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Exam (elaborations)

HESI 799 RN EXIT EXAM
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  • Course
  • Nursing pharmacology
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  • Nursing Pharmacology

Following discharge teaching, a male client with duodenal ulcer tells the nurse the he will drink plenty of dairy products, such as milk, to help coat and protect his ulcer. What is the best follow-up action by the nurse? a. Remind the client that it is also important to switch to decaffeinated ...

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  • December 1, 2022
  • 204
  • 2022/2023
  • Exam (elaborations)
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  • such as milk
  • hesi 799 rn exit exam following discharge teaching
  • a male client with duodenal ulcer tells the nurse the he will drink plenty of dairy products
  • to help coat and protect his ulcer what

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  • Nursing pharmacology
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HESI 799 RN EXIT EXAM

Following discharge teaching, a male client with duodenal ulcer tells the nurse the he will drink plenty of
dairy products, such as milk, to help coat and protect his ulcer. What is the best follow-up action by the
nurse?

a. Remind the client that it is also important to switch to decaffeinated coffee and tea.
b. Suggest that the client also plan to eat frequent small meals to reduce discomfort
c. Review with the client the need to avoid foods that are rich in milk and cream.
d. Reinforce this teaching by asking the client to list a dairy food that he might select.
Review with the client the need to avoid foods that are rich in milk and cream

Rationale: Diets rich in milk and cream stimulate gastric acid secretion and should be avoided.
A male client with hypertension, who received new antihypertensive prescriptions at his last visit returns
to the clinic two weeks later to evaluate his blood pressure (BP). His BP is 158/106 and he admits that he
has not been taking the prescribed medication because the drugs make him "feel bad". In explaining the
need for hypertension control, the nurse should stress that an elevated BP places the client at risk for
which pathophysiological condition?

a. Blindness secondary to cataracts
b. Acute kidney injury due to glomerular damage
c. Stroke secondary to hemorrhage
d. Heart block due to myocardial damage
Stroke secondary to hemorrhage

Rationale: Stroke related to cerebral hemorrhage is major risk for uncontrolled hypertension.
The nurse observes an unlicensed assistive personnel (UAP) positioning a newly admitted client who has
a seizure disorder. The client is supine and the UAP is placing soft pillows along the side rails. What
action should the nurse implement?


a. Ensure that the UAP has placed the pillows effectively to protect the client.
b. Instruct the UAP to obtain soft blankets to secure to the side rails instead of pillows.
c. Assume responsibility for placing the pillows while the UAP completes another task.
d. Ask the UAP to use some of the pillows to prop the client in a side lying position.
Instruct the UAP to obtain soft blankets to secure to the side rails instead of pillows

Rationale: The nurse should instruct the UAP to pad the side rails with soft blankest because the use of
pillows could result in suffocation and would need to be removed at the onset of the seizure. The nurse
can delegate paddling the side rails to the UAP

,An adolescent with major depressive disorder has been taking duloxetine (Cymbalta) for the past 12 days.
Which assessment finding requires immediate follow-up

a. Describes life without purpose
b. Complains of nausea and loss of appetite
c. States is often fatigued and drowsy
d. Exhibits an increase in sweating.
Describes life without purpose

Rationale: Cymbalta is a selective serotonin and norepinephrine reuptake inhibitor that is known to
increase the risk of suicidal thinking in adolescents and young adults with major depressive disorder. B, C
and D are side effects
A 60-year-old female client with a positive family history of ovarian cancer has developed an abdominal
mass and is being evaluated for possible ovarian cancer. Her Papanicolau (Pap) smear results are
negative. What information should the nurse include in the client's teaching plan

a. Further evaluation involving surgery may be needed
b. A pelvic exam is also needed before cancer is ruled out
c. Pap smear evaluation should be continued every six month
d. One additional negative pap smear in six months is needed.
Further evaluation involving surgery may be needed

Rationale: An abdominal mass in a client with a family history for ovarian cancer should be evaluated
carefully
A client who recently underwent a tracheostomy is being prepared for discharge to home. Which
instructions is most important for the nurse to include in the discharge plan?

a. Explain how to use communication tools.
b. Teach tracheal suctioning techniques
c. Encourage self-care and independence.
d. Demonstrate how to clean tracheostomy site.
Teach tracheal suctioning techniques

Rationale: Suctioning helps to clear secretions and maintain an open airway, which is critical.
In assessing an adult client with a partial rebreather mask, the nurse notes that the oxygen reservoir bag
does not deflate completely during inspiration and the client's respiratory rate is 14 breaths / minute. What
action should the nurse implement

a. Encourage the client to take deep breaths
b. Remove the mask to deflate the bag
c. Increase the liter flow of oxygen
d. Document the assessment data

,Document the assessment data

Rational: reservoir bag should not deflate completely during inspiration and the client's respiratory rate is
within normal limits.
During shift report, the central electrocardiogram (EKG) monitoring system alarms. Which client alarm
should the nurse investigate first?

a. Respiratory apnea of 30 seconds
b. Oxygen saturation rate of 88%
c. Eight premature ventricular beats every minute
d. Disconnected monitor signal for the last 6 minutes.
Respiratory apnea of 30 seconds

Rationale: The priority is the client whose alarm indicating respiratory apnea that should be assessed first.
During a home visit, the nurse observed an elderly client with diabetes slip and fall. What action should
the nurse take first?

a. Give the client 4 ounces of orange juice
b. Call 911 to summon emergency assistance
c. Check the client for lacerations or fractures
d. Asses clients blood sugar level
Check the client for lacerations or fractures

Rationale: After the client falls, the nurse should immediately assess for the possibility of injuries and
provide first aid as needed
At 0600 while admitting a woman for a schedule repeat cesarean section (C-Section), the client tells the
nurse that she drank a cup a coffee at 0400 because she wanted to avoid getting a headache. Which action
should the nurse take first?

a. Ensure preoperative lab results are available
b. Start prescribed IV with lactated Ringer's
c. Inform the anesthesia care provider
d. Contact the client's obstetrician.
Inform the anesthesia care provider

Rationale: Surgical preoperative instruction includes NPO after midnight the day of surgery to decrease
the risk of aspiration should vomiting occur during anesthesia. While it is possible the C-section will be
done on schedule or rescheduled for later in the day, the anesthesia provider should be notified first.
After placing a stethoscope as seen in the picture, the nurse auscultates S1 and S2 heart sounds. To
determine if an S3 heart sound is present, what action should the nurse take first

a. Side the stethoscope across the sternum.
b. Move the stethoscope to the mitral site

, c. Listen with the bell at the same location
d. Observe the cardiac telemetry monitor
Listen with the bell at the same location

Rationale: The nurse uses the bell of the stethoscope to hear low-pitched sounds such as S3 and S4. The
nurse listens at the same site using the diaphragm the diaphragm and bell before moving systematically to
the next sites.
A 66-year-old woman is retiring and will no longer have a health insurance through her place of
employment. Which agency should the client be referred to by the employee health nurse for health
insurance needs?

a. Woman, Infant, and Children program
b. Medicaid
c. Medicare
d. Consolidated Omnibus Budget Reconciliation Act provision.
Medicare

Rationale: Title XVII of the social security Act of 1965 created Medicare Program to provide medical
insurance for person more than 65 years or older, disable or with permeant kidney failure, WIC provides
supplemental nutrition to meet the needs of pregnant of breastfeeding woman, infants and children up to
age of 6. Medicaid provides financial assistance to pay for medical services for poor older adults, blind,
disable and families with dependent children. COBRA(D) health benefit provisions is a limited insurance
plan for those who has been laid off or become unemployed.
A client who is taking an oral dose of a tetracycline complains of gastrointestinal upset. What snack
should the nurse instruct the client to take with the tetracycline?

a. Fruit-flavored yogurt.
b. Cheese and crackers.
c. Cold cereal with skim milk.
d. Toasted wheat bread and jelly
Toasted wheat bread and jelly

Rationale: Dairy products decrease the effect of tetracycline, so the nurse instructs the client to eat a snack
such as toast, which contains no dairy products and may decrease GI symptoms.
Following a lumbar puncture, a client voices several complaints. What complaint indicated to the nurse
that the client is experiencing a complication?

a. "I am having pain in my lower back when I move my legs"
b. "My throat hurts when I swallow"
c. "I feel sick to my stomach and am going to throw up"
d. I have a headache that gets worse when I sit up"
"I have a headache that gets worse when I sit up"

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