IHP HESI RN EXIT STUDY MATERIAL FOR 2024 EXAM
A client with end stage liver failure is declared brain dead. The family wants to discontinue feeding and donate and viable organs. Which action should the nurse take? CONTACT THE REGIONAL ORGAN PROCUREMENT AGENCY The nurse is caring for a client immediately after insertion of a PICC line. Suddenly the client becomes anxious and tachycardia, and loud churning is heard over the pericardium upon auscultate. What action should the nurse take first? PLACE CLIENT IN TRENDELENBURG POSITION ON LEFT SIDE A female client was recently diagnosed with myasthenia gravis MG is receiving pyridostigmine bromide five times daily. Before administering the evening dose , the nurse notes that the client was stronger than she was earlier in the day. What action should the nurse take? ADMINISTER THE SCHEDULE DOSE OF THE MEDICATION A client with pelvic inflammatory disease is receiving an intermittent infusion of erythromycin lactobionate for injection, USP, 500mg every 6 hours. The pharmacy provides a 100ml normal saline solution wiith erythromycin 5mg/ml to infuse over 2 hours. The nurse should program the infusion pump to deliver how many ml/hr ? 5ML/ML x 100ML=500 MG (USE D/H x Q) 500mg/500mg x 100= 100ml/2 hrs =50ml/hr A male client with altered mental status is admitted to the intensive care unit following a motor collision. He is short of breath, lethargic and initial arterial blood gas (ABG) results are pH7.32, PaCO2, 62 mmHg HCO, 35 mEq/L. Which assessment finding warrants immediate intervention by the nurse? REGULAR PERIODS OF TEN SECOND APNEA When providing diet teaching for a client with with cholecystitis, which types of food choice should the nurse recommend to the client? LOW FAT A primigravida at 31 weeks gestation is admitted with a bloody show and contractions every 10 minutes. After administering betamethasone, which laboratory finding should the nurse monitor? LECITHIN-SPHINOGOMYELIN RATIO The Unlicensed assistive personnel (UAP) is preparing to turn and position a client with multiple myeloma. The nurse advises the UAP to use caution when positioning this client, since the client is at high risk for EXCESSIVE BLEEDING AND BRUISING A male client who was hit by a car while dodging through traffic is admitted to the emergency department with signs of increased intracranial pressure (ICP). A computerized tomography (CT) scans reveals an intracranial bleed. After evacuation of the hematoma, postoperative prescriptions include: intubation with controlled mechanical ventilation to PaCO2 of 32 to 37mmHg. What is the pathophysiological basis for this ventilator setting? HYPOCAPNEA REDUCES ICP An older adult woman, who has a long history of alcohol abuse, is brought to the emergency department by her husband because he believes his wife is in the final stages of alcoholism. The client is admitted to the medical unit with a diagnosis of cirrhosis of the liver. Which interventions should the nurse include in this clients plan of care? MONITOR THE CLIENT OFR BLEEDING AND SIGNS OF SHOCK MEASURE THE CLIENTS ABDOMIANL GIRTH DAILY DETERMINE THE CLIENTS ORIENTATION TO TIME AND PLACE
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