Exam (elaborations)
NU272 HESI Practice Exam
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- BCH 462 Urea Cycle, Fatty Acid Synthesis
NU272 HESI Practice Exam
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NU272 HESI Practice ExamA male client with chronic atrial fibrillation and a slow ventricular response is
scheduled for surgical placement of a permanent pacemaker. The client asks the
nurse how this device will help him. How should the nurse explain the action of a
synchronous pacemaker? - CORRECT ANSWER-An electrical stimulus is
discharged when no ventricular response is sensed.
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The artificial cardiac pacemaker is an electronic device used to pace the heart
when the normal conduction pathway is damaged or diseased, such as a
symptomatic dysrhythmias like atrial fibrillation with a slow ventricular response.
Pacing modes that are synchronous (impulse generated on demand or as
needed according to the patient's intrinsic rhythm) send an electrical signal from
the pacemaker to the wall of the myocardium stimulating it to contract when no
ventricular depolarization is sensed.
The nurse is caring for a client with end stage liver disease who is being
assessed for the presence of asterixis. To assess the client for asterixis, what
position should the nurse ask the client to demonstrate? - CORRECT
ANSWER-Extend the arm, dorsiflex the wrist, and extend the fingers.
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Asterixis (flapping tremor, liver flap) is a hand-flapping tremor that is often seen
frequently in hepatic encephalopathy. The tremor is induced by extending the
arm and dorsiflexing the wrist causing rapid, non-rhythmic extension and flexion
of the wrist while attempting to hold position.
The nurse is giving discharge instructions to a client with chronic prostatitis. What
instruction should the nurse provide the client to reduce the risk of spreading the
infection to other areas of the client's urinary tract? - CORRECT ANSWER-Have
intercourse or masturbate at least twice a week.
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The prostate is not easily penetrated by antibiotics and can serve as a reservoir
for microorganisms, which can infect other areas of the genitourinary tract.
Draining the prostate regularly through intercourse or masturbation decreases
,the number of microorganisms present and reduces the risk for further infection
from stored contaminated seminal fluids.
Which action should the nurse implement on the scheduled day of surgery for a
client with type 1 diabetes mellitus (DM)? - CORRECT ANSWER-Obtain a
prescription for an adjusted dose of insulin.
-
Stressors, such as surgery, increase serum glucose levels. A client with type 1
DM who is NPO for scheduled surgery should receive a prescribed adjusted
dose of insulin.
A client with osteoarthritis receives a prescription for Naproxen (Naprosyn).
Which potential side effect should the nurse provide to the client about this
medication? - CORRECT ANSWER-Gastrointestinal disturbance.
-
Prostaglandin synthesis inhibitors such as naproxen can have gastrointestinal
side effects such as nausea and gastric burning. It is recommended that this drug
be taken with food to avoid gastrointestinal upset.
The nurse is caring for a male client who had an inguinal herniorrhaphy 3 hours
ago. The nurse determines the client's lower abdomen is distended and
assesses dullness to percussion. What is the priority nursing action? -
CORRECT ANSWER-Determine the time the client last voided.
-
Swelling at the surgical site in the immediate postoperative period can impact the
bladder and prostate area causing the client to experience difficulty voiding due
to pressure on the urethra. To provide additional data supporting bladder
distention, the last time the client voided should be determined next.
When teaching a client with breast cancer about the prescribed radiation therapy
for treatment, what information is important to include? - CORRECT
ANSWER-Dry, itchy skin changes may occur.
-
Side effects from radiation to the breast most often include temporary skin
changes such as: dryness, tenderness, redness, swelling, and pruritis.
, Which finding should the nurse identify as an indication of carbon monoxide
poisoning in a client who experienced a burn injury during a house fire? -
CORRECT ANSWER-Cherry red color to the mucous membranes.
-
The saturation of hemoglobin molecules with carbon monoxide molecules,
instead of oxygen molecules and the subsequent vasodilation induced cherry red
color of the mucous membranes is an indication of carbon monoxide poisoning.
What assessment finding should the nurse identify that indicates a client with an
acute asthma exacerbation is beginning to improve after treatment? - CORRECT
ANSWER-Wheezing becomes louder.
-
In an acute asthma attack, air flow may be so significantly restricted that breath
sounds and wheezing is diminished. If the client is successfully responding to
bronchodilators and respiratory treatments, wheezing should become louder as
the air flow increases in the airways. As the airways open and mucous is
mobilized in response to treatment, the cough should become more productive.
The nurse is caring for a client with human immunodeficiency virus (HIV)
infection who develops Mycobacterium avium complex (MAC). What is the most
significant desired outcome for this client? - CORRECT ANSWER-Return to
pre-illness weight.
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MAC is an opportunistic infection that presents as a tuberculosis-like pulmonary
process. MAC is a major contributing factor to the development of wasting
syndrome, so the most significant desired outcome is the client's return to a
pre-illness weight using oral, enteral, or parenteral supplementation as needed.
The nurse obtains a client's history that includes right mastectomy and radiation
therapy for cancer of the breast 10 years ago. Which current health problem
should the nurse consider is a consequence of the radiation therapy? -
CORRECT ANSWER-Pathologic fracture of two ribs on the right chest.
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