Hesi rn comprehensive predictor exam docx

HESI RN COMPREHENSIVE PREDICTOR EXAM
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37. Whichhassessmenthfindinghinhahpatienthwhohhashreceivedhomalizumabh(Xolair)hishmosthimportanthtohreporthi
mmediatelyhtohthehhealthhcarehprovider?
a. Painhathinjectionhsitehc.hPeakhflowhreadingh75%hofhnormal
b. Flushinghandhdizzinesshd.hRespiratoryhrateh24hbreaths/minuteh
ANS:hB

Flushinghandhdizzinesshmayhindicatehthaththehpatienthishexperiencinghanhanaphylactichreaction,handhimmediatehinte
rventionhishneeded.hThehotherhinformationhshouldhalsohbehreported,hbuthdohnothindicatehpossiblyhlife-
hthreateninghcomplicationshofhomalizumabhtherapy.


38. Thehnursehinhthehemergencyhdepartmenthreceivesharterialhbloodhgashresultshforhfourhrecentlyhadmittedhpatient
shwithhobstructivehpulmonaryhdisease.hThehresultshforhwhichhpatienthwillhrequirehthehmosthrapidhactionh byhthehnur
se?
a. pHh7.28,hPaCO2h50hmmhHg,handhPaO2h58hmmhHg
b. pHh7.48,hPaCO2h30hmmhHg,handhPaO2h65hmmhHg
c. pHh7.34,hPaCO2h33hmmhHg,handhPaO2h80hmmhHg
d. pHh7.31,hPaCO2h58hmmhHg,handhPaO2h64hmmhHgh
ANS:hA

ThehpH,hPaCO2,handhPaO2hindicatehthaththehpatienthhashseverehuncompensatedhrespiratoryhacidosishandhhypoxemi
a.hRapidhactionhwillhbehrequiredhtohpreventhincreasinghhypoxemiahandhcorrecththehacidosis.
OBJ:hSpecialhQuestions:hPrioritizationh|hSpecialhQuestions:hMultiplehPatients
39. Whichhnursinghactionhforhahpatienthwithhchronichobstructivehpulmonaryhdiseaseh(COPD)hcouldhthehnurseh
delegatehtohexperiencedhunlicensedhassistivehpersonnelh(UAP)?
a. ObtainhO2hsaturationhusinghpulsehoximetry.
b. MonitorhforhincreasedhO2hneedhwithhexercise.
c. TeachhthehpatienthabouthsafehusehofhO2hathhome.
d. AdjusthO2htohkeephsaturationhinhprescribedhparameters.h
ANS:hA



UAPhcanhobtainhO2hsaturationh(afterhbeinghtrainedhandhevaluatedhinhthehskill).h Thehotherhactionshrequirehmor
eheducationhandhahscopehofhpracticehthathlicensedhpractical/vocationalhnursesh(LPN/LVNs)horhregisteredhnurse
sh(RNs)hwouldhhave.
OBJ:hSpecialhQuestions:hDelegationh40.hThehclinichnursehmakeshahfollow-
uphtelephonehcallhtohahpatienthwithhasthma.hThehpatienthreportshhavinghahbaselinehpeakhflowhreadinghofh600hL/min,h
andhthehcurrenthpeakhflowhish420hL/min.hWhichhactionhshouldhthehnursehtakehfirst?
a. Tellhthehpatienthtohgohtohthehhospitalhemergencyhdepartment.
b. Instrucththehpatienthtohusehthehprescribedhalbuterolh(VentolinhHFA).
c. Askhabouthrecenthexposurehtohanyhnewhallergenshorhasthmahtriggers.

,d. Questionhthehpatienthabouthusehofhthehprescribedhinhaledhcorticosteroids.h
ANS:hB

Thehpatient’shpeakhflowhish70%hofhnormal,hindicatinghahneedhforhimmediatehusehofhshort-actinghb2-
adrenergichSABAhmedications.hAssessinghforhcorrecthusehofhmedicationshorhexposurehtohallergenshishalsohappropria
te,hbuthwouldhnothaddresshthehcurrenthdecreasehinhpeakhflow.hBecausehthehpatienthishcurrentlyhinhthehyellowhzone,hh
ospitalizationhishnothneeded.
OBJ:hSpecialhQuestions:hPrioritizationh41.hThehnursehreviewshthehmedicationhadministrationhrecordh(MAR)hforh
ahpatienthhavinghanhacutehasthmahattack.hWhichhmedicationhshouldhthehnursehadministerhfirst?
a. Methylprednisoloneh(Solu-Medrol)h60hmghIV
b. Albuterolh(VentolinhHFA)h2.5hmghperhnebulizer
c. Salmeterolh(Serevent)h50hmcghperhdry-powderhinhalerh(DPI)
d. Ipratropiumh(Atrovent)h2hpuffshperhmetered-
dosehinhalerh(MDI)hANS:hA

Albuterolhishahrapidlyhactinghbronchodilatorhandhishthehfirst-
linehmedicationhtohreversehairwayhnarrowinghinhacutehasthmahattacks.hThehotherhmedicationshworkhmorehslowly
.
OBJ:hSpecialhQuestions:hPrioritizationh42.hThehnursehreceiveshahchange-of-
shifthreporthonhthehfollowinghpatientshwithhchronichobstructivehpulmonaryhdiseaseh(COPD).hWhichhpatienthshouldh
thehnursehassesshfirst?
a. Ahpatienthwithhloudhexpiratoryhwheezes
b. Ahpatienthwithhahrespiratoryhratehofh38hbreaths/min
c. Ahpatienthwhohhashahcoughhproductivehofhthick,hgreenhmucus
d. Ahpatienthwithhjugularhvenoushdistentionhandhperipheralhedemah
ANS:hB



Ahrespiratoryhratehofh38/minhindicateshseverehrespiratoryhdistress,handhthehpatienthneedshimmediatehassessmentha
ndhinterventionhtohpreventhpossiblehrespiratoryharrest.hThehotherhpatientshalsohneedhassessmenthashsoonhashpossi
ble,hbuththeyhdohnothneedhtohbehassessedhashurgentlyhashthehpatienthwithhtachypnea.
OBJ:hSpecialhQuestions:hPrioritizationh|hSpecialhQuestions:hMultiplehPatients
43.hWhichhfindinghinhahpatienthhospitalizedhwithhbronchiectasishishmosthimportanthtohreporthtohthehhealthhcarehprovi
der?
a. Coughhproductivehofhbloody,hpurulenthmucus
b. Scatteredhcrackleshandhwheezeshheardhbilaterally
c. Complainthofhsharphchesthpainhwithhdeephbreathing
d. Respiratoryhrateh28hbreaths/minutehwhilehambulatingh
ANS:hA

, Hemoptysishmayhindicatehlife-
threateninghhemorrhage,handhshouldhbehreportedhimmediatelyhtohthehhealthhcarehprovider.hThehotherhfi
ndingsharehfrequentlyhnotedhinhpatientshwithhbronchiectasishandhmayhneedhfurtherhassessmenthbutharehn
othindicatorshofhlife-threateninghcomplications.
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