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Hesi Milestone exam 1 questions with complete solutions
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Hesi Milestone exam 1 questions with complete solutions
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Name: Score:21 Multiple choice questions
Term
The nurse has completed diabetic teaching for a client who was newly diagnosed with diabetes
mellitus. Which statement by this client would indicate to the nurse that further teaching is
needed?
A."Regular insulin can be stored at room temperature for 30 days."
B."My legs, arms, and abdomen are all good sites to inject my insulin."
C."I will always carry hard candies to treat hypoglycemic reactions."
D."When I exercise, I should plan to increase my insulin dosage."
D
Rationale:Atropine sulfate, an anticholinergic agent, is given to decrease oral secretions
during a surgical procedure. Options B, C, and D are not actions of anticholinergic agents.
Rationale:Combining hepatotoxic drugs, such as acetaminophen and alcohol, increases
the risk of liver damage, so option A is an important discharge instruction. Although clients
who receive hepatotoxic drugs should be screened for any changes in serum liver
function test (LFT) results, option B is not indicated. Rest is advantageous during an
infectious process, but activity restriction is unnecessary. A client who is receiving a
hepatotoxic drug should report any hepatotoxic symptoms, such as jaundice, dark urine,
or light-colored stools, but an increased appetite does not need medical attention.
Exercise helps facilitate the entry of glucose into the cell, so increasing insulin doses with
exercise would place the client at high risk for a hypoglycemic reaction. Options A, B, and
C reflect accurate statements about the use of insulin and management of hypoglycemic
reactions.
Rationale:Insulin aspart is a very rapidly acting insulin, with an onset of 5 to 15 minutes.
Insulin aspart should be administered when the client's tray is available. Insulin aspart
peaks in 45 minutes to 1 ½ hours and has a duration of 3 to 4 hours. The client should have
eaten to ensure absorption of the meal so that serum glucose levels will coincide with the
peak. Insulin glargine has a flat peak of action and is usually given at bedtime.1 of 21 Term
A client has a positive skin test for tuberculosis. Which prophylactic drug should the nurse expect
to administer to this client?
A.Isoniazid
B.Carvedilol
C.Acyclovir
D.Griseofulvin
A
Rationale:The client receiving isoniazid is at risk for the development of hepatitis;
therefore, liver function test results should be monitored carefully during drug therapy.
Options B, C, and D are not specific indicators of liver function, so they are not monitored
closely during isoniazid therapy.
Rationale:Certain antibiotics, such as tetracycline, decrease the effectiveness of oral
contraceptives. Options B, C, and D do not convey accurate information related to client
teaching about this medication.
Rationale:Isoniazid is the drug of choice for treatment of clients with positive skin tests for
tuberculosis. Options B, C, and D are not the drugs used for treatment of TB.
Rationale:Nitroglycerin tablets should be taken at the onset of angina, and the client
should stop activity and rest. One tablet can be taken every 5 minutes, up to three doses.
Nitroglycerin should be replaced every 3 to 6 months, not every 12 months. Nitroglycerin
should provide relief in 5 minutes, not 30 minutes.2 of 21 Term
The nurse is providing discharge instructions to a client who has received a prescription for an
antibiotic that is hepatotoxic. Which information should the nurse include in the instructions?
A.Avoid ingesting any alcohol or acetaminophen.
B.Schedule a follow-up visit for a liver biopsy in 1 month.
C.Activities that are strenuous should be avoided.
D.Notify the health care provider of any increase in appetite.
A
Rationale: Determining when the child last voided is most important because urine output
is decreased with dehydration and an 18-month-old with a 3-day history of diarrhea could
be severely dehydrated. Although the manufacturer states that loperamide should not be
given to a child younger than 2 years except under the direction of a health care provider,
option A is not the best answer for this question. In addition, loperamide causes an
anticholinergic effect of urinary retention. Data obtained in options B and C are not as
high a priority as option D in this situation.
Rationale:Atropine sulfate, an anticholinergic agent, is given to decrease oral secretions
during a surgical procedure. Options B, C, and D are not actions of anticholinergic agents.
Rationale:Insulin aspart is a very rapidly acting insulin, with an onset of 5 to 15 minutes.
Insulin aspart should be administered when the client's tray is available. Insulin aspart
peaks in 45 minutes to 1 ½ hours and has a duration of 3 to 4 hours. The client should have
eaten to ensure absorption of the meal so that serum glucose levels will coincide with the
peak. Insulin glargine has a flat peak of action and is usually given at bedtime.
Rationale:Combining hepatotoxic drugs, such as acetaminophen and alcohol, increases
the risk of liver damage, so option A is an important discharge instruction. Although clients
who receive hepatotoxic drugs should be screened for any changes in serum liver
function test (LFT) results, option B is not indicated. Rest is advantageous during an
infectious process, but activity restriction is unnecessary. A client who is receiving a
hepatotoxic drug should report any hepatotoxic symptoms, such as jaundice, dark urine,
or light-colored stools, but an increased appetite does not need medical attention.3 of 21
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