HESI RN MED SURG EXAM TEST BANK - COMPILATION OF 20 DIFFERENT VERSIONS

An adult male client is admitted for pneumocystis carinil pneumonia (PCP) secondary to aids. While hospitalize he receives IV pentamidine isethionate therapy. In preparing this client for discharge what important aspect regarding his medication therapy should the nurse explain? AZT therapy must be stopped when IV aerosol pentamine is being used. IV pentamine will be given until oral pentamine can be tolerated It will be necessary to continue prophylactic doses of IV or aerosol pentamine every month Iv pentamine may offer protection to others aids related conditions such as kaposis sarcoma A client subjective data includes dysuria, urgency, and urinary frequency. What action should the nurse implement next? collect a clean catch specimen palpate the suprapubic region instruct to wipe from front to back inquire about recent sexual activity A client tells the nurse that her biopsy results indicate that the cancer cells are well differentiated How should the nurse respond? offer the client reassurance that this information indicates that the clients cancer cells are benign explain that these tissue cells often respond more effectively to radiation than to chemotherapy ask the client in the healthcare provider has giving her any information about the classification of her cancer help the client make plans to begin inmediate treatment since her cancer is likely to spread quickly A client with a chronic kidney disease is treated on hemodialysis. During the 1 treatment clients blood pressure drops from 150/90 to 80/30 Which action should the nurse take first? monitor bp q45 minutes lower the head of the chair and elevate feet stop dialysis treatment administer 5%albumin IV 10. A client with deep vain thrombosis (DVT) is receiving a continues infusion of heparin sodium 25,000 unit in 5% dextrose injection 250ml. The prescription indicates the dosage should be increase 900 units/hr. The nurse should program the infusion pump to deliver how many ml/hr? =9 11. The nurse is obtaining the admission history for a client with suspected peptic ulcer disease (PUD). Which subjective data reported by the client supports this diagnosis? upper mid abdominal gnawing and burning pain severe abdominal cramps and diarrhea after eating spicy foods marked loss of weight and appetite over the last few months use of chewable and liquid antacids for indigestion 12. The nurse is providing preoperative education for a jewish client schedule to receive a xenograft graft to promote burn healing. Which information should the nurse provide this client? the xenograft is taken from nonhuman sources grafting increases the risk for bacterial infection as the burn heals the graft permanently attaches grafts are later removed by debriding procedure 13. A client who took a camping vacation two weeks ago in a country with a tropical climate comes to the clinic describing vague symptoms and diarrhea for the past week. Which finding is most important for the nurse to report? jaundice sclera intestinal cramping weakness and fatigue weight loss 14. During a home visit the nurse assesses the skin of a client with eczema who reports than an exacerbation of symptoms has occurred during the last week. Which information is most useful in determining the possible cause of the symptoms? an old friend with eczema came for visit recently received an influenza immunization corticosteroid cream was applied to eczema a grandson and his new dog recently visited 15. When explaining dietary guidelines to a client with acute glomerulonephritis (AGN) which instruction should the nurse include in the dietary teaching? select a protein rich food daily restrict sodium intake eat high potassium foods Avoid foods high in carbohydrate 16. A male client who is 24hr post operative for an exploratory laparoctomy complains that he is starving because he has had no real food since before surgery. Prior to advancing his diet which interventionshould the nurse implememt? discontinue intravenous therapy Assess for abdominal distension and tenderness Obtain a prescription for a diet change Auscultate bowel sound in all four quadrants 17. A client diagnose with stable angina secondary to ischemic heart disease has a prescription for sublingual (SL) nitroglycerin (NTG). The nurse should tell the client to follow which instructions if chest pain is not relieved after taking 3 NTG tables 5 min apart? drive to the nearest emergency department take another NTG SL tablet and lie down until angina subsides call primary healthcare provider call 911 pain is unrelieved and chew a tablet of aspirin 325mg 18. After taking orlistat (Xenical) for one week a femela client tells the home health nurse that she is experiencing increasingly frequent oily stools and flatus. What action should the nurse take? obtain stool specimen to evaluate for occult blood and fat content instruct the client to increase her intake of saturated fats over the next week ask the client to describe her dietary intake history for the last several days advice the client to stop taking the drug and contact the healthcare provider 19. Two days after an abscess of the chin was drained the client returns to the clinic with fever chills and a maculopapular rash with pruritis. The client has taken an oral antibiotic and cleansed the wound today with provide iodine (Betadine) solution. Which intervention should the nurse implement first? determine if the client has a history of diabetes assess airway patency and oxygen saturation review recent medication history and allergies ( POSSIBLE ANSWER TOO) obtain samples for complete blood count and cultures 20. A client experiences an ABO incompatibility reaction after multiple blood transfusions. Which finding should the nurse report immediately to the health care provider? low back pain and hypotension rhinitis and nasal stuffiness delayed painful rash with urticarial arthritic joint changes and chronic pain 21. A young adult male who has had type 2 diabetes mellitus (DM) is admitted to the intensive care unit with hyperglycemic nonketotic syndrome (HHNS). A sliding scale protocol for an isotonic IV solution with regular insulin is prescribed based on the results of a continuous blood glucose monitoring device that is attached to the client’s central venous catheter. When the client’s respirations become labored and his lungs sound indicate crackles what action should the nurse take? collect a specimen for a white blood cell count and cultures determine the clients glycosylated hemoglobin (A1C) (POSSIBLE ANSWER) administer insulin IV push until the clients fluid volume is adjusted decrease infusion rate to address fluid overload 22. When preparing to apply a fentanyl (Duragesic) transdermal patch the nurse notes that the previously applied patch is intact on the client’s upper back and the client denies pain. What action should the nurse take? Remove the patch and consult with the healthcare provider about the client pain resolution Place the patch on the clients shoulder and leave both patches in place for 12 hours Administer an oral analgesic and evaluate its effectiveness before applying a new patch Apply a new patch in a different location after removing the original patch 23. A client who had a myocardial infarction is admitted to the coronary critical care unit (CCU) with a nitroglycerin drip infusing. The clients last blood pressure measurements was 78/36.What action should the nurse implement? obtain blood pressure q5 minutes using duranap machine change the dilution of the nitroglycerin infusion reduce the rate of the nitroglycerin infusion begin dopamine infusion at 5mcg/kg per minute 24. An adolescent is admitted to the hospital because of a suicide attempt with an overdose of acetaminophen (Tylenol). Which blood values are most important for the nurse to monitor during the first 72 hours following ingestion of this overdose? BUN creatinine specific gravity White blood count, hemoglobin hematocrit PH,PCO2, HC03 LDH OR LD, SGOT OR ALT, SGPT OR AST 25. An elderly post-operative female client is receiving morphine sulfate via a PCA pump. Which assessment finding should prompt a nurse to administer the prescribed PRN medication naloxone? her respiratory rate is 7 breath/minute she indicates that she feels as if she cannot get enough air to breath she has intercostal retractions and bilateral wheezing is auscultated her pulse oximeter is 89% on room air 26. Which assessment finding indicates to the nurse that the muscarinic agent bethanechol (Urecholine) is effective for a client diagnose with urinary retention? urinary output equal to intake no terminal urinary dribbling denies stress incontinence absence of xerostomia 27. Following involvement in a motor vehicle collision, a middle aged adult client is admitted to the hospital with multiple facial fractures. The client’s blood alcohol level is high on admission. Which PRN prescription should be administer if the clients begins to exhibit signs and symptoms of delirium tremens (DT s)? Lorazepam (Ativan) 2mg IM Chlorpromazine (thorazine) 50 mg IM Prochlorperazine (Compazine) 5 mg IM Hydromorphone (Dilaudid) 2 mg IM 28. Which instructions should the nurse include in the teaching plan of a client who is taking the diuretic spironolactone (Aldactone)? call the healthcare provider f you develop gynecomastia Take the medication in the morning