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EXIT HESI COMPREHENSIVE B EVOLVE PRACTICE QUESTIONS AND ANSWERS WITH SOLUTIONS 2024
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EXIT HESI COMPREHENSIVE B EVOLVE PRACTICE QUESTIONS AND ANSWERS WITH SOLUTIONS 2024
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EXIT HESI COMPREHENSIVE B EVOLVEPRACTICE QUESTIONS AND ANSWERS
WITH SOLUTIONS 2024
TheWnurseWisWcaringWforWaWclientWwithWaWcerebrovascularWaccidentW(CVA)WwhoWisWreceivingWenteralWtube
Wfeedings.WWhichWtaskWperformedWbyWtheWUAPWrequiresWimmediateWinterventionWbyWtheWnurse?
A.SuctionsWoralWsecretionsWfromWmouth
B.PositionsWheadWofWbedWflatWwhenWchangingWsheets
C.TakesWtemperatureWusingWtheWaxillaryWmethod
D.KeepsWheadWofWbedWelevatedWatW30WdegreesW-WANSWERWB
Rationale:
PositioningWtheWheadWofWtheWbedWflatWwhenWenteralWfeedingsWareWinWprogressWputsWtheWclientWatWriskWf
orWaspirationW(B).WTheWothersWareWallWacceptableWtasksWperformedWbyWtheWUAPW(A,WC,WandWD).
WhenWcaringWforWaWpostsurgicalWclientWwhoWhasWundergoneWmultipleWbloodWtransfusions,WwhichWserum
WlaboratoryWfindingWisWofWmostWconcernWtoWtheWnurse?
A.SodiumWlevel,W137WmEq/L
B.PotassiumWlevel,W5.5WmEq/L
C.BloodWureaWnitrogenW(BUN)Wlevel,W18Wmg/dL
D.CalciumWlevel,W10WmEq/LW-WANSWERWB
Rationale:
MultipleWbloodWtransfusionsWareWaWriskWfactorWforWhyperkalemia.WAWserumWpotassiumWlevelWhigherWthan
W5.0WmEq/LWindicatesWhyperkalemiaW(B).WTheWothersWareWnormalWfindingsW(A,WC,WandWD).
WhichWvaccinationWshouldWtheWnurseWadministerWtoWaWnewborn?
A.HepatitisWB
B.HumanWpapillomaWvirusW(HPV)
C.Varicella
D.MeningococcalWvaccineW-WANSWERWA
Rationale:
,TheWhepatitisWBWvaccinationWshouldWbeWgivenWtoWallWnewbornsWbeforeWhospitalWdischargeW(A).WHPVWisWn
otWrecommendedWuntilWadolescenceW(B).WVaricellaWimmunizationWbeginsWatW12WmonthsW(C).WMeningoco
ccalWvaccineWisWadministeredWbeginningWatW2WyearsW(D).
TheWnurseWisWcaringWforWaWclientWonWtheWmedicalWunit.WWhichWtaskWcanWbeWdelegatedWtoWunlicensedWas
sistiveWpersonnelW(UAP)?
A.AssessWtheWneedWtoWchangeWaWcentralWlineWdressing.
B.ObtainWaWfingerstickWbloodWglucoseWlevel.
C.AnswerWaWfamilyWmember'sWquestionsWaboutWtheWclient'sWplanWofWcare.
D.TeachWtheWclientWsideWeffectsWtoWreportWrelatedWtoWtheWcurrentWmedicationWregimen.W-WANSWERWB
Rationale:
ObtainingWaWfingerstickWbloodWglucoseWlevelWisWaWsimpleWtreatmentWandWisWanWappropriateWskillWforWUA
PWtoWperformW(B).W(A,WC,WandWD)WareWskillsWthatWcannotWbeWdelegatedWtoWUAP.
TheWnurseWisWcaringWforWaWclientWwithWanWischemicWstrokeWwhoWhasWaWprescriptionWforWtissueWplasmino
genWactivatorW(t-
PA)WIV.WWhichWaction(s)WshouldWtheWnurseWexpectWtoWimplement?W(SelectWallWthatWapply.)
A.AdministerWaspirinWwithWtissueWplasminogenWactivatorW(t-PA).
B.CompleteWtheWNationalWInstituteWofWHealthWStrokeWScaleW(NIHSS).
C.AssessWtheWclientWforWsignsWofWbleedingWduringWandWafterWtheWinfusion.
D.StartWt-PAWwithinW6WhoursWafterWtheWonsetWofWstrokeWsymptoms.
E.InitiateWmultidisciplinaryWconsultWforWpotentialWrehabilitation.W-WANSWERWB,C,E
Rationale:
NeurologicWassessment,WincludingWtheWNIHSS,WisWindicatedWforWtheWclientWreceivingWt-
PA.WThisWincludesWcloseWmonitoringWforWbleedingWduringWandWafterWtheWinfusion;WifWbleedingWorWotherWs
ignsWofWneurologicWimpairmentWoccur,WtheWinfusionWshouldWbeWstoppedW(B,WC,WandWE).WAspirinWisWcontra
indicatedWwithWt-PAWbecauseWitWincreasesWtheWriskWforWbleedingW(A).WTheWadministrationWofWt-
PAWwithinW6WhoursWofWsymptomsWisWconcurrentWwithWaWdiagnosisWofWaWmyocardialWinfarctionWandWwithi
nW4.5WhoursWofWsymptomsWisWconcurrentWforWaWstrokeW(D).
WhenWcaringWforWaWclientWinWlabor,WwhichWfindingWisWmostWimportantWtoWreportWtoWtheWprimaryWhealthW
careWprovider?
A.MaternalWheartWrate,W90Wbeats/min.
,B.FetalWheartWrate,W100Wbeats/min
C.MaternalWbloodWpressure,W140/86WmmWHg
D.MaternalWtemperature,W100.0°WFW-WANSWERWB
Rationale:
AWfetalWheartWrateW(FHR)WofW100Wbeats/minWmayWindicateWfetalWdistressW(B)WbecauseWtheWaverageWFHRW
atWtermWisW140Wbeats/minWandWtheWnormalWrangeWisW110WtoWbeats/minW160.WTheWothersW(A,WC,WandWD)
WareWnormalWfindingsWforWaWwomanWinWlabor.
TheWnurseWisWcaringWforWaWclientWwithWheartWfailureWwhoWdevelopsWrespiratoryWdistressWandWcoughsWupW
pinkWfrothyWsputum.WWhichWactionWshouldWtheWnurseWtakeWfirst?
A.DrawWarterialWbloodWgases.
B.NotifyWtheWprimaryWhealthWcareWprovider.
C.PositionWinWaWhighWFowler'sWpositionWwithWtheWlegsWdown.
D.ObtainWaWchestWX-ray.W-WANSWERWC
Rationale:
PositioningWtheWpatientWinWaWhighWFowler'sWpositionWwithWdanglingWfeetWwillWdecreaseWfurtherWvenousWr
eturnWtoWtheWleftWventricleW(C).WTheWotherWactionsWshouldWbeWperformedWafterWtheWchangeWinWpositionW
(A,WB,WandWD).
AWclientWwhoWisWprescribedWchlorpromazineWHClW(Thorazine)WforWschizophreniaWdevelopsWrigidity,WaWshu
fflingWgait,WandWtremors.WWhichWactionWbyWtheWnurseWisWmostWimportant?A.AdministerWaWdoseWofWbenz
tropineWmesylateW(Cogentin)WPRN.
B.DetermineWifWtheWclientWhasWincreasedWphotosensitivity.
C.ProvideWcomfortWmeasuresWforWsoreWmuscles.
D.AssessWtheWclientWforWvisualWandWauditoryWhallucinations.W-WANSWERWA
Rationale:
Rigidity,WshufflingWgait,Wpill-
rollingWhandWmovements,Wtremors,Wdyskinesia,WandWmasklikeWfaceWareWextrapyramidalWsideWeffectsWass
ociatedWwithWThorazine.WItWisWmostWimportantWforWtheWnurseWtoWadministerWanWanticholinergicWsuchWasW
CogentinWtoWreverseWtheseWeffectsW(A).WTheWothersW(B,WC,WD)WmayWbeWappropriateWinterventionsWbutWar
eWnotWasWurgentWasW(A).
, AWnurseWisWinterviewingWaWmotherWduringWaWwell-
childWvisit.WWhichWfindingWwouldWalertWtheWnurseWtoWcontinueWfurtherWassessmentWofWtheWinfant?
A.Two-month-oldWwhoWisWunableWtoWrollWfromWbackWtoWabdomen
B.Ten-month-oldWwhoWcannotWsitWwithoutWsupport
C.Nine-month-oldWwhoWcriesWwhenWhisWmotherWleavesWtheWroom
D.Eight-month-oldWwhoWhasWnotWyetWbegunWtoWspeakWwordsW-WANSWERWB
Rationale:
AsWaWdevelopmentalWmilestone,WinfantsWshouldWsitWunsupportedWbyW8WmonthsW(B).WTheWmilestoneWofWr
ollingWoverWisWachievedWatW5WtoW6WmonthsWforWmostWinfantsW(A).WStrangerWanxietyWisWcommonWfromW7Wt
oW9WmonthsW(C).WSpeakingWaWfewWwordsWisWexpectedWatWaboutW12WmonthsW(D).
WhichWinterventionWshouldWbeWincludedWinWtheWplanWofWcareWforWaWclientWadmittedWtoWtheWhospitalWwit
hWulcerativeWcolitis?
A.AdministerWstoolWsofteners.
B.PlaceWtheWclientWonWfluidWrestriction.
C.ProvideWaWlow-residueWdiet.
D.AddWaWmilkWproductWtoWeachWmeal.W-WANSWERWC
Rationale:
AWlow-
residueWdietW(C)WwillWhelpWdecreaseWsymptomsWofWdiarrhea,WwhichWareWclinicalWmanifestationsWofWulcer
ativeWcolitis.W(A,WB,WandWD)WareWcontraindicatedWandWcouldWworsenWtheWcondition.
TheWnurseWisWcaringWforWaWclientWwithWdeepWveinWthrombosisWwhoWisWonWaWcontinuousWIVWheparinWinfus
ion.WTheWactivatedWpartialWprothrombinWtimeW(aPTT)WisW120Wseconds.WWhichWactionWshouldWtheWnurseWt
ake?
A.IncreaseWtheWrateWofWtheWheparinWinfusionWusingWaWnomogram.
B.DecreaseWtheWheparinWinfusionWrateWandWgiveWvitaminWKWIM.
C.ContinueWtheWheparinWinfusionWatWtheWcurrentWprescribedWrate.
D.StopWtheWheparinWdripWandWprepareWtoWadministerWprotamineWsulfate.W-WANSWERWD
Rationale:
AnWaPTTWmoreWthanW100WsecondsWisWaWcriticallyWhighWvalue;Wtherefore,WtheWheparinWshouldWbeWstoppe
d.WTheWantidoteWforWheparinWisWprotamineWsulfateW(D).WIncreasingWtheWrateWwouldWincreaseWtheWriskWfor
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