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Hesi practice exam evolve Questions and correct Answers An adult client who is hospitalized after surgery reports sudden onset of chest pain and dyspnea. The client appears anxious, restless, and mildly cyanotic. The nurse should further assess the client for which condition?
- pulmonary embolism
- heart failure
- tuberculosis
- bronchitis - ✔pulmonary embolism Which information should the nurse obtain when performing an initial assessment of a client who presents to the emergency department with a painful ankle injury? (Select all that apply.)
- quality of the pain
- signs of inflammation
- ankle range of motion
- muscle strength testing
- visible deformities of the joint - ✔- quality of the pain
- signs of inflammation
- ankle range of motion
- visible deformities of the joint
Which description of pain is consistent with a diagnosis of rheumatoid arthritis?
- joint pain is worse in the morning and involves symmetric joints
- joint pain is better in the morning and worsens throughout the day
- joint pain is consistent throughout the day and is relieved by pain medication
- joint pain is worse during the day and involves unilateral joints - ✔joint pain is worse in the morning and involves symmetric joints Which physical assessment finding should the nurse anticipate in a client with long-term gastroesophagealreflux disease (GERD)?
- hoarseness
- dry mouth
- mouth ulcers
- weight loss - ✔hoarseness A client presents with chronic venous insufficiency. Which assessment finding should the nurse anticipate?
- bilateral lower leg stasis dermatitis
- clubbing of fingers and toes
- intermittent claudication
- peripheral cyanosis - ✔bilateral lower leg stasis dermatitis
- do not leave the diaphragm in place longer than 8 hours after intercourse
- replace the old diaphragm every 3 months - ✔- do not leave the diaphragm in place longer than 8 hours after intercourse
- replace the old diaphragm every 3 months A male client who smokes two packs of cigarettes a day states he understands that smoking cigarettes is contributing to the difficulty that he and his wife are having in getting pregnant and wants to know if other factors could be contributing to their difficulty. What information is best for the nurse to provide? (Select all that apply.)
- marijuana cigarettes do not affect sperm count
- alcohol consumption can cause erectile dysfunction
- low testosterone levels affect sperm production
- cessation of smoking improves general health and fertility
- obesity has no effect on sperm production - ✔- alcohol consumption can cause erectile dysfunction
- low testosterone levels affect sperm production
- cessation of smoking improves general health and fertility Twenty four hours after a client returns from surgical gastric bypass, the registered nurse (RN) observes large amounts of blood in the nasogastric tube (NGT) cannister. Which assessment finding should the RN report as early signs of hypovolemic shock?
- faint pedal pulses
- decrease in blood pressure
- lethargy
- slow breathing - ✔lethargy The registered nurse (RN) is assessing a male client who arrives at the clinic with severe abdominal cramping, pain, tenesmus, and dehydration. The RN discovers that the client has had 14 to 20 loose stools with rectal bleeding. When taking the client's medical history, which information is most for the nurse to obtain?
- irritable bowel syndrome
- diverticulitis
- crohn's disease
- ulcerative colitis - ✔ulcerative colitis A client is newly diagnosed with diverticulosis. The registered nurse (RN) is assessing the client's basic knowledge about the disease process. Which statement by the client conveys an understanding of the etiology of diverticula?
- over use of laxatives for bowel regularity result in loss of peristaltic tone
- inflammation of the colon mucosa cause growths that protrude into the colon lumen
- explain that sperm production will be suppressed after radiotherapy is over - ✔propose sperm banking before RT then artificial insemination is an option A client's susceptibility to ulcerative colitis is most likely due to which aspect in the client's history?
- Jewish European ancestry
- H. pylori bowel infection
- family history of irritable bowel syndrome
- age between 25 and 55 years - ✔Jewish European ancestry Small bowel obstruction is a condition characterized by which finding?
- severe fluid and electrolyte imbalances
- metabolic acidosis
- ribbon-like stools
- intermittent lower abdominal cramping - ✔severe fluid and electrolyte imbalances Which client should the nurse recognize as most likely to experience sleep apnea?
- middle-aged female who takes a diuretic nightly
- obese older male client with a short, thick neck
- adolescent female with a history of tonsillectomy
- school-aged male with a history of hyperactivity disorder - ✔obese older male client with a short, thick neck Which milestone indicates to the nurse successful achievement of young adulthood?
- demonstrates a conceptualization of death and dying
- completes education and becomes self-supporting
- creates a new definition of self and roles with others
- develops a strong need for parental support and approval - ✔completes education and becomes self-supporting A client who has heart failure is admitted with a serum potassium level of 2.9 mEq/L (2.9 mmol/L). Which action is most important for the nurse to implement?
- give 20 mEq of potassium chloride
- initiate continuous cardiac monitoring
- arrange a consultation with the dietician
- teach about the side effects of diuretics - ✔initiate continuous cardiac monitoring Which postmenopausal client's complaint should the nurse refer to the healthcare provider?
- breasts feel lumpy when palpated
- history of white nipple discharge
- episodes of vaginal bleeding
Which discharge instruction is most important for a client after a kidney transplant?
- weigh weekly
- report symptoms of secondary candidiasis
- use daily reminders to take immunosuppressants
- stop cigarette smoking - ✔use daily reminders to take immunosuppressants The nurse is assessing a client with chronic kidney disease (CKD). Which finding is most important for the nurse to respond to first?
- potassium 6.0 mEq
- daily urine output of 400 ml
- peripheral neuropathy
- uremic fetor - ✔potassium 6.0 mEq Which finding should the nurse identify as most significant for a client diagnosed with polycystic kidney disease (PKD)?
- hematuria
- 2 pounds weight gain
- 3+ bacteria in urine
- Steady, dull flank pain - ✔3+ bacteria in urine
The nurse is planning care for a client with newly diagnosed diabetes mellitus that requires insulin. Which assessment should the nurse identify before beginning the teaching session?
- present knowledge related to the skill of injection
- intelligence and developmental level of the client
- willingness of the client to learn the injection sites
- financial resources available for the equipment - ✔willingness of the client to learn the injection sites When providing discharge teaching for a client with osteoporosis, the nurse should reinforce which home care activity?
- a diet low in phosphates
- skin inspection for bruising
- exercise regimen, including swimming
- elimination of hazards to home safety - ✔elimination of hazards to home safety A client with gastroesophageal reflux disease (GERD) has been experiencing severe reflux during sleep. Which recommendation by the nurse is most effective to assist the client?
- losing weight
- decreasing caffeine intake
- avoiding large meals
- raising the head of the bed on blocks - ✔raising the head of the bed on blocks
- report the findings to the surgeon
- irrigate the indwelling urinary catheter
- apply manual pressure to the bladder
- increase the IV flow rate for 15 minutes - ✔report the findings to the surgeon A client who is fully awake after a gastroscopy asks the nurse for something to drink. After confirming that liquids are allowed, which assessment action should the nurse consider a priority?
- listen to bilateral lung and bowel sounds
- obtain the client's pulse and blood pressure
- assist the client to the bathroom to void
- check the client's gag and swallow reflexes - ✔check the client's gag and swallow reflexes During an interview with a client planning elective surgery, the client asks the nurse, "What is the advantage of having a preferred provider organization insurance plan?" Which response is best for the nurse to provide?
- neither plan allows selections of healthcare providers or hospitals
- there are fewer healthcare providers to choose from than in an HMO plan
- an individual may select healthcare providers from outside of the PPO network
- an individual can become a member of a PPO without belonging to a group - ✔an individual may select healthcare providers from outside of the PPO network The nurse is providing dietary instructions to a 68-year-old client who is at high risk for development of coronary heart disease (CHD). Which information should the nurse include?
- limit dietary selection of cholesterol to 300 mg per day
- increase intake of soluble fiber to 10 to 25 grams per day
- decrease plant stanols and sterols to less than 2 grams/day
- ensure saturated fat is less than 30% of total caloric intake - ✔increase intake of soluble fiber to 10 to 25 grams per day A male client receives a local anesthetic during surgery. During the post-operative assessment, the nurse notices the client is slurring his speech. Which action should the nurse take?
- determine the client is anxious and allow him to sleep
- evaluate his blood pressure, pulse, and respiratory status
- review the client's pre-operative history for alcohol abuse
- continue to monitor the client for reactivity to anesthesia - ✔evaluate his blood pressure, pulse, and respiratory status
✔an accurate menstrual cycle diary for the past 6 to 12 months A 32-year-old female client complains of severe abdominal pain each month before her menstrual period, painful intercourse, and painful defecation. Which additional history should the nurse obtain that is consistent with the client's complaints?
- frequent urinary tract infections.
- inability to get pregnant
- premenstrual syndrome
- chronic use of laxatives - ✔inability to get pregnant A 20 - year-old female client calls the nurse to report a lump she found in her breast. Which response is the best for the nurse to provide?
- "Check it again in one month, and if it is still there schedule an appointment."
- "Most lumps are benign, but it is always best to come in for an examination."
- "Try not to worry too much about it, because usually, most lumps are benign."
- "If you are in your menstrual period it is not a good time to check for lumps." - ✔"Most lumps are benign, but it is always best to come in for an examination."
The nurse is working with a 71-year-old obese client with bilateral osteoarthritis (OA) of the hips. Which recommendation should the nurse make that is most beneficial in protecting the client's joints?
- increase the amount of calcium intake in the diet
- apply alternating heat and cold therapies
- initiate a weight-reduction diet to achieve a healthy body weight
- use a walker for ambulation to lessen weight-bearing on the hips - ✔initiate a weight-reduction diet to achieve a healthy body weight A 58-year-old client who has been post-menopausal for five years is concerned about the risk for osteoporosis because her mother has the condition. Which information should the nurse offer?
- osteoporosis is a progressive genetic disease with no effective treatment
- calcium loss from bones can be slowed by increasing calcium intake and exercise
- estrogen replacement therapy should be started to prevent the progression osteoporosis
- low-dose corticosteroid treatment effectively halts the course of osteoporosis - ✔calcium loss from bones can be slowed by increasing calcium intake and exercise
- disabled family coping related to dissonant coping style of significant person
- interrupted family processes related to shift in health status of family member
- risk for ineffective therapeutic regimen management related to complexity of care - ✔disabled family coping related to dissonant coping style of significant person A client with a completed ischemic stroke has a blood pressure of 180/90 mmHg. Which action should the nurse implement?
- position the head of the bed (HOB) flat
- withhold intravenous fluids
- administer a bolus of IV fluids
- give an antihypertensive medication - ✔give an antihypertensive medication A client with a 16-year history of diabetes mellitus is having renal function tests because of recent fatigue, weakness, elevated blood urea nitrogen, and serum creatinine levels. Which finding should the nurse conclude as an early symptom of renal insufficiency?
- dyspnea
- nocturia
- confusion
- stomatitis -
✔nocturia The nurse is caring for a client with a continuous feeding through a percutaneous endoscopic gastrostomy (PEG) tube. Which intervention should the nurse include in the plan of care?
- flush the tube with 50 ml of water q 8 hours
- check for tube placement and residual volume q4 hours
- obtain a daily x- ray to verify tube placement
- position on left side with head of bed elevated 45 degrees - ✔check for tube placement and residual volume q4 hours The nurse is planning care to prevent complications for a client with multiple myeloma. Which intervention is most important for the nurse to include?
- safety precautions during activity
- assess for changes in size of lymph nodes
- maintain a fluid intake of 3 to 4 L per day
- administer narcotic analgesic around the clock - ✔maintain a fluid intake of 3 to 4 L per day When teaching diaphragmatic breathing to a client with chronic obstructive pulmonary disease (COPD), which information should the nurse provide?
- place a small book or magazine on the abdomen and make it rise while inhaling deeply
