HESI Comprehensive Exam Questions
With Correct Answers
Enalapril maleate is prescribed for a hospitalized client. Which
| | | | | | | | |
assessment does the nurse perform as a priority before administering
| | | | | | | | | |
the medication?
|
Checking the client's blood pressure
| | | | |
Checking the client's peripheral pulses
| | | |
Checking the most recent potassium level
| | | | |
Checking the client's intake-and-output record for the last 24 hours -
| | | | | | | | | | |
CORRECT ANSWER✔✔-Checking the client's blood pressure
| | | | | |
Rationale: Enalapril maleate is an angiotensin-converting enzyme (ACE)
| | | | | | | |
inhibitor used to treat hypertension. One common side effect is postural
| | | | | | | | | |
|hypotension. Therefore the nurse would check the client's blood
| | | | | | | | |
pressure immediately before administering each dose. Checking the
| | | | | | | |
client's peripheral pulses, the results of the most recent potassium level,
| | | | | | | | | |
|and the intake and output for the previous 24 hours are not specifically
| | | | | | | | | | | | |
associated with this mediation. | | |
,A client is scheduled to undergo an upper gastrointestinal (GI) series,
| | | | | | | | | | |
and the nurse provides instructions to the client about the test. Which
| | | | | | | | | | | |
statement by the client indicates a need for further instruction?
| | | | | | | | |
"The test will take about 30 minutes."
| | | | | |
"I need to fast for 8 hours before the test."
| | | | | | | | |
"I need to drink citrate of magnesia the night before the test and give
| | | | | | | | | | | | | |
myself a Fleet enema on the morning of the test."
| | | | | | | | | |
"I need to take a laxative after the test is completed, because the liquid
| | | | | | | | | | | | | |
that I'll have to drink for the test can be constipating." - CORRECT
| | | | | | | | | | | | |
ANSWER✔✔-"I need to drink citrate of magnesia the night before the | | | | | | | | | | |
test and give myself a Fleet enema on the morning of the test."
| | | | | | | | | | | | |
Rationale: No special preparation is necessary before a GI series, except
| | | | | | | | | | |
that NPO (nothing by mouth) status must be maintained for 8 hours
| | | | | | | | | | | |
before the test. An upper GI series involves visualization of the
| | | | | | | | | | |
esophagus, duodenum, and upper jejunum by means of the use of a
| | | | | | | | | | | |
contrast medium. It involves swallowing a contrast medium (usually
| | | | | | | | |
barium), which is administered in a flavored milkshake. Films are taken
| | | | | | | | | | |
at intervals during the test, which takes about 30 minutes. After an
| | | | | | | | | | | |
upper GI series, the client is prescribed a laxative to hasten elimination
| | | | | | | | | | | |
of the barium. Barium that remains in the colon may become hard and
| | | | | | | | | | | | |
difficult to expel, leading to fecal impaction.
| | | | | |
,A nurse on the evening shift checks a primary health care provider's
| | | | | | | | | | | |
prescriptions and notes that the dose of a prescribed medication is
| | | | | | | | | | |
higher than the normal dose. The nurse calls the primary health care
| | | | | | | | | | | |
provider's answering service and is told that the primary health care
| | | | | | | | | | |
provider is off for the night and will be available in the morning. What
| | | | | | | | | | | | | |
should the nurse do next?
| | | |
Call the nursing supervisor
| | |
Ask the answering service to contact the on-call primary health care
| | | | | | | | | | |
provider |
Withhold the medication until the primary health care provider can be
| | | | | | | | | | |
reached in the morning | | |
Administer the medication but consult the primary health care provider
| | | | | | | | | |
when he becomes available - CORRECT ANSWER✔✔-Ask the answering
| | | | | | | | |
service to contact the on-call primary health care provider
| | | | | | | | |
Rationale: The nurse has a duty to protect the client from harm. A nurse
| | | | | | | | | | | | | |
who believes that a primary health care provider's prescription may be
| | | | | | | | | | |
in error is responsible for clarifying the prescription before carrying it
| | | | | | | | | | |
out. Therefore the nurse would not administer the medication; instead,
| | | | | | | | | |
the nurse would withhold the medication until the dose can be clarified.
| | | | | | | | | | |
|The nurse would not wait until the next morning to obtain clarification.
| | | | | | | | | | | |
It is premature to call the nursing supervisor.
| | | | | | |
, An emergency department (ED) nurse is monitoring a client with
| | | | | | | | | |
suspected acute myocardial infarction (MI) who is awaiting transfer to
| | | | | | | | | |
the coronary intensive care unit. The nurse notes the sudden onset of
| | | | | | | | | | | |
premature ventricular contractions (PVCs) on the monitor, checks the
| | | | | | | | |
client's carotid pulse, and determines that the PVCs are not perfusing.
| | | | | | | | | | |
What is the nurse's most appropriate action?
| | | | | |
Document the findings | |
Ask the ED primary health care provider to check the client
| | | | | | | | | | |
Continue to monitor the client's cardiac status
| | | | | |
Inform the client that PVCs are expected after an MI - CORRECT
| | | | | | | | | | | |
ANSWER✔✔-Ask the ED primary health care provider to check the | | | | | | | | | |
client |
Rationale: The most appropriate action by the nurse would be to ask the
| | | | | | | | | | | |
|ED health care provider to check the client. PVCs are a result of
| | | | | | | | | | | | |
increased irritability of ventricular cells. Peripheral pulses may be absent
| | | | | | | | |
|or diminished with the PVCs themselves because the decreased stroke
| | | | | | | | | |
volume of the premature beats may in turn decrease peripheral
| | | | | | | | | |
perfusion. Because other rhythms also cause widened QRS complexes, it
| | | | | | | | |
|is essential that the nurse determine whether the premature beats are
| | | | | | | | | | |
resulting in perfusion of the extremities. This is done by palpating the
| | | | | | | | | | | |
carotid, brachial, or femoral artery while observing the monitor for
| | | | | | | | | |
widened complexes or by auscultating for apical heart sounds. In the
| | | | | | | | | | |
situation of acute MI, PVCs may be considered warning dysrhythmias,
| | | | | | | | | |
possibly heralding the onset of ventricular tachycardia or ventricular
| | | | | | | | |
With Correct Answers
Enalapril maleate is prescribed for a hospitalized client. Which
| | | | | | | | |
assessment does the nurse perform as a priority before administering
| | | | | | | | | |
the medication?
|
Checking the client's blood pressure
| | | | |
Checking the client's peripheral pulses
| | | |
Checking the most recent potassium level
| | | | |
Checking the client's intake-and-output record for the last 24 hours -
| | | | | | | | | | |
CORRECT ANSWER✔✔-Checking the client's blood pressure
| | | | | |
Rationale: Enalapril maleate is an angiotensin-converting enzyme (ACE)
| | | | | | | |
inhibitor used to treat hypertension. One common side effect is postural
| | | | | | | | | |
|hypotension. Therefore the nurse would check the client's blood
| | | | | | | | |
pressure immediately before administering each dose. Checking the
| | | | | | | |
client's peripheral pulses, the results of the most recent potassium level,
| | | | | | | | | |
|and the intake and output for the previous 24 hours are not specifically
| | | | | | | | | | | | |
associated with this mediation. | | |
,A client is scheduled to undergo an upper gastrointestinal (GI) series,
| | | | | | | | | | |
and the nurse provides instructions to the client about the test. Which
| | | | | | | | | | | |
statement by the client indicates a need for further instruction?
| | | | | | | | |
"The test will take about 30 minutes."
| | | | | |
"I need to fast for 8 hours before the test."
| | | | | | | | |
"I need to drink citrate of magnesia the night before the test and give
| | | | | | | | | | | | | |
myself a Fleet enema on the morning of the test."
| | | | | | | | | |
"I need to take a laxative after the test is completed, because the liquid
| | | | | | | | | | | | | |
that I'll have to drink for the test can be constipating." - CORRECT
| | | | | | | | | | | | |
ANSWER✔✔-"I need to drink citrate of magnesia the night before the | | | | | | | | | | |
test and give myself a Fleet enema on the morning of the test."
| | | | | | | | | | | | |
Rationale: No special preparation is necessary before a GI series, except
| | | | | | | | | | |
that NPO (nothing by mouth) status must be maintained for 8 hours
| | | | | | | | | | | |
before the test. An upper GI series involves visualization of the
| | | | | | | | | | |
esophagus, duodenum, and upper jejunum by means of the use of a
| | | | | | | | | | | |
contrast medium. It involves swallowing a contrast medium (usually
| | | | | | | | |
barium), which is administered in a flavored milkshake. Films are taken
| | | | | | | | | | |
at intervals during the test, which takes about 30 minutes. After an
| | | | | | | | | | | |
upper GI series, the client is prescribed a laxative to hasten elimination
| | | | | | | | | | | |
of the barium. Barium that remains in the colon may become hard and
| | | | | | | | | | | | |
difficult to expel, leading to fecal impaction.
| | | | | |
,A nurse on the evening shift checks a primary health care provider's
| | | | | | | | | | | |
prescriptions and notes that the dose of a prescribed medication is
| | | | | | | | | | |
higher than the normal dose. The nurse calls the primary health care
| | | | | | | | | | | |
provider's answering service and is told that the primary health care
| | | | | | | | | | |
provider is off for the night and will be available in the morning. What
| | | | | | | | | | | | | |
should the nurse do next?
| | | |
Call the nursing supervisor
| | |
Ask the answering service to contact the on-call primary health care
| | | | | | | | | | |
provider |
Withhold the medication until the primary health care provider can be
| | | | | | | | | | |
reached in the morning | | |
Administer the medication but consult the primary health care provider
| | | | | | | | | |
when he becomes available - CORRECT ANSWER✔✔-Ask the answering
| | | | | | | | |
service to contact the on-call primary health care provider
| | | | | | | | |
Rationale: The nurse has a duty to protect the client from harm. A nurse
| | | | | | | | | | | | | |
who believes that a primary health care provider's prescription may be
| | | | | | | | | | |
in error is responsible for clarifying the prescription before carrying it
| | | | | | | | | | |
out. Therefore the nurse would not administer the medication; instead,
| | | | | | | | | |
the nurse would withhold the medication until the dose can be clarified.
| | | | | | | | | | |
|The nurse would not wait until the next morning to obtain clarification.
| | | | | | | | | | | |
It is premature to call the nursing supervisor.
| | | | | | |
, An emergency department (ED) nurse is monitoring a client with
| | | | | | | | | |
suspected acute myocardial infarction (MI) who is awaiting transfer to
| | | | | | | | | |
the coronary intensive care unit. The nurse notes the sudden onset of
| | | | | | | | | | | |
premature ventricular contractions (PVCs) on the monitor, checks the
| | | | | | | | |
client's carotid pulse, and determines that the PVCs are not perfusing.
| | | | | | | | | | |
What is the nurse's most appropriate action?
| | | | | |
Document the findings | |
Ask the ED primary health care provider to check the client
| | | | | | | | | | |
Continue to monitor the client's cardiac status
| | | | | |
Inform the client that PVCs are expected after an MI - CORRECT
| | | | | | | | | | | |
ANSWER✔✔-Ask the ED primary health care provider to check the | | | | | | | | | |
client |
Rationale: The most appropriate action by the nurse would be to ask the
| | | | | | | | | | | |
|ED health care provider to check the client. PVCs are a result of
| | | | | | | | | | | | |
increased irritability of ventricular cells. Peripheral pulses may be absent
| | | | | | | | |
|or diminished with the PVCs themselves because the decreased stroke
| | | | | | | | | |
volume of the premature beats may in turn decrease peripheral
| | | | | | | | | |
perfusion. Because other rhythms also cause widened QRS complexes, it
| | | | | | | | |
|is essential that the nurse determine whether the premature beats are
| | | | | | | | | | |
resulting in perfusion of the extremities. This is done by palpating the
| | | | | | | | | | | |
carotid, brachial, or femoral artery while observing the monitor for
| | | | | | | | | |
widened complexes or by auscultating for apical heart sounds. In the
| | | | | | | | | | |
situation of acute MI, PVCs may be considered warning dysrhythmias,
| | | | | | | | | |
possibly heralding the onset of ventricular tachycardia or ventricular
| | | | | | | | |
