HESI review Med 1
A 26 yo WF has been engaging in multiple colonic therapies (enemas) to lose water weight. Following a therapy she begins to complain abnormal facial twitch that occurs when she is touching her cheek. What is she experiencing? a. Chvostek's sign b. Tinnitus c. Allergic Reaction d. Trosseau's sign
a
A client asks the nurse why his residual limb cannot be elevated on a pillow. What is the best response by the nurse? a. "Elevating the leg might lead to a flexion contracture." b. "Elevating the extremity may increase your chances of compartment syndrome." c. "You need to turn yourself side to side. If your leg is on a pillow, you would not be able to do that." d. "I am sorry. We ran out of pillows. I can elevate it on a few blankets."
a
A client who has occasional gastric symptoms is receiving teaching on how to prevent gastroesophageal reflux disease (GERD). Which statement indicates the client understands the teaching? a. "Eliminating my morning coffee will help." b. "I should take a nap after meals, when possible." c. "I should eat two large meals a day, instead of three." d. "Sleeping flat without pillows is beneficial."
a
A client with diabetic ketoacidosis has been brought into the ED. Which intervention is not a goal in the initial medical treatment of diabetic ketoacidosis? a. Administer glucose b. Administer isotonic fluid at a high volume c. Monitor serum electrolytes and blood glucose levels d. Administer potassium replacements
a
A client with excess fluid volume and hyponatremia is in a comatose state. What are the nursing considerations concerning fluid replacement? a. Administer small volumes of a hypertonic solution b. Correct the sodium deficit rapidly with salt c. Restrict fluids and salt for 24 hours d. Monitor the serum sodium for changes hourly
a
A college student presents to the health clinical with signs and symptoms of viral rhinitis (common cold). The patient states, "I've felt terrible all week; what can I do to feel better?" Which of the following is the best response the nurse can give? a. "You should rest, increase your fluids, and take Ibuprofen." b. "Have you tried a topical nasal decongestant? They work well." c. "Antibiotics will be prescribed, which will make you feel better." d. "Your symptoms should go away soon, just try to get some rest."
a
A nurse completed a client physical examination for an insurance company. The nurse determined the client has increased blood pressure, increased blood glucose, levels and obesity. What condition for coronary artery disease does the nurse consider next? a. Metabolic syndrome b. Hypolipidemia c. Congestive heart failure d. Diabetes mellitus
a
A nurse is teaching a client about medications for glaucoma. What is the main purpose of glaucoma medication? a. Lowering intraocular pressure b. Reducing the appearance of optic nerve head c. Increasing the visual field d. Decreasing the opacity of the lens
a
A patient in the emergency room has signs and symptoms associated with cholecystitis. Which of the following diagnostic tests would not be helpful to diagnose this condition? a. Colonoscopy b. Computed Tomography (CT) scan of abdomen & pelvis c. Abdominal ultrasound d. HIDA Scan (Hepatobiliary Iminodiacetic AciD scan)
a
A patient is scheduled to undergo a liver biopsy. Which of the following lab levels might cause this procedure to be canceled? a. INR 3.6 & Platelets 50,000/mL b. Amylase 98 U/L & Lipase 150 U/L c. Aspartate Aminotransferase (AST) 45 u/L & Bilirubin 0.8 mg/dL d. White Blood Cell Count 13,000 & BUN 26 mg/dL
a
An emergency department nurse assesses a client with ketoacidosis. Which clinical manifestation should the nurse correlate with this condition? a) Increased rate and depth of respiration b) Extremity tremors followed by seizure activity c) Oral temperature of 102° F (38.9°C) d)Severe orthostatic hypotension
a
CB has had diabetes for over a year and his new provider prescribed a medication-Lisinopril. What does the patient say that makes you feel he understands the reason he is taking it? a. "This blood pressure medication is used to protect my kidneys" b. "This medication will help me keep my blood sugar controlled so I won't need insulin" c. "I need this medication to help prevent my cholesterol from being abnormal" d. "This will protect my sight and help prevent cataracts"
a
The emergency department nurse teaches clients with sports injuries to remember the acronym PRICE. This acronym stands for which combination of treatments? a. Protection, rest, ice, compression, elevation b. Pressure, rotation, ice, compression, examination c. Pressure, rest, immersion, compression, elevation d. Protection, rotation, ice, circulation, examination
a
The nurse is caring for a client admitted with a diagnosis of bacterial pharyngitis. The nurse anticipates the client will be ordered which medication? a. penicillin b. robitussin DM c. tylenol d. tylenon with codeine
a
Which intervention would be INCORRECT for the nurse to implement for a client who has an external fixator? a. Turn the clamps by one-half every day. b. Perform neurovascular assessments. c. Supervise the client during transfers. d. Inspect pin sites for signs of infection.
a
Which of the following digestive enzymes is NOT secreted by the pancreas? a. Pepsin b. Lipase c. Amylase d. Trypsin
a
You are caring for a patient post cataract surgery. Which of the following assessment findings would be a NOT be a cause for concern? a. erythema and a "scratchy" feeling to the eye b. development of "floaters" in the field of vision c. increase in pain with associated decrease in vision d. sensation of "flashing lights" in the eye
a
The nurse receives a client from the post-anesthesia unit with a new onset of sinus tachycardia and a heart rate of 118 beats per minute. The client's other VS are as follows: T 101.1, RR 24, and BP 130/80. The client states she feels terrible and is scared. To which reasons does the nurse relate the increased heart rate? Select all that apply. a. Anxiety b. Fever c. Blood loss d. Hypoglycemia e. Sleep
a, b, c
The nurse is reviewing lab work on a newly admitted client. Which of the following diagnostic studies confirm the nursing diagnosis of Deficient Fluid Volume? Select all that apply. a. An elevated hematocrit level b. A low urine specific gravity c. Electrolyte imbalance d. Low protein level in the urine
a, c
A client reports pain in the right knee, stating, "My knee got twisted when I was going down the stairs." The client was diagnosed with an injury to the ligaments and tendons of the right knee. Which terminology, documented by the nurse, best reflects the injury? a. Fracture b. Sprain c. Strain d. Dislocation
b
A client with calculi in the gallbladder is said to have: a. Cholecystitis b. Cholelithiasis c. Choledocholithiasis d. Choledochotomy
b
A patient is receiving treatment for Crohn's Disease. Which of the following foods is the patient allowed to eat? a. corn on the cob b. baked fish c. yogurt d. raw broccoli
b
A patient is scheduled to have Cefazolin (Ancef) given intravenously "on call" to the operating room. At what point will this medication be administered? a. 90-120 minutes prior to transport to the Operating Room b. 30-60 minutes prior to transport to the Operating Room c. When the patient is on the operating room table d. Once the patient arrives in the recovery room
b
A patient presents to the Emergency Rooms with complaint of taking a Tylenol overdose. What medication is likely to be prescribed to protect this patient from fulminant liver failure? a. Isoniazid (Nydrazid) b. N-acetylcysteine (Mucomyst) c. Methyldopa (Aldomet) d. Halothane (Fluthane)
b
A patient with a prolonged episode of nausea, vomiting, and diarrhea has an ABG ordered on admission. You would expect the results to show: a. Metabolic Alkalosis b. Metabolic Acidosis c. Respiratory Alkalosis d. Respiratory Acidosis
b
An client who has been diagnosed with arteriosclerosis is confused by what this means. The nurse explains that arteriosclerosis is: a. a vascular occlusive disease. b. an expected part of the aging process. c. high level of blood fat. d. a condition in which the lumen of arteries fill with scar tissue.
b
If a dislocation is not treated promptly, tissue death due to anoxia can occur. This would be documented as which of the following? a. Osteomyelitis b. Avascular necrosis (AVN) c. Subluxation d. Heterotopic ossification
b
Interpret the following ABG results: pH = 7.21 pCO2 = 60 HCO3 = 24 a. Normal b. Respiratory acidosis without compensation c. Metabolic acidosis with partial compensation d. Respiratory alkalosis with complete compensation
b
The nurse assesses a patient with diabetes insipidus. Which of the following would be an expected assessment finding? a. Decreased pulse b. Increased urine output c. Decreased gastric motility d. Increased serum glucose
b
The nurse is collecting a stool specimen from a patient. What characteristic of the stool indicates to the nurse that the patient may have an upper GI bleed? a. Clay-colored b. Tarry and black c. Bright red d. Greasy and foamy
b
The nurse is discussing macrovascular complications of diabetes with a client. The nurse would address what topic during this dialogue? a. The need for frequent eye examinations for clients with diabetes b. The fact that clients with diabetes have an elevated risk of myocardial infarction c. The relationship between kidney function and blood glucose levels d. The need to monitor urine for the presence of albumin
b
The nurse is preparing discharge instructions for a patient diagnosed with pancreatic cancer. Which of the following services is the patient most likely to require? a. Routine care with primary provider b. Hospice care c. Intensive outpatient physical therapy d. Inpatient rehabilitation
b
What is the ideal body weight of a small framed woman who is 5 ft 6 inches tall? a. 128 lbs b. 117 lbs c. 130 lbs d. 143 lbs
b
What is true about both HHS and DKA? a. Both have rapid onset b. Both can affect renal function c. Both have similar mortality rates d. Both have slow onset
b
When teaching a patient about self-administration of insulin injections which of these should you include: a. Draw up cloudy insulin before clear insulin when mixing b. Make sure to rotate injection sites c. Hypoglycemia is not a concern with insulin therapy d. Refrigerated insulin never expires
b
Which term refers to a muscular, cramplike pain in the extremities consistently reproduced with the same degree of exercise and relieved by rest? a. Aneurysm b. Intermittent claudication c. Ischemia d. Bruit
b
1. A 59 yo presents for a routine physical exam. His BMI is 38.0. His serum lab fasting blood sugar is 142. The provider ordered a HgbA1c which was 6.7%. What will you include in his teaching plan based on his results? Select all that apply. a. how and where to inject injulin b. how to check blood sugar c. all of the above d. a weight reduction calorie plan
b & d
A patient undergoing thyroidectomy is at risk postoperatively for which of the following? Select all that apply. a) hyperparathyroidism b) vocal cord injury c) thyroid storm d) hypocalcemia
b, c, d
A client with severe hypoparathyroidism is experiencing tetany. What medication, prescribed by the physician for emergency use, will the nurse administer to correct the deficit? a. Fludrocortisone b. Sodium bicarbonate c. Calcium gluconate d. Insulin aspart
c
A nurse is assessing a patient who has thick, dry skin; weight gain; and cold insensitivity. What possible cause does the nurse suspect? a. hyperthyroidism b. addison's disease c. hypothyroidism d. diabetes insipidus
c
A nurse is caring for a client after cardiac surgery. Upon assessment, the client appears restless and reports nausea and weakness. The client's ECG reveals peaked T waves. The nurse reviews the client's serum electrolytes, anticipating which abnormality? a. hypomagnesemia b. hyponatremia c. hyperkalemia d. hypercalcemia
c
A nurse provides care for a client receiving oxygen from a nonrebreather mask. Which nursing intervention has the highest priority? a. Applying an oil-based lubricant to the client's mouth and nose b. Changing the mask and tubing daily c. Assessing the client's respiratory status, orientation, and skin color d. Posting a "No smoking" sign over the client's bed
c
A patient is being educated in the use of incentive spirometry prior to having a surgical procedure. What should the nurse be sure to include in the education? a. Encourage the patient to try to stop coughing during and after using the spirometer. b. Inform the patient that using the spirometer is not necessary if the patient is experiencing pain. c. Encourage the patient to take approximately 10 breaths per hour, while awake. d. Have the patient lie in a supine position during the use of the spirometer.
c
A patient is receiving parenteral nutrition. The current solution is nearing completion, and a new solution is to be hung, but it has not arrived from the pharmacy. Which action by the nurse would be most appropriate? a. Have someone go to the pharmacy to obtain the new solution. b. Begin an infusion of normal saline in another site to maintain hydration. c. Hang a solution of dextrose 10% and water until the new solution is available. d. Slow the current infusion rate so that it will last until the new solution arrives.
c
An incoherent client with a history of hypothyroidism is brought to the emergency department by the rescue squad. Physical and laboratory findings reveal hypothermia, hypoventilation, respiratory acidosis, bradycardia, hypotension, and nonpitting edema of the face and periorbital area. Knowing that these findings suggest severe hypothyroidism, the nurse prepares to take emergency action to prevent the potential complication of: a. thyroid storm b. hashimoto's thyroiditis c. myexedema coma d. acromegaly
c
The nurse determines a client scheduled to undergo an abdominal ultrasonography should receive which instruction? a. Do not undertake any strenuous exercise for 24 hours before the test. b. Avoid exposure to sunlight for at least 6 to 8 hours before the test. c. Restrict eating of solid food for 6 to 8 hours before the test. d. Do not consume anything sweet for 24 hours before the test.
c
The nurse is providing information about foot care to a client with diabetes. Which of the following would the nurse include? a. "Wash your feet in hot water every day." b. "Use a razor to remove corns or calluses." c. "Be sure to apply a moisturizer to feet daily." d. "Wear well-fitting comfortable rubber shoes
c
To compensate for decreased fluid volume (hypovolemia), the nurse can anticipate which response by the body? a. Increased urine output b. Vasodilation c. Tachycardia d. Bradycardia
c
What is the earliest and most sensitive indicator of malignant hyperthermia? a. Increase in urine output during surgery b. Presence of tonic-clonic seizure activity c. Exhaled carbon dioxide (CO2) measurements d. Rise in temperature above 101 degrees Fahrenheit
c
Which one of the following actions would NOT be effective in preventing a post-op DVT? a. applying compression hose b. encouraging use of foot exercises while in bed c. enforcing strict bedrest with little movement in bed d. assisting the patient with ambulation
c
Which type of sleep apnea is characterized by lack of airflow due to pharyngeal occlusion? a. Central b. Mixed c. Obstructive d. Simple
c
A monitor technician on the telemetry unit asks a charge nurse why every client whose monitor shows atrial fibrillation is receiving warfarin. Which response by the charge nurse is best? a. "Warfarin controls heart rate in the client with atrial fibrillation." b. "It's just a coincidence; most clients with atrial fibrillation don't receive warfarin." c. "Warfarin prevents atrial fibrillation from progressing to a lethal arrhythmia." d. "Warfarin prevents clot formation in the atria of clients with atrial fibrillation."
d
The nurse assesses a client who is bleeding profusely from the nose. The nurse documents this finding as which condition? a. Xerostomia b. Rhinorrhea c. Dysphagia d. Epistaxis
d
The nurse has completed a teaching session on self-administration of sublingual nitroglycerin. Which client statement indicates that the teaching has been effective? a. "Side effects of nitroglycerin include flushing, throbbing headache, and hypertension". b. "I can put the nitroglycerin tablets in my daily pill dispenser with my other medications". c. "After taking two tablets with no relief, I should call EMS." d. "I can take nitroglycerin before exercise so I won't develop chest pain".
d
The nurse is planning client teaching for a client who is scheduled for an open hemicolectomy. The nurse intends to address the topics of incision splinting and leg exercises during this teaching session. When is the best time for the nurse to provide teaching? a. Upon the client's admission to the post-anesthesia care unit (PACU) b. When the client returns from the PACU c. During the intraoperative period d. As soon as possible before the surgical procedure
d
When during the peri-operative period should a handoff report occur? a. When a patient moves from pre-op holding to the operating room b. When a patient moves from the operating room to the recovery room c. When there is a change in staff for breaks or the shift d. Handoff should occur at all of these times
d
Which of the following would be most important to report to the surgical team prior to surgery? a. The family will be in the waiting room during surgery. b. The patient has a Foley catheter that was placed last night. c. The surgical consent was signed yesterday instead of today. d. The patient ate a full breakfast this morning.
d
Your patient is newly diagnosed with bacterial conjunctivitis. Which of the following instructions would be most appropriate regarding the contact lenses they are currently wearing? a. You can never wear contact lenses again. b. You should use the prescribed antibiotic drops to disinfect your contacts. c. You can disinfect your contact lenses by soaking them in your regular cleaning solution for 24 hours. d. The contact lenses you are currently wearing should be discarded.
d
