HESI Exit Exam 2024, Question Bank. 804 Questions and Correct Answers With Rationale. Actual Exam Questions Included. Verified Solution, Guaranteed Acing Of Your Exam.

HESI Exit Exam 2024, Question Bank. 804 Questions and Correct Answers With Rationale. Actual Exam Questions Included. Verified Solution, Guaranteed Acing Of Your Exam. What PO2 value indicates respiratory failure in adults? PO2 60 mmHg What blood value indicates hypercapnia? PCO2 45 mmHg What condition occurs when the PO2 is 60 mmHg (acute hypoxemia), the CO2 tension rises 50 mmHg (acute hypercarbia, hypercapnia) & the pH drops 7.35, or both? Acute respiratory failure What are the S/S of respiratory failure in adults? Dyspnea, SOB Tachypnea Intercostal & sternal retractions Cyanosis Tachycardia Cough that produces sputum Fatigue Fever Crackles, wheezes Chest pain (especially when trying to deep breathe) Hypotension Confusion Agitation, restlessness What are the common causes of respiratory failure in peds? CHD RDS Infection, sepsis NM diseases Trauma, burns Aspiration FVO & dehydration Anesthesia & narcotic OD Structural anomalies resulting in airway obstruction What percentage of O2 should a child in severe respiratory distress receive? 100% O2 What is shock? Widespread, serious reduction of tissue perfusion, which leads to generalized impairment of cellular function. What is the most common cause of shock? Hypovolemia What causes septic shock? Release of endotoxins from bacteria, which act on the nerves in peripheral vascular spaces, causing vascular pooling, reduced venous return, decreased CO & results in poor systemic perfusion. What is the goal of tx for hypovolemic shock? Quick restoration of CO & tissue perfusion. It's important to differentiate between hypovolemic & cardiogenic shock. How might the RN determine the existence of cardiogenic shock? H/o MI with LV failure or possible cardiomyopathy, with S/S of pulmonary edema. If a pt is in cardiogenic shock, what might result from administration of volume-expanding fluids, and what intervention can the RN expect to perform in the event of such an occurrence? Pulmonary edema -- administer meds to manage preload, contractility and/or afterload. For example, to decrease afterload, nitroprusside may be given. What are 5 assessment findings occur in most shock pt's? Tachycardia Tachypnea Hypotension Cool, clammy skin Decreased urine output Once circulating volume is restored, vasopressors may be given to increase venous return. What are the main drugs that are used? Epi & NE Dopamine Dobutamine Isoproterenol What is the established minimum renal output per hour? 30 mL/hr What are 4 measurable criteria that are the major expected outcomes of a shock crisis? MAP 80-90 mmHg PO2 50 mmHg CVP 2-6 mmHg H2O Urine output ≥ 30 mL/hr What is DIC? A coagulation disorder in which there's paradoxical thrombosis & hemorrhage. What medication is used to tx DIC? Heparin The RN assesses a pt with the admitting dx of bipolar affective disorder, mania. Which pt S/S require the RN's immediate action? a) Incessant talking & sexual innuendos b) Grandiose delusions & poor concentration c) Outlandish behaviors & inappropriate dress d) Nonstop physical activity & poor nutritional intake d) Nonstop physical activity & poor nutritional intake Rationale: Mania is a mood characterized by excitement, euphoria, hyperactivity, excessive energy, decreased need for sleep, and impaired ability to concentrate or complete a single train of thought. The client's mood is predominantly elevated, expansive, or irritable. All of the options reflect a client's possible symptoms. However, the correct option clearly presents a problem that compromises physiological integrity and needs to be addressed immediately. The RN is caring for a pt who was involuntarily hospitalized to a mental health unit & is scheduled for ECT. The RN notes that the informed consent hasn't been obtained for the procedure. Based on this information, what is the RN's best determination in care planning? a) The informed consent doesn't need to be obtained. b) The informed consent would be obtained from the family. c) The informed consent needs to be obtained from the pt. d) The PCP will provide informed consent. c) The informed consent needs to be obtained from the pt. Rationale: Clients who are admitted involuntarily to a mental health unit do not lose their right to informed consent. Clients must be considered legally competent until they have been declared incompetent through a legal proceeding. The best determination for the nurse to make is to obtain the informed consent from the client. A pt presents to the ED with UGI bleeding & in moderate distress. In care planning, what is the priority RN action for this pt? a) VS assessment b) Abdominal examination c) Inserting NG tube d) Thorough investigation of precipitating events a) VS assessment Rationale: The priority nursing action is to assess the vital signs. This would provide information about the amount of blood loss that has occurred and provide a baseline by which to monitor the progress of treatment. The client may be unable to provide subjective data until the immediate physical needs are met. Although an abdominal examination and an assessment of the precipitating events may be necessary, these actions are not the priority. Insertion of a nasogastric tube is not the priority and will require a primary health care provider's prescription; in addition, the vital signs would be checked before performing this procedure. The RN is caring for a pt with anorexia nervosa. Which behavior is characteristic of this disorder & reflects anxiety mgmt? a) Engaging in immoral acts b) Always reinforcing self-approval c) Observing rigid rules & regulations d) Having the need to always make the right decision c) Observing rigid rules & regulations Rationale: Clients with anorexia nervosa have the desire to please others. Their need to be correct or perfect interferes with rational decision-making processes. These clients are moralistic. Rules and rituals help these clients manage their anxiety. The RN provides instructions to a malnourished pregnant pt regarding Fe2+ supplementation. Which pt statement indicates an understanding of the instructions? a) "Iron supplements will give me diarrhea." b) "Meat doesn't provide iron & should be avoided." c) "The iron is best absorbed if taken on an empty stomach." d) "On the days that I eat green leafy veggies or calf liver I can omit taking the iron supplement." c) "The iron is best absorbed if taken on an empty stomach." Rationale: Iron is needed to allow for transfer of adequate iron to the fetus and to permit expansion of the maternal red blood cell mass. During pregnancy, the relative excess of plasma causes a decrease in the hemoglobin concentration and hematocrit, known as physiological anemia of pregnancy. This is a normal adaptation during pregnancy. Iron is best absorbed if taken on an empty stomach. Taking it with a fluid high in ascorbic acid such as tomato juice enhances absorption. Iron supplements usually cause constipation. Meats are an excellent source of iron. The client needs to take the iron supplements regardless of food intake. Levothyroxine is prescribed for a pt with hypothyroidism. Upon review of the pt's record, the RN notes that the pt is taking warfarin. Which modification to the POC would the RN review with the pt's HCP? a) Decreased dosage of levothyroxine b) Increased dosage of levothyroxine c) Decreased dosage of warfarin d) Increased dosage of warfarin c) Decreased dosage of warfarin Rationale: Levothyroxine accelerates the degradation of vitamin K–dependent clotting factors. As a result, the effects of warfarin are enhanced. If thyroid hormone replacement therapy is instituted in a client who has been taking warfarin, the dosage of warfarin would be reduced. The RN is teaching a pt with emphysema about positions that help breathing during dyspneic episodes. The RN instructs the pt that which positions alleviate dyspnea? (SATA) a) Sitting up & leaning on a table b) Standing & leaning against a wall c) Lying supine with feet elevated d) Sitting up with elbows resting on knees e) Lying on the back in low-Fowler's position a) Sitting up & leaning on a table b) Standing & leaning against a wall d) Sitting up with elbows resting on knees Rationale: The client would use the positions outlined in options 1, 2, and 4. These allow for maximal chest expansion. The client would not lie on the back because this reduces movement of a large area of the client's chest wall. Sitting is better than standing, whenever possible. If no chair is available, leaning against a wall while standing allows accessory muscles to be used for breathing and not posture control. A pt is about to undergo a LP. The RN describes which position that will be necessary during to the procedure to the pt? a) Side-lying with pillow under hip b) Prone with pillow under abdomen c) Prone in slight Trendelenburg d) Side-lying with legs pulled up & head bent down onto chest d) Side-lying with legs pulled up & head bent down onto chest Rationale: A client undergoing lumbar puncture is positioned lying on the side, with the legs pulled up to the abdomen and the head bent down onto the chest. This position helps open the spaces between the vertebrae and allows for easier needle insertion by the primary health care provider. The nurse remains with the client during the procedure to help the client maintain this position. The other options identify incorrect positions for this procedure. The RN recognizes that which interventions are likely to facilitate communication between a dying pt & family? (SATA) a) The RN encourages the pt & family to identify & discuss feelings openly. b) The RN assists the pt & family in carrying out spiritually meaningful practices. c) The RN removes autonomy from the pt to alleviate any unnecessary stress for the pt. d) The RN makes decisions for the pt & family to relieve them of unnecessary demands. e) The RN maintains a calm attitude & one of acceptance when the family or pt expresses anger. a) The RN encourages the pt & family to identify & discuss feelings openly. b) The RN assists the pt & family in carrying out spiritually meaningful practices. e) The RN maintains a calm attitude & one of acceptance when the family or pt expresses anger. Rationale: Maintaining effective and open communication among family members affected by death and grief is of the greatest importance. Option 1 describes encouraging discussion of feelings and is likely to enhance communication. Option 2 is also an effective intervention because spiritual practices give meaning to life and have an impact on how people react to crisis. Option 5 is also an effective technique because the client and family need to know that someone will be there who is supportive and nonjudgmental. The remaining options describe the nurse removing autonomy and decision making from the client and family, who are already experiencing feelings of loss of control in that they cannot change the process of dying. These are ineffective interventions that could impair communication further. The RN reviews ABG results of a pt with emphysema & notes that the lab report indicates pH 7.30, PaCO2 58 mmHg, PaO2 80 mmHg & HCO3 27 mEq/L. The RN interprets the pt has which acid-base disturbance? a) Metabolic acidosis b) Metabolic alkalosis c) Respiratory acidosis d) Respiratory alkalosis c) Respiratory acidosis Rationale: The normal pH is 7.35 to 7.45. Normal Paco2 is 35 to 45 mm Hg. In respiratory acidosis, the pH is low and Paco2 is elevated. Options 1, 2, and 4 are incorrect interpretations of the values identified in the question. On day 2 postpartum, a pt complains of burning on urination, urgency & frequency. A UA indicates the presence of a UTI. The RN instructs the pt regarding measures to take for the tx of the infection. Which pt statement indicates need for further teaching? a) "I need to urinate frequently throughout the day." b) "The prescribed meds must be taken until they're finished." c) "My fluid intake needs to be increased to at least 3000 mL/day." d) "Foods & fluids that will increase urine alkalinity need to be consumed." d) "Foods & fluids that will increase urine alkalinity need to be consumed." Rationale: A client with a urinary tract infection must be encouraged to take the prescribed medication for the entire time it is prescribed. The client would also be instructed to drink at least 3000 mL of fluid each day to flush the infection from the bladder and to urinate frequently throughout the day. Foods and fluids that acidify the urine need to be encouraged. A pt received 20 U of Humulin N insulin SQ at 0800. At what time would the RN plan to assess the pt for a hypoglycemic rxn? a) 1000 b) 1100 c) 1700 d) 2400 c) 1700 Rationale: Humulin N is an intermediate-acting insulin. The onset of action is 60 to 120 minutes, it peaks in 6 to 14 hours, and the duration of action is 16 to 24 hours. Hypoglycemic reactions most likely occur during peak time. A pregnant pt at 10 wks gestation calls the prenatal clinic to report recent exposure to a child with rubella. The RN reviews the pt's chart. What is the RN's best response to the pt? Chart: Weight: 135 lb (61 kg) Positive Goodell & Chadwick GTPAL: 1,0,0,0,0 Blood type: O, Rh+ VDRL: non-reactive Rubella: immune Meds: prenatal vitamins a) "You need to avoid all school-aged children during pregnancy." b) "There's no need to be concerned if you don't have a fever or rash within the next 2 days." c) "You were wise to call. Your rubella titer indicates that you are immune & your baby is not at risk." d) "Be sure to tell the HCP in 2 weeks, as additional screening will be prescribed during your 2nd trimester." c) "You were wise to call. Your rubella titer indicates that you are immune & your baby is not at risk." Rationale: Rubella virus is spread by aerosol droplet transmission through the upper respiratory tract and has an incubation period of 14 to 21 days. The risks of maternal and subsequent fetal infection during the first trimester include hearing loss and congenital anomalies; these risks decrease after the first 12 weeks of pregnancy. Rubella titer determination is a standard prenatal test for pregnant women during their initial screening and entry into the health care delivery system. As noted in this client's chart, she is immune to rubella. The correct option is the only option that helps clarify maternal concerns with accurate information. A breastfeeding parent of an infant with lactose intolerance asks the RN about dietary measures. What foods would the RN tell the parent are acceptable to consume while breastfeeding? (SATA) a) 1% milk b) Egg yolk c) Dried beans d) Hard cheeses e) Green leafy veggies b) Egg yolk c) Dried beans e) Green leafy veggies Rationale: Breast-feeding or chest-feeding parents with lactose-intolerant infants need to be encouraged to limit dairy products. Milk and cheese are dairy products. Alternative calcium sources that can be consumed by the parent include egg yolk, dried beans, green leafy vegetables, cauliflower, and molasses. A pt with terminal cancer arrives at the ED DOA. After an autopsy is ordered, the family requests no autopsy be performed. Which response to the family is most appropriate? a) "The decision is made by the medical examiner." b) "An autopsy is mandatory for any pt who is DOA." c) "I will contact the medical examiner regarding your request." d) "It's required by federal law. Tell me why you don't want the autopsy done." c) "I will contact the medical examiner regarding your request." Rationale: An autopsy is required by state law in certain circumstances, including the sudden death of a client and a death that occurs under suspicious circumstances. A client may have provided oral or written instructions regarding an autopsy after death. If an autopsy is not required by law, these oral or written requests will be granted. If no oral or written instructions were provided, state law determines who has the authority to consent for an autopsy. Most often, the decision rests with the surviving relative or next of kin. A pt who is positive for HIV delivers a newborn infant. The RN provides instructions to help the pt with care of the infant. Which pt statement indicates a need for further teaching? a) "I will be sure to wash my hands before & after bathroom use." b) "I need to breastfeed with my milk, especially for the first 6 wks postpartum." c) "Support groups are available to assist me with understanding my HIV dx." d) "My newborn infant needs to be on antivirals for the first 6 wks after delivery." b) "I need to breastfeed with my milk, especially for the first 6 wks postpartum." Rationale: The mode of perinatal transmission of HIV to the fetus or neonate of an HIV-positive parent can occur during the prenatal, intrapartal, or postpartum period. HIV transmission can occur during chest-feeding. In the United States and most developed countries, HIV-positive clients are encouraged to bottle-feed their infants (the primary health care provider's prescription is always followed). Frequent handwashing is encouraged. Support groups and community agencies can be identified to assist the parents with the newborn infant's home care, the impact of the diagnosis of HIV infection, and available financial resources. It is recommended that infants of HIV-positive clients receive antiviral medications for the first 6 weeks of life. A teen pt is dx'd with conjunctivitis & the RN provides information about using contact lenses. Which pt statement indicates need for further teaching? a) "I need to obtain new contact lenses." b) "I need to not wear my contact lenses." c) "My old contact lenses need to be discarded." d) "My contact lenses can be worn if they are cleaned as directed." d) "My contact lenses can be worn if they are cleaned as directed." Rationale: If the adolescent wears contact lenses, the adolescent needs to be instructed to discontinue wearing them until the infection has cleared completely. Obtaining new contact lenses would eliminate the chance of reinfection from contaminated contact lenses and would lessen the risk of a corneal ulceration. The RN teaches a pt newly dx'd with DM1 about storing Humulin N insulin. Which statement indicates to the RN that the pt understood the d/c teaching? a) "I would keep the insulin in the cabinet during the day only." b) "I know I have to keep my insulin in the refrigerator at all times." c) "I can store the open insulin bottles in the kitchen cabinet for 1 month." d) "The best place for my insulin is on the windowsill, but in the cupboard is just as good." c) "I can store the open insulin bottles in the kitchen cabinet for 1 month." Rationale: An insulin vial in current use can be kept at room temperature for 1 month without significant loss of activity. Direct sunlight and heat must be avoided. Therefore, options 1, 2, and 4 are incorrect. The RN is caring for a pt scheduled for a transsphenoidal hypophysectomy. The pre-op teaching instructions would include which statement? a) "Your hair will need to be shaved." b) "You will receive spinal anesthesia." c) "You will need to ambulate after surgery." d) "Brushing your teeth needs to be avoided for at least 2 weeks post-op." d) "Brushing your teeth needs to be avoided for at least 2 weeks post-op." Rationale: A transsphenoidal hypophysectomy is a surgical approach that uses the nasal sinuses and nose for access to the pituitary gland. Based on the location of the surgical procedure, spinal anesthesia would not be used. In addition, the hair would not be shaved. Although ambulating is important, specific to this procedure is avoiding brushing the teeth to prevent disruption of the surgical site. During a routine prenatal visit, a pt complains of easily bleeding gums when brushing. The RN does an assessment & teaches the pt about proper nutrition to minimize this problem. Which pt statement indicates an understanding? a) "I will drink 8 oz of water with each meal." b) "I will eat 3 servings of cracked wheat bread each day." c) "I will eat 2 saltine crackers before I get up each morning." d) "I will eat fresh fruits & veggies for snacks & for dessert each day." d) "I will eat fresh fruits & veggies for snacks & for dessert each day." Rationale: Fresh fruits and vegetables provide vitamins and minerals needed for healthy gums. Drinking water with meals has no direct effect on gums. Cracked wheat bread may abrade the tender gums. Eating saltine crackers can also abrade the tender gums. A 6 yo child was just dx'd with Hodgkin's disease & chemo is planned to begin immediately. The parent asks the RN why XDR was not ordered as part of tx. The RN should make which response? a) "It's very costly & chemo works just as well." b) "I'm not sure. I'll discuss it with the HCP." c) "Sometimes age has to do with the decision for XDR." d) "The HCP would prefer that you discuss the tx options with the oncologist." c) "Sometimes age has to do with the decision for XDR." Rationale: Radiation therapy is usually delayed, whenever possible, until a child is 8 years old to prevent retardation of bone growth and soft tissue development. Options 1, 2, and 4 are inappropriate responses to the parent and place the parent's question on hold. The RN is doing an initial assessment on a newborn infant. When assessing the infant's head, the RN notes that the ears are low-set. Which RN action is most appropriate? a) Document the findings. b) Arrange for a hearing test. c) Notify the pediatrician. d) Cover the ears with gauze pads. c) Notify the pediatrician. Rationale: Low or oddly placed ears are associated with various congenital defects and need to be reported immediately. Although the findings need to be documented, the most appropriate action would be to notify the pediatrician. Options 2 and 4 are inaccurate and inappropriate nursing actions. The RN is assigned to care for a pt in traction. The RN creates a POC for the pt & would include which action? a) Ensure that the knots are at the pulleys. b) Check the weights to ensure they are off the floor. c) Ensure the HOB is kept at 45-90˚ angle. d) Monitor the weights to ensure they're resting on a firm surface. b) Check the weights to ensure they are off the floor. Rationale: To achieve proper traction, weights need to be free-hanging, with knots kept away from the pulleys. Weights would not be kept resting on a firm surface. The head of the bed is usually kept low to provide countertraction. The RN is setting up the physical environment for an interview with a pt & plans to obtain subjective data regarding the pt's health. Which interventions are appropriate? (SATA) a) Set the room temp at a comfortable level. b) Remove distracting objects from the interviewing area. c) Place a chair for the pt across from the RN's desk. d) Ensure comfortable seating at eye level for the pt & RN. e) Provide seating for the pt so that they face a strong light. f) Ensure that the distance between the pt & RN is at least 7 feet. a) Set the room temp at a comfortable level. b) Remove distracting objects from the interviewing area. d) Ensure comfortable seating at eye level for the pt & RN. Rationale: When preparing the physical environment for an interview, the nurse would set the room temperature at a comfortable level. The nurse would provide sufficient lighting for the client and nurse to see each other. The nurse would avoid having the client face a strong light because the client would have to squint into the full light. Distracting objects and equipment need to be removed from the interview area. The nurse would arrange seating so that the nurse and client are seated comfortably at eye level, and the nurse avoids facing the client across a desk or table, because this creates a barrier. The distance between the nurse and the client would be set by the nurse at 4 to 5 feet (1.2 to 1.5 meters). If the nurse places the client any closer, the nurse will be invading the client's private space and may create anxiety in the client. If the nurse places the client farther away, the nurse may be seen as distant and aloof by the client. The RN is caring for an older adult who has been placed in Buck's extension traction after a hip fx. On assessment, the RN notes that the pt is disoriented. What is the best RN action based on this info? a) Apply restraints to the pt. b) Ask the family to stay with the pt. c) Place a clock & calendar in the pt's room. d) Ask the lab to do an electrolyte study. c) Place a clock & calendar in the pt's room. Rationale: An inactive older adult may become disoriented because of lack of sensory stimulation. The most appropriate nursing intervention would be to reorient the client frequently and to place objects such as a clock and a calendar in the client's room to maintain orientation. Restraints may cause further disorientation and would not be applied unless specifically prescribed; agency policies and procedures need to be followed before the application of restraints. The family can assist with orientation of the client, but it is inappropriate to ask the family to stay with the client. It is not within the scope of nursing practice to prescribe laboratory studies. The RN is creating a POC for a pt with skin traction. The RN would monitor for which priority finding in this pt? a) Urinary incontinence b) Signs of skin breakdown c) Presence of bowel sounds d) Signs of infection around the pin sites b) Signs of skin breakdown Rationale: Skin traction is achieved by Ace wraps, boots, or slings that apply a direct force on the client's skin. Traction is maintained with 5 to 8 lb (2.3 to 3.6 kg) of weight, and this type of traction can cause skin breakdown. Urinary incontinence is not related to the use of skin traction. Although constipation can occur as a result of immobility and monitoring bowel sounds may be a component of the assessment, this intervention is not the priority assessment. There are no pin sites with skin traction. The home health RN is visiting a pt who's in a body cast. While doing an assessment, the RN plans to evaluate the psychosocial adjustment of the pt to the cast. What is the most appropriate assessment for this pt? a) The need for sensory stimulation. b) The amount of home care support available. c) The ability to perform ADLs. d) The type of transportation available for f/u care. a) The need for sensory stimulation. Rationale: A psychosocial assessment of a client who is immobilized would most appropriately include the need for sensory stimulation. This assessment would also include such factors as body image, past and present coping skills, and coping methods used during the period of immobilization. Although home care support, the ability to perform activities of daily living, and transportation are components of an assessment, they are not as specifically related to psychosocial adjustment as is the need for sensory stimulation. The HCP orders levothyroxine 150 mcg PO daily. The label states it's 0.1 mg per tablet. The RN would plan to give how many tablet(s)? 1.5 tablets Rationale: It is necessary to convert 150 mcg to mg. In the metric system, to convert a smaller unit of measure to a larger unit of measure, divide by 1000 or move the decimal 3 places to the left: 150 mcg = 0.15 mg. Next, use the formula to calculate the correct dose. Metformin is ordered for a pt with DM2. What is the most common SE that the RN would include in the pt's teaching plan? a) Weight gain b) Hypoglycemia c) Flushing & palpitations d) GI disturbances d) GI disturbances Rationale: The most common side effect of metformin is gastrointestinal disturbances, including decreased appetite, nausea, and diarrhea. These generally subside over time. This medication does not cause weight gain; clients lose an average of 7 to 8 lb (3.2 to 3.6 kg) because the medication causes nausea and decreased appetite. Although hypoglycemia can occur, it is not the most common side effect. Flushing and palpitations are not specifically associated with this medication. Which RN actions apply to the care of a child who is having a seizure? (SATA) a) Time the seizure. b) Restrain the child. c) Stay with the child. d) Insert a PO airway. e) Loosen clothing around child's neck. f) Place the child in a lateral side-lying position. a) Time the seizure. c) Stay with the child. e) Loosen clothing around child's neck. f) Place the child in a lateral side-lying position. Rationale: During a seizure, the nurse would stay with the child to reduce the risk of injury and allow for observation and timing of the seizure. The child is not restrained, because this could cause injury to the child. The child is placed on the side in a lateral position. Nothing is placed in the child's mouth during a seizure because this could injure the child's mouth, gums, or teeth. Positioning on the side prevents aspiration, because saliva drains out of the corner of the child's mouth. The nurse would loosen clothing around the child's neck and ensure a patent airway. The RN is conducting an interview of an older pt & is concerned about the possibility of BPH. Which are characteristics of this disorder? (SATA) a) Nocturia b) Incontinence c) Enlarged prostate d) Nocturnal emissions e) Decreased desire for sex a) Nocturia b) Incontinence c) Enlarged prostate Rationale: Nocturia, incontinence, and an enlarged prostate are characteristics of BPH and need to be assessed for in clients over 50 years of age. Nocturnal emissions are commonly associated with prepubescent individuals. Low testosterone levels (not BPH) may be associated with a decreased desire for sexual intercourse. A pt arrives at the clinic complaining of fatigue, lack of energy, constipation & depression. Hypothyroidism is dx'd & levothyroxine is prescribed. What is an expected outcome of the med? a) Alleviates depression b) Increases energy levels c) Increases blood glucose levels d) Achieves normal thyroid hormone levels d) Achieves normal thyroid hormone levels Rationale: Laboratory determinations of the serum thyroid-stimulating hormone (TSH) level are an important means of evaluation. Successful therapy causes elevated TSH levels to decline. These levels begin their decline within hours of the onset of therapy and continue to decrease as plasma levels of thyroid hormone build up. If an adequate dosage is administered, TSH levels remain suppressed for the duration of therapy. Although energy levels may increase and the client's mood may improve following effective treatment, these are not noted until normal thyroid hormone levels are achieved with medication therapy. An increase in the blood glucose level is not associated with this condition. The community health RN is creating a poster for an educational session for a group of community members & will be discussing the RFs associated with breast CA. Which RFs for breast CA would the RN list on the poster? (SATA) a) Multiparity b) Early menarche c) Early menopause d) FHx breast CA e) High-dose XDR to the chest f) H/o breast, uterine, or ovarian CA b) Early menarche d) FHx breast CA e) High-dose XDR to the chest f) H/o breast, uterine, or ovarian CA Rationale: Risk factors for breast cancer include nulliparity or first child born after age 30 years; early menarche; late menopause; family history of breast cancer; high-dose radiation exposure to the chest; and previous cancer of the breast, uterus, or ovaries. In addition, specific inherited mutations in BReast CAncer (BRCA)1 and BRCA2 increase the risk of female breast cancer; these mutations are also associated with an increased risk for ovarian cancer. The RN is caring for a pt with acute pancreatitis & is monitoring for paralytic ileus. Which piece of assessment data would alert the RN to this occurrence? a) Inability to pass gas b) Loss of anal sphincter control c) Severe, constant pain with rapid onset d) Firm, nontender mass palpable in the lower right costal margin a) Inability to pass gas Rationale: An inflammatory reaction such as acute pancreatitis can cause paralytic ileus, the most common form of nonmechanical obstruction. Inability to pass flatus is a clinical manifestation of paralytic ileus. Loss of sphincter control is not a sign of paralytic ileus. Pain is associated with paralytic ileus, but the pain usually manifests as a more constant generalized discomfort. Option 4 is the description of the physical finding of liver enlargement. The liver may be enlarged in cases of cirrhosis or hepatitis. Although this