EXIT HESI - Comprehensive PN Exam A Practice Questions
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1. A nurse who has recently completed orientation is beginning work in
the labor and delivery unit for the first time. When making assignments,
which client should the charge nurse assign to this new nurse?
A.A primigravida who is 8 cm dilated after 14 hours of labor
B.A client scheduled for a repeat cesarean birth at 38 weeks' gestation
C.A client being induced for fetal demise at 20 weeks' gestation
D.A multiparous client who is dilated 5 cm and 50% effaced: D
The new nurse should be assigned the least complicated client to gain
experience and confidence, as well as protect client safety. Of the
clients available for assign- ment, (D) is progressing well and is the
least complicated. (A, B and C) have actual or potential complications
and should be assigned to a more experienced nurse.
2. A client with human immunodeficiency virus (HIV) infection has white
lesions in the oral cavity that resemble milk curds. Nystatin (Mycostatin)
preparation is prescribed as a swish and swallow. Which information is
most important for the nurse to provide the client?
A. Oral hygiene should be performed before the medication.
B.Antifungal medications are available in tablet, suppository, and liquid
forms.
C.Candida albicans is the organism that causes the white lesions in the
mouth.
D.The dietary intake of dairy and spicy foods should be limited.: A
HIV infection causes depression of cell-mediated immunity that allows
an over- growth of Candida albicans (oral moniliasis), which appears as
white, cheesy plaque or lesions that resemble milk curds. To ensure
effective contact of the medication with the oral lesions, oral liquids
should be consumed and oral hygiene performed before swishing the
liquid Mycostatin (A). (B and C) provide the client with additional
information about the pathogenesis and treatment of opportunistic
infections, but (A) allows the client to participate in self-care of the oral
infection. Dietary restriction of spicy foods reduces discomfort
associated with stomatitis, but restriction of dairy products is not
indicated (D).
3. A client who is admitted with emphysema is having difficulty breathing.
In which position should the nurse place the client?
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, EXIT HESI - Comprehensive PN Exam A Practice Questions
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A.High Fowler's position without a pillow behind the head
B.Semi-Fowler's position with a single pillow behind the
head
C.Right side-lying position with the head of the bed elevated 45 degrees
D.Sitting upright and forward with both arms supported on an over the bed
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, EXIT HESI - Comprehensive PN Exam A Practice Questions
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table: D
Adequate lung expansion is dependent on deep breaths that allow the
respiratory muscles to increase the longitudinal and anterior-posterior
size of the thoracic cage. Sitting upright and leaning forward with the
arms supported on an over
the bed table (D) allows the thoracic cage to expand in all four
directions and reduces dyspnea. A high Fowler's position does not
allow maximum expansion of the posterior lobes of the lungs (A). A
semi-Fowler's position restricts expansion of the anterior-posterior
diameter of the thoracic cage (B). Positioning a client on the right side
with the head of the bed elevated (C) does not facilitate lung
expansion.
4. A client with chronic renal insufficiency (CRI) is taking 25 mg of hy-
drochlorothiazide (HCTZ) PO and 40 mg of furosemide (Lasix) PO daily.
Today, at a routine clinic visit, the client's serum potassium level is 4
mEq/L. What is the most likely cause of this client's potassium level?
A. The client is noncompliant with his medications.
B. The client recently consumed large quantities of pears or nuts.
C. The client's renal function has affected his potassium level.
D. The client needs to be started on a potassium supplement.: C
The client has a normalized potassium level despite diuretic use (C).
The kid- ney automatically secretes 90% of potassium consumed,
but in chronic renal insufficiency (CRI), less potassium is excreted
than normal. Therefore, the two potassium-wasting drugs, a thiazide
diuretic and loop diuretic, are not likely to affect potassium levels.
The normal potassium level is 3.5 to 5 mEq/L, and with a potassium
level of 4 mEq/L, there is no reason to believe that the client is
noncompliant with his treatment (A). Pears and nuts do not affect
the serum potassium level (B). There is no need for a potassium
supplement (D) because the client's potassium level is within the
normal range.
5. A registered nurse (RN) delivers telehealth services to clients via
elec- tronic communication. Which nursing action creates the greatest
risk for professional liability and has the potential for a malpractice
lawsuit?
A. Participating in telephone consultations with clients
B. Identifying oneself by name and title to clients in telehealth
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, EXIT HESI - Comprehensive PN Exam A Practice Questions
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communica- tions
C. Sending medical records to health care providers via the
Internet D.Answering a client-initiated health question via
electronic mail: C
Sending medical records over the Internet, even with the latest
security protection, creates the greatest risk for liability because of the
high potential of breaching client confidentiality and the amount of
information being transferred (C). Client
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