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HESI Comprehensive Exit Exam with Correct Answers
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  • Hesi Comprehensive Review for the Nclex-RN Examination

HESI Comprehensive Exit Exam with Correct Answers Enalapril maleate is prescribed for a hospitalized client. Which assessment does the nurse perform as a priority before administering the medication? Checking the client's blood pressure Checking the client's peripheral pulses Checking t...

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  • August 8, 2023
  • 140
  • 2023/2024
  • Exam (elaborations)
  • Questions & answers

Subjects

  • enalapril maleate
  • widened qrs complexes
  • ventricular tachycardia
  • undergo elect
  • upper gastrointestinal gi series
  • angiotensin converting enzyme ace inhibitor
  • premature ventricular contractions pvcs

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,HESI Comprehensive Exit Exam with Correct
Answers




Enalapril maleate is prescribed for a hospitalized client. Which assessment does the
nurse perform as a priority before administering the medication?

Checking the client's blood pressure
Checking the client's peripheral pulses
Checking the most recent potassium level
Checking the client's intake-and-output record for the last 24 hours
(ANS- Checking the client's blood pressure

Rationale: Enalapril maleate is an angiotensin-converting enzyme (ACE) inhibitor
used to treat hypertension. One common side effect is postural hypotension.
Therefore the nurse would check the client's blood pressure immediately before
administering each dose. Checking the client's peripheral pulses, the results of the
most recent potassium level, and the intake and output for the previous 24 hours
are not specifically associated with this mediation.

A client is scheduled to undergo an upper gastrointestinal (GI) series, and the nurse
provides instructions to the client about the test. Which statement by the client
indicates a need for further instruction?

"The test will take about 30 minutes."
"I need to fast for 8 hours before the test."
"I need to drink citrate of magnesia the night before the test and give myself a Fleet
enema on the morning of the test."
"I need to take a laxative after the test is completed, because the liquid that I'll have
to drink for the test can be constipating."
(ANS- "I need to drink citrate of magnesia the night before the test and give myself
a Fleet enema on the morning of the test."

,Rationale: No special preparation is necessary before a GI series, except that NPO
(nothing by mouth) status must be maintained for 8 hours before the test. An
upper GI series involves visualization of the esophagus, duodenum, and upper
jejunum

, by means of the use of a contrast medium. It involves swallowing a contrast
medium (usually barium), which is administered in a flavored milkshake. Films are
taken at intervals during the test, which takes about 30 minutes. After an upper GI
series, the client is prescribed a laxative to hasten elimination of the barium.
Barium that remains in the colon may become hard and difficult to expel, leading
to fecal impaction.

A nurse on the evening shift checks a primary health care provider's prescriptions
and notes that the dose of a prescribed medication is higher than the normal dose.
The nurse calls the primary health care provider's answering service and is told that
the primary health care provider is off for the night and will be available in the
morning. What should the nurse do next?

Call the nursing supervisor
Ask the answering service to contact the on-call primary health care provider
Withhold the medication until the primary health care provider can be reached
in the morning
Administer the medication but consult the primary health care provider when
he becomes available
(ANS- Ask the answering service to contact the on-call primary health care
provider

Rationale: The nurse has a duty to protect the client from harm. A nurse who
believes that a primary health care provider's prescription may be in error is
responsible for clarifying the prescription before carrying it out. Therefore the
nurse would not administer the medication; instead, the nurse would withhold the
medication until the dose can be clarified. The nurse would not wait until the
next morning to obtain clarification. It is premature to call the nursing supervisor.

An emergency department (ED) nurse is monitoring a client with suspected acute
myocardial infarction (MI) who is awaiting transfer to the coronary intensive care
unit. The nurse notes the sudden onset of premature ventricular contractions
(PVCs) on the monitor, checks the client's carotid pulse, and determines that the
PVCs are not perfusing. What is the nurse's most appropriate action?

Document the findings

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