HESI EXIT EXAM VOLUME 2 LATET UPDATE
Grave's disease signs and symptoms
(correct answers)-Enlarged thyroid
-Acceleration of body process: weight loss, increased appetite, diarrhea, heat intolerance, tachycardia,
palpitations, increased BP, diaphoresis, nervousness, insomnia
-Exopthalamos
-Increased T3 and T4 levels
-Low TSH levels
Grave's disease test
(correct answers)-Radioactive Iodine Uptake to detect how the thyroid is working
-Ultrasound
-Bloodwork
-Imaging tests
Grave's disease treatment
(correct answers)-Goal: inhibit production of thyroid hormones and block effect on the body
-Radioactive iodine therapy: destroys overactive thyroid cells over time
-Propylthiouracil, methimazole
-Betablockers
-Subtotal or full thyroidectomy (risk of damaging vocal cords and parathyroid glands)
Nursing interventions for a pt with COPD
(correct answers)-Sit upright (positioning)
-Pursed lip breathing
-Diaphragmatic breathing
-HOB up
-Not too much O2: decreases stimulus to breathe
,-O2 is not first choice!
Considerations when choosing an IV site
(correct answers)-Avoid restricted extremities (fistula, breast CA (mastectomy/lymphedema), cellulitis)
-If no upper extremities available, can use legs
-Infiltration is a problem, dont reinstill IV access; keep IV in but start a new line
Pheochromocytoma
(correct answers)-Tumor on the adrenals that causes release of catecholamines (epi and norepi)
-Can cause hypertensive crisis (above 240)
-Monitor BP frequently
-Mosly cardio sx: increased HR and BP
General teaching points for pt taking meds
(correct answers)-Take the full dose of antibiotics (can build resistance)
-Pay attention to timing and whether you take with food or on an empty stomach
Describe post-surgical nursing assessment
(correct answers)-VITALS!!
-Take VS first to give you "the lay of the land" and plan further treatment
-Watch for shock and hemorrhaging
-Make sure BP is above 90
-Give O2 if decreased sat
-Look/ask about pain if HR increased
Describe Lupus and pt education (correct answers)-*Autoimmune disorder
-Could have a decreased WBC count; increased risk for infection
-Avoid crowds, avoid sick people, avoid sunlight (trigger)
Explain safe insulin administration practice and how to teach another nurse (correct answers)-Give in
SubQ fat, rotate spots
-Sliding scale dose is based on most recent glucose level
, -Check orders in the computer if forget dose/med
-Clean area with alcohol
-Make sure you have the right pt
Assessment points for pt with constipation (correct answers)-Assess current medications
-Check measures that they're currently taking (daily enemas, laxatives, etc)
-Assessment: no bowel sounds, abd distention
-Make a doctors appointment
-Assess current nutrition, diet, and exercise
-Drink more water
Osteomalacia and implications for pt teaching (correct answers)-Focus on nutritional support
-Sunlight is a good source of vitamin D
-Vitamin D is important to absorb calcium and phosphorous
-Check vitamin D levels
Osteomyelitis (correct answers)-Bone infection
-Treat with antibiotics
-Poor healing, injury entered the bone
UTI (correct answers)-Pt doesn't always report sx!
-Urine sample is foul smelling and cloudy
-Send sample to lab for urinalysis
-Order a secondary test (culture and sensitivity) to choose the correct tx
Assessment and nursing interventions for hip fx (correct answers)-Assess for pain
-Hip fracture sometimes shortens the leg/rotates it
-Treat like its a hip fracture even if no testing done yet
-Assess circulation (pulse, cap refill, feeling, movement, wiggle toes, color)
-Don't elevate the leg
Grave's disease signs and symptoms
(correct answers)-Enlarged thyroid
-Acceleration of body process: weight loss, increased appetite, diarrhea, heat intolerance, tachycardia,
palpitations, increased BP, diaphoresis, nervousness, insomnia
-Exopthalamos
-Increased T3 and T4 levels
-Low TSH levels
Grave's disease test
(correct answers)-Radioactive Iodine Uptake to detect how the thyroid is working
-Ultrasound
-Bloodwork
-Imaging tests
Grave's disease treatment
(correct answers)-Goal: inhibit production of thyroid hormones and block effect on the body
-Radioactive iodine therapy: destroys overactive thyroid cells over time
-Propylthiouracil, methimazole
-Betablockers
-Subtotal or full thyroidectomy (risk of damaging vocal cords and parathyroid glands)
Nursing interventions for a pt with COPD
(correct answers)-Sit upright (positioning)
-Pursed lip breathing
-Diaphragmatic breathing
-HOB up
-Not too much O2: decreases stimulus to breathe
,-O2 is not first choice!
Considerations when choosing an IV site
(correct answers)-Avoid restricted extremities (fistula, breast CA (mastectomy/lymphedema), cellulitis)
-If no upper extremities available, can use legs
-Infiltration is a problem, dont reinstill IV access; keep IV in but start a new line
Pheochromocytoma
(correct answers)-Tumor on the adrenals that causes release of catecholamines (epi and norepi)
-Can cause hypertensive crisis (above 240)
-Monitor BP frequently
-Mosly cardio sx: increased HR and BP
General teaching points for pt taking meds
(correct answers)-Take the full dose of antibiotics (can build resistance)
-Pay attention to timing and whether you take with food or on an empty stomach
Describe post-surgical nursing assessment
(correct answers)-VITALS!!
-Take VS first to give you "the lay of the land" and plan further treatment
-Watch for shock and hemorrhaging
-Make sure BP is above 90
-Give O2 if decreased sat
-Look/ask about pain if HR increased
Describe Lupus and pt education (correct answers)-*Autoimmune disorder
-Could have a decreased WBC count; increased risk for infection
-Avoid crowds, avoid sick people, avoid sunlight (trigger)
Explain safe insulin administration practice and how to teach another nurse (correct answers)-Give in
SubQ fat, rotate spots
-Sliding scale dose is based on most recent glucose level
, -Check orders in the computer if forget dose/med
-Clean area with alcohol
-Make sure you have the right pt
Assessment points for pt with constipation (correct answers)-Assess current medications
-Check measures that they're currently taking (daily enemas, laxatives, etc)
-Assessment: no bowel sounds, abd distention
-Make a doctors appointment
-Assess current nutrition, diet, and exercise
-Drink more water
Osteomalacia and implications for pt teaching (correct answers)-Focus on nutritional support
-Sunlight is a good source of vitamin D
-Vitamin D is important to absorb calcium and phosphorous
-Check vitamin D levels
Osteomyelitis (correct answers)-Bone infection
-Treat with antibiotics
-Poor healing, injury entered the bone
UTI (correct answers)-Pt doesn't always report sx!
-Urine sample is foul smelling and cloudy
-Send sample to lab for urinalysis
-Order a secondary test (culture and sensitivity) to choose the correct tx
Assessment and nursing interventions for hip fx (correct answers)-Assess for pain
-Hip fracture sometimes shortens the leg/rotates it
-Treat like its a hip fracture even if no testing done yet
-Assess circulation (pulse, cap refill, feeling, movement, wiggle toes, color)
-Don't elevate the leg
