Hesi Questions I got wrong
What therapeutic effect does the nurse expect to identify when mannitol is administered parenterally to a client with cerebral edema? 1. Improved renal blood flow 2. Decreased intracranial pressure 3. Maintenance of circulatory volume 4. Prevention of the development of thrombi
As an osmotic diuretic, mannitol helps reduce cerebral edema. Although there may be a transient increase in blood volume as a result of an increased osmotic pressure, which increases renal perfusion, this is not the therapeutic effect. Prevention of the development of thrombi is not the reason for giving this drug.
A client is admitted to the hospital for an adrenalectomy. The nurse is providing postoperative care before the client's replacement steroid therapy is regulated fully. The nurse should monitor the client for which complication? 1. Hypotension 2. Hypokalemia 3. Hypernatremia 4. Hyperglycemia
Because of instability of the vascular system and the lability of circulating adrenal hormones after an adrenalectomy, hypotension frequently occurs until the hormonal level is controlled by replacement therapy. Hyperglycemia is a sign of excessive adrenal hormones; after an adrenalectomy, adrenal hormones are not secreted. Sodium retention is a sign of hyperadrenalism; it does not occur after the adrenals are removed. Potassium excretion is a response to excessive adrenal hormones; after an adrenalectomy, adrenal hormones are decreased until replacement therapy is regulated.
A client is undergoing diagnostic testing to determine if the client has myasthenia gravis. The nurse understands that the test that is most specific for determining the presence of this disease is what? 1. Electromyography 2. Pyridostigmine test 3. History of physical deterioration 4. Edrophonium chloride test
Edrophonium chloride test uses a drug that is a cholinergic and an anticholinesterase; it blocks the action of cholinesterase at the myoneural junction and inhibits the destruction of acetylcholine. Its action of increasing muscle strength is immediate for a short time. The results of an electromyography will be added to the database, but they are nonspecific. Pyridostigmine is a slower-acting anticholinesterase drug that is prescribed commonly to treat myasthenia gravis; edrophonium chloride is used instead of pyridostigmine to diagnose myasthenia gravis because, when injected intravenously, it immediately increases muscle strength for a short time. The results of a history and physical are added to the database, but the data collected are not as definitive as another specific test for the diagnosis of myasthenia gravis.
Ranitidine has been prescribed to help treat a client's gastric ulcer. The nurse expects this drug to act specifically by which mechanism? 1. Lowering the gastric pH 2. Promoting the release of gastrin 3. Regenerating the gastric mucosa 4. Inhibiting the histamine at H 2 receptors
Ranitidine inhibits histamine at H 2 receptor sites in parietal cells, which limits gastric secretion. Lowering the gastric pH is not the direct action of this drug. Promoting the release of gastrin is undesirable; gastric hormones increase gastric acid secretion. Ranitidine does not regenerate the gastric mucosa; the drug prevents its erosion by gastric secretions.
