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HESI Exit Exam Fundamentals Updated 2020

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HESI Exit Exam Fundamentals A client is receiving furosemide (Lasix) to relieve edema. The nurse should monitor the client for which response to the medication? 1 Retention of sodium ions 2 Negative nitrogen balance Correct3 Excessive loss of potassium ions 4 Increase in the urine specific gravity Furosemide is a potent diuretic used to provide rapid diuresis; it acts in the loop of Henle and causes depletion of electrolytes, such as potassium and sodium. Furosemide inhibits the reabsorption, not retention, of sodium. Furosemide does not affect protein metabolism. With edema, the specific gravity of the fluid more likely will be low. Test-Taking Tip: Pace yourself when taking practice quizzes. Because most nursing exams have specified time limits, you should pace yourself during the practice testing period accordingly. It is helpful to estimate the time that can be spent on each item and still complete the examination in the allotted time. You can obtain this figure by dividing the testing time by the number of items on the test. For example, a 1-hour (60-minute) testing period with 50 items averages 1.2 minutes per question. The NCLEX exam is not a timed test. Both the number of questions and the time to complete the test varies according to each candidate's performance. However, if the test taker uses the maximum of 5 hours to answer the maximum of 265 questions, each question equals 1.3 minutes. 80%of students nationwide answered this question correctly. View Topics 1 Confidence: Pretty sure Stats Issue with this question? 5. A routine urinalysis is prescribed for a client. What should the nurse do if the specimen cannot be sent immediately to the laboratory?1 Take no special action. Correct2 Refrigerate the specimen. 3 Store it in the dirty utility room and send it later. 4 Discard the specimen and collect another specimen later. Refrigeration retards the growth of bacteria and may preserve the specimen for several hours. Growth of bacteria will alter the pH and the glucose and protein levels in the urine; it must be refrigerated to retard growth. Discarding the specimen and collecting another specimen later represents an unnecessary waste of time, effort, and money. Test-Taking Tip: Being emotionally prepared for an examination is key to your success. Proper use of this text over an extended period of time ensures your understanding of the mechanics of the examination and increases your confidence about your nursing knowledge. Your lifelong dream of becoming a nurse is now within your reach! You are excited, yet anxious. This feeling is normal. A little anxiety can be good because it increases awareness of reality; but excessive anxiety has the opposite effect, acting as a barrier and keeping you from reaching your goal. Your attitude about yourself and your goals will help keep you focused, adding to your strength and inner conviction to achieve success. 83%of students nationwide answered this question correctly. View Topics 1 Confidence: Nailed it Stats Issue with this question? 7. A nurse is notified that the latest potassium level for a client in acute renal failure is 6.2 mEq. What action should the nurse take? 1 Alert the cardiac arrest team 2 Call the laboratory to repeat the test Correct3 Take vital signs and notify the primary health care provider 4 Obtain an ECG strip and obtain an antiarrhythmic medicatio

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1




A client is receiving furosemide (Lasix) to relieve edema. The nurse should monitor
the client for which response to the medication?
1

Retention of sodium ions
2

Negative nitrogen balance
Correct3


Excessive loss of potassium ions
4

Increase in the urine specific gravity

Furosemide is a potent diuretic used to provide rapid diuresis; it acts in the loop of Henle
and causes depletion of electrolytes, such as potassium and sodium. Furosemide inhibits the
reabsorption, not retention, of sodium. Furosemide does not affect protein metabolism. With
edema, the specific gravity of the fluid more likely will be low.

Test-Taking Tip: Pace yourself when taking practice quizzes. Because most nursing exams
have specified time limits, you should pace yourself during the practice testing period
accordingly. It is helpful to estimate the time that can be spent on each item and still
complete the examination in the allotted time. You can obtain this figure by dividing the
testing time by the number of items on the test. For example, a 1-hour (60-minute) testing
period with 50 items averages 1.2 minutes per question. The NCLEX exam is not a timed
test. Both the number of questions and the time to complete the test varies according to
each candidate's performance. However, if the test taker uses the maximum of 5 hours to
answer the maximum of 265 questions, each question equals 1.3 minutes.

80%of students nationwide answered this question correctly.

View Topics
1 140407851
Confidence: Pretty sure
Stats
Issue with this question?

5.
A routine urinalysis is prescribed for a client. What should the nurse do if the
specimen cannot be sent immediately to the laboratory?

,1

Take no special action.
Correct2


Refrigerate the specimen.
3

Store it in the dirty utility room and send it later.
4

Discard the specimen and collect another specimen later.

Refrigeration retards the growth of bacteria and may preserve the specimen for several
hours. Growth of bacteria will alter the pH and the glucose and protein levels in the urine; it
must be refrigerated to retard growth. Discarding the specimen and collecting another
specimen later represents an unnecessary waste of time, effort, and money.

Test-Taking Tip: Being emotionally prepared for an examination is key to your success.
Proper use of this text over an extended period of time ensures your understanding of the
mechanics of the examination and increases your confidence about your nursing knowledge.
Your lifelong dream of becoming a nurse is now within your reach! You are excited, yet
anxious. This feeling is normal. A little anxiety can be good because it increases awareness
of reality; but excessive anxiety has the opposite effect, acting as a barrier and keeping you
from reaching your goal. Your attitude about yourself and your goals will help keep you
focused, adding to your strength and inner conviction to achieve success.

83%of students nationwide answered this question correctly.

View Topics
1 140350078
Confidence: Nailed it
Stats
Issue with this question?

7.
A nurse is notified that the latest potassium level for a client in acute renal failure is
6.2 mEq. What action should the nurse take?
1

Alert the cardiac arrest team
2

Call the laboratory to repeat the test
Correct3


Take vital signs and notify the primary health care provider
4

Obtain an ECG strip and obtain an antiarrhythmic medication

,Vital signs monitor the cardiopulmonary status; the health care provider must treat
this hyperkalemia to prevent cardiac dysrhythmias. The cardiac arrest team responds to a
cardiac arrest; there is no sign of arrest in this client. A repeat laboratory test will take time
and probably reaffirm the original results; the client needs medical attention. Obtaining an
ECG strip and having an antiarrhythmic available are correct interventions if available, but
the priority is medical attention and the health care provider should be notified
immediately.

82%of students nationwide answered this question correctly.

View Topics
1 130049918
Confidence: Nailed it
Stats
Issue with this question?

8.
A client with a diagnosis of uncontrolled diabetes began receiving Lasix
(Furosemide) two days ago. The nurse reviews the morning lab results and discovers
that the client's potassium level is 2.8 mEq/L. What is the most appropriate action
for the nurse to take?
1

Hold the morning dose of the diuretic and have the lab repeat the test.
2

Continue to monitor the level to ensure that it stays within the normal limits.
Correct3


Notify the primary healthcare provider of the result, which is critically low.
4

Anticipate a prescription for an increase in the dosage of the Lasix.

The physician should be notified because a potassium level of 2.8 mEq/L is low. Normal
range for serum potassium is 3.5 to 5 mEq/L. Clients who are on diuretics require monitoring
of serum electrolytes, especially potassium and sodium, because they also are excreted with
water. The nurse should not hold the diuretic or repeat the lab test unless advised by the
physician. The client's serum potassium level is critically below the normal limit and the
physician should be notified. An increase in Lasix would cause an increased loss of
potassium.

77%of students nationwide answered this question correctly.

View Topics
1 140385582
Confidence: Nailed it
Stats
Issue with this question?

9.
Which is the most serious complication for which the nurse must monitor a client
with kidney failure?

, 1

Anemia
2

Weight loss
Correct3


Hyperkalemia
4

Platelet dysfunction

Decreased glomerular filtration leads to hyperkalemia, which may cause lethal dysrhythmias
such as cardiac arrest. Anemia may occur, but is not the most serious complication and
should be treated in relation to the client's clinical manifestation; erythropoietin and iron
supplements usually are used. Weight loss alone is not life threatening. Platelet dysfunction
may occur because of decreased cell surface adhesiveness, but it is not as life threatening
as hyperkalemia.

79%of students nationwide answered this question correctly.

View Topics
1 140370911
Confidence: Nailed it
Stats
Issue with this question?

11.
An obese client who is mildly hypertensive is hospitalized with a diagnosis of
ureteral colic and hematuria. What is the immediate focus of nursing care for this
client?
Correct1


Pain
2

Weight
3

Hematuria
4

Hypertension

Sharp, severe pain (renal colic) radiating toward the genitalia and thigh is caused by ureteral
distention and smooth muscle spasm; relief from pain is the priority. Although the client is
overweight and weight loss is desirable, it is a long-term goal. Although hematuria needs to
be monitored, blood loss usually is not massive with ureteral colic. Mild hypertension is not
the priority when a client is in severe pain.

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