RN HESI Exit Exam Remediation
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a) Smelling the cast and feeling for the
presence of hot spots on the cast.
b) Checking neurovascular status of the
right exposed foot and toes every four
The nurse is caring for a client who has
hours.
a fiberglass long leg cast on the right leg.
d) Placing the nurse's finger in the client's
Which nursing actions should be imple-
cast while performing cast care.
mented in the cast care of this client?
e) Covering the perineal area of the cast
SATA
with plastic before client uses the fracture
bedpan.
a) Smelling the cast and feeling for the
presence of hot spots on the cast.
Rationale
b) Checking neurovascular status of the
Cast care should include ensuring the
right exposed foot and toes every four
cast is not too tight, by placing a finger
hours.
between the client's skin and cast; by
c) Using a soft cotton-tipped 6-inch swab
protecting the cast from being soiled by
to help scratch beneath the cast.
placing a protective plastic covering in
d) Placing the nurse's finger in the
the perineal area before the client uses
client's cast while performing cast care.
a bedpan; by smelling for a foul odor
e) Covering the perineal area of the cast
coming from the cast; by palpating for
with plastic before client uses the frac-
hot spots on the cast every shift; and
ture bedpan.
by performing neurovascular checks dis-
tal to the cast every four hours. Nothing
should be placed in the cast to facilitate
scratching beneath the cast.
c) Atenolol (Tenormin).
The nurse is caring for an older client
being treated for a cardiac condition who Rationale
has developed "dry eyes". Which med- Dry eyes is an annoying side effect of
ication may be contributing to this condi- some medications that can cause a client
tion? to feel like they have something in their
eye or a continuous scratchy sensation.
a) Procainamide (Procanbid). This condition can cause eye strain and
b) Iron supplements. discomfort to a client. Clients prescribed
c) Atenolol (Tenormin). Atenolol for hypertension are at risk of
d) Lipitor (Atorvastatin). developing dry eyes as a side effect of
the medication.
, RN HESI Exit Exam Remediation
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The UAP is assisting a client getting into
the shower. The charge nurse answers
a call from the cast clinic to immediately b) Notify the delegating nurse of the cur-
send the UAP's other assigned client to rent request from the cast clinic.
the clinic. Which action should the nurse
take? Rationale
The charge nurse should notify the del-
a) Ask the UAP to find another team egating nurse of the situation. The third
member to take the client to the clinic. principle of delegation is "The person
b) Notify the delegating nurse of the cur- to whom the assignment was delegat-
rent request from the cast clinic. ed cannot delegate that assignment to
c) Instruct the UAP to take the client to someone else... the delegating nurse
clinic after helping the other client taking needs to be notified and reassign the
a shower. task..."
d) While the client is showering the UAP
should take the other client to cast clinic.
During a literature review for a research c) Perform the current study as a replica-
study, the nurse discovers a separate tion study.
study has already proved the proposed
hypothesis to be true. Which action Rationale
should the nurse take regarding the pro- Because of inherent scientific error that
posed research study? may exist within all research studies, hy-
potheses require more than one test to
a) Discontinue the research. support their accuracy. A critical weak-
b) Revise the hypothesis of the current ness with nursing research is a lack of
study so it is unique. replication. Retesting a hypothesis that
c) Perform the current study as a replica- has been shown to be true strengthens
tion study. the findings of the earlier study and sup-
d) Contact the authors of the original ports the use of those findings to influ-
study for permission to continue. ence clinical practice.
In assessing the scrotum of a male b) Taut appearance of skin surface.
client, which finding would need to be
reported to the healthcare provider? Rationale
The skin surface of the scrotum should
a) Asymmetric appearance. appear coarse, rather than taut, which
b) Taut appearance of skin surface. may indicate swelling or edema and
c) Deeper pigmentation of the underside. should be reported to the healthcare
d) Presence of sebaceous cysts. provider.
, RN HESI Exit Exam Remediation
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d) Monitor fluid intake and urine output.
Rationale
Due to the pathophysiology of nephrotic
Which nursing intervention should the
syndrome, decreased colloidal osmotic
nurse implement when caring for a child
pressure in the capillaries is decreased,
with nephrotic syndrome?
resulting in overall body edema. Treat-
ment usually includes infusion of 25%
a) Take vital signs every 2 hours.
albumin and use of diuretics to help pull
b) Restrict the number of visitors.
fluids out of the interstitial tissues back
c) Reposition the client every 2 hours.
into the vascular system. Fluid intake and
d) Monitor fluid intake and urine output.
urine output should be carefully moni-
tored to prevent hypervolemia and ede-
ma and monitor the efficacy of the med-
ical interventions.
A six-year-old client, who received a kid-
ney transplant presents with signs in- c) Transplant rejection.
cluding fever, decreased urine output,
and tenderness over the transplanted or- Rationale
gan. Laboratory results reveal an elevat- Transplant rejection is caused by the
ed serum creatinine level. This presenta- recipient's immune system response to
tion is likely due to which cause? foreign tissue. Signs that may alert the
nurse to rejection of a kidney transplant
a) Immunosuppression medications. include fever, tenderness over the graft
b) Obstructive uropathy. area, decreased urine output, and ele-
c) Transplant rejection. vated serum creatinine.
d) Nephrotic syndrome.
A child recently treated for strep throat
presents with gross hematuria, facial
b) Acute glomerular nephritis.
swelling, and elevated blood pressure.
Laboratory tests reveal proteinuria and
Rationale
azotemia. Which condition should the
Acute glomerulonephritis (GN) usually
nurse suspect?
manifests after strept throat or other
streptococcal infection. Typical signs of
a) Acute pyelonephritis.
acute GN include gross hematuria, facial
b) Acute glomerular nephritis.
edema, hypertension, and proteinuria.
c) Nephrotic syndrome.
d) IgA nephropathy.
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A child who is recovering from surgery a) Intestinal obstruction.
for removal of a Wilms tumor develops
abdominal pain and distension, absence Rationale
of bowel sounds, and vomiting. Which Surgical intervention for Wilms tumor in-
complication should the nurse suspect? volves removal of the tumor, which re-
quires either a partial or radical nephrec-
a) Intestinal obstruction. tomy. Small bowel obstruction is one of
b) Abdominal peritonitis. the most common postoperative compli-
c) Pyloric stenosis. cations following removal of a Wilms tu-
d) Infectious gastritis. mor.
A child diagnosed with Wilms tumor is
b) Antitumor antibiotic.
being treated with dactinomycin. What
class of drug is this medication?
Rationale
Dactinomycin, also known as actino-
a) Mitotic inhibitor.
mycin D, is an anti-tumor antibiotic used
b) Antitumor antibiotic.
in the treatment of a variety of cancers,
c) Corticosteroid.
including Wilms tumor.
d) Alkylating agent.
The nurse is reviewing medication edu-
cation with a client who was prescribed
triamcinolone (Dermasorb) for the treat-
ment of eczema. Which statement by
the client indicates the client misunder-
stands safe administration?
a) Apply to affected areas, avoiding con- c) Cover weeping or denuded areas with
tact with the eyes. an occlusive dressing after medication
b) Continue to apply medication for a few application.
days after area has cleared.
c) Cover weeping or denuded areas with
an occlusive dressing after medication
application.
d) Affected areas treated with the med-
ication can burn easily with sunlight ex-
posure.
The nurse explains to a new staff mem-
ber that the goals of the therapeutic mi-
lieu for eating disorder are designed to
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