HESI EXIT 2023/2024 EXAM QUESTIONS AND ANSWERS A+ FOR SUCCESS

A pt is receiving IV oxytocin to stimulate labor. The RN monitoring the pt notes uterine hypertonicity & immediately: a) Stops the infusion b) Checks the vagina for crowning c) Encourages the pt to take short, deep breaths d) Increases the rate of oxytocin infusion & calls the HCP - CORRECT ANSWERS a) Stops the infusion. Rationale: You must stop the infusion because the pt is very HR for uterine rupture when there's uterine hypertonicity. A pt with cervical CA is undergoing chemo with cisplatin. For which AE of cisplatin will the RN assess the pt? a) Nausea b) Bloody urine c) Hearing loss d) ECG ∆ - CORRECT ANSWERS c) Hearing loss Rationale: Cisplatin is a platinum-based agent used for various types of CA. One AE of cisplatin is OTOTOXICITY & the RN should monitor for tinnitus & hearing loss. Cyclophosphamide causes hemorrhagic cystitis, AEB bloody urine. Doxorubicin causes CARDIOTOXICITY. A RN is monitoring a pregnant pt with suspected partial placenta previa who is experiencing vaginal bleeding. Which finding would the RN expect to note on assessment of the pt? a) Painful vaginal bleeding b) Sustained tetanic contractions c) C/o abdominal pain d) Soft, relaxed, nontender uterus - CORRECT ANSWERS d) Soft, relaxed, nontender uterus Rationale: Partial placenta previa is incomplete coverage of the internal os by the placenta. One characteristic of placenta previal is PAINLESS BRIGHT RED VAGINAL BLEEDING. The abdominal assessment would reveal a soft, relaxed, nontender uterus with normal tone. Vaginal bleeding & uterine pain & tenderness may accompany placental abruption, especially with a central abruption & blood trapped behind the placenta. In placental abruption, the abdomen feels hard & board-like (similar to peritonitis) on palpation as the blood penetrates the myometrium, resulting in uterine irritability. A sustained tetanic contraction may occur if the pt is in labor & uterine muscles can't relax. A RN assessing with a delivery is monitoring the pt for placental separation after the delivery of a viable newborn. Which observation indicates to the RN that placental separation has occurred? a) A discoid uterus b) Sudden sharp vaginal pain c) Shortening of the umbilical cord d) A sudden gush of dark blood from the introitus - CORRECT ANSWERS d) A sudden gush of dark blood from the introitus Rationale: S/S of placental separation include lengthening of the umbilical cord, a sudden gush of dark blood from the introitus, a firmly contracted uterus & a ∆ in uterine shape from discoid to globular. The pt may experience vaginal fullness but sudden sharp vaginal pain is not usual.