HESI Exit V2
1. A student nurse is assigned to assist in caring for a client with acute pulmonary
edema who is receiving digoxin (Lanoxin) and heparin therapy. The nursing
instructor reviews the plan of care formulated by the student and tells the student
that which intervention is unsafe? - ANS-Restricting the client's potassium intake
\A 24-year-old man seeks medical attention for complaints of claudication in the arch
of the foot. The nurse also notes superficial thrombophlebitis of the lower leg. The
nurse should check the client for which next? - ANS-Smoking history
\A 62-year-old woman who lives alone tripped on a rug in her home and fractured
her hip. Which predisposing factor most likely contributed to the fracture in the
proximal end of her femur? - ANS-Osteoporosis resulting from declining hormone
levels
\A client admitted to the hospital with a diagnosis of myocardial infarction (MI) tells
the nurse that the pain likely resulted from the fried chicken sandwich that the client
had for lunch. The nurse's response is based on which fact? - ANS-Denial is a
common occurrence early after MI.
\A client admitted to the hospital with coronary artery (CAD) disease complains of
dyspnea at rest. The nurse determines that which would be of most help to the
client? - ANS-Elevating the head of the bed to at least 45 degrees
\A client being seen in the emergency department for complaints of chest pain
confides in the nurse about regular use of cocaine as a recreational drug. The nurse
takes which important action in delivering holistic nursing care to this client? -
ANS-Teaches about the effects of cocaine on the heart and offers referral for further
help
\A client brings the following medications to the clinic for a yearly physical. The
LPN/LVN realizes which medication has been prescribed to treat heart failure? -
ANS-Digoxin (Lanoxin)
\A client complaining of chest pain has an as-needed (PRN) prescription for
sublingual nitroglycerin (Nitrostat). Before administering the medication to the client,
the nurse should first check which? - ANS-Blood pressure
\A client diagnosed with angina pectoris returns to the nursing unit after experiencing
an angioplasty. The nurse reinforces instructions to the client regarding the
procedure and home care measures. Which statement by the client indicates an
understanding of the instructions? - ANS-"I need to adhere to my dietary
restrictions."
\A client diagnosed with thrombophlebitis 1 day ago suddenly complains of chest
pain and shortness of breath, and the client is visibly anxious. The LPN/LVN
understands that a life-threatening complication of this condition is which? -
ANS-Pulmonary embolism
, \A client has a history of left-sided heart failure. The nurse should look for the
presence of which finding to determine whether the problem is currently active? -
ANS-Bilateral lung crackles
\A client has an inoperable abdominal aortic aneurysm (AAA). Which measure
should the nurse anticipate reinforcing when teaching the client? -
ANS-Antihypertensives
\A client has experienced an episode of pulmonary edema. The LPN/ LVN
determines that the client's respiratory status is improving if which breath sounds are
noted? - ANS-Crackles in the lung bases
\A client has just completed an information session about measures to minimize the
progression of coronary artery disease (CAD). Which statement indicates an initial
understanding of lifestyle alterations? - ANS-I should eat a diet that is low in fat and
cholesterol.
\A client has just returned from the cardiac catheterization laboratory. The left
femoral vessel was used as the access site. After returning the client to bed and
conducting an initial assessment, the nurse assisting in caring for the client expects
the health care provider to write a prescription for the client to remain on bed rest. In
which position should the bed be positioned? - ANS-With the head of bed elevated
no more than 30 degrees
\A client has just returned from the cardiac catheterization laboratory. The left
femoral vessel was used as the access site. After returning the client to bed, the
nurse places a sign above the bed stating that the client should remain on bed rest
and in which position? - ANS-With the head of the bed elevated no more than 15
degrees
\A client has received instructions about an upcoming cardiac catheterization. The
nurse determines that the client has the best understanding of the procedure if the
client knows to report which symptoms? - ANS-Chest pain
\A client in a long-term care facility who has a history of angina pectoris wants to go
for a short walk outside with a family member. It is a sunny but chilly December day.
The nurse should perform which intervention to care for this client in a holistic
manner? - ANS-Instruct the family member to dress the client warmly before going
outside.
\A client in pulmonary edema has a prescription to receive morphine sulfate
intravenously. The licensed practical nurse assisting in caring for the client
determines that the client experienced an intended effect of the medication if which
is noted? - ANS-Relief of apprehension
\A client in the emergency department is bleeding profusely from a gunshot wound to
the abdomen. In what position should the nurse immediately place the client to
promote maintenance of the client's blood pressure above a systolic pressure of 90
mm Hg? - ANS-Maintain the client in a supine position to reduce diaphragmatic
pressure and visualize the wound.
\A client is admitted to the hospital with a diagnosis of pericarditis. The nurse reviews
the client's record for which sign or symptom that differentiates pericarditis from other
cardiopulmonary problems? - ANS-Pericardial friction rub
1. A student nurse is assigned to assist in caring for a client with acute pulmonary
edema who is receiving digoxin (Lanoxin) and heparin therapy. The nursing
instructor reviews the plan of care formulated by the student and tells the student
that which intervention is unsafe? - ANS-Restricting the client's potassium intake
\A 24-year-old man seeks medical attention for complaints of claudication in the arch
of the foot. The nurse also notes superficial thrombophlebitis of the lower leg. The
nurse should check the client for which next? - ANS-Smoking history
\A 62-year-old woman who lives alone tripped on a rug in her home and fractured
her hip. Which predisposing factor most likely contributed to the fracture in the
proximal end of her femur? - ANS-Osteoporosis resulting from declining hormone
levels
\A client admitted to the hospital with a diagnosis of myocardial infarction (MI) tells
the nurse that the pain likely resulted from the fried chicken sandwich that the client
had for lunch. The nurse's response is based on which fact? - ANS-Denial is a
common occurrence early after MI.
\A client admitted to the hospital with coronary artery (CAD) disease complains of
dyspnea at rest. The nurse determines that which would be of most help to the
client? - ANS-Elevating the head of the bed to at least 45 degrees
\A client being seen in the emergency department for complaints of chest pain
confides in the nurse about regular use of cocaine as a recreational drug. The nurse
takes which important action in delivering holistic nursing care to this client? -
ANS-Teaches about the effects of cocaine on the heart and offers referral for further
help
\A client brings the following medications to the clinic for a yearly physical. The
LPN/LVN realizes which medication has been prescribed to treat heart failure? -
ANS-Digoxin (Lanoxin)
\A client complaining of chest pain has an as-needed (PRN) prescription for
sublingual nitroglycerin (Nitrostat). Before administering the medication to the client,
the nurse should first check which? - ANS-Blood pressure
\A client diagnosed with angina pectoris returns to the nursing unit after experiencing
an angioplasty. The nurse reinforces instructions to the client regarding the
procedure and home care measures. Which statement by the client indicates an
understanding of the instructions? - ANS-"I need to adhere to my dietary
restrictions."
\A client diagnosed with thrombophlebitis 1 day ago suddenly complains of chest
pain and shortness of breath, and the client is visibly anxious. The LPN/LVN
understands that a life-threatening complication of this condition is which? -
ANS-Pulmonary embolism
, \A client has a history of left-sided heart failure. The nurse should look for the
presence of which finding to determine whether the problem is currently active? -
ANS-Bilateral lung crackles
\A client has an inoperable abdominal aortic aneurysm (AAA). Which measure
should the nurse anticipate reinforcing when teaching the client? -
ANS-Antihypertensives
\A client has experienced an episode of pulmonary edema. The LPN/ LVN
determines that the client's respiratory status is improving if which breath sounds are
noted? - ANS-Crackles in the lung bases
\A client has just completed an information session about measures to minimize the
progression of coronary artery disease (CAD). Which statement indicates an initial
understanding of lifestyle alterations? - ANS-I should eat a diet that is low in fat and
cholesterol.
\A client has just returned from the cardiac catheterization laboratory. The left
femoral vessel was used as the access site. After returning the client to bed and
conducting an initial assessment, the nurse assisting in caring for the client expects
the health care provider to write a prescription for the client to remain on bed rest. In
which position should the bed be positioned? - ANS-With the head of bed elevated
no more than 30 degrees
\A client has just returned from the cardiac catheterization laboratory. The left
femoral vessel was used as the access site. After returning the client to bed, the
nurse places a sign above the bed stating that the client should remain on bed rest
and in which position? - ANS-With the head of the bed elevated no more than 15
degrees
\A client has received instructions about an upcoming cardiac catheterization. The
nurse determines that the client has the best understanding of the procedure if the
client knows to report which symptoms? - ANS-Chest pain
\A client in a long-term care facility who has a history of angina pectoris wants to go
for a short walk outside with a family member. It is a sunny but chilly December day.
The nurse should perform which intervention to care for this client in a holistic
manner? - ANS-Instruct the family member to dress the client warmly before going
outside.
\A client in pulmonary edema has a prescription to receive morphine sulfate
intravenously. The licensed practical nurse assisting in caring for the client
determines that the client experienced an intended effect of the medication if which
is noted? - ANS-Relief of apprehension
\A client in the emergency department is bleeding profusely from a gunshot wound to
the abdomen. In what position should the nurse immediately place the client to
promote maintenance of the client's blood pressure above a systolic pressure of 90
mm Hg? - ANS-Maintain the client in a supine position to reduce diaphragmatic
pressure and visualize the wound.
\A client is admitted to the hospital with a diagnosis of pericarditis. The nurse reviews
the client's record for which sign or symptom that differentiates pericarditis from other
cardiopulmonary problems? - ANS-Pericardial friction rub
