MS HESI BS

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A client is diagnosed with hypertension that is related to atherosclerosis. Which information should the nurse consider when planning care for this client? 1 Renin causes a gradual decrease in arterial pressure. 2 Lipid plaque formation occurs within the arterial vessels. 3 Development of atheromas within the myocardium is characteristic. 4 Mobilization of free fatty acid from adipose tissue contributes to plaque formation.

2 The term atherosclerosis means a thickening of the arterial lining by lipid plaques, which become atheromas.

A nurse instructs a client to breathe deeply to open collapsed alveoli. What should the nurse include in the explanation of the relationship between alveoli and improved oxygenation? 1 "The alveoli need oxygen to live." 2 "The alveoli have no direct effect on oxygenation." 3 "Collapsed alveoli increase oxygen demands." 4 "Oxygen is exchanged for carbon dioxide in the alveolar membrane."

4 The exchange of oxygen and carbon dioxide occurs in the alveolar membrane

A nurse is assessing a group of clients. Which client is considered at the highest risk for a dissecting aneurysm? 1 70-year-old male with peripheral vascular disease 2 65-year-old male with uncontrolled hypertension 3 40-year-old female with controlled hypertension 4 42-year-old female with peripheral vascular disease

2 The highest incidence of dissecting aneurysm is in people in their sixth and seventh decades of life; it is seen 2 to 5 times more frequently in men than in women. It occurs most often in older clients with hypertension.

Which drug can cause diabetes insipidus? 1 Cabergoline 2 Metyrapone 3 Demeclocycline 4 Aminoglutethimide

3 Prolonged administration of demeclocycline may cause diabetes insipidus, as this drug decreases the production of antidiuretic hormone by the kidneys

When obtaining a health history from a client recently diagnosed with type 1 diabetes, the nurse expects the client to report what clinical manifestations? 1 Irritability, polydipsia, and polyuria 2 Polyuria, polydipsia, and polyphagia 3 Nocturia, weight loss, and polydipsia 4 Polyphagia, polyuria, and diaphoresis

2 Excessive thirst (polydipsia), excessive hunger (polyphagia), and frequent urination (polyuria) are caused by the body's inability to metabolize glucose adequately.

A client states, "I feel like my heart is jumping out of my chest, and it is skipping beats." The client passes a thallium stress test; however, the healthcare provider identifies one premature ventricular complex (PVC) and several premature atrial complexes (PACs) on the 24-hour follow-up Holter monitor. Which question is most important for the nurse to ask the client? 1 "Do you eat foods high in vitamins?" 2 "Do you have small children at home?" 3 "How much caffeine do you consume each day?" 4 "How many glasses of water do you drink per day?"

3 Caffeine is a stimulant that causes the heart to become irritable; it can result in tachycardia and atrial dysrhythmias.

Which condition results in elevated serum adrenocorticotropic hormone (ACTH) and urine cortisol levels? 1 Diabetes insipidus 2 Adrenal Cushing's syndrome 3 Pituitary Cushing's syndrome 4 Syndrome of inappropriate antidiuretic hormone

3 In pituitary Cushing's syndrome, urine cortisol and serum adrenocorticotropic hormone levels are raised. Diabetes insipidus is the result of decreased levels of antidiuretic hormone and is not associated with cortisol and ACTH levels. Adrenal Cushing's syndrome is caused by chronic steroid use, so the client will have increased urine cortisol and decreased ACTH levels. Syndrome of inappropriate antidiuretic hormone is the result of elevated levels of antidiuretic hormone and is not related with the ACTH and cortisol levels.

The treatment regimen for a female diagnosed with Hodgkin disease, stage III, will start with nodal irradiation. Because the client and her husband have been trying to conceive a child, the client becomes visibly anxious when she learns that the radiation therapy includes the pelvic nodal area. The nurse refers the client to the primary healthcare provider when the client starts to question the treatment. What is the rationale for the nurse's actions? 1 Radiation used is not radical enough to destroy ovarian function. 2 Intermittent radiation to the area does not cause permanent sterilization. 3 Reproductive ability may be preserved through a variety of interventions. 4 Ovarian function will be destroyed temporarily but will return in about six months

3 Reproductive ability may be preserved through shielding the ovaries or harvesting ova

A nurse is conducting cholesterol screening for a manufacturing corporation during a health fair. A 50-year-old man who is 6 feet (183 cm) tall and weighs 293 pounds (133 kg) puts out his cigarette and asks the nurse how to modify his risk factors for coronary artery disease. On which risk factors should the nurse help the client focus? Select all that apply. 1 Age 2 Height 3 Weight 4 Smoking 5 Family history

3 4 Obesity is a modifiable risk factor that is associated with coronary artery disease (CAD); an increased fat intake contributes to an increased serum cholesterol and atherosclerosis. Smoking, which constricts the blood vessels, is a modifiable risk factor for CAD.

A client with arterial insufficiency of both lower extremities is visited by the home healthcare nurse. What client teaching is an essential nursing intervention? 1 "Maintain elevation of both legs." 2 "Massage the legs when they are painful." 3 "Apply a hot water bottle to the legs." 4 "Check pulses in the legs regularly."

4 Altered quantity and quality of pulses are the earliest indications of increasingly limited circulation

Which pulmonary function test provides a more sensitive index of obstruction in smaller airways? 1 Forced vital capacity 2 Functional residual capacity 3 Forced expiratory volume in 1 second 4 Forced expiratory flow over the 25% to 75% volume of the forced vital capacity

4 Forced expiratory flow over the 25% to 75% volume of the forced vital capacity is the measure that provides a more sensitive index of obstruction in smaller airways.


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