HESI Comprehensive Exam B
1 An 8-year-old child is receiving digoxin A
. (Lanoxin) for congestive heart failure Rationale:
(CHF). In assessing the child, the nurse Nausea and vomiting are early signs
finds that her apical heart rate is 80 of digoxin toxicity. However, the
beats/min, she complains of being normal resting heart rate for a child
slightly nauseated, and her serum 8 to 10 years of age is 70 to 110
digoxin level is 1.2 ng/mL. What action beats/min and the therapeutic
should the nurse take? range of serum digoxin levels is 0.5
A.Because the child's heart rate and to 2 ng/mL. Based on the objective
digoxin level are within normal range, data, (A) is the best of the choices
assess for the cause of the nausea. provided because the serum digoxin
B.Hold the next dose of digoxin until level is within normal levels. (B) is
the health care provider can be notified not warranted by the data
because the serum digoxin level is presented. The digoxin level is
elevated. within the therapeutic range and
C.Administer the next dose of digoxin the child is not showing signs of
and notify the health care provider that toxicity (C). The child's pulse rate is
the child is showing signs of toxicity. within normal range for her age
D.Notify the health care provider that group (D).
the child's pulse rate is below normal
for her age group.
2 A 12-year-old boy complains to the C
. nurse that he is "short" (4'5" [53 Rationale:
inches]). His twin sister is 5 inches taller Girls experience a growth spurt at
than he is (4'10" [58 inches]). Based on 9.5 to 14.5 years of age and boys at
these findings, what conclusion should 10.5 to 16 years of age (C). There
the nurse reach? are insufficient data to support (A);
A.The boy is not growing as normally growth trends must be assessed to
expected. reach such a conclusion. (B) is not
B.The girl is experiencing a period of unexpected. The fact that the
unexpected growth. children are twins has less to do
C.A normal growth spurt occurs in girls with their growth than the fact that
1 to 2 years earlier than boys. they are male and female (D).
D.Male-female twins are not identical;
, therefore, their growth cannot be
compared.
3 A 45-year-old female client is admitted C
. to the psychiatric unit for evaluation. Rationale:
Her husband states that she has been Agoraphobia (C) is the fear of
reluctant to leave home for the last 6 crowds or of being in an open
months. The client has not gone to work place. (A) is the fear of being in
for a month, has been terminated from closed places. (B) is the fear of high
her job, and has not left the house since places. (D) is an abnormal fear of
that time. This client is displaying death or bodies after death. A
symptoms of which disorder? phobia is an unrealistic fear
A.Claustrophobia associated with severe anxiety.
B.Acrophobia
C.Agoraphobia
D.Necrophobia
4 An adult client with a medical diagnosis C
. of substance abuse and schizophrenia Rationale:
was recently switched from oral Alcohol enhances the side effects
fluphenazineHCl (Prolixin) to IM of Prolixin. The half-life of Prolixin
fluphenazinedecanoate PO is 8 hours, whereas the half-life
(ProlixinDecanoate) because of of the ProlixinDecanoate IM is 2 to
medication noncompliance. What 4 weeks. Therefore, the side effects
should the nurse teach the client and of drinking alcohol are far more
family about this change in medication severe when the client drinks
regimen? alcohol after taking the long-acting
A.Long-acting medication is more ProlixinDecanoate IM (C). (A, B, and
effective than daily medication. D) provide incorrect information.
B.A client with substance abuse must
not take any oral medications.
C.There will continue to be a risk of
alcohol and drug interaction.
D.Support groups are only helpful for
substance abuse treatment.
5 An adult female who presents at the D
. mental clinic trembling and crying Rationale:
becomes distressed when the nurse The client is exhibiting signs of
1 An 8-year-old child is receiving digoxin A
. (Lanoxin) for congestive heart failure Rationale:
(CHF). In assessing the child, the nurse Nausea and vomiting are early signs
finds that her apical heart rate is 80 of digoxin toxicity. However, the
beats/min, she complains of being normal resting heart rate for a child
slightly nauseated, and her serum 8 to 10 years of age is 70 to 110
digoxin level is 1.2 ng/mL. What action beats/min and the therapeutic
should the nurse take? range of serum digoxin levels is 0.5
A.Because the child's heart rate and to 2 ng/mL. Based on the objective
digoxin level are within normal range, data, (A) is the best of the choices
assess for the cause of the nausea. provided because the serum digoxin
B.Hold the next dose of digoxin until level is within normal levels. (B) is
the health care provider can be notified not warranted by the data
because the serum digoxin level is presented. The digoxin level is
elevated. within the therapeutic range and
C.Administer the next dose of digoxin the child is not showing signs of
and notify the health care provider that toxicity (C). The child's pulse rate is
the child is showing signs of toxicity. within normal range for her age
D.Notify the health care provider that group (D).
the child's pulse rate is below normal
for her age group.
2 A 12-year-old boy complains to the C
. nurse that he is "short" (4'5" [53 Rationale:
inches]). His twin sister is 5 inches taller Girls experience a growth spurt at
than he is (4'10" [58 inches]). Based on 9.5 to 14.5 years of age and boys at
these findings, what conclusion should 10.5 to 16 years of age (C). There
the nurse reach? are insufficient data to support (A);
A.The boy is not growing as normally growth trends must be assessed to
expected. reach such a conclusion. (B) is not
B.The girl is experiencing a period of unexpected. The fact that the
unexpected growth. children are twins has less to do
C.A normal growth spurt occurs in girls with their growth than the fact that
1 to 2 years earlier than boys. they are male and female (D).
D.Male-female twins are not identical;
, therefore, their growth cannot be
compared.
3 A 45-year-old female client is admitted C
. to the psychiatric unit for evaluation. Rationale:
Her husband states that she has been Agoraphobia (C) is the fear of
reluctant to leave home for the last 6 crowds or of being in an open
months. The client has not gone to work place. (A) is the fear of being in
for a month, has been terminated from closed places. (B) is the fear of high
her job, and has not left the house since places. (D) is an abnormal fear of
that time. This client is displaying death or bodies after death. A
symptoms of which disorder? phobia is an unrealistic fear
A.Claustrophobia associated with severe anxiety.
B.Acrophobia
C.Agoraphobia
D.Necrophobia
4 An adult client with a medical diagnosis C
. of substance abuse and schizophrenia Rationale:
was recently switched from oral Alcohol enhances the side effects
fluphenazineHCl (Prolixin) to IM of Prolixin. The half-life of Prolixin
fluphenazinedecanoate PO is 8 hours, whereas the half-life
(ProlixinDecanoate) because of of the ProlixinDecanoate IM is 2 to
medication noncompliance. What 4 weeks. Therefore, the side effects
should the nurse teach the client and of drinking alcohol are far more
family about this change in medication severe when the client drinks
regimen? alcohol after taking the long-acting
A.Long-acting medication is more ProlixinDecanoate IM (C). (A, B, and
effective than daily medication. D) provide incorrect information.
B.A client with substance abuse must
not take any oral medications.
C.There will continue to be a risk of
alcohol and drug interaction.
D.Support groups are only helpful for
substance abuse treatment.
5 An adult female who presents at the D
. mental clinic trembling and crying Rationale:
becomes distressed when the nurse The client is exhibiting signs of
