HESI REMEDIATION
The most appropriate time for a nurse manager to schedule a 30-minute nursing education class is:
At the overlap of each shift
While conducting an initial assessment on a client, which classic sign would alert the nurse that the client has chronic obstructive pulmonary disease (COPD)?
Barrel chest
The mother of a 2-year-old child calls her neighbor, who is a nurse, exclaiming that her child just ate some automatic dishwasher powder. What should the nurse tell the mother to do first?
Call the Poison Control Center.
A nurse performs an assessment of a 3-day-old infant. What finding should the nurse report to the health care provider?
Petechiae covering the chest
A client has carotid atherosclerotic plaques, and a right carotid endarterectomy is performed. Two hours after surgery the client demonstrates progressive hypotension. The nurse should:
Notify the health care provider
Two portable drainage catheters with hemovacs attached were placed during a client's hemiglossectomy and right radical neck dissection. Six hours after the catheters were placed, the nurse empties 180 mL of serosanguineous drainage from one of the drainage catheters. The priority nursing intervention is to:
Notify the health care provider immediately
A client is experiencing diplopia, ptosis, and mild dysphagia. Myasthenia gravis is diagnosed and an anticholinergic medication is prescribed. The nurse is planning care with the client and spouse. What instruction is the priority?
Take the medication according to a specific schedule.
Which statement is true about temporary pacemakers?
Transcutaneous pacemakers pace through the skin.
A nurse reviews the laboratory test results of a client with emphysema who is recovering from a myocardial infarction. The nurse obtains the client's vital signs and performs a physical assessment. Which prescribed medication should the nurse consider the priority at this time?
metaprolo
Which intervention may be delegated to nursing assistive personnel (NAP)? Select all that apply.
Having a client care technician obtain routine vital signs Having a client care technician ambulate a stable client
A widow who is hospitalized for a medical problem has dementia of the Alzheimer type and is no longer able to live alone. The client is to be transferred from the hospital to a long-term care facility. When should the staff begin preparation for the transfer?
Immediately after the client's admission to the hospital
A nurse finds a victim under the wreckage of a collapsed building. The individual is conscious, supine, breathing satisfactorily, and reports back pain and an inability to move the legs. Which action should the nurse take first?
Leave the individual lying on the back with instructions not to move, and leave to seek additional help.
A client who is to be discharged from an inpatient mental health facility is referred to a mental health daycare center in the community. What should the nurse identify as the primary reason for this referral?
Maintaining gains achieved during hospitalization
A low-dose intravenous dopamine hydrochloride (Dopamine) infusion drip is prescribed for a client in acute renal failure (ARF). What is the most appropriate way for the nurse to administer this intravenous medication to the client?
Peripherally inserted central line catheter (PICC) line
A client presents with bilateral leg pain and cramping in the lower extremities. The client has a history of cardiovascular disease, diabetes, and varicose veins. To guide the assessment of the pain and cramping, the nurse should include which question when completing the initial assessment?
"Does walking for long periods of time increase your pain?"
The day after undergoing abdominal appendectomy a school-aged child is prepared for ambulation. Which nursing action would be most effective before the start of ambulation?
Administering the prescribed pain medication
After surgical repair of a urinary tract malformation, a school-aged child is to be discharged with an indwelling catheter. The nurse teaches the parents the necessary interventions if urine does not appear in the drainage bag for 1 hour or more. Place the interventions in the order that they should be performed.
Checking for blocked drainage tubing Correct 2. Pressing on the abdominal wall just above the bladder Correct 3. Offering more fluids Correct 4. Calling the practitioner
A nurse provides instruction to a client who was treated for renal colic as a result of uric acid stones. What should the nurse include in the teaching plan? Select all that apply.
Eliminate organ meats from diet. Drink two glasses of water at bedtime. Increase fluid intake to three quarts daily.
The husband of a client in labor asks about an indentation on his wife's abdomen. The nurse explains that it is a retraction ring (Bandl's ring). What is the next nursing action?
Explaining to him what it means and notify the practitioner
A physician prescribes a Schilling Test for a client. Which measure would the nurse take to ensure the prescription is carried out?
Start a 24 to 48 hour urine specimen collection.