HESI RN EXIT EXAM V2 2024 1) The nurse assumes care of a postoperative adult client with type 2 diabetes mellitus and learns that the client has a current blood glucose level of 750 mg/dL. When assessing the client, what is the priority?
a. Assess for signs of fluids volume deficit
2) A male clie...
HESI RN EXIT EXAM V2 2023
1) The nurse assumes care of a postoperative adult client with type 2
diabetes mellitus and learns that the client has a current blood
glucose level of 750 mg/dL. When assessing the client, what is the
priority?
a. Assess for signs of fluids volume deficit
2) A male client tells the nurse that he is concerned that he may have a
stomach ulcer, because he is experiencing heartburn and a dull gnawing
pain that is relieved when he eats. Which is the best response by the
nurse?
a. Encourage the client to obtain a complete physical exam,
since these symptoms are consistent with an ulcer
3) A male client with stomach cancer returns to the unit following a total
gastrectomy. He has a nasogastric tube to suction and is receiving
Lactated Ringer’s solution at 75 mL/hour IV. One hour after admission
to the unit, the nurse notes 300mL of blood in the suction canister, the
client’s heart rate is 155bpm, and his blood pressure is 78/48 mmHg. In
addition to reporting the findings to the surgeon, which action should
the nurse implement first?
a. Increase the infusion rate of Lactated Ringer’s solution
4) A heparin infusion is prescribed for a client who weighs 220 pounds.
After administering a bolus dose of 80 units/kg, the nurse calculates the
infusion rate for the heparin solution at 18 units/kg/hour. The available
solution is Heparin Sodium 25,000 units in 5% Dextrose injection 250
mL. the nurse should program the infusion pump to deliver how many
mL/hour? (Enter numeric value only. If rounding is required, round to
the nearest whole number)
a. 18
Rationale: 1st we calculate the weight; 220/2.2 = 100kg
Then we calculate total dose in units; dose = 18 units x 100 =
1800 units/hr We use the reference to get the final answer
25,000units --- in
250mL 1800 units
--- in X mL
X = 1800 * 250/25,000 = 18
5) An adult male who fell 20 feet from her roof of his home has multiple
injuries, including a right pneumothorax. Chest tubes were inserted in
the emergency department prior to his transfer to the intensive care
unit (ICU). The nurse notes that the suction control chamber is bubbling
at the -10 cm H2O mark, with fluctuation in the water seal, and over the
,past hour 75 mL of bright red blood is measured in the collection
chamber. Which intervention should the nurse implement?
a. Add sterile water to the suction control chamber
,6) An adult male was diagnosed with stage IV lung cancer three weeks
ago. His wife approaches the nurse and asks how she will know that her
husband’s death is imminent because their two adult children want to
be there when he dies. Which is the best response by the nurse?
a. Explain that the client will start to lose consciousness and the
body systems will slow down
7) The charge nurse of a critical care unit is informed at the beginning of
the shift that less than the optimal number of registered nurses will be
working that shift. In planning assignments, which client should receive
the most care hours by the registered nurse (RN)?
a. An 82-year-old client with Alzheimer’s disease and a newly
fractured femur who has a Foley catheter and soft wrist
restraints applied
8) The nurse is preparing a dose of 60 mcg of teriparatide. The medication
is labeled “750 mcg/2.4mL.” How many mL should the nurse administer?
(if rounding is required, round to the nearest tenth)
a. 0.2
9) In caring for a client with Cushing’s syndrome, which serum
laboratory value is most important for the nurse to monitor?
a. Glucose
10) A client who received hemodialysis yesterday is experiencing a blood
pressure of 200/100 mmHg, heart rate 110bpm, and respiratory rate 36
bpm. The client manifested shortness of breath, bilateral 2+ edema,
and an oxygen saturation on room air of 89%. Which action should the
nurse take first?
a. Begin supplement oxygen
11) When caring for a client with full thickness burns to both lower
extremities, which assessment findings warrant immediate
intervention? (SATA)
a. Complaint of increased pain and pressure
b. Change in the quality of the peripheral pulse
c. Loss of sensation to the left lower extremity
12) An older client is admitted with fluid volume deficit and dehydration.
Which assessment finding is the best indicator of hydration that the
nurse should report to the healthcare provider?
a. Skin tenting occurs when the client’s forearm is pinched
13) The healthcare provider prescribes methylergonovine maleate for a
, postpartum client with uterine atony. What findings should indicate to
the nurse to withhold the next dose of the medication?
a. Hypertension
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