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HESI COMPREHENSIVE EXAM QUESTIONS WITH COMPLETE ANSWERS
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HESI COMPREHENSIVE EXAM QUESTIONS WITH COMPLETE ANSWERS
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HESI COMPREHENSIVE EXAMQUESTIONS WITH COMPLETE
ANSWERS
Enalapril eemaleate eeis eeprescribed eefor eea eehospitalized eeclient. eeWhich eeassessment
eedoes eethe eenurse eeperform eeas eea eepriority eebefore eeadministering eethe
eemedication?
Checking eethe eeclient's eeblood eepressure ee
Checking eethe eeclient's eeperipheral eepulses
Checking eethe eemost eerecent eepotassium eelevel
Checking eethe eeclient's eeintake-and-output eerecord eefor eethe eelast ee24 eehours ee-
eeAnswer eeChecking eethe eeclient's eeblood eepressure ee
Rationale: eeEnalapril eemaleate eeis eean eeangiotensin-converting eeenzyme ee(ACE)
eeinhibitor eeused eeto eetreat eehypertension. eeOne eecommon eeside eeeffect eeis eepostural
eehypotension. eeTherefore eethe eenurse eewould eecheck eethe eeclient's eeblood eepressure
eeimmediately eebefore eeadministering eeeach eedose. eeChecking eethe eeclient's
eeperipheral eepulses, eethe eeresults eeof eethe eemost eerecent eepotassium eelevel, eeand
eethe eeintake eeand eeoutput eefor eethe eeprevious ee24 eehours eeare eenot eespecifically
eeassociated eewith eethis eemediation.
A eeclient eeis eescheduled eeto eeundergo eean eeupper eegastrointestinal ee(GI) eeseries,
eeand eethe eenurse eeprovides eeinstructions eeto eethe eeclient eeabout eethe eetest. eeWhich
eestatement eeby eethe eeclient eeindicates eea eeneed eefor eefurther eeinstruction?
"The eetest eewill eetake eeabout ee30 eeminutes."
"I eeneed eeto eefast eefor ee8 eehours eebefore eethe eetest."
"I eeneed eeto eedrink eecitrate eeof eemagnesia eethe eenight eebefore eethe eetest eeand eegive
eemyself eea eeFleet eeenema eeon eethe eemorning eeof eethe eetest." ee
"I eeneed eeto eetake eea eelaxative eeafter eethe eetest eeis eecompleted, eebecause eethe
eeliquid eethat eeI'll eehave eeto eedrink eefor eethe eetest eecan eebe eeconstipating." ee-
eeAnswer ee"I eeneed eeto eedrink eecitrate eeof eemagnesia eethe eenight eebefore eethe eetest
eeand eegive eemyself eea eeFleet eeenema eeon eethe eemorning eeof eethe eetest." ee
Rationale: eeNo eespecial eepreparation eeis eenecessary eebefore eea eeGI eeseries, eeexcept
eethat eeNPO ee(nothing eeby eemouth) eestatus eemust eebe eemaintained eefor ee8 eehours
eebefore eethe eetest. eeAn eeupper eeGI eeseries eeinvolves eevisualization eeof eethe
eeesophagus, eeduodenum, eeand eeupper eejejunum eeby eemeans eeof eethe eeuse eeof eea
eecontrast eemedium. eeIt eeinvolves eeswallowing eea eecontrast eemedium ee(usually
eebarium), eewhich eeis eeadministered eein eea eeflavored eemilkshake. eeFilms eeare eetaken
,eeat eeintervals eeduring eethe eetest, eewhich eetakes eeabout ee30 eeminutes. eeAfter eean
eeupper eeGI eeseries, eethe eeclient eeis eeprescribed eea eelaxative eeto eehasten
eeelimination eeof eethe eebarium. eeBarium eethat eeremains eein eethe eecolon eemay
eebecome eehard eeand eedifficult eeto eeexpel, eeleading eeto eefecal eeimpaction.
A eenurse eeon eethe eeevening eeshift eechecks eea eeprimary eehealth eecare eeprovider's
eeprescriptions eeand eenotes eethat eethe eedose eeof eea eeprescribed eemedication eeis
eehigher eethan eethe eenormal eedose. eeThe eenurse eecalls eethe eeprimary eehealth eecare
eeprovider's eeanswering eeservice eeand eeis eetold eethat eethe eeprimary eehealth eecare
eeprovider eeis eeoff eefor eethe eenight eeand eewill eebe eeavailable eein eethe eemorning.
eeWhat eeshould eethe eenurse eedo eenext?
Call eethe eenursing eesupervisor
Ask eethe eeanswering eeservice eeto eecontact eethe eeon-call eeprimary eehealth eecare
eeprovider ee
Withhold eethe eemedication eeuntil eethe eeprimary eehealth eecare eeprovider eecan eebe
eereached eein eethe eemorning
Administer eethe eemedication eebut eeconsult eethe eeprimary eehealth eecare eeprovider
eewhen eehe eebecomes eeavailable ee- eeAnswer eeAsk eethe eeanswering eeservice eeto
eecontact eethe eeon-call eeprimary eehealth eecare eeprovider ee
Rationale: eeThe eenurse eehas eea eeduty eeto eeprotect eethe eeclient eefrom eeharm. eeA
eenurse eewho eebelieves eethat eea eeprimary eehealth eecare eeprovider's eeprescription
eemay eebe eein eeerror eeis eeresponsible eefor eeclarifying eethe eeprescription eebefore
eecarrying eeit eeout. eeTherefore eethe eenurse eewould eenot eeadminister eethe
eemedication; eeinstead, eethe eenurse eewould eewithhold eethe eemedication eeuntil eethe
eedose eecan eebe eeclarified. eeThe eenurse eewould eenot eewait eeuntil eethe eenext
eemorning eeto eeobtain eeclarification. eeIt eeis eepremature eeto eecall eethe eenursing
eesupervisor.
An eeemergency eedepartment ee(ED) eenurse eeis eemonitoring eea eeclient eewith
eesuspected eeacute eemyocardial eeinfarction ee(MI) eewho eeis eeawaiting eetransfer eeto
eethe eecoronary eeintensive eecare eeunit. eeThe eenurse eenotes eethe eesudden eeonset eeof
eepremature eeventricular eecontractions ee(PVCs) eeon eethe eemonitor, eechecks eethe
eeclient's eecarotid eepulse, eeand eedetermines eethat eethe eePVCs eeare eenot eeperfusing.
eeWhat eeis eethe eenurse's eemost eeappropriate eeaction?
Document eethe eefindings
Ask eethe eeED eeprimary eehealth eecare eeprovider eeto eecheck eethe eeclient ee
Continue eeto eemonitor eethe eeclient's eecardiac eestatus
Inform eethe eeclient eethat eePVCs eeare eeexpected eeafter eean eeMI ee- eeAnswer eeAsk
eethe eeED eeprimary eehealth eecare eeprovider eeto eecheck eethe eeclient ee
Rationale: eeThe eemost eeappropriate eeaction eeby eethe eenurse eewould eebe eeto eeask
eethe eeED eehealth eecare eeprovider eeto eecheck eethe eeclient. eePVCs eeare eea eeresult
eeof eeincreased eeirritability eeof eeventricular eecells. eePeripheral eepulses eemay eebe
,eeabsent eeor eediminished eewith eethe eePVCs eethemselves eebecause eethe eedecreased
eestroke eevolume eeof eethe eepremature eebeats eemay eein eeturn eedecrease eeperipheral
eeperfusion. eeBecause eeother eerhythms eealso eecause eewidened eeQRS eecomplexes,
eeit eeis eeessential eethat eethe eenurse eedetermine eewhether eethe eepremature eebeats
eeare eeresulting eein eeperfusion eeof eethe eeextremities. eeThis eeis eedone eeby eepalpating
eethe eecarotid, eebrachial, eeor eefemoral eeartery eewhile eeobserving eethe eemonitor eefor
eewidened eecomplexes eeor eeby eeauscultating eefor eeapical eeheart eesounds. eeIn eethe
eesituation eeof eeacute eeMI, eePVCs eemay eebe eeconsidered eewarning eedysrhythmias,
eepossibly eeheralding eethe eeonset eeof eeventricular eetachycardia eeor eeventricular
eefibrillation. eeTherefore, eethe eenurse eewould eenot eetell eethe eeclient eethat eethe eePVCs
eeare eeexpected. eeAlthough eethe eenurse eewill eecontinue eeto eemonitor eethe eeclient
eeand eedocument eethe eefindings, eethese eeare eenot eethe eemost eeappropriate eeactions
eeof eethose eeprovided.
NPO eestatus eeis eeimposed ee8 eehours eebefore eethe eeprocedure eeon eea eeclient
eescheduled eeto eeundergo eeelectroconvulsive eetherapy ee(ECT) eeat ee1 eep.m. eeOn eethe
eemorning eeof eethe eeprocedure, eethe eenurse eechecks eethe eeclient's eerecord eeand
eenotes eethat eethe eeclient eeroutinely eetakes eean eeoral eeantihypertensive eemedication
eeeach eemorning. eeWhat eeaction eeshould eethe eenurse eetake?
Administer eethe eeantihypertensive eewith eea eesmall eesip eeof eewater ee
Withhold eethe eeantihypertensive eeand eeadminister eeit eeat eebedtime
Administer eethe eemedication eeby eeway eeof eethe eeintravenous ee(IV) eeroute
Hold eethe eeantihypertensive eeand eeresume eeits eeadministration eeon eethe eeday eeafter
eethe eeECT ee- eeAnswer eeAdminister eethe eeantihypertensive eewith eea eesmall eesip eeof
eewater ee
Rationale: eeThe eenurse eeshould eeadminister eethe eeantihypertensive eewith eea eesmall
eesip eeof eewater. eeGeneral eeanesthesia eeis eerequired eefor eeECT, eeso eeNPO eestatus
eeis eeimposed eefor ee6 eeto ee8 eehours eebefore eetreatment eeto eehelp eeprevent
eeaspiration. eeExceptions eeinclude eeclients eewho eeroutinely eereceive eecardiac
eemedications, eeantihypertensive eeagents, eeor eehistamine ee(H2) eeblockers, eewhich
eeshould eebe eeadministered eeseveral eehours eebefore eetreatment eewith eea eesmall eesip
eeof eewater. eeWithholding eethe eeantihypertensive eeand eeadministering eeit eeat
eebedtime eeand eewithholding eethe eeantihypertensive eeand eeresuming eeadministration
eeon eethe eeday eeafter eethe eeECT eeare eeincorrect eeactions, eebecause
eeantihypertensives eemust eebe eeadministered eeon eetime; eeotherwise, eethe eerisk eefor
eerebound eehypertension eeexists. eeThe eenurse eewould eenot eeadminister eea
eemedication eeby eeway eeof eea eeroute eethat eehas eenot eebeen eeprescribed.
A eeclient eewho eerecently eeunderwent eecoronary eeartery eebypass eegraft eesurgery
eecomes eeto eethe eeprimary eehealth eecare eeprovider's eeoffice eefor eea eefollow-up eevisit.
eeOn eeassessment, eethe eeclient eetells eethe eenurse eethat eehe eeis eefeeling eedepressed.
eeWhich eeresponse eeby eethe eenurse eeis eetherapeutic?
"Tell eeme eemore eeabout eewhat eeyou're eefeeling." ee
, "That's eea eenormal eeresponse eeafter eethis eetype eeof eesurgery."
"It eewill eetake eetime, eebut eeI eepromise eeyou, eeyou eewill eeget eeover eethis eedepression."
"Every eeclient eewho eehas eethis eesurgery eefeels eethe eesame eeway eefor eeabout eea
eemonth." ee- eeAnswer ee"Tell eeme eemore eeabout eewhat eeyou're eefeeling." ee
Rationale: eeThe eetherapeutic eeresponse eeby eethe eenurse eeis, ee"Tell eeme eemore
eeabout eewhat eeyou're eefeeling." eeWhen eea eeclient eeexpresses eefeelings eeof
eedepression, eeit eeis eeextremely eeimportant eefor eethe eenurse eeto eefurther eeexplore
eethese eefeelings eewith eethe eeclient. eeIn eestating, ee"This eeis eea eenormal eeresponse
eeafter eethis eetype eeof eesurgery" eethe eenurse eeprovides eefalse eereassurance eeand
eeavoids eeaddressing eethe eeclient's eefeelings. ee"It eewill eetake eetime, eebut eeI eepromise
eeyou, eeyou eewill eeget eeover eethe eedepression" eeis eealso eea eefalse eereassurance,
eeand eeit eedoes eenot eeencourage eethe eeexpression eeof eefeelings. ee"Every eeclient
eewho eehas eethis eesurgery eefeels eethe eesame eeway eefor eeabout eea eemonth" eeis eea
eegeneralization eethat eeavoids eethe eeclient's eefeelings.
A eeclient eein eelabor eeexperiences eespontaneous eerupture eeof eethe eemembranes.
eeThe eenurse eeimmediately eecounts eethe eefetal eeheart eerate ee(FHR) eefor ee1 eefull
eeminute eeand eethen eechecks eethe eeamniotic eefluid. eeThe eenurse eenotes eethat eethe
eefluid eeis eeyellow eeand eehas eea eestrong eeodor. eeWhich eeaction eeshould eebe eethe
eenurse's eepriority?
Contact eethe eeprimary eehealth eecare eeprovider ee
Document eethe eefindings
Check eethe eefluid eefor eeprotein
Continue eeto eemonitor eethe eeclient eeand eethe eeFHR ee- eeAnswer eeContact eethe
eeprimary eehealth eecare eeprovider ee
Rationale: eeThe eepriority eeaction eeis eefor eethe eenurse eeto eecontact eethe eeprimary
eehealth eecare eeprovider. eeThe eeFHR eeis eeassessed eefor eeat eeleast ee1 eeminute
eewhen eethe eemembranes eerupture. eeThe eenurse eealso eechecks eethe eequantity,
eecolor, eeand eeodor eeof eethe eeamniotic eefluid. eeThe eefluid eeshould eebe eeclear ee(often
eewith eebits eeof eevernix) eeand eehave eea eemild eeodor. eeFluid eewith eea eefoul eeor
eestrong eeodor, eecloudy eeappearance, eeor eeyellow eecoloration eesuggests
eechorioamnionitis eeand eewarrants eenotifying eethe eeprimary eehealth eecare eeprovider.
eeA eelarge eeamount eeof eevernix eein eethe eefluid eesuggests eethat eethe eefetus eeis
eepreterm. eeGreenish, eemeconium-stained eefluid eemay eebe eeseen eein eecases eeof
eepostterm eegestation eeor eeplacental eeinsufficiency. eeChecking eethe eefluid eefor
eeprotein eeis eenot eeassociated eewith eethe eedata eein eethe eequestion. eeThe eenurse
eewould eecontinue eeto eemonitor eethe eeclient eeand eethe eeFHR eeand eewould
eedocument eethe eefindings.
A eenurse eehas eeassisted eea eeprimary eehealth eecare eeprovider eein eeinserting eea
eecentral eevenous eeaccess eedevice eeinto eea eeclient eewith eea eediagnosis eeof eesevere
eemalnutrition eewho eewill eebe eereceiving eeparenteral eenutrition ee(PN). eeAfter eeinsertion
eeof eethe eecatheter eewhat eedoes eethe eenurse eeimmediately eedo?
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