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Hesi rn exit exam 800 questions and answers with rationale
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Hesi rn exit exam 800 questions and answers with rationale 2024
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HESI Exit Practice Questions and Rationale (2)1. The nurse has completed giving discharge instructions to a client who has
had a total joint replacement (TJR) of the knee with a metal prosthetic system.
The nurse determines that the client understands the instructions if the client
makes which statement?
1."Changes in the shape of the knee are expected."
2."Fever, redness, and increased pain are expected."
3."All caregivers should be told about the metal implant."
4."Bleeding gums or black stools may occur, but this is normal.": 3 A TJR is
also known as a total joint arthroplasty (TJA). The client must inform other
caregivers of the presence of the metal implant because certain tests and
procedures will need to be avoided. After total knee replacement, the client
should report signs and symptoms of infection and any changes in the shape of
the knee. These could indicate developing complications. With a metal implant,
the client may be on anticoagulant therapy and should report adverse effects of
this therapy, including bleeding from a variety of sources, and the client will need
antibiotic prophylaxis for invasive procedures.
2. The nurse is caring for a client after the application of a plaster cast for a
fractured left radius. The nurse should suspect impairment with the
neurovascular status of the client's casted extremity if which findings are
noted? Select all that apply.
1.Capillary refill is less than 3 seconds 2.Pulses present and with swollen,
pink fingers
3.Client report of severe, deep, unrelenting pain
4.Client report of pain as nurse assesses finger movement
5.Client report of numbness and tingling sensation in the fingers: 3, 4, 5 The
pressure in compartment syndrome, if unrelieved, will cause permanent damage to
nerve and muscle tissue distal to the pressure. Circulatory damage may result in
necrosis. Nerve and muscle damage may result in permanent contractures,
deformity of the extremity, and functional impairment. Normal capillary refill time is
3 seconds or less. Pink appearance and a pulse indicate adequate blood flow;
swelling is expected after a fracture. Client report of severe, deep, unrelenting pain;
client report of numbness and tingling sensation; and client report of pain as the
nurse assesses finger movement are indicative of development of compartment
syndrome.
, HESI Exit Practice Questions and Rationale (2)
3. A client with a 4-day-old lumbar vertebral fracture is experiencing muscle
spasms. Which are interventions to aid the client in relieving the spasm?
Select all that apply.
1.Ice
2.Heat
3.Analgesics
4.Muscle relaxers
5.Intermittent traction: 2, 3, 4, 5
Heat, analgesics, muscle relaxers, and traction all may be used to relieve the pain
of muscle spasm in the client with a vertebral fracture. Ice is applied to a painful site
only for the first 48 to 72 hours (depending on the health care provider's preference)
after an injury. Application of ice to the spine of a client could be uncomfortable and
could result in feelings of being chilled.
4. The nurse is caring for a client who had surgery to repair a fractured left-
sided hip using a posterior approach. In implementing hip precautions, which
action should the nurse teach the client to avoid?
1.Crossing legs at the ankle
2.Using an elevated toilet seat 3.Placing a pillow between the legs 4.Keeping
the legs abducted from the midline: 1
Following surgery to repair a fractured hip using a posterior approach, client
education should include the following: avoiding crossing the legs at the ankle or
the knee, using an elevated toilet seat, placing a pillow between the legs while lying
down for the first 6 weeks, keeping the legs abducted from the midline, and keeping
the hip in a neutral position at all times.
5. An older client is diagnosed with osteoporosis. The nurse teaches the
client about self-care measures, knowing that the client is most at risk for
which problem as a result of this disorder of the bones?
1.Anemia
2.Fractures
3.Infection
4.Muscle sprains: 2
The client is most at risk for fractures as a result of osteoporosis. Although other
complications can occur, fracture is the greatest concern. Anemia and infection can
occur with bone marrow disorders, and muscle sprains are unrelated to
osteoporosis.
, HESI Exit Practice Questions and Rationale (2)
6. A client with a new medication prescription for allopurinol asks the
nurse, "I know this is for gout, but how does it work?" The nurse plans to
reply based on which medication action?
1.Allopurinol decreases uric acid production.
2.Allopurinol reduces the production of fibrinogen.
3.Allopurinol decreases the risk of sulfa crystal formation in the urine.
4.Allopurinol prevents influx of calcium ions during cell depolarization.: 1
Allopurinol is classified as an antigout medication. It decreases uric acid production
by inhibiting the xanthine oxidase enzyme, and it reduces uric acid concentrations
in both serum and urine. The other options are incorrect.
7. The nurse is caring for a client diagnosed with osteitis deformans
(Paget's disease). Which does the nurse identify as the cause of the client's
stooped posture and bowing of lower extremities?
1.Muscle metabolism and growth 2.Bone resorption and regeneration
3.Nervous system impulse transmission 4.Joint integrity and synovial fluid
production: 2
Paget's disease is characterized by skeletal deformities resulting from abnormal
bone resorption followed by abnormal regeneration. It is not caused by problems
with muscle, nervous system, or joint functioning.
8. A client has been diagnosed with gout, and the nurse provides dietary
instructions. The nurse determines that the client needs additional teaching
if the client states that it is acceptable to eat which food?
1.Carrots
2.Tapioca
3.Chocolate
4.Chicken liver: 4
Liver and other organ meats should be omitted from the diet of a client who has
gout because of their high purine content. Purines are a form of protein. The food
items identified in the other options contain negligible amounts of purines and may
be consumed freely by the client with gout.
9. Diagnostic studies are prescribed for a client with suspected Paget's
disease. In reviewing the client's record, the nurse would expect to note that
the health care provider has prescribed which laboratory study?
1.Platelet count
2.Alkaline phosphatase
3.White blood cell count
, HESI Exit Practice Questions and Rationale (2)
4.Complete blood cell count: 2
Paget's disease is a chronic metabolic disorder in which bone is excessively broken
down and reformed. The result is bone that is structurally disorganized, causing
bone to be weak with increased risk for bowing of long bones and fractures.
Diagnostic laboratory findings for Paget's disease include an elevated serum
alkaline phosphatase level and elevated urinary hydroxyproline excretion. The
remaining options are unrelated to diagnostic evaluation of this disease.
10. A client is to receive a prescription for methocarbamol. The nurse
provides instructions to the client about the medication. Which client
statement would indicate a need for further education?
1."My urine may turn brown or green." 2."I might get some nasal congestion
from this medication."
3."This medication is prescribed to help relieve my muscle spasms."
4."If my vision becomes blurred, I don't need to be concerned about it.": 4
Methocarbamol is a muscle relaxant that works by blocking nerve impulses (or
pain sensations) that are sent to the brain. The client needs to be told that the
urine may turn brown, black, or green. Other adverse effects include blurred
vision, nasal congestion, urticaria, and rash. The client needs to be instructed to
notify the health care provider if these side/adverse effects occur.
11. The nurse is planning measures to increase bed mobility for a client in
skeletal leg traction. Which item should the nurse consider to be most helpful
for this client?
1.Television
2.Fracture bedpan
3.Overhead trapeze
4.Reading materials: 3
The use of an overhead trapeze is extremely helpful for a client to move about in
bed and to get on and off the bedpan. This device has the greatest value in
increasing overall bed mobility. Television and reading materials, although helpful
in reducing boredom and providing distraction, do not increase bed mobility. A
fracture bedpan is useful in reducing discomfort with elimination.
12. The nurse is caring for a client who sustained an open fracture and is
diagnosed with acute osteomyelitis of the right lower extremity. Which
intervention should the nurse plan to perform?
1.Apply ice to the affected area. 2.Perform sterile dressing changes. 3.Instruct
the client on leg exercises. 4.Measure the leg circumference daily.: 2
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