HESI Remediation

Acetylcysteine (Mucomyst) is prescribed for a client in the hospital emergency department after diagnosis of acetaminophen (Tylenol) overdose. The nurse prepares to administer the medication using which procedure? 1. Diluting the medication in cola and administering it to the client orally 2. Calling the respiratory department to administer the medication via inhaler 3. Obtaining a 1-mL syringe to administer the small dose via the subcutaneous route 4. Initiating an intravenous line and diluting the medication in 100 mL of normal saline for administration

1. Diluting the medication in cola and administering it to the client orally Focus on the subject, administration of the antidote for acetaminophen overdose. Remember that acetylcysteine can be given orally, by nasogastric tube, or via inhalation; however, it is given orally to treat acetaminophen overdose.

Which should the nurse do when setting up an arterial line? 1. Tighten all tubing connections. 2. Use macrodrop intravenous tubing. 3. Level the transducer to the ventricle. 4. Raise the height of the normal saline infusion to prevent backup.

1. Tighten all tubing connections Because the arterial vasculature is a high-pressure system, all tubing connections must be tight to avoid blood loss from loose connections. High-pressure tubing with a transducer is used (not macrodrip tubing). The transducer should be level to the atrium not the ventricle. Raising the height of the infusion is not sufficient to prevent backflow.

The nurse is providing a health promotion session to a group of teenagers and is discussing the abuse of barbiturates. The nurse should provide which information to the teenagers? 1. Commonly results in a rush of energy 2. Is the cause of many drug overdose deaths 3. Results in only psychological dependency 4. Brings about an increase in blood pressure (BP)

2. Is the cause of many drug overdose deaths The abuse of barbiturates, a class of central nervous system (CNS) depressants, is a major cause of fatal drug overdoses. The abuse of barbiturates results in both physical and psychological dependency. Energy rushes and elevated BP result from the use of a CNS stimulant.

A client has a high level of carbon dioxide (CO2) in the bloodstream, as measured by arterial blood gases. A nurse reviewing the client's record plans care, knowing that a high CO2 level will have which effect on circulation to the brain? 1. It will cause arteriovenous shunting. 2. It will cause vasodilation of blood vessels in the brain. 3. It will cause blood vessels in the circle of Willis to collapse. 4. It will cause hyperresponsiveness of blood vessels in the brain.

2. It will cause vasodilation of blood vessels in the brain. CO2 is one of the metabolic end products that can alter the tone of the blood vessels in the brain. High CO2 levels cause vasodilation, which may cause headache, whereas low CO2 levels cause vasoconstriction, which may cause lightheadedness. The statements included in the other options are incorrect effects.

The nurse is assisting in the care of a client who is being seen in the clinic with a suspected acetaminophen (Tylenol) overdose. Which medication should the nurse plan to have readily available if the suspected diagnosis is confirmed A. Auranofin (Ridaura) B. Pentostatin (Nipent) C. Fludarabine (Fludara) D. Acetylcysteine (Mucomyst)

Acetylcysteine (Mucomyst) The antidote for acetaminophen (Tylenol) is acetylcysteine (Mucomyst), which works by preventing the hepatotoxic metabolites of acetaminophen from forming. Auranofin (Ridaura) is a gold preparation that may be used in rheumatoid arthritis; fludarabine (Fludara) and pentostatin (Nipent) are antineoplastic agents.

A nurse is collecting data on a client diagnosed with mild depression. The client says to the nurse, "I haven't had an appetite at all for the last few weeks." Which best response should the nurse make? A. "The last few weeks?" B. "You haven't had an appetite at all?" C. "When the medication begins to work, you will begin to feel better." D. "Think about everything that you have been through. It will take time for your appetite to improve."

B. "You haven't had an appetite at all?" Note the strategic word best. Use the therapeutic communication techniques to answer the question. Eliminate options 3 and 4 first because they are blocks to the communication process. Option 1 does not focus on the specific problem and is therefore eliminated. Option 2 will promote the communication process and provide the perception of the problem from the client's perspective.

A child is receiving succimer (Chemet) for the treatment of lead poisoning. A nurse should monitor which most important laboratory result? 1. Iron level 2. Calcium level 3. Red blood cell count 4. Blood urea nitrogen level

Blood Urea Nitrogen Level Succimer is a medication that is used to treat lead poisoning. Renal function (blood urea nitrogen and creatinine) is monitored closely during the administration of chelation therapy because the medication is excreted via the kidneys. Although it is important to monitor the iron level, calcium level, and red blood cell count, these results are not specific to chelation therapy, so are not the most important lab values to monitor.