HESI RN Exit Exam 2023 Overview

HESI RN Exit Exam 2023 Enalapril maleate (Vasotec) is prescribed for a hospitalized client. Which assessment does the nurse perform as a priority before administering the medication? A) Checking the client's blood pressure B) checking the client's peripheral pulses C) checking the most recent potassium level D) checking the client's intake and output record for the last 24 hours A) Checking the client's blood pressure Rationale--enalapril maleate is an angiotensin-converting enzyme (ACE) inhibitor used to treat hypertension. One common side effect is postural hypotension. Therefore the nurse would check the client's blood pressure immediately before administering each dose. C) "I need to drink citrate of magnesia the night before the test and give myself a Fleet enema on the morning of the test." Rationale An upper GI series involves visualization of the esophagus, duodenum, and upper jejunum by means of the use of a contrast medium. It involves swallowing a contrast medium (usually barium), which is administered in a flavored A) "The test will take about 30 minutes" milkshake. Films are taken B) "I need to fast for 8 hours before the test" at intervals during the test, which takes about 30 minutes. No C) "I need to drink citrate of magnesia the night before the test and special preparation is give myself a Fleet enema on the morning of the test." necessary before a GI series, except that NPO status must be D) "I need to take a laxative after the test is completed, because maintained for 8 hours the liquid that I'll have to drink for the test can be constipating." before the test. After an upper GI series, the client is prescribed a laxative to hasten elimination of the barium. Barium that remains in the colon may become hard and difficult to expel, leading to fecal impaction. A client is scheduled to undergo an upper gastrointestinal (GI) series, and the nurse provides instructions to the client about the test. Which statement by the client indicates a need for further instruction? A nurse on the evening shift checks a physician's prescriptions and notes that the dose of a prescribed medication is higher than the normal dose. The nurse calls the physician's answering service and is told that the physician if off for the night and will be available the next morning. The nurse should: A) call the nursing supervisor B) Ask the answering service to contact the on-call physician C) Withhold the medication until the physician can be reached in the morning D) Administer the medication but consult the physician when he becomes available B) Ask the answering service to contact the on-call physician An emergency department (ED) nurse is monitoring a client with suspected acute myocardial infarction (MI) who is awaiting transfer to the coronary intensive care unit. The nurse notes the sudden onset of premature ventricular contractions (PVCs) on the monitor, checks the client's carotid pulse, and determines that the PVCs are not resulting in perfusion. The appropriate action by the nurse is: A. Documenting the findings B. Asking the ED physician to check the client C. Continuing to monitor the client's cardiac status D. Informing the client that PVCs are expected after an MI B. Asking the ED physician to check the client NPO status is imposed 8 hours before the procedure on a client scheduled to undergo electroconvulsive therapy (ECT) at 1 p.m. On the morning of the procedure, the nurse checks the client's record and notes that the client routinely takes an oral antihypertensive medication each morning. The nurse should: A. Administer the antihypertensive with a small sip of water B. Withhold the antihypertensive and administer it at bedtime C. Administer the medication by way of the intravenous (IV) route Administer the antihypertensive with a small sip of water 1/4 D. Hold the antihypertensive and resume its administration on the day after the ECT A client who recently underwent coronary artery bypass graft surgery comes to the physician's office for a follow-up visit. On assessment, the client tells the nurse that he is feeling depressed. Which response by the nurse is therapeutic? A. "Tell me more about what you're feeling." B. "That's a normal response after this type of surgery." C. "It will take time, but, I promise you, you will get over this depression." D. "Every client who has this surgery feels the same way for about a month." A. "Tell me more about what you're feeling." Which information is most concerning to the nurse when caring for an older client with bilateral cataracts? A. States having difficulty with color perception B. Presents with opacity of the lens upon assessment C. Complains of seeing a cobweb-type structure in the visual field D. Reports the need to use a magnifying glass to see small print C. Complains of seeing a cobweb-type structure in the visual field B. Decrease in cognitive status of the client When caring for a client hospitalized with Guillain-Barré syndrome, which information is most important for the nurse to report to the primary health care provider? A. Ascending numbness from the feet to the knees B. Decrease in cognitive status of the client C. Blurred vision and sensation changes D. Persistent unilateral headache Rationale A decline in cognitive status in a client is indicative of symptoms of hypoxia and a possible need to assist the client with mechanical ventilation. A primary health care provider will need to be contacted immediately. Options A, C, and D are findings associated with Guillain-Barré syndrome that should also be reported but are not as critical as the client's hypoxic status. A client is admitted with a diagnosis of leukemia. This condition is manifested by which of the following? A. Fever, elevated white blood count, elevated platelets B. Fatigue, weight loss and anorexia, elevated red C. Hyperplasia of the gums, elevated white blood count, weakness blood cells C. Hyperplasia of the gums, elevated white blood count, weakness D. Hypocellular bone marrow aspirate, fever, decreased hemoglobin level The nurse enters the examination room of a client who has been told by her health care provider that she has advanced ovarian cancer. Which response by the nurse is likely to be most supportive for the client? A. "I know many women who have survived ovarian cancer." B. "Let's talk about the treatments of ovarian cancer." C. "In my opinion, I would suggest getting a second opinion." D. "Tell me about what you are feeling right now." D. "Tell me about what you are feeling right now." A nurse performs an initial admission assessment of a 56-year-old client. Which factor(s) would indicate that the client is at risk for metabolic syndrome? (Select all that apply.) A. Abdominal obesity 2/4 A) abdominal obesity B) sedentary lifestyle B. Sedentary lifestyle C. History of hypoglycemia D. Hispanic or Asian ethnicity E. Increased triglycerides D) hispanic or Asian ethnicity E) increased triglycerides Which clinical manifestation in the client with hyperthyroidism is most important to report to the health care provider? A. Nervousness B. Increased appetite C. Apical heart rate of 130 beats/min D. Insomnia C. Apical heart rate of 130 beats/min The nurse administers atropine sulfate ophthalmic drops preoperatively to the right eye of a client scheduled for cataract surgery. Which response by the client indicates that the drug was effective? A. The pupils become equal and reactive to light. B. The right pupil constricts within 30 minutes. C. Bilateral visual accommodation is restored. D. The right pupil dilates after drop instillation. D. The right pupil dilates after drop instillation. A client with human immunodeficiency virus (HIV) develops a painful blistering skin rash on the right lateral abdominal area. Which drug should the nurse expect to administer to treat this condition? A. Levofloxacin B. Acyclovir sodium C. Fluconazole D. Esomeprazole B. Acyclovir sodium When assessing a 38-year-old client with tuberculosis who is taking rifampin, which finding would be most important to report to the primary health care provider immediately? A. Orange-colored urine B. Potassium level, 4.9 mEq/L C. Elevated liver enzyme levels D. Blood urea nitrogen (BUN) level, 12 mg/dL. C. Elevated liver enzyme levels The nurse empties a client's urinary drainage from an indwelling Foley catheter. Which finding should be reported to the primary health care provider? A. Ammonia odor is noted when the catheter is emptied. B. 240 mL of urinary output is produced in 12 hours. C. A 16-French catheter was used for an adult female. D. Drainage system is hanging below the level of the bladder. B. 240 mL of urinary output is produced in 12 hours. When blood or blood products are administered, which task can be assigned to the licensed practical nurse (PN)? A. Initiation of the blood product B. Obtaining vital signs after infusion has begun C. Assessment of client's condition prior to blood administration D. Evaluation of client's response after receiving blood product B. Obtaining vital signs after infusion has begun The charge nurse observes a student nurse enter the room of a client who is prescribed airborne precautions. The application of which personal protective equipment by the student indicates a correct understanding of this precaution? A. Surgical mask, clean gloves, and gown B. Properly fitted N95 respirator or mask 3/4 B. Properly fitted N95 respirator or mask C. Sterile gloves and gown D. Goggles, clean gloves, and gown The nurse reviews the comprehensive metabolic panel for a client with an electrolyte imbalance. Which data requires the most immediate intervention by the nurse? A. Potassium level, 3.9 mEq/dL B. Creatinine level, 1.1 mg/dL C. Sodium level, 125 mEq/L D. Calcium level, 9 mg/dL C. Sodium level, 125 mEq/L When assessing safety for the older adult, which of the following is of highest priority to the nurse? A. The client has a cataract in the right eye. B. The client is not married and lives alone. C. The client lives in a two-story building. D. The client reports a history of repeated falls. D. The client reports a history of repeated falls. While assessing a client with recurring chest pain, the unit secretary notifies the nurse that the client's health care provider is on the telephone. What action should the nurse instruct the unit secretary to implement? C. Ask another nurse to take the phone call. A. Transfer the call into the room of the client. B. Instruct the secretary to explain the reason for the call. C. Ask another nurse to take the phone call. D. Ask the health care provider to see the client on the unit The family of a male adult with schizophrenia does not want the client to be involved in decisions regarding his treatment. The nurse should inform the family that the client has a right to be involved in his treatment planning based on which law? B. American with Disabilities Act of 1990 A. Social Security Act of 1990 B. American with Disabilities Act of 1990 C. Medicaid Act of 1965 D. Mental Health Act of 1946 Which vital sign in a pediatric client is most important to report to the primary health care provider? A. Newborn with a heart rate of 140 beats/min B. Three-year-old with a respiratory rate of 28 breaths/min C. Six-year-old with a heart rate of 130 beats/min D. Twelve-year-old with a respiratory rate of 16 breaths/min C. Six-year-old with a heart rate of 130 beats/min When caring for a client in labor, which finding is most important to report to the primary health care provider? A. Maternal heart rate, 90 beats/min B. Fetal heart rate, 100 beats/min C. Maternal blood pressure, 140/86 mm Hg D. Maternal temperature, 100.0°F B. Fetal heart rate, 100 beats/min In caring for a pregnant woman with gestational diabetes, the nurse should be alert to which finding? A. A consistent fasting blood sugar level between 80 and 85 mg/dL B. A 2-hour postprandial level >120 mg/dL C. Client reports taking a 30-minute walk after dinner D. Client describes eating pattern of four to six meals daily B. A 2-hour postprandial level >120 mg/dL 4/4