 40 mm Hg, HCO3(-) 20 mEq/L (20 mmol/L)
Which blood gas report MOST likely reflects the acid-base balance of an infant with severe dehydration? [] pH of 7.50 and PCO2 of 34 mm Hg [] pH of 7.23 and PCO2 of 70 mm Hg [] pH of 7.20 and HCO3 of 20 mEq/L (20 mmol/L) [] pH of 7.56 and HCO3 of 30 mEq/L (30 mmol/L)
[*] pH of 7.20 and HCO3 of 20 mEq/L (20 mmol/L)
Which blood gas value would the nurse expect in a ventilated client with an air leak and suspected alveolar hypoventilation? [] pH of 7.32 [] PO2 of 95 mm Hg [] PCO2 of 30 mm Hg [] HCO3(-) of 20 mEq/L (20 mmol/L)
[*] pH of 7.32