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HESI HEALTH ASSESSMENT VERSION 4 LATEST ACTUAL EXAM ALL 55 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ $27.49
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HESI HEALTH ASSESSMENT VERSION 4 LATEST ACTUAL EXAM ALL 55 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+
HESI HEALTH ASSESSMENT VERSION 4 LATEST ACTUAL EXAM ALL 55 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+
HESI HEA LTH ASSESSMENT VERSION 4 LATEST 2023 -2024 ACTUAL EXAM ALL 55 QUESTIONS AND CORRECT DETAILED AN SWERS WITH RATIONALES (VERIFIED ANSWERS ) |ALREADY GRADED A+ HESI HEA LTH ASSESSMENT VERSION 4 The registered nurse (RN) is caring for a client with a newly placed nasogastric tube (NGT). Once the placement of the NG tube is verified by x -ray, which technique should the RN use as a reliable method to ensure the NGT is not displaced? a. check the pH of aspirated stomach contents obtained from the NGT b. auscultate over the epigastrium while injecting air into the NGT c. disconnect and place the end of NGT in water to see if bubbles appear d. listen for hyperactive bowel sounds in all four quadrants in the abdomen - ANSWER - A Rationale : Checking the pH of the aspirate (A) is the best method to validate that the NGT is not displaced and should reveal an acidic pH of 1.5 to 3.5 due to presence of gastric acid. (B, C and D) are not reliable methods to ensure NGT placement in the stomach. A client is admitted for dehydration, weight loss, and a flat affect. After reviewing the client's history, the registered nurse (RN) discovers that the client's spouse died 2 weeks ago. Which nursing interventions should the RN implement to help the clien t begin the process of dealing with loss? (Select all that apply) a. Establish trust by creating a safe atmosphere for sharing. b. Share personal stories about how other clients dealt with grief. c. Help the client identify ways to adapt lifestyle to accommodate loss. d. Assure the client that their grief will last a short period of time. e. Explore ways to assist the client to make new emotional investments. - ANSWER - A, C, E Rationale : (A, C, and E) are correct, and these interventions aid the client in maneuvering through the stages of grieving and establishing a foundation to continue life. Assisting the client in finding the support group and sharing stories of other clients can be mi scontrued as a violation of HIPPA rights of other clients (B). Each client deals with grief differently, so offering a time line for grieving (D) is not an expected outcome for this client and offers false reassurance. The registered nurse (RN) is caring for a client who has a closed head injury from a motor vehicle collision. Which finding should the RN assess the client for the risk of diabetes insipidus (DI)? a. high fever b. low blood pressure c. muscle rigidity d. polydipsia - ANSWER - D Rationale : A characteristic finding of DI is excretion of large quantities of urine (5 to 20L/day), and most clients compensate for fluid loss by drinking large amounts of water (polydipsia) (D). (A) is indicative of an infection, not DI. (B) can be characteristic of hypovolemia, but not an initial finding of DI. Muscle rigidity (C) can be a serious manifestation of a closed head injury that requires immediate action, but is not related to DI. The registered nurse (RN) is teaching a client who is newly diagnosed with emphysema to perform pursed -lip breathing. What is the primary reason for teaching the client this method of breathing? a. Decreases respiratory rate b. Increases O2 saturation throughout the body c. Conserves energy while ambulating d. Promotes CO2 elimination - ANSWER - D Rationale : Pursed lip breathing helps eliminate CO2 (D) by increasing positive pressure within the alveoli which makes it easier to expel air from lungs. (A, B and C) do not explain the reason for using pursed lip breathing. 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. Which condition should the RN ask the client about his medical history? a. Irritable bowel syndrome b. diverticulitis c. Crohn's disease d. ulcerative colitis - ANSWER - D Rationale : The RN should ask the client if he has a history of ulcerative colitis (D), which is characterized by these presenting symptoms. Irritable bowel (A) often includes irregular bowel movements with constipation. Diverticulitis (B) is related to constipation, bowel irregularity and cramping. Crohn's disease (C) can cause constipation or diarrhea, abscess formation, and abdominal cramping, but tenesmus is rare. The registered nurse (RN) is making early morning rounds on a group of clients when a client begins exhibiting symptoms of an acute asthma attack. The RN administers a PRN prescription for a Beta 2 receptor agonist agent. Which client response should the R N expect? (Select all that apply) a. tachycardia b. increased blood pressure c. rapid resolution of wheezing d. improved pulse oximetry values e. reduce fever airway inflammation - ANSWER - C, D Rationale : (C and D) are correct. Beta 2 receptor agonist agents provide immediate return of airflow and resolve wheezing (C) and improve oxygenation (D). (A and B) are side effects. (E) is not an expected response. A registered nurse (RN) is performing a mini -mental state examination (MMSE) for a client who is being admitted to an assisted living community. Which communication techniques should the RN implement to decrease anxiety in the client? (Select all that appl y.) A. Use simple sentences during the examination. B. Move to another question if the client seems confused. C. Reduce environmental distractions during the examination. D. Allow the family to answer for the client to decrease frustration. E. Ask questions one at a time to decrease confusion. - ANSWER - A, C, E Rationale : Communication techniques for clients with cognitive impairments should be simple (A), without environmental distractions (C), and direct (E). (B) increases anxiety in a client, so it is important to give the client time to answer a question before moving t o the next one. (D) is the family's view of the client's mental status and does not give the RN an objective view of the client's cognitive impairment. The registered nurse (RN) reviews the new prescription, phenelzine, a monoamine oxidase inhibitor (MAOI), for a client on the psychiatric unit with depression. Which information is most important for the RN to assess? A. Consumption of any alcohol or tyramine -rich foods.
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