Exam (elaborations)
Exit HESI vn19 3
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Exit HESI vn19 3 Exit HESI vn19 3 Exit HESI vn19 3
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Exit HESI vn19 3Male client admitted the morning of scheduled surgery told nurse he drank water last night - ANS
amount of water and what time was taken
why would nurse apply pressure to lacrimal duct after optic meds - ANS reduce systemic effects
comatose patient mouth care - ANS side lying position
morning care client have seizure - ANS protect pt head
charge nurse assign pn - ANS insulin injections
2 doses missing - ANS complete report
pt on suicide ask about discharge - ANS increases suicide precautions
photo of chest and locating apical HR - ANS just below left nipple
at the end of 12hr shift the nurse observes the urine in a clients drainage - ANS most recent white
blood count
male client diagnosed with schizophrenia is withdrawn, isolates himself, with one or two word
responses - ANS measure appropriate vital signs
8 yr old on 90-90 traction for a fractured femur - ANS weights are touching the foot of the bed
nurse reviewing diet instructions with female client who has hyper and increased her intakes of
protein and calories - ANS continue dietary changes she has made
discontinue IV therapy infusing at 150ml per hour at 1200 the pn notes that there are 750ml of
solution remaining - ANS 1700
, the PN is caring for a client who had a total laryngectomy, left radical neck dissection... client is
receiving nasogastric tube feedings via an internal pump. today the rate of the feeding was
increased...ml/hr. What parameter should the PN use to evaluate the clients tolerate to the rate of
the feeding? - ANS gastric residual volumes
A new mother is breastfeeding her newborn for the first time after delivery and complains of nipple
pain...Based on the client complaint, what action should the PN take? - ANS Ensure that all the
areolar tissue of the nipple is in the infants mouth.
Which site should the PN use when administering an injection of Rho (D) Immune negative
postpartum client? - ANS deltoid
A new mother is bottle feeding instead of breastfeeding her newborn, The PN...most effectively deal
with breast engorgement and discomfort? - ANS Wear a supportive bra at all times
A female Native American client who is receiving chemotherapy places a native artifact...the health
care provider removes the medicine wheel and tells the client "this type..hospital" what intervention
should the PN implement - ANS Act as the clients advocate when discussing the issue with the HCP
A client on bed rest refuses to wear the prescribed pneumatic compression device after surgery,
what action should the PN implement in response to the clients refusal - ANS emphasize the
importance of active foot flexion
A client recovering from a stroke is learning how to use a cane. How should it be placed - ANS on the
stronger side of the body
A client with small bowel obstruction is experiencing frequent vomiting which instructions are most
important for the PN to provide to the UAP who is completing morning care for this clien - ANS
measure all emeisies accurately
on admission to the medical unit a client who is homeless and has a history of HIV with persistent
cough? - ANS erythema and indurations of 5mm at site
When preparing to administer medications to an older resident the PN notices that several
medications that were supposed to be administered during the previous shift have not been entered
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