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HESI CAT

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A nurse is counseling the spouse of a client who has a history of alcohol abuse. What does the nurse explain is the main reason for drinking alcohol in people with a long history of alcohol abuse? 1 They are dependent on it. 2 They lack the motivation to stop. 3 They use it for coping. 4 They enjoy the associated socialization. 1 Alcohol causes both physical and psychological dependence; the individual needs the alcohol to function. Alcoholism is a disorder that entails physical and psychological dependence. Because alcohol is so physiologically addictive, the client's body craves the alcohol, so most clients lack the motivation to stop because they will go into withdrawal. Clients who abuse alcohol have numbed their ability to utilize other coping mechanisms, so alcohol is used as an excuse for coping. People with alcoholism usually drink alone or feel alone in a crowd; socialization is not the prime reason for their drinking. How do adolescents establish family identity during psychosocial development? Select all that apply. 1 By acting independently to make his or her own decisions 2 By evaluating his or her own health with a feeling of well-being 3 By fostering his or her own development within a balanced family structure 4 By building close peer relationships to achieve acceptance in the society 5 By achieving marked physical changes 13 An adolescent establishes family identity by acting independently for taking important decisions about self. They also need to foster their development along with maintaining a balanced family structure. Health identity is associated with the evaluation of one's own health with a feeling of well-being. By building close peer relationships, an adolescent develops a sense of belonging, approval, and the opportunity to learn acceptable behavior. These actions establish an adolescent's group identity. The sound and healthy growth of the adolescent, with marked physical changes, helps to build an adolescent's sexual identity. A clinic nurse observes a 2-year-old client sitting alone, rocking and staring at a small, shiny top that she is spinning. Later the father relates his concerns, stating, "She pushes me away. She doesn't speak, and she only shows feelings when I take her top away. Is it something I've done?" What is the most therapeutic initial response by the nurse? 1 Asking the father about his relationship with his wife 2 Asking the father how he held the child when she was an infant 3 Telling the father that it is nothing he has done and sharing the nurse's observations of the child 4 Telling the father not to be concerned and stressing that the child will outgrow this developmental phase 3 The nurse provides support in a nonjudgmental way by sharing information and observations about the child. This child exhibits symptoms of autism, which is not attributable to the actions of the parents. Asking the father about his relationship with his wife or how he held the child when she was an infant indirectly indicates that the parent may be at fault; it negates the father's need for support and increases his sense of guilt. Telling the father not to be concerned and stressing that the child will outgrow this developmental phase is false reassurance that does not provide support; the father recognizes that something is wrong. What is most appropriate for a nurse to say when interviewing a newly admitted depressed client whose thoughts are focused on feelings of worthlessness and failure? 1 "Tell me how you feel about yourself." 2 "Tell me what has been bothering you." 3 "Why do you feel so bad about yourself?" 4 "What can we do to help you while you're here?" 1 Because major depression is a result of the client's feelings of self-rejection, it is important for the nurse to have the client initially identify these feelings before developing a plan of care. Later discussion should be focused on other topics to prevent reinforcement of negative thoughts and feelings. "Tell me what has been bothering you" is asking the client to draw a conclusion; the client may be unable to do so at this time. Also, depression may be related not to external events but instead to a client's psychobiology. Asking why does not let a client explore feelings; it usually elicits an "I don't know" response. "What can we do to help you while you're here?" is beyond the scope of the client's abilities at this time. A client is admitted to the mental health unit with the diagnosis of major depressive disorder. Which statement alerts the nurse to the possibility of a suicide attempt? 1 "I don't feel too good today." 2 "I feel much better; today is a lovely day." 3 "I feel a little better, but it probably won't last." 4 "I'm really tired today, so I'll take things a little slower." 2 A rapid mood upswing and psychomotor change may signal that the client has made a decision and has developed a plan for suicide. "I don't feel too good today"; "I feel a little better, but it probably won't last"; and "I'm really tired today, so I'll take things a little slower" are all typical of the depressed client; none of these statements signals a change in mood. During a group discussion it is learned that a group member hid suicidal urges and committed suicide several days ago. What should the nurse leading the group be prepared to manage? 1 Guilt of the co-leaders for failing to anticipate and prevent the suicide 2 Guilt of group members because they could not prevent another's suicide 3 Lack of concern over the suicide expressed by several of the members in the group 4 Fear by some members that their own suicidal urges may go unnoticed and that they may go unprotected 4 Ambivalence about life and death, plus the introspection commonly found in clients with emotional problems, can lead to increased anxiety and fear among the group members. These feelings must be handled within the support and supervisory systems for the staff; the group members are the primary concern. Guilt that the group's leaders or members might feel because they could not prevent another's suicide will probably be a secondary concern of the group leader. Lack of concern over the suicide expressed by several of the members in the group is not a primary concern, but this should be explored later to determine the reason for such apparent indifference, which may be a mask to cover true feelings.

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HESI RN EXIT Exam Questions and
Answers
In planning care for a 6 month-old infant, what must the nurse provide to assist in the
development of trust? A) Food B) Warmth C) Security D) Comfort - correct answerC)
Security A nurse has just received a medication order which is not legible. Which
statement best reflects assertive communication? A) "I cannot give this medication as it
is written. I have no idea of what you mean." B) "Would you please clarify what you
have written so I am sure I am reading it correctly?" C) "I am having difficulty reading
your handwriting. It would save me time if you would be more careful." D) "Please print
in the future so I do not have to spend extra time attempting to read your writing." -
correct answerB) "Would you please clarify what you have written so I am sure I am
reading it correctly?" What is the most important consideration when teaching parents
how to reduce risks in the home? A) Age and knowledge level of the parents B)
Proximity to emergency services C) Number of children in the home D) Age of children
in the home - correct answerD) Age of children in the home A 35 year-old client with
sickle cell crisis is talking on the telephone but stops as the nurse enters the room to
request something for pain. The nurse should A) Administer a placebo B) Encourage
increased fluid intake C) Administer the prescribed analgesia D) Recommend relaxation
exercises for pain control - correct answerC) Administer the prescribed analgesia While
caring for a toddler with croup, which initial sign of croup requires the nurse's immediate
attention? A) Respiratory rate of 42 B) Lethargy for the past hour C) Apical pulse of 54
D) Coughing up copious secretions - correct answerA) Respiratory rate of 42 A client is
admitted with low T3 and T4 levels and an elevated TSH level. On initial assessment,
the nurse would anticipate which of the following assessment findings? A) Lethargy B)
Heat intolerance C) Diarrhea D) Skin eruptions - correct answerA) Lethargy The
emergency room nurse admits a child who experienced a seizure at school. The father
comments that this is the first occurrence, and denies any family history of epilepsy.
What is the best response by the nurse? A) "Do not worry. Epilepsy can be treated with
medications." B) "The seizure may or may not mean your child has epilepsy." C) "Since
this was the first convulsion, it may not happen again." D) "Long term treatment will
prevent future seizures." - correct answerB) "The seizure may or may not mean your
child has epilepsy." Alcohol and drug abuse impairs judgment and increases risk taking
behavior. What nursing diagnosis best applies? A) Risk for injury B) Risk for knowledge
deficit C) Altered thought process D) Disturbance in self-esteem - correct answerA) Risk
for injury Which these findings would the nurse more closely associate with anemia in a
10 month-old infant? A) Hemoglobin level of 12 g/dI B) Pale mucosa of the eyelids and
lips C) Hypoactivity D) A heart rate between 140 to 160 - correct answerB) Pale mucosa

,of the eyelids and lips The nurse is caring for a client in hypertensive crisis in an
intensive care unit. The priority assessment in the first hour of care is A) Heart rate B)
Pedal pulses C) Lung sounds D) Pupil responses - correct answerD) Pupil responses
Which of these clients who are all in the terminal stage of cancer is least appropriate to
suggest the use of patient controlled analgesia (PCA) with a pump? A) A young adult
with a history of Down's syndrome B) A teenager who reads at a 4th grade level C) An
elderly client with numerous arthritic nodules on the hands D) A preschooler with
intermittent episodes of alertness - correct answerD) A preschooler with intermittent
episodes of alertness The nurse is about to assess a 6 month-old child with nonorganic
failure-to thrive (NOFTT). Upon entering the room, the nurse would expect the baby to
be A) Irritable and "colicky" with no attempts to pull to standing B) Alert, laughing and
playing with a rattle, sitting with support C) Skin color dusky with poor skin turgor over
abdomen D) Pale, thin arms and legs, uninterested in surroundings - correct answerD)
Pale, thin arms and legs, uninterested in surroundings As the nurse is speaking with a
group of teens which of these side effects of chemotherapy for cancer would the nurse
expect this group to be more interested in during the discussion? A) Mouth sores B)
Fatigue C) Diarrhea D) Hair loss - correct answerD) Hair loss While caring for a client
who was admitted with myocardial infarction (MI) 2 days ago, the nurse notes today's
temperature is 101.1 degrees Fahrenheit (38.5 degreesCelsius). The appropriate
nursing intervention is to A) Call the health care provider immediately B) Administer
acetaminophen as ordered as this is normal at this time C) Send blood, urine and
sputum for culture D) Increase the client's fluid intake - correct answerB) Administer
acetaminophen as ordered as this is normal at this time A client is admitted for first and
second degree burns on the face, neck, anterior chest and hands. The nurse's priority
should be A) Cover the areas with dry sterile dressings B) Assess for dyspnea or stridor
C) Initiate intravenous therapy D) Administer pain medication - correct answerB) Assess
for dyspnea or stridor Which of these clients who call the community health clinic would
the nurse ask to come in that day to be seen by the health care provider? A) I started
my period and now my urine has turned bright red. B) I am an diabetic and today I have
been going to the bathroom every hour. C) I was started on medicine yesterday for a
urine infection. Now my lower belly hurts when I go to the bathroom. D) I went to the
bathroom and my urine looked very red and it didn't hurt when I went. - correct
answerD) I went to the bathroom and my urine looked very red and it didn't hurt when I
went. Which of these parents' comment for a newborn would most likely reveal an initial
finding of a suspected pyloric stenosis? A) I noticed a little lump a little above the belly
button. B) The baby seems hungry all the time. C) Mild vomiting that progressed to
vomiting shooting across the room. D) Irritation and spitting up immediately after
feedings. - correct answerC) Mild vomiting that progressed to vomiting shooting across
the room. The nurse is assessing a child for clinical manifestations of iron deficiency
anemia. Which factor would the nurse recognize as cause for the findings? A)
Decreased cardiac output B) Tissue hypoxia C) Cerebral edema D) Reduced oxygen

, saturation - correct answerB) Tissue hypoxia The nurse would expect the cystic fibrosis
client to receive supplemental pancreatic enzymes along with a diet A) High in
carbohydrates and proteins B) Low in carbohydrates and proteins C) High in
carbohydrates, low in proteins D) Low in carbohydrates, high in proteins - correct
answerA) High in carbohydrates and proteins In evaluating the growth of a 12 month-old
child, which of these findings would the nurse expect to be present in the infant? A)
Increased 10% in height B) 2 deciduous teeth C) Tripled the birth weight D) Head >
chest circumference - correct answerC) Tripled the birth weight A Hispanic client in the
postpartum period refuses the hospital food because it is "cold." The best initial action
by the nurse is to A) 1Have the unlicensed assistive personnel (UAP) reheat the food if
the client wishes B) Ask the client what foods are acceptable or bad C) Encourage her
to eat for healing and strength D) Schedule the dietitian to meet with the client as soon
as possible - correct answerB) Ask the client what foods are acceptable or bad The
father of an 8 month-old infant asks the nurse if his infant's vocalizations are normal for
his age. Which of the following would the nurse expect at this age? A) Cooing B)
Imitation of sounds C) Throaty sounds D) Laughter - correct answerB) Imitation of
sounds The nurse should recognize that physical dependence is accompanied by what
findings when alcohol consumption is first reduced or ended? A) Seizures B)
Withdrawal C) Craving D) Marked tolerance - correct answerB) Withdrawal Immediately
following an acute battering incident in a violent relationship, the batterer may respond
to the partner's injuries by A) Seeking medical help for the victim's injuries B) Minimizing
the episode and underestimating the victim's injuries C) Contacting a close friend and
asking for help D) Being very remorseful and assisting the victim with medical care -
correct answerB) Minimizing the episode and underestimating the victim's injuries A
client with pneumococcal pneumonia had been started on antibiotics 16 hours
ago.During the nurse's initial evening rounds the nurse notices a foul smell in the room.
The client makes all of these statements during their conversation. Which statement
would alert the nurse to a complication? A) "I have a sharp pain in my chest when I take
a breath. "B) "I have been coughing up foul-tasting, brown, thick sputum. " C) "I have
been sweating all day. "D) "I feel hot off and on." - correct answer"B) "I have been
coughing up foul-tasting, brown, thick sputum. The nurse is performing an assessment
on a client in congestive heart failure. Auscultation of the heart is most likely to reveal A)
S3 ventricular gallop B) Apical click C) Systolic murmur D) Split S2 - correct answerA)
S3 ventricular gallop Which of these observations made by the nurse during an
excretory urogram indicate a complicaton? A) The client complains of a salty taste in the
mouth when the dye is injected B) The client's entire body turns a bright red color C)
The client states "I have a feeling of getting warm." D) The client gags and complains " I
am getting sick." - correct answerB) The client's entire body turns a bright red color A
client is diagnosed with a spontaneous pneumothorax necessitating the insertion of a
chest tube. What is the best explanation for the nurse to provide this client? A) "The
tube will drain fluid from your chest. "B) "The tube will remove excess air from your

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