HESI EXAM vc
Exam Solution vc
HESI Medical Surgical Nursing test 2026 A+ GRADE ASS
vc vc vc vc vc vc vc vc
URED COMPLETE SOLUTIONS AND VERIFIED ANSWERS vc vc vc vc vc vc
(4D8ED)
QUESTION 1 vc
When describing patient education approaches, the nurse educator would explain that in
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formal teaching is an approach that
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a. follows formalized plans
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b. has standardized content
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c. often occurs one-to-one
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d. addresses group needs
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ANSWER
C. Informal teaching is individualized one on one teaching which represents the majority of patient educ
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ation done by nurses that occurs when an intervention is explained or a question is answered. Group ne
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eds are often the focus of formal patient education courses or classes. Informal teaching does not necess
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arily follow a specific formalized plan. It may be planned with specific content, but it is individualized re
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sponses to patient needs. Formal teaching involves the use of a curriculum/course plan with standardiz
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ed content.
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QUESTION 2 vc
A patient expresses a strong interest in returning to their work, family, and hobbies afte
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r having a stroke. Which theory type would the nurse use to develop a plan of care for th
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e best results of this patient's motivation style?
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a. field
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b. biological
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c. cognitive
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d. sociologic
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ANSWER
C. Cognitive theorists believe that attention, relevance, confidence, and satisfaction (ARCS) are the condi
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tions that, when integrated, motivate someone to learn. Field theorists place significance on how achiev
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ement, power, the need for affiliation, and avoidance motives influence individual behavior. Sociologic t
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heories are not involved in motivation.
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,QUESTION 3 vc
The nurse is assessing a group of clients. Which clients are at greater risk for hypotherm
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ia or frostbite? (select all that apply)
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a. an older woman with hypertension
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b. a young man with a body mass index of 42
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c. a young many who has just consumed six martinis
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d. an older man who smokes a pack of cigarettes a day
vc vc vc vc vc vc vc vc vc vc vc
e. a young woman who is anorexic f. a young woman who is diabetic
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ANSWER
C, D, E, F clients with poor nutrition, fatigue, and multiple chronic illnesses are at greater risk for hypoth
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ermia. Clients who smoke, consume alcohol, or have impaired peripheral circulation have a higher incid
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ence of frostbite.
vc vc
QUESTION 4 vc
The client is receiving an IV of 60 mEq of potassium chloride ina 1000 mL solution of dex
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trose 5% in 0.45% saline. The client states that the area around the IV site burns. What i
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ntervention does the nurse perform first? vc vc vc vc vc
a. assess for a blood return
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b. notify the physician
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c. document the finding
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d. stop the IV infusion
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ANSWER
D Potassium is a severe tissue irritant. The safest action is to discontinue the solution that contains the
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potassium and discontinue the IV altogether, in which case the client would need another site started. A
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ssessing for a blood return may or may not be successful. The solution could be diluted (less potassium)
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and the rate could be slowed once it is determined that the needle is in the vein.
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QUESTION 5 vc
A nurse is caring for an older adult client who lives alone. Which economic situation pres
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ents the most serious problem for this client?
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a. costs of creating a living will
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b. stock market fluctuations
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c. increased provider benefits
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d. social security as the basis of income
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ANSWER
D Older adults on fixed incomes are unable to adjust their income to meet rising costs associated with
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meeting basic needs vc vc
,QUESTION 6 vc
Which intervention in a client with dehydration induced confusion is most likely to relie
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ve the confusion?
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a. increasing the IV flow rate to 250 mL/hr
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b. applying oxygen by mask or nasal cannula
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c. placing the client in a high Fowler's position
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d. Measuring intake and output every four hours
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ANSWER
A Dehydration most frequently leads to poor cerebra perfusion and cerebral hypoxia, causing confusion.
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Applying oxygen can reduce confusion, even if perfusion is still less than optimum. Increasing the IV flo
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w rate would increase perfusion. However, depending on the degree of dehydration, rehydrating the per
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son too rapidly with IV fluids can lead to cerebral edema.
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QUESTION 7 vc
Which client is at greatest risk for dehydration?
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a. younger adult client on bedrest
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b. older adult client receiving hypotonic IV fluid
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c. older adult client with cognitive impairment
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d. younger adult client receiving hypertonic IV fluid
vc vc vc vc vc vc vc
ANSWER
C Older adults, because they have less total body water than younger adults, are at greater risk for devel
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
opment of dehydration. Anyone who is cognitively impaired and cannot obtain fluids independently or c
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annot make his or her need for fluids known is at high risk for dehydration
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
QUESTION 8 vc
A nurse is caring for several clients. Which client does the nurse assess most carefully fo
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
r hyperkalemia?
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a. client with type 2 diabetes taking an oral anti-diabetic agent
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b. client with heart failure using a salt substitute
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c. client taking a thiazide diuretic for hypertension
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d. client taking non-steroidal anti-inflammatory drugs daily
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ANSWER
B Many salt substitutes are composed of potassium chloride. Heavy use cna contribute to the developme
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nt of hyperkalemia. The client should be taught to read labels and to choose a salt substitute that does n
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ot contain potassium. NSAIDs promote the retention of sodium but not potassium.
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QUESTION 9 vc
An older adult client presents with signs and symptoms related to dig toxicity. Which age
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
related change may have contributed to this problem?
vc vc vc vc vc vc vc vc
, a. decreased renal blood flow
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b. increased gastrointestinal motility
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c. decreased ratio of adipose tissue to lean body mass
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d. increased total body water
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ANSWER
A Decreased renal blood flow and reduced glomerular filtration can result in slower medication excretio
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
n time, potentially leading to toxic drug accumulation. Aging results in decreased total body water and g
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
astrointestinal motility and an increase in the ratio of adipose tissue to lean body mass, but is not relate
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d to dig toxicity.
vc vc vc
QUESTION 10 vc
A client is being treated for dehydration. Which statement made by the client indicates u
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
nderstanding of this condition? vc vc vc
a. I will use a salt substitute when making and eating my meals.
vc vc vc vc vc vc vc vc vc vc vc vc
b. I must drink a quart of water or other liquid each day.
vc vc vc vc vc vc vc vc vc vc vc vc
c. I will not drink liquids after 6 PM so I won't have to get up at night.
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
d. I will weigh myself each morning before I eat or drink.
vc vc vc vc vc vc vc vc vc vc vc
ANSWER
D Because 1 L of water weighs 1 kg, change in body weight is a good measure of excess fluid loss or flui
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
d retention. Weight loss greater than 0.5 lb daily is indicative of excessive fluid loss. The other statemen
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ts are not indicative of practices that will prevent dehydration.
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QUESTION 11 vc
The nurse notes that the handgrip of the client with hypokalemia has diminished since t
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he previous assessment one hour ago. Which intervention by the nurse is the priority?
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a. assess the client's respiratory rate, rhythm, and depth
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b. document findings and monitor the client
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c. measure the client's pulse and blood pressure
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d. call the health care provider
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ANSWER
A In a client with hypokkalemia, progressive skeletal muscle weakness is associated with increasing sev
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erity of hypokalemia. The most life-
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threatening complication of hypokalemia is respiratory insufficiency. It is imperative for the nurse to pe
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rform a respiratory assessment first to make sure that the client is not in immediate jeopardy. Next, the
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nurse would call the health care provider to obtain orders for potassium replacement.
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QUESTION 12 vc
The physician orders Lasix (furosemide) 60 mg po every day for your patient. On hand y
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ou have Lasix 40 mg. How many tablets will you give the patient?
vc vc vc vc vc vc vc vc vc vc vc vc
Exam Solution vc
HESI Medical Surgical Nursing test 2026 A+ GRADE ASS
vc vc vc vc vc vc vc vc
URED COMPLETE SOLUTIONS AND VERIFIED ANSWERS vc vc vc vc vc vc
(4D8ED)
QUESTION 1 vc
When describing patient education approaches, the nurse educator would explain that in
vc vc vc vc vc vc vc vc vc vc vc
formal teaching is an approach that
vc vc vc vc vc
a. follows formalized plans
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b. has standardized content
vc vc vc
c. often occurs one-to-one
vc vc vc
d. addresses group needs
vc vc vc
ANSWER
C. Informal teaching is individualized one on one teaching which represents the majority of patient educ
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ation done by nurses that occurs when an intervention is explained or a question is answered. Group ne
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
eds are often the focus of formal patient education courses or classes. Informal teaching does not necess
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
arily follow a specific formalized plan. It may be planned with specific content, but it is individualized re
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
sponses to patient needs. Formal teaching involves the use of a curriculum/course plan with standardiz
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ed content.
vc
QUESTION 2 vc
A patient expresses a strong interest in returning to their work, family, and hobbies afte
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
r having a stroke. Which theory type would the nurse use to develop a plan of care for th
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
e best results of this patient's motivation style?
vc vc vc vc vc vc vc
a. field
vc
b. biological
vc
c. cognitive
vc
d. sociologic
vc
ANSWER
C. Cognitive theorists believe that attention, relevance, confidence, and satisfaction (ARCS) are the condi
vc vc vc vc vc vc vc vc vc vc vc vc vc
tions that, when integrated, motivate someone to learn. Field theorists place significance on how achiev
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ement, power, the need for affiliation, and avoidance motives influence individual behavior. Sociologic t
vc vc vc vc vc vc vc vc vc vc vc vc vc
heories are not involved in motivation.
vc vc vc vc vc
,QUESTION 3 vc
The nurse is assessing a group of clients. Which clients are at greater risk for hypotherm
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ia or frostbite? (select all that apply)
vc vc vc vc vc vc
a. an older woman with hypertension
vc vc vc vc vc
b. a young man with a body mass index of 42
vc vc vc vc vc vc vc vc vc vc
c. a young many who has just consumed six martinis
vc vc vc vc vc vc vc vc vc
d. an older man who smokes a pack of cigarettes a day
vc vc vc vc vc vc vc vc vc vc vc
e. a young woman who is anorexic f. a young woman who is diabetic
vc vc vc vc vc vc vc vc vc vc vc vc vc
ANSWER
C, D, E, F clients with poor nutrition, fatigue, and multiple chronic illnesses are at greater risk for hypoth
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ermia. Clients who smoke, consume alcohol, or have impaired peripheral circulation have a higher incid
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ence of frostbite.
vc vc
QUESTION 4 vc
The client is receiving an IV of 60 mEq of potassium chloride ina 1000 mL solution of dex
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
trose 5% in 0.45% saline. The client states that the area around the IV site burns. What i
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ntervention does the nurse perform first? vc vc vc vc vc
a. assess for a blood return
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b. notify the physician
vc vc vc
c. document the finding
vc vc vc
d. stop the IV infusion
vc vc vc vc
ANSWER
D Potassium is a severe tissue irritant. The safest action is to discontinue the solution that contains the
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
potassium and discontinue the IV altogether, in which case the client would need another site started. A
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ssessing for a blood return may or may not be successful. The solution could be diluted (less potassium)
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
and the rate could be slowed once it is determined that the needle is in the vein.
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
QUESTION 5 vc
A nurse is caring for an older adult client who lives alone. Which economic situation pres
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ents the most serious problem for this client?
vc vc vc vc vc vc vc
a. costs of creating a living will
vc vc vc vc vc vc
b. stock market fluctuations
vc vc vc
c. increased provider benefits
vc vc vc
d. social security as the basis of income
vc vc vc vc vc vc vc
ANSWER
D Older adults on fixed incomes are unable to adjust their income to meet rising costs associated with
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
meeting basic needs vc vc
,QUESTION 6 vc
Which intervention in a client with dehydration induced confusion is most likely to relie
vc vc vc vc vc vc vc vc vc vc vc vc vc
ve the confusion?
vc vc
a. increasing the IV flow rate to 250 mL/hr
vc vc vc vc vc vc vc vc
b. applying oxygen by mask or nasal cannula
vc vc vc vc vc vc vc
c. placing the client in a high Fowler's position
vc vc vc vc vc vc vc vc
d. Measuring intake and output every four hours
vc vc vc vc vc vc vc
ANSWER
A Dehydration most frequently leads to poor cerebra perfusion and cerebral hypoxia, causing confusion.
vc vc vc vc vc vc vc vc vc vc vc vc vc v
Applying oxygen can reduce confusion, even if perfusion is still less than optimum. Increasing the IV flo
c vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
w rate would increase perfusion. However, depending on the degree of dehydration, rehydrating the per
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
son too rapidly with IV fluids can lead to cerebral edema.
vc vc vc vc vc vc vc vc vc vc
QUESTION 7 vc
Which client is at greatest risk for dehydration?
vc vc vc vc vc vc vc
a. younger adult client on bedrest
vc vc vc vc vc
b. older adult client receiving hypotonic IV fluid
vc vc vc vc vc vc vc
c. older adult client with cognitive impairment
vc vc vc vc vc vc
d. younger adult client receiving hypertonic IV fluid
vc vc vc vc vc vc vc
ANSWER
C Older adults, because they have less total body water than younger adults, are at greater risk for devel
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
opment of dehydration. Anyone who is cognitively impaired and cannot obtain fluids independently or c
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
annot make his or her need for fluids known is at high risk for dehydration
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
QUESTION 8 vc
A nurse is caring for several clients. Which client does the nurse assess most carefully fo
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
r hyperkalemia?
vc
a. client with type 2 diabetes taking an oral anti-diabetic agent
vc vc vc vc vc vc vc vc vc vc
b. client with heart failure using a salt substitute
vc vc vc vc vc vc vc vc
c. client taking a thiazide diuretic for hypertension
vc vc vc vc vc vc vc
d. client taking non-steroidal anti-inflammatory drugs daily
vc vc vc vc vc vc
ANSWER
B Many salt substitutes are composed of potassium chloride. Heavy use cna contribute to the developme
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
nt of hyperkalemia. The client should be taught to read labels and to choose a salt substitute that does n
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ot contain potassium. NSAIDs promote the retention of sodium but not potassium.
vc vc vc vc vc vc vc vc vc vc vc
QUESTION 9 vc
An older adult client presents with signs and symptoms related to dig toxicity. Which age
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
related change may have contributed to this problem?
vc vc vc vc vc vc vc vc
, a. decreased renal blood flow
vc vc vc vc
b. increased gastrointestinal motility
vc vc vc
c. decreased ratio of adipose tissue to lean body mass
vc vc vc vc vc vc vc vc vc
d. increased total body water
vc vc vc vc
ANSWER
A Decreased renal blood flow and reduced glomerular filtration can result in slower medication excretio
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
n time, potentially leading to toxic drug accumulation. Aging results in decreased total body water and g
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
astrointestinal motility and an increase in the ratio of adipose tissue to lean body mass, but is not relate
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
d to dig toxicity.
vc vc vc
QUESTION 10 vc
A client is being treated for dehydration. Which statement made by the client indicates u
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
nderstanding of this condition? vc vc vc
a. I will use a salt substitute when making and eating my meals.
vc vc vc vc vc vc vc vc vc vc vc vc
b. I must drink a quart of water or other liquid each day.
vc vc vc vc vc vc vc vc vc vc vc vc
c. I will not drink liquids after 6 PM so I won't have to get up at night.
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
d. I will weigh myself each morning before I eat or drink.
vc vc vc vc vc vc vc vc vc vc vc
ANSWER
D Because 1 L of water weighs 1 kg, change in body weight is a good measure of excess fluid loss or flui
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
d retention. Weight loss greater than 0.5 lb daily is indicative of excessive fluid loss. The other statemen
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ts are not indicative of practices that will prevent dehydration.
vc vc vc vc vc vc vc vc vc
QUESTION 11 vc
The nurse notes that the handgrip of the client with hypokalemia has diminished since t
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
he previous assessment one hour ago. Which intervention by the nurse is the priority?
vc vc vc vc vc vc vc vc vc vc vc vc vc
a. assess the client's respiratory rate, rhythm, and depth
vc vc vc vc vc vc vc vc
b. document findings and monitor the client
vc vc vc vc vc vc
c. measure the client's pulse and blood pressure
vc vc vc vc vc vc vc
d. call the health care provider
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ANSWER
A In a client with hypokkalemia, progressive skeletal muscle weakness is associated with increasing sev
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erity of hypokalemia. The most life-
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threatening complication of hypokalemia is respiratory insufficiency. It is imperative for the nurse to pe
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rform a respiratory assessment first to make sure that the client is not in immediate jeopardy. Next, the
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nurse would call the health care provider to obtain orders for potassium replacement.
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QUESTION 12 vc
The physician orders Lasix (furosemide) 60 mg po every day for your patient. On hand y
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ou have Lasix 40 mg. How many tablets will you give the patient?
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