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EXIT HESI Comprehensive B Evolve Practice Questions
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EXIT HESI Comprehensive B Evolve Practice Questions
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EXIT HESI Comprehensive B Evolve Practice Questions And Answers The ccnurse ccis cccaring ccfor cca ccclient ccwith cca cccerebrovascular ccaccident cc(CVA) ccwho ccis ccreceiving ccenteral cctube ccfeedings. ccWhich cctask ccperformed ccby ccthe ccUAP ccrequires ccimmediate ccintervention ccby ccthe ccnurse? A.Suctions ccoral ccsecretions ccfrom ccmouth B.Positions cchead ccof ccbed ccflat ccwhen ccchanging ccsheets C.Takes cctemperature ccusing ccthe ccaxillary ccmethod D.Keeps cchead ccof ccbed ccelevated ccat cc30 ccdegrees cc- ccB Rationale: Positioning ccthe cchead ccof ccthe ccbed ccflat ccwhen ccenteral ccfeedings ccare ccin ccprogress ccputs ccthe ccclient ccat ccrisk ccfor ccaspiration cc(B). ccThe ccothers ccare ccall ccacceptable cctasks ccperformed ccby ccthe ccUAP cc(A, ccC, ccand ccD). When cccaring ccfor cca ccpostsurgical ccclient ccwho cchas ccundergone ccmultiple ccblood cctransfusions, ccwhich ccserum cclaboratory ccfinding ccis ccof ccmost ccconcern ccto ccthe ccnurse? A.Sodium cclevel, cc137 ccmEq/L B.Potassium cclevel, cc5.5 ccmEq/L C.Blood ccurea ccnitrogen cc(BUN) cclevel, cc18 ccmg/dL D.Calcium cclevel, cc10 ccmEq/L cc- ccB Rationale: Multiple ccblood cctransfusions ccare cca ccrisk ccfactor ccfor cchyperkalemia. ccA ccserum ccpotassium cclevel cchigher ccthan cc5.0 ccmEq/L ccindicates cchyperkalemia cc(B). ccThe ccothers ccare ccnormal ccfindings cc(A, ccC, ccand ccD). Which ccvaccination ccshould ccthe ccnurse ccadminister ccto cca ccnewborn? A.Hepatitis ccB B.Human ccpapilloma ccvirus cc(HPV) C.Varicella D.Meningococcal ccvaccine cc- ccA Rationale: The cchepatitis ccB ccvaccination ccshould ccbe ccgiven ccto ccall ccnewborns ccbefore cchospital ccdischarge cc(A). ccHPV ccis ccnot ccrecommended ccuntil ccadolescence cc(B). ccVaricella ccimmunization ccbegins ccat cc12 ccmonths cc(C). ccMeningococcal ccvaccine ccis ccadministered ccbeginning ccat cc2 ccyears cc(D). The ccnurse ccis cccaring ccfor cca ccclient ccon ccthe ccmedical ccunit. ccWhich cctask cccan ccbe ccdelegated ccto ccunlicensed ccassistive ccpersonnel cc(UAP)? A.Assess ccthe ccneed ccto ccchange cca cccentral ccline ccdressing. B.Obtain cca ccfingerstick ccblood ccglucose cclevel. C.Answer cca ccfamily ccmember's ccquestions ccabout ccthe ccclient's ccplan ccof cccare. D.Teach ccthe ccclient ccside cceffects ccto ccreport ccrelated ccto ccthe cccurrent ccmedication ccregimen. cc- ccB Rationale: Obtaining cca ccfingerstick ccblood ccglucose cclevel ccis cca ccsimple cctreatment ccand ccis ccan ccappropriate ccskill ccfor ccUAP ccto ccperform cc(B). cc(A, ccC, ccand ccD) ccare ccskills ccthat cccannot ccbe ccdelegated ccto ccUAP . The ccnurse ccis cccaring ccfor cca ccclient ccwith ccan ccischemic ccstroke ccwho cchas cca ccprescription ccfor cctissue ccplasminogen ccactivator cc(t-PA) ccIV. ccWhich ccaction(s) ccshould ccthe ccnurse ccexpect ccto ccimplement? cc(Select ccall ccthat ccapply.) A.Administer ccaspirin ccwith cctissue ccplasminogen ccactivator cc(t-PA). B.Complete ccthe ccNational ccInstitute ccof ccHealth ccStroke ccScale cc(NIHSS). C.Assess ccthe ccclient ccfor ccsigns ccof ccbleeding ccduring ccand ccafter ccthe ccinfusion. D.Start cct-PA ccwithin cc6 cchours ccafter ccthe cconset ccof ccstroke ccsymptoms. E.Initiate ccmultidisciplinary ccconsult ccfor ccpotential ccrehabilitation. cc- ccB,C,E Rationale: Neurologic ccassessment, ccincluding ccthe ccNIHSS, ccis ccindicated ccfor ccthe ccclient ccreceiving cct-PA. ccThis ccincludes ccclose ccmonitoring ccfor ccbleeding ccduring ccand ccafter ccthe ccinfusion; ccif ccbleeding ccor ccother ccsigns ccof ccneurologic ccimpairment ccoccur, ccthe ccinfusion ccshould ccbe ccstopped cc(B, ccC, ccand ccE). ccAspirin ccis cccontraindicated ccwith cct-PA ccbecause ccit ccincreases ccthe ccrisk ccfor ccbleeding cc(A). ccThe ccadministration ccof cct-PA ccwithin cc6 cchours ccof ccsymptoms ccis ccconcurrent ccwith cca ccdiagnosis ccof cca ccmyocardial ccinfarction ccand ccwithin cc4.5 cchours ccof ccsymptoms ccis ccconcurrent ccfor cca ccstroke cc(D). When cccaring ccfor cca ccclient ccin cclabor, ccwhich ccfinding ccis ccmost ccimportant ccto ccreport ccto ccthe ccprimary cchealth cccare ccprovider? A.Maternal ccheart ccrate, cc90 ccbeats/min. B.Fetal ccheart ccrate, cc100 ccbeats/min C.Maternal ccblood ccpressure, cc140/86 ccmm ccHg D.Maternal cctemperature, cc100.0° ccF cc- ccB Rationale: A ccfetal ccheart ccrate cc(FHR) ccof cc100 ccbeats/min ccmay ccindicate ccfetal ccdistress cc(B) ccbecause ccthe ccaverage ccFHR ccat ccterm ccis cc140 ccbeats/min ccand ccthe ccnormal ccrange ccis cc110 ccto ccbeats/min cc160. ccThe ccothers cc(A, ccC, ccand ccD) ccare ccnormal ccfindings ccfor cca ccwoman ccin cclabor. The ccnurse ccis cccaring ccfor cca ccclient ccwith ccheart ccfailure ccwho ccdevelops ccrespiratory ccdistress ccand cccoughs ccup ccpink ccfrothy ccsputum. ccWhich ccaction ccshould ccthe ccnurse cctake ccfirst? A.Draw ccarterial ccblood ccgases. B.Notify ccthe ccprimary cchealth cccare ccprovider. C.Position ccin cca cchigh ccFowler's ccposition ccwith ccthe cclegs ccdown. D.Obtain cca ccchest ccX-ray. cc- ccC Rationale: Positioning ccthe ccpatient ccin cca cchigh ccFowler's ccposition ccwith ccdangling ccfeet ccwill ccdecrease ccfurther ccvenous ccreturn ccto ccthe ccleft ccventricle cc(C). ccThe ccother ccactions ccshould ccbe ccperformed ccafter ccthe ccchange ccin ccposition cc(A, ccB, ccand ccD). A ccclient ccwho ccis ccprescribed ccchlorpromazine ccHCl cc(Thorazine) ccfor ccschizophrenia ccdevelops ccrigidity, cca ccshuffling ccgait, ccand cctremors. ccWhich ccaction ccby ccthe ccnurse ccis ccmost ccimportant?A.Administer cca ccdose ccof ccbenztropine ccmesylate cc(Cogentin) ccPRN. B.Determine ccif ccthe ccclient cchas ccincreased ccphotosensitivity. C.Provide cccomfort ccmeasures ccfor ccsore ccmuscles. D.Assess ccthe ccclient ccfor ccvisual ccand ccauditory cchallucinations. cc- ccA Rationale: Rigidity, ccshuffling ccgait, ccpill-rolling cchand ccmovements, cctremors, ccdyskinesia, ccand ccmasklike ccface ccare ccextrapyramidal ccside cceffects ccassociated ccwith ccThorazine. ccIt ccis ccmost ccimportant ccfor ccthe ccnurse ccto ccadminister ccan ccanticholinergic ccsuch ccas ccCogentin ccto ccreverse ccthese cceffects cc(A). ccThe ccothers cc(B, ccC, ccD) ccmay ccbe ccappropriate ccinterventions ccbut ccare ccnot ccas ccurgent ccas cc(A). A ccnurse ccis ccinterviewing cca ccmother ccduring cca ccwell-child ccvisit. ccWhich ccfinding ccwould ccalert ccthe ccnurse ccto cccontinue ccfurther ccassessment ccof ccthe ccinfant? A.Two -month -old ccwho ccis ccunable ccto ccroll ccfrom ccback ccto ccabdomen B.Ten -month -old ccwho cccannot ccsit ccwithout ccsupport C.Nine -month -old ccwho cccries ccwhen cchis ccmother ccleaves ccthe ccroom D.Eight -month -old ccwho cchas ccnot ccyet ccbegun ccto ccspeak ccwords cc- ccB Rationale: As cca ccdevelopmental ccmilestone, ccinfants ccshould ccsit ccunsupported ccby cc8 ccmonths cc(B). ccThe ccmilestone ccof ccrolling ccover ccis ccachieved ccat cc5 ccto cc6 ccmonths ccfor ccmost ccinfants cc(A). ccStranger ccanxiety ccis cccommon ccfrom cc7 ccto cc9 ccmonths cc(C). ccSpeaking cca ccfew ccwords ccis ccexpected ccat ccabout cc12 ccmonths cc(D). Which ccintervention ccshould ccbe ccincluded ccin ccthe ccplan ccof cccare ccfor cca ccclient ccadmitted ccto ccthe cchospital ccwith cculcerative cccolitis? A.Administer ccstool ccsofteners. B.Place ccthe ccclient ccon ccfluid ccrestriction. C.Provide cca cclow-residue ccdiet. D.Add cca ccmilk ccproduct ccto cceach ccmeal. cc- ccC Rationale: A cclow-residue ccdiet cc(C) ccwill cchelp ccdecrease ccsymptoms ccof ccdiarrhea, ccwhich ccare ccclinical ccmanifestations ccof cculcerative cccolitis. cc(A, ccB, ccand ccD) ccare cccontraindicated ccand cccould ccworsen ccthe cccondition. The ccnurse ccis cccaring ccfor cca ccclient ccwith ccdeep ccvein ccthrombosis ccwho ccis ccon cca cccontinuous ccIV ccheparin ccinfusion. ccThe ccactivated ccpartial ccprothrombin cctime cc(aPTT) ccis cc120 ccseconds. ccWhich ccaction ccshould ccthe ccnurse cctake? A.Increase ccthe ccrate ccof ccthe ccheparin ccinfusion ccusing cca ccnomogram. B.Decrease ccthe ccheparin ccinfusion ccrate ccand ccgive ccvitamin ccK ccIM. C.Continue ccthe ccheparin ccinfusion ccat ccthe cccurrent ccprescribed ccrate. D.Stop ccthe ccheparin ccdrip ccand ccprepare ccto ccadminister ccprotamine ccsulfate. cc- ccD Rationale: An ccaPTT ccmore ccthan cc100 ccseconds ccis cca cccritically cchigh ccvalue; cctherefore, ccthe ccheparin ccshould ccbe ccstopped. ccThe ccantidote ccfor ccheparin ccis ccprotamine ccsulfate cc(D). ccIncreasing ccthe ccrate ccwould ccincrease ccthe ccrisk ccfor cchemorrhage cc(A). ccThe ccinfusion ccshould ccbe ccstopped, ccand ccvitamin ccK ccis cctheThe benefits of buying summaries with Stuvia:
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